Billing code 27808: Ankle fracture careMedicare rate & RVUs in Guam
Report closed treatment of a bimalleolar ankle fracture when the fracture is managed without manipulation, such as with immobilization in a cast or boot.
Medicare pays $410.53 for 27808 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27808 covers
This code covers closed care of a bimalleolar ankle fracture without manipulation, such as a fracture involving the medial and lateral malleoli or the lateral and posterior malleoli. An orthopedic surgeon or another clinician who provides fracture care may diagnose the injury and choose immobilization, commonly with a cast or boot. The fracture is managed without manually manipulating it to obtain a reduction.
Select the code from the documented fracture pattern and treatment: two malleoli are involved, and the provider does not manipulate the fracture. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
27808 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $410.53 | $339.51 |
How the 27808 rate is calculated
Each of 27808’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27808
RVUs × geographic indexes × conversion factor
Work2.95
2.95 RVUs× 1.000 GPCI
Practice expense7.92
7.92 RVUs× 1.000 GPCI
Malpractice0.58
0.58 RVUs× 1.000 GPCI
Adjusted RVUs
11.4500
Conversion factor
$33.4009
Medicare rate
$382.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27808
27808 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27808
Ankle fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27808
Ankle fracture care
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27808 without 50 · national office
$382.44
Ankle fracture care
27808-50 · Bilateral: 150%
$573.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27808 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27810Ankle fracture treatment
- Both address bimalleolar fractures. Choose 27808 when the fracture is treated without manipulation; choose 27810 when the provider manipulates it.
- 27814Ankle fracture
- 27808 is closed fracture care without manipulation. 27814 applies when the bimalleolar fracture receives open treatment.
- 27816Ankle fracture care
- 27816 is for a trimalleolar fracture treated closed without manipulation. 27808 is for a bimalleolar fracture treated the same way.
27808 billing questions
When is 27808 appropriate instead of 27810?
Use 27808 for a bimalleolar fracture treated without manipulation. Use 27810 when the provider manipulates the fracture.
How does 27808 differ from 27814?
27808 describes closed treatment without manipulation. 27814 is for open treatment of a bimalleolar fracture.
Can cast application be billed separately?
The immobilization used as part of the fracture treatment is included in the fracture-care service. Do not separately report a cast application for that same treatment.
What documentation supports 27808?
Document the malleoli involved and the closed treatment provided. The record should support that the provider treated the fracture without manipulation.
How does the global period affect follow-up visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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