Billing code 27788: Ankle fracture careMedicare rate & RVUs in Illinois
Report closed treatment with manipulation for a distal fibular fracture at the lateral malleolus when the clinician performs a closed reduction.
Medicare pays $489.92–$544.13 for 27788 in the office in Illinois, from Rest Of Illinois to Chicago. 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 27788 covers
This code represents closed treatment of a distal fibular fracture at the lateral malleolus when the clinician manipulates the fracture to improve alignment. It is typically reported by an orthopedic surgeon or other qualified treating clinician after a closed reduction, with immobilization such as a cast or splint. The fracture may be managed in an office, emergency department, or hospital setting; the code hinges on the manipulation, not the location of care.
Choose this code when documentation supports a distal fibular fracture and closed manipulation, rather than closed treatment without manipulation or open treatment. The record should identify the fracture site, reduction or manipulation performed, and treatment plan. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; 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.
Where 27788 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$489.92 to $544.13
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $544.13 | $459.20 |
| East St. Louis | $507.03 | $429.29 |
| Rest Of Illinois | $489.92 | $412.77 |
| Suburban Chicago | $533.76 | $446.97 |
How the 27788 rate is calculated
Each of 27788’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 · 27788
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.52Practice expense 9.42Malpractice 0.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27788
27788 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27788
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 · 27788
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
27788 without 50 · national office
$498.68
Ankle fracture care
27788-50 · Bilateral: 150%
$748.02
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).
27788 compared with similar codes
Compare codes
27788 vs 27786 vs 27792 vs 27762: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27786Ankle fracture care
- Both address closed treatment of the lateral malleolus. Report 27788 when the fracture is manipulated; report 27786 when it is treated without manipulation.
- 27792Ankle fracture surgery
- 27792 describes open treatment of a distal fibular fracture. This code applies when treatment and manipulation are closed.
- 27762Ankle fracture care
- 27762 is for closed treatment with manipulation of a medial malleolar fracture. This code is for the distal fibula at the lateral malleolus.
27788 billing questions
How does this code differ from 27786?
Both concern closed treatment of a distal fibular fracture at the lateral malleolus. Use 27788 when manipulation is performed; 27786 describes treatment without manipulation.
When is 27792 a better fit?
Use 27792 for open treatment of a distal fibular fracture. This code is for closed treatment with manipulation.
Is fracture follow-up included?
CMS assigns this code a 90-day global period. Related postoperative care during that period is included, as is the day-before preoperative visit.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the treatment performed on both sides.
Can an assistant or co-surgeon be billed?
CMS applies a statutory restriction to assistant-at-surgery payment 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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