No office rate
Use 27840 for closed treatment without anesthesia. Use 27846 when the surgeon opens the site to reduce the dislocation.
On this page
CMS RVU26D · Effective 2026-10-01
27846 Ankle dislocation Medicare reimbursement rates in Indiana
Reports operative exposure and reduction of an ankle dislocation, with internal fixation when performed, rather than closed reduction. Compare 27846 office and facility rates across CMS payment localities in Indiana.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27846 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$622.05
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27846: Open ankle dislocation reduction
Reports operative exposure and reduction of an ankle dislocation, with internal fixation when performed, rather than closed reduction.
The surgeon exposes the ankle joint to reposition a dislocated talus and restore joint alignment. Internal fixation may be used to maintain the reduction when needed. Orthopedic and trauma surgeons typically perform this operation in a hospital operating room, often after an injury that cannot be managed with closed reduction or requires direct operative treatment. The record should establish the dislocation, the open approach, the reduction performed, and any fixation used.
Report this code for the open dislocation treatment, not for a closed reduction performed under anesthesia. Distinguish a separately treated ankle fracture by the fracture pattern and work documented; fracture treatment codes describe a different service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27846
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.02 · 50%
- Practice expense (office) RVU8.28 · 41%
- Malpractice RVU1.91 · 9%
219
Medicare services in 2024 · #4244 by national volume
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.
27846 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
27842 describes closed treatment requiring anesthesia; 27846 describes open operative treatment.
No office rate
27848 is distinguished by fixation of the posterior lip of the tibia. Use 27846 when that specific treatment is not part of the procedure.
$516.52
27810 is an ankle-fracture treatment code, not the code for open reduction of an ankle dislocation. Select based on the injury and operative work documented.
Compare 27846 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
Unavailable
Facility
$622.05
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27846 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
3,071
- Code
- 27846
- Physician work
- 10.02
- Practice expense
- 8.28
- Malpractice
- 1.91
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.02 | × 1.000 | 10.0200 |
| Practice expense | 8.28 | × 0.927 | 7.6756 |
| Malpractice | 1.91 | × 0.486 | 0.9283 |
| Total RVUs | 18.6238 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$622.05
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.02 | 1 |
| Practice expense | 8.28 | 0.927 |
| Malpractice | 1.91 | 0.486 |
(10.02 × 1 + 8.28 × 0.927 + 1.91 × 0.486) × $33.4009 = $622.05
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27846 billing questions
How does 27846 differ from 27840 and 27842?
27846 is for operative exposure and reduction. Codes 27840 and 27842 describe closed treatment, with 27842 used when anesthesia is required.
Does 27846 include internal fixation?
Yes, fixation may be included when performed as part of the open dislocation treatment. Document the reduction and any stabilization used.
When should 27848 be considered instead?
Consider 27848 when the operative treatment includes fixation of the posterior lip of the tibia. The operative report should identify that specific fracture component and its treatment.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is 27846 handled when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral treatment, modifier 50 is paid at 150%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,06827832,,Treat lower leg dislocation,A,,9.92,9.43,NA,9.43,,2.11,21.46,21.46,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06927840,,Treat ankle dislocation,A,,4.65,7.83,NA,7.83,,1.08,13.56,13.56,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07027842,,Treat ankle dislocation,A,,6.30,7.09,NA,7.09,,1.31,14.70,14.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07127846,,Treat ankle dislocation,A,,10.02,8.28,NA,8.28,,1.91,20.21,20.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07227848,,Treat ankle dislocation,A,,11.39,8.55,NA,8.55,,2.15,22.09,22.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07327860,,Fixation of ankle joint,A,,2.33,1.95,NA,1.95,,0.35,4.63,4.63,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07427870,,Fusion of ankle joint open,A,,15.02,10.07,NA,10.07,,2.69,27.78,27.78,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915