Billing code 27818: Ankle fracture careMedicare rate & RVUs in Utah
Reports closed reduction and treatment of a trimalleolar ankle fracture when the physician manipulates the fracture to restore alignment.
Medicare pays $559.13 for 27818 in the office in Utah (Utah). 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 27818 covers
Code 27818 represents closed reduction and treatment of a trimalleolar ankle fracture: a fracture involving the medial, lateral, and posterior malleoli. The physician manipulates the ankle to restore alignment without surgically exposing the fracture, then immobilizes it as part of the treatment. Orthopedic surgeons commonly perform this service in a hospital or other setting where the fracture is managed.
Choose this code when the fracture pattern is trimalleolar and manipulation is performed; a splint or cast alone does not establish that manipulation occurred. Document the fracture pattern, reduction maneuver, and resulting alignment. CMS assigns a 90-day major-surgery global period, including the day before surgery and 90 days of related postoperative care. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is 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.
27818 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $559.13 | $457.09 |
How the 27818 rate is calculated
Each of 27818’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 · 27818
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.55Practice expense 10.71Malpractice 1.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27818
27818 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27818
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 · 27818
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
27818 without 50 · national office
$584.85
Ankle fracture care
27818-50 · Bilateral: 150%
$877.28
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).
27818 compared with similar codes
Compare codes
27818 vs 27816 vs 27810 vs 27822 vs 27823: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27816Ankle fracture care
- Use 27818 when a trimalleolar fracture is manipulated to restore alignment. Use 27816 when closed treatment is performed without manipulation.
- 27810Ankle fracture treatment
- Both involve closed treatment with manipulation, but 27810 is for a bimalleolar fracture; 27818 is for a trimalleolar fracture.
- 27822Ankle fracture surgery
- 27822 describes open treatment of a trimalleolar fracture. Choose 27818 when treatment is closed and manipulation is performed without surgically exposing the fracture.
- 27823Ankle fracture repair
- 27823 is open treatment of a trimalleolar fracture with fixation of the posterior lip. Code 27818 for closed treatment with manipulation.
27818 billing questions
How does 27818 differ from 27816?
Both address closed treatment of a trimalleolar ankle fracture. Report 27818 when manipulation is performed; 27816 is the corresponding code when it is not.
How does 27818 differ from 27810?
The fracture pattern is the key distinction: 27818 is for a trimalleolar fracture, while 27810 is for a bimalleolar fracture treated with manipulation.
Can cast or splint application be billed separately?
Routine immobilization is part of the fracture treatment represented by 27818. Do not report a separate cast or splint application for that same treatment.
What documentation supports reporting manipulation?
Document the trimalleolar fracture pattern and the reduction maneuver used to restore alignment, including the result when known. A note that only describes applying a splint or cast does not establish manipulation.
How is bilateral treatment reported?
When the service is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS applies a statutory restriction on 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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