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See a sample rate comparisonCPT 27816 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Treatment Of Ankle Fracture, Closed Treatment Of All Three The Portions Of The Bones Of The Leg (Tibia And Fibula) In The Region Of The Ankle Without Manipulation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | None 54 - Surgical Care Only RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27816 |
| Medicaid Fee Schedule | View Medicaid rates for 27816 |
National average reimbursement for CPT 27816 by major payers:
$416.99
$426.80
$451.55
$534.95
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CPT 27816
5 of 25 sample ratesHigher to lower in this preview
Prospect Ccmc, LLC
$1,957.00Published rateMiami Surgical Suites LLC
$566.00Published rateZitelli & Brodland PC, Zitelli & Brodland Asf South
John A. Zitelli, Md, PC
$328.00Published rateNorth Orange County Surgery Center
North Orange County Surgery Center, LLC
$117.00Published rateCertified Ambulatory Surgery Center, Casc
Certified Ambulatory Surgery Center
$53.00Published rate
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See a sample payer proposalCPT 27816 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27816 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 27816 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 27769-CPT | High | Repair And Secure Broken Ankle, Surgical Repair Of Broken Ankle (Posterior Malleolus) Using Pins Screws Plates Or Wires As Needed. |
| 27814-CPT | High | Treatment Of Ankle Fracture, Open Treatment Of Bimalleolar Ankle Fracture Eg Lateral And Medial Malleoli Or Lateral And Posterior Malleoli Or Medial And Posterior Malleoli Includes Internal Fixation When Performed |
| 27816-CPT | Moderate | Treatment Of Ankle Fracture, Closed Treatment Of All Three The Portions Of The Bones Of The Leg (Tibia And Fibula) In The Region Of The Ankle Without Manipulation |
| 27818-CPT | Moderate | Treatment Of Ankle Fracture, Closed Treatment Of All Three The Portions Of The Bones Of The Leg (Tibia And Fibula) In The Region Of The Ankle With Manipulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27816. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27816 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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