CPT 27814 Surgery

How Much Does Open treatment of bimalleolar ankle fracture Cost?

Open treatment of bimalleolar ankle fracture (CPT 27814) costs $683 at Medicare rates. Hospital outpatient rate: $7.

Cost Comparison by Payer

How much Open treatment of bimalleolar ankle fracture costs across different settings and payers

Medicare
Facility rate
$683
Hospital Outpatient
OPPS rate
$7
Surgery Center
ASC rate
$4
Medicare (Facility)
$683
CMS PFS 2026 national rate
Hospital Outpatient
$7
OPPS rate
Surgery Center (ASC)
$4
Ambulatory surgery center

Open treatment of bimalleolar ankle fracture Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
US — Carrier 01112 Locality 05 $836 $1,253 — $2,089
US — Carrier 01112 Locality 09 $848 $1,273 — $2,121
US — Carrier 01112 Locality 51 $802 $1,203 — $2,006
US — Carrier 01112 Locality 52 $838 $1,257 — $2,095
US — Carrier 01112 Locality 53 $799 $1,198 — $1,997
US — Carrier 01112 Locality 54 $727 $1,090 — $1,817
US — Carrier 01112 Locality 55 $721 $1,082 — $1,803
US — Carrier 01112 Locality 56 $721 $1,082 — $1,803
US — Carrier 01112 Locality 57 $721 $1,082 — $1,803
US — Carrier 01112 Locality 58 $721 $1,082 — $1,803
US — Carrier 01112 Locality 59 $721 $1,082 — $1,803
US — Carrier 01112 Locality 60 $721 $1,082 — $1,803
US — Carrier 01112 Locality 61 $721 $1,082 — $1,803
US — Carrier 01112 Locality 62 $743 $1,115 — $1,858
US — Carrier 01112 Locality 63 $748 $1,122 — $1,870
US — Carrier 01112 Locality 64 $745 $1,118 — $1,863
US — Carrier 01112 Locality 65 $858 $1,287 — $2,145
US — Carrier 01112 Locality 66 $758 $1,138 — $1,896
US — Carrier 01112 Locality 67 $766 $1,148 — $1,914
US — Carrier 01112 Locality 68 $721 $1,082 — $1,803
US — Carrier 01112 Locality 69 $721 $1,082 — $1,803
US — Carrier 01112 Locality 70 $721 $1,082 — $1,803
US — Carrier 01112 Locality 75 $721 $1,082 — $1,803
US — Carrier 01182 Locality 17 $757 $1,135 — $1,892
US — Carrier 01182 Locality 18 $765 $1,147 — $1,911

How to Reduce Your Cost for Open treatment of bimalleolar ankle fracture

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $642 to $881 depending on location. Commercial rates vary even more.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $4, compared to $7 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

12.12
Work RVU
6.95
Practice Expense RVU
2.05
Malpractice RVU

Payment = Total RVU () x CF ($33.40) = N/A

Frequently Asked Questions

How much does Open treatment of bimalleolar ankle fracture cost?

The Medicare facility rate for Open treatment of bimalleolar ankle fracture is $683. In a hospital outpatient setting, the rate is $7. At an ambulatory surgery center, the rate is $4. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Open treatment of bimalleolar ankle fracture cost without insurance?

Without insurance, the cost of Open treatment of bimalleolar ankle fracture can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Open treatment of bimalleolar ankle fracture?

Most commercial health insurance plans and Medicare cover Open treatment of bimalleolar ankle fracture when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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