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CPT code 27814: Ankle fracture, open bimalleolar treatment2026 Medicare rate & RVUs

Report this service when a surgeon treats a bimalleolar ankle fracture through open surgery, with internal fixation when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities10.3K Medicare services in 2024

Medicare pays $714.45 for 27814 nationally in a facility.

Medicare rate · 27814

Ankle fracture, open bimalleolar treatment

Office or facility?

Work RVUs
10.35
Total RVUs
21.39
Global days
090

National rate · 2026

$714.45

Facility setting, before claim adjustments.

See every locality for 27814 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27814 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27814 covers

This code represents operative treatment of a fracture involving two malleoli of the ankle. An orthopedic surgeon typically exposes the fracture to restore alignment and may secure the fragments with plates, screws, or other fixation. The service is commonly performed in a hospital or ambulatory surgery center. The operative report should establish the fracture pattern and document the open treatment performed; internal fixation is part of the reported service when used.

Select this code for an open operation on a bimalleolar fracture, rather than closed treatment or open treatment of a trimalleolar fracture. 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 may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 27814 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27814 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$647.30
AlaskaUnavailable$876.24
ArizonaUnavailable$695.31
ArkansasUnavailable$639.01
Atlanta, GAUnavailable$733.99
Austin, TXUnavailable$724.80
Bakersfield, CAUnavailable$723.23
Baltimore area, MDUnavailable$758.07
Beaumont, TXUnavailable$682.55
Brazoria, TXUnavailable$699.52

27814 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27814 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27814 rate is calculated

Each of 27814’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 · 27814

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.35

10.35 RVUs× 1.000 GPCI

Practice expense9.00

9.00 RVUs× 1.000 GPCI

Malpractice2.04

2.04 RVUs× 1.000 GPCI

Adjusted RVUs

21.3900

Conversion factor

$33.4009

Medicare rate

$714.45

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27814

27814 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27814

Ankle fracture, open bimalleolar treatment

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27814

Ankle fracture, open bimalleolar treatment

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27814 without 50 · national facility

$714.45

Ankle fracture, open bimalleolar treatment

27814-50 · Bilateral: 150%

$1,071.68

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).

When to use modifier 50

27814 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27814

    Ankle fracture, open bimalleolar treatment10.35 wRVU

    Not priced

  • 27810

    Ankle fracture treatment, bimalleolar, with manipulation5.19 wRVU

    $562.14

  • 27822

    Ankle fracture surgery, without posterior lip fixation10.93 wRVU

    Not priced

  • 27823

    Ankle fracture repair, posterior lip fixation12.83 wRVU

    Not priced

How to choose

27810Ankle fracture treatmentBimalleolar, with manipulation
27810 is closed treatment of a bimalleolar fracture with manipulation. Report 27814 when the surgeon performs open operative treatment.
27822Ankle fracture surgeryWithout posterior lip fixation
27822 is for open treatment of a trimalleolar fracture without fixation of the posterior lip. Use 27814 for a bimalleolar fracture.
27823Ankle fracture repairPosterior lip fixation
27823 describes open treatment of a trimalleolar fracture with fixation of the posterior lip; 27814 describes a bimalleolar fracture.

Codes related to 27814

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27814
CodeHow it relatesNational office range
Same family
27808Ankle fracture care, bimalleolar, without manipulationClosed treatment of a bimalleolar fracture without manipulation.$335.75–$501.21
27810Ankle fracture treatment, bimalleolar, with manipulationClosed treatment of a bimalleolar fracture with manipulation.$493.88–$717.64
27816Ankle fracture care, trimalleolar, no manipulationClosed treatment of a trimalleolar fracture without manipulation.$335.19–$499.08
27818Ankle fracture care, trimalleolar, with manipulationClosed treatment of a trimalleolar fracture with manipulation.$514.16–$743.98
27822Ankle fracture surgery, without posterior lip fixationOpen treatment of a trimalleolar fracture without posterior-lip fixation.No office rate
27823Ankle fracture repair, posterior lip fixationOpen treatment of a trimalleolar fracture with posterior-lip fixation.No office rate

27814 billing questions

How does this code differ from closed treatment codes 27808 and 27810?

Use 27814 for open operative treatment of a bimalleolar fracture. Codes 27808 and 27810 describe closed treatment, without and with manipulation, respectively.

When should 27822 or 27823 be reported instead?

Those codes describe open treatment of a trimalleolar fracture. Code 27823 includes fixation of the posterior lip; 27822 is used when that fragment is not fixed.

Is internal fixation separately reported with 27814?

Internal fixation performed as part of the open fracture treatment is included in this service; it is not separately reported as another fracture-treatment code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How does CMS treat bilateral reporting and other procedures in the same session?

With modifier 50, bilateral reporting is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is 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
RVUs for 27814PPRRVU2026_Oct_nonQPP.csv, line 3,055 (RVU26D)

Open CMS sourceHow we calculate rates

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