CPT code 27822: Ankle fracture surgery, without posterior lip fixation2026 Medicare rate & RVUs

Medicare pays $826.34 for 27822 nationally in a facility.

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

What 27822 covers

Code 27822 represents open operative treatment of a trimalleolar ankle fracture when the surgeon exposes the fracture and stabilizes the medial and/or lateral malleolus, but does not fix the posterior tibial lip fragment. Orthopedic surgeons typically perform this operation in an operating room, often using plates or screws for the malleolar components. The code is distinguished by the three-malleolus fracture pattern and the absence of posterior fragment fixation—not simply by whether imaging shows a posterior fragment.

Report the service for the open treatment and document the fracture pattern, approach, which malleoli were stabilized, and whether the posterior lip was fixed. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery may be paid; 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 27822 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

27822 rates by state

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

How the 27822 rate is calculated

Each of 27822’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.

Payment rules and modifiers for 27822

27822 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27822 compared with similar codes

How to choose

27823Ankle fracture repairPosterior lip fixation

Both describe open treatment of a trimalleolar fracture. Choose 27823 when the posterior lip fragment is fixed; 27822 applies when it is not.

27814Ankle fractureOpen bimalleolar treatment

27814 is for an open-treated bimalleolar fracture. Use 27822 when the fracture involves all three malleolar regions and the posterior lip is not fixed.

27816Ankle fracture careTrimalleolar, no manipulation

27816 describes closed treatment of a trimalleolar fracture without manipulation. 27822 describes open operative treatment.

27818Ankle fracture careTrimalleolar, with manipulation

27818 describes closed treatment of a trimalleolar fracture with manipulation. 27822 applies when the fracture is treated through an open approach.

Codes related to 27822

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

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

Open CMS sourceHow we calculate rates