CPT code 27822: Ankle fracture surgery, without posterior lip fixation2026 Medicare rate & RVUs in Guam
Open surgery for a three-malleolus ankle fracture when the medial and/or lateral malleoli are treated and the posterior lip is not fixed.
CMS doesn’t publish an office rate for 27822 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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.
27822 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $849.65 |
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.
How the rate is built · 27822
RVUs × geographic indexes × conversion factor
Work10.93
10.93 RVUs× 1.000 GPCI
Practice expense11.67
11.67 RVUs× 1.000 GPCI
Malpractice2.14
2.14 RVUs× 1.000 GPCI
Adjusted RVUs
24.7400
Conversion factor
$33.4009
Medicare rate
$826.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27822
27822 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27822
Ankle fracture surgery, without posterior lip fixation
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27822
Ankle fracture surgery, without posterior lip fixation
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
27822 without 50 · national facility
$826.34
Ankle fracture surgery, without posterior lip fixation
27822-50 · Bilateral: 150%
$1,239.51
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).
27822 compared with similar codes
Compare codes · National
5 codes, side by side
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.
27822 billing questions
When should 27823 be reported instead?
Use 27823 when the posterior lip fragment is also fixed during open treatment of the trimalleolar fracture. Code 27822 applies when that fragment is not fixed.
How does 27822 differ from 27814?
27822 is for open treatment of a trimalleolar fracture without posterior lip fixation. 27814 is the open-treatment code for a bimalleolar fracture.
Can closed treatment codes be used for the same fracture pattern?
27816 and 27818 describe closed treatment of a trimalleolar fracture, respectively without and with manipulation. They are not substitutes when the fracture is treated through an open surgical approach.
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 Medicare handle bilateral cases and surgical assistance?
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.
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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