CPT code 27823: Ankle fracture repair, posterior lip fixation2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 27823 in California.

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

What 27823 covers

This code describes operative treatment of a trimalleolar ankle fracture when the posterior malleolus, also called the posterior lip, is fixed. The surgeon exposes the fracture and stabilizes the posterior component; internal fixation of the medial and/or lateral malleolus may also be performed. Orthopedic surgeons most often provide this service in a hospital operating room or ambulatory surgery setting. The code identifies the fracture pattern and posterior fixation, not whether the fracture communicated with the skin.

Report 27823 when the operative documentation supports a trimalleolar fracture and fixation of the posterior lip. Documentation should identify the involved malleoli and describe the posterior fixation; use 27822 when the posterior lip is not fixed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued 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 27823 pays more and less in California

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

29 of 29 payment localities

How the 27823 rate is calculated

Each of 27823’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 27823

27823 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

27823 compared with similar codes

How to choose

27822Ankle fracture surgeryWithout posterior lip fixation

Both are open treatments of trimalleolar fractures. Use 27823 when the posterior lip is fixed; use 27822 when it is not.

27814Ankle fractureOpen bimalleolar treatment

27814 is for open treatment of a bimalleolar fracture. 27823 requires a trimalleolar fracture with posterior-lip fixation.

27818Ankle fracture careTrimalleolar, with manipulation

27818 describes closed treatment of a trimalleolar fracture with manipulation. 27823 describes operative treatment with posterior-lip fixation.

Codes related to 27823

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