CPT code 27826: Fracture repair, posterior malleolus2026 Medicare rate & RVUs

Reports open treatment of a posterior malleolus fracture, including internal fixation when performed, rather than closed care or pilon fracture repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities144 Medicare services in 2024

Medicare pays $812.98 for 27826 nationally in a facility.

Medicare rate · 27826

Fracture repair, posterior malleolus

Office or facility?

Work RVUs
10.82
Total RVUs
24.34
Global days
090

National rate · 2026

$812.98

Facility setting, before claim adjustments.

See every locality for 27826 →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 27826 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 27826 covers

This code describes open reduction of a fracture of the posterior malleolus, the back portion of the distal tibia at the ankle. An orthopedic surgeon typically exposes the fracture, restores the fragment’s position, and stabilizes it when needed, such as with screws or a plate. The procedure is generally performed in an operating room for a fracture requiring open treatment; internal fixation is included when performed.

Select the code when the operative report identifies open treatment of the posterior malleolus, distinguishing it from closed treatment and from repair of a distal tibial pilon fracture. Documentation should identify the fracture site, the open reduction, and any fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; 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 27826 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

27826 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$734.96
AlaskaUnavailable$987.15
ArizonaUnavailable$791.09
ArkansasUnavailable$725.29
Atlanta, GAUnavailable$834.20
Austin, TXUnavailable$827.89
Bakersfield, CAUnavailable$829.20
Baltimore area, MDUnavailable$863.17
Beaumont, TXUnavailable$773.66
Brazoria, TXUnavailable$797.08

27826 rates by state

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

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Local rates. Clear comparisons.

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

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27826 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 27826 rate is calculated

Each of 27826’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 · 27826

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.82

10.82 RVUs× 1.000 GPCI

Practice expense11.43

11.43 RVUs× 1.000 GPCI

Malpractice2.09

2.09 RVUs× 1.000 GPCI

Adjusted RVUs

24.3400

Conversion factor

$33.4009

Medicare rate

$812.98

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

Payment rules and modifiers for 27826

27826 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27826

Fracture repair, posterior malleolus

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)2Permitted.
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 · 27826

Fracture repair, posterior malleolus

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

27826 without 50 · national facility

$812.98

Fracture repair, posterior malleolus

27826-50 · Bilateral: 150%

$1,219.47

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

27826 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 27826

    Fracture repair, posterior malleolus10.82 wRVU

    Not priced

  • 27824

    Fracture treatment, distal tibia, no manipulation3.23 wRVU

    $356.72

  • 27825

    Fracture treatment, distal tibia, with manipulation6.52 wRVU

    $604.22

  • 27827

    Pilon fracture repair, tibia only14.42 wRVU

    Not priced

  • 27823

    Ankle fracture repair, posterior lip fixation12.83 wRVU

    Not priced

How to choose

27824Fracture treatmentDistal tibia, no manipulation
27824 is for closed treatment of a posterior malleolus fracture without manipulation; 27826 is for open treatment.
27825Fracture treatmentDistal tibia, with manipulation
27825 is for closed treatment of a posterior malleolus fracture with manipulation. Open reduction points to 27826 instead.
27827Pilon fracture repairTibia only
27827 addresses open treatment of a distal tibial plafond fracture involving the tibia alone; 27826 is for a posterior malleolus fracture.
27823Ankle fracture repairPosterior lip fixation
27823 describes open treatment of a trimalleolar fracture with posterior-lip fixation. Use 27826 when the operative service is for a posterior malleolus fracture rather than that trimalleolar fracture pattern.

27826 billing questions

How does 27826 differ from closed posterior malleolus treatment?

Use 27826 for open treatment of the posterior malleolus. Codes 27824 and 27825 describe closed treatment, distinguished by whether manipulation is performed.

Does 27826 include internal fixation?

Yes. Internal fixation is included when performed as part of the open treatment.

When should a pilon fracture code be considered instead?

For open treatment of a fracture involving the distal tibial weight-bearing surface or plafond, consider 27827 or 27828, based on whether treatment involves the tibia alone or the tibia and fibula.

What postoperative care is included in the Medicare global period?

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

How are multiple procedures and bilateral treatment handled?

In the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

CMS permits assistant-at-surgery payment and co-surgeons for this code; 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 27826PPRRVU2026_Oct_nonQPP.csv, line 3,062 (RVU26D)

Open CMS sourceHow we calculate rates

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