CPT code 27829: Syndesmosis repair, distal tibiofibular joint2026 Medicare rate & RVUs

Medicare pays $673.03 for 27829 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 27829 covers

The surgeon exposes and reduces a disrupted distal tibiofibular syndesmosis, the ligament-supported joint between the lower tibia and fibula above the ankle. Stabilization may use a screw or another fixation construct. Orthopedic surgeons and orthopedic trauma surgeons typically perform this operation in a hospital or ambulatory surgical setting, often while repairing an associated ankle fracture. The code concerns the syndesmotic disruption, not fixation of the malleolar fracture itself.

Report it when the operative record documents syndesmotic instability and the open reduction or stabilization performed. An ankle fracture repair alone does not establish that this additional work occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS permits payment for an assistant at surgery and co-surgeons; 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 27829 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

27829 rates by state

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

How the 27829 rate is calculated

Each of 27829’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 27829

27829 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

27829 compared with similar codes

How to choose

27792Ankle fracture surgeryDistal fibula, open treatment

Use 27792 for open treatment of a distal fibular fracture. Use 27829 for open treatment of distal tibiofibular syndesmotic disruption; both may be reported when both services are documented.

27814Ankle fractureOpen bimalleolar treatment

Code 27814 describes open treatment of a bimalleolar ankle fracture. Code 27829 describes the separate syndesmotic disruption, not the malleolar fracture.

27822Ankle fracture surgeryWithout posterior lip fixation

Code 27822 describes open treatment of a trimalleolar fracture without fixation of the posterior lip. Code 27829 identifies open treatment of the distal tibiofibular syndesmosis.

27823Ankle fracture repairPosterior lip fixation

Code 27823 describes trimalleolar fracture treatment with posterior-lip fixation. Choose 27829 for separately documented open syndesmotic reduction or stabilization.

Codes related to 27829

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