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Billing code 27696: Ankle ligament repairMedicare rate & RVUs

Primary operative repair of both collateral ligaments in one ankle is reported when the surgeon restores disrupted medial and lateral ligament support.

CMS RVU26DEffective Oct 1, 2026109 payment localities374 Medicare services in 2024

Medicare pays $510.37 for 27696 nationally in a facility.

Medicare rate · 27696

Ankle ligament repair

Swap in your local Medicare rate.

Work RVUs
8.37
Total RVUs
15.28
Global days
090

National rate · 2026

$510.37

Facility setting, before claim adjustments.

See every locality for 27696 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 27696 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 27696 covers

Code 27696 represents primary operative repair of both collateral ligaments of one ankle, generally the lateral ligament complex and medial deltoid ligament when both are disrupted. The surgeon exposes the injured structures and restores continuity, typically with direct suture repair. Orthopedic foot-and-ankle surgeons perform this procedure in an operating room after significant ankle trauma. The operative report should identify the collateral ligaments treated and establish that both were primarily repaired, rather than describing reconstruction for chronic insufficiency.

Report one service for both collateral ligaments in one ankle; code 27695 is for primary repair of a single collateral ligament, while 27698 describes secondary repair. 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 procedure is paid in full and others at 50%. For procedures on both ankles, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require 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 27696 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

27696 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$469.96
Alaska*Unavailable$645.92
ArizonaUnavailable$498.98
ArkansasUnavailable$464.95
AtlantaUnavailable$521.82
AustinUnavailable$517.88
BakersfieldUnavailable$519.62
Baltimore/Surr. CntysUnavailable$537.82
BeaumontUnavailable$490.30
BrazoriaUnavailable$502.63

27696 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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View every state and territory as a table
27696 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 27696 rate is calculated

Each of 27696’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 · 27696

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.37Practice expense 5.79Malpractice 1.12

15.2800 adjusted RVUs×$33.4009 conversion factor=$510.37

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27696

27696 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27696

Ankle ligament repair

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)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
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 · 27696

Ankle ligament repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

27696 without 50 · national facility

$510.37

Ankle ligament repair

27696-50 · Bilateral: 150%

$765.56

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

27696 compared with similar codes

Compare codes

27696 vs 27695 vs 27698 vs 27829: national Medicare rates

Swap in your local Medicare rate.

  • 27696
    Ankle ligament repair · 8.37 wRVU
    —
  • 27695
    Ankle ligament repair · 6.53 wRVU
    —
  • 27698
    Ankle ligament repair · 9.37 wRVU
    —
  • 27829
    Syndesmosis repair · 8.58 wRVU
    —

How to choose

27695Ankle ligament repair
Choose 27695 for primary repair of one collateral ligament. Choose 27696 when both collateral ligaments in the ankle are primarily repaired.
27698Ankle ligament repair
27698 describes secondary repair of a disrupted collateral ligament, such as a reconstruction for chronic instability; 27696 is primary repair of both collateral ligaments.
27829Syndesmosis repair
27829 addresses distal tibiofibular syndesmosis disruption. It is not the code for primary repair of the ankle’s medial and lateral collateral ligaments.

Codes related to 27696

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

Codes related to 27696
CodeHow it relatesNational office range
Same family
27695Ankle ligament repairPrimary repair of a single ankle collateral ligament rather than both.No office rate
Used instead
27698Ankle ligament repairSecondary repair of a disrupted ankle collateral ligament rather than primary repair.No office rate
27829Syndesmosis repairFor operative treatment of a distal tibiofibular syndesmosis disruption, not collateral ligament repair.No office rate

27696 billing questions

Does 27696 describe repair of both ligaments in one ankle or surgery on both ankles?

It describes primary repair of both collateral ligaments in one ankle. For surgery performed on both ankles, CMS lists a bilateral payment rule using modifier 50.

When should 27695 be reported instead?

Use 27695 when the surgeon primarily repairs one disrupted collateral ligament. Use 27696 when the operative documentation supports primary repair of both collateral ligaments in the ankle.

How does 27696 differ from 27698?

27696 is a primary repair of both collateral ligaments. Code 27698 describes secondary repair of a disrupted ankle collateral ligament.

What documentation supports 27696?

The operative report should identify both collateral ligaments treated and describe their primary repair. Documentation should distinguish this from a secondary repair or reconstruction for chronic insufficiency.

How does the 90-day global period affect postoperative billing?

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

Can an assistant or co-surgeon be reported?

CMS restricts assistant-at-surgery payment for this code. Co-surgeons are paid only with supporting documentation; 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 27696PPRRVU2026_Oct_nonQPP.csv, line 3,012 (RVU26D)

Open CMS sourceHow we calculate rates

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