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Billing code 27766: Ankle fracture repairMedicare rate & RVUs

Open surgical treatment of a medial malleolus fracture, typically with reduction and fixation, when the fracture requires operative exposure and stabilization.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $579.84 for 27766 nationally in a facility.

Medicare rate · 27766

Ankle fracture repair

Swap in your local Medicare rate.

Work RVUs
7.69
Total RVUs
17.36
Global days
090

National rate · 2026

$579.84

Facility setting, before claim adjustments.

See every locality for 27766 → · 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 27766 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 27766 covers

An orthopedic surgeon uses an operative approach to expose and reduce a fracture of the medial malleolus, the inner side of the ankle. The surgeon may stabilize the fracture with screws or other fixation. This code fits operative treatment directed at the medial malleolus, such as repair of an isolated medial malleolar fracture, rather than closed treatment or repair of a different malleolus. These procedures are commonly performed in a hospital operating room or ambulatory surgery center.

Report the code when the operative record supports open treatment of the medial malleolar fracture; document the fracture site, operative approach, reduction, and fixation performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 for bilateral procedures is paid at 150%. Medicare does not pay an assistant at surgery; 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 27766 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

27766 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$524.09
Alaska*Unavailable$703.68
ArizonaUnavailable$564.20
ArkansasUnavailable$517.18
AtlantaUnavailable$594.98
AustinUnavailable$590.53
BakersfieldUnavailable$591.49
Baltimore/Surr. CntysUnavailable$615.69
BeaumontUnavailable$551.72
BrazoriaUnavailable$568.49

27766 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.

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

View every state and territory as a table
27766 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 27766 rate is calculated

Each of 27766’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 · 27766

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.69Practice expense 8.18Malpractice 1.49

17.3600 adjusted RVUs×$33.4009 conversion factor=$579.84

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

Payment rules and modifiers for 27766

27766 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27766

Ankle fracture 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 · 27766

Ankle fracture 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

27766 without 50 · national facility

$579.84

Ankle fracture repair

27766-50 · Bilateral: 150%

$869.76

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

27766 compared with similar codes

Compare codes

27766 vs 27760 vs 27762 vs 27792 vs 27814: national Medicare rates

Swap in your local Medicare rate.

  • 27766
    Ankle fracture repair · 7.69 wRVU
    —
  • 27760
    Ankle fracture care · 3.13 wRVU
    $376.43
  • 27762
    Ankle fracture care · 5.33 wRVU
    $589.19
  • 27792
    Ankle fracture surgery · 8.53 wRVU
    —
  • 27814
    Ankle fracture · 10.35 wRVU
    —

How to choose

27760Ankle fracture care
Use 27760 for closed treatment of a medial malleolus fracture without manipulation. Code 27766 describes operative open treatment.
27762Ankle fracture care
Use 27762 when the medial malleolus fracture is treated closed with manipulation. Code 27766 applies when the surgeon opens the site for treatment.
27792Ankle fracture surgery
27792 is for open treatment of a distal fibular fracture, including the lateral malleolus. Code 27766 is for the medial malleolus.
27814Ankle fracture
27814 describes open treatment of a bimalleolar fracture. Code 27766 is for operative treatment of the medial malleolus rather than the combined bimalleolar pattern.

Codes related to 27766

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

Codes related to 27766
CodeHow it relatesNational office range
Used instead
27760Ankle fracture careClosed treatment of a medial malleolus fracture without manipulation.$331.31–$490.25
27762Ankle fracture careClosed treatment of a medial malleolus fracture with manipulation.$517.31–$753.89
27769Ankle fracture repairOpen treatment targets the posterior malleolus rather than the medial malleolus.No office rate
27792Ankle fracture surgeryOpen treatment targets the distal fibula, including the lateral malleolus.No office rate
27814Ankle fractureOpen treatment for a bimalleolar ankle fracture involving both malleoli.No office rate

27766 billing questions

How is this code different from 27762?

27762 describes closed treatment of a medial malleolus fracture with manipulation. Use 27766 when the surgeon treats the fracture through an open operative approach.

Can fixation be reported separately?

Internal fixation performed as part of the open fracture treatment is included in this service. The operative note should describe the reduction and fixation performed.

When does 27814 apply instead?

27814 describes open treatment of a bimalleolar ankle fracture. Consider it for a fracture involving both the medial and lateral malleoli treated operatively, rather than coding this as an isolated medial malleolus repair.

How is bilateral treatment reported?

For bilateral medial malleolar procedures, CMS lists modifier 50 payment at 150%. The record should support operative treatment on both sides.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care. When another procedure is performed in the same session, the standard multiple-procedure reduction applies.

Can an assistant surgeon be paid for this procedure?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are paid only with 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
RVUs for 27766PPRRVU2026_Oct_nonQPP.csv, line 3,043 (RVU26D)

Open CMS sourceHow we calculate rates

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