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Billing code 27768: Ankle fracture treatmentMedicare rate & RVUs

Closed treatment of a posterior malleolus fracture requiring manipulation to restore alignment, typically performed by an orthopedic surgeon in a facility setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities42 Medicare services in 2024

Medicare pays $442.23 for 27768 nationally in a facility.

Medicare rate · 27768

Ankle fracture treatment

Swap in your local Medicare rate.

Work RVUs
5.01
Total RVUs
13.24
Global days
090

National rate · 2026

$442.23

Facility setting, before claim adjustments.

See every locality for 27768 → · 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 27768 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 27768 covers

This code describes closed management of a fracture involving the posterior portion of the distal tibia at the ankle when the clinician manipulates the fracture to improve alignment. An orthopedic surgeon typically performs the reduction, often using imaging to assess fracture position before and after manipulation. The fracture is managed without surgically exposing the bone; stabilization may follow the reduction.

Choose this code when the documented treatment includes manipulation, rather than closed care without manipulation or open fixation. The record should identify the posterior malleolus fracture and support the need for reduction, including the alignment findings and treatment performed. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral treatment reported with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are 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 27768 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

27768 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$396.82
Alaska*Unavailable$525.40
ArizonaUnavailable$429.67
ArkansasUnavailable$391.17
AtlantaUnavailable$453.74
AustinUnavailable$452.36
BakersfieldUnavailable$454.39
Baltimore/Surr. CntysUnavailable$470.83
BeaumontUnavailable$418.17
BrazoriaUnavailable$433.55

27768 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
27768 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 27768 rate is calculated

Each of 27768’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 · 27768

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.01Practice expense 7.16Malpractice 1.07

13.2400 adjusted RVUs×$33.4009 conversion factor=$442.23

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

Payment rules and modifiers for 27768

27768 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27768

Ankle fracture treatment

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)0Not permitted.
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 · 27768

Ankle fracture treatment

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

27768 without 50 · national facility

$442.23

Ankle fracture treatment

27768-50 · Bilateral: 150%

$663.35

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

27768 compared with similar codes

Compare codes

27768 vs 27767 vs 27769 vs 27810: national Medicare rates

Swap in your local Medicare rate.

  • 27768
    Ankle fracture treatment · 5.01 wRVU
    —
  • 27767
    Ankle fracture care · 2.57 wRVU
    $321.65
  • 27769
    Ankle fracture repair · 9.89 wRVU
    —
  • 27810
    Ankle fracture treatment · 5.19 wRVU
    $562.14

How to choose

27767Ankle fracture care
Both address closed treatment of a posterior malleolus fracture. Select 27768 when manipulation is performed; 27767 is for treatment without manipulation.
27769Ankle fracture repair
27769 describes open treatment of a posterior malleolus fracture. Use 27768 for closed treatment that includes manipulation.
27810Ankle fracture treatment
27810 applies to closed treatment with manipulation of a bimalleolar ankle fracture. This code is specific to a posterior malleolus fracture.

Codes related to 27768

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

Codes related to 27768
CodeHow it relatesNational office range
Same family
27767Ankle fracture careClosed treatment of a posterior malleolus fracture without manipulation.$282.89–$420.80
Used instead
27769Ankle fracture repairOpen treatment for a posterior malleolus fracture when surgical exposure is performed.No office rate
27808Ankle fracture careClosed treatment without manipulation for a bimalleolar ankle fracture.$335.75–$501.21
27810Ankle fracture treatmentClosed treatment with manipulation for a bimalleolar ankle fracture.$493.88–$717.64

27768 billing questions

How does this differ from 27767?

Use 27768 when closed treatment includes manipulation of the posterior malleolus fracture. Code 27767 is the corresponding closed-treatment option without manipulation.

When would 27769 be more appropriate?

27769 is for open treatment of a posterior malleolus fracture. This code describes closed treatment with manipulation, without surgically exposing the fracture.

Is related postoperative care included?

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

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

How is bilateral treatment handled?

When the procedure is performed bilaterally and reported with modifier 50, Medicare payment is 150%.

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 27768PPRRVU2026_Oct_nonQPP.csv, line 3,045 (RVU26D)

Open CMS sourceHow we calculate rates

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