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Billing code 27823: Ankle fracture repairMedicare rate & RVUs

Open treatment of a trimalleolar ankle fracture with fixation of the posterior malleolus, typically reported for operative repair of all three malleolar components.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.9K Medicare services in 2024

Medicare pays $923.20 for 27823 nationally in a facility.

Medicare rate · 27823

Ankle fracture repair

Swap in your local Medicare rate.

Work RVUs
12.83
Total RVUs
27.64
Global days
090

National rate · 2026

$923.20

Facility setting, before claim adjustments.

See every locality for 27823 → · 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 27823 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 27823 covers

This code describes operative treatment of a trimalleolar ankle fracture when the posterior malleolus, also called the posterior lip, is fixed. The surgeon exposes the fracture and stabilizes the posterior component; internal fixation of the medial and/or lateral malleolus may also be performed. Orthopedic surgeons most often provide this service in a hospital operating room or ambulatory surgery setting. The code identifies the fracture pattern and posterior fixation, not whether the fracture communicated with the skin.

Report 27823 when the operative documentation supports a trimalleolar fracture and fixation of the posterior lip. Documentation should identify the involved malleoli and describe the posterior fixation; use 27822 when the posterior lip is not fixed. 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 is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 27823 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

27823 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$835.26
Alaska*Unavailable$1,126.19
ArizonaUnavailable$898.32
ArkansasUnavailable$824.38
AtlantaUnavailable$948.03
AustinUnavailable$938.21
BakersfieldUnavailable$937.68
Baltimore/Surr. CntysUnavailable$980.03
BeaumontUnavailable$880.29
BrazoriaUnavailable$904.35

27823 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
27823 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 27823 rate is calculated

Each of 27823’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 · 27823

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.83Practice expense 12.28Malpractice 2.53

27.6400 adjusted RVUs×$33.4009 conversion factor=$923.20

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

Payment rules and modifiers for 27823

27823 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27823

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)2Paid.
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 · 27823

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

27823 without 50 · national facility

$923.20

Ankle fracture repair

27823-50 · Bilateral: 150%

$1,384.80

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

27823 compared with similar codes

Compare codes

27823 vs 27822 vs 27814 vs 27818: national Medicare rates

Swap in your local Medicare rate.

  • 27823
    Ankle fracture repair · 12.83 wRVU
    —
  • 27822
    Ankle fracture surgery · 10.93 wRVU
    —
  • 27814
    Ankle fracture · 10.35 wRVU
    —
  • 27818
    Ankle fracture care · 5.55 wRVU
    $584.85

How to choose

27822Ankle fracture surgery
Both are open treatments of trimalleolar fractures. Use 27823 when the posterior lip is fixed; use 27822 when it is not.
27814Ankle fracture
27814 is for open treatment of a bimalleolar fracture. 27823 requires a trimalleolar fracture with posterior-lip fixation.
27818Ankle fracture care
27818 describes closed treatment of a trimalleolar fracture with manipulation. 27823 describes operative treatment with posterior-lip fixation.

Codes related to 27823

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

Codes related to 27823
CodeHow it relatesNational office range
Same family
27822Ankle fracture surgeryOpen trimalleolar fracture treatment without fixation of the posterior lip.No office rate
27814Ankle fractureOpen treatment of a bimalleolar ankle fracture rather than a trimalleolar pattern.No office rate
Used instead
27816Ankle fracture careClosed treatment of a trimalleolar ankle fracture without manipulation.$335.19–$499.08
27818Ankle fracture careClosed treatment of a trimalleolar ankle fracture with manipulation.$514.16–$743.98

27823 billing questions

How does 27823 differ from 27822?

Both describe open treatment of a trimalleolar ankle fracture. Report 27823 when the posterior lip is fixed; 27822 is for cases without posterior-lip fixation.

Does an open fracture require 27823?

No. “Open treatment” refers to operative exposure and treatment, not an open wound. Select the code based on the fracture pattern and whether the posterior lip is fixed.

What documentation supports 27823?

The operative report should establish a trimalleolar fracture and describe fixation of the posterior malleolus or posterior lip. It should also identify the fracture components treated.

Are related postoperative visits separately reported?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The code’s global package covers those related services.

How are bilateral and same-session procedures handled?

CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. 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 27823PPRRVU2026_Oct_nonQPP.csv, line 3,059 (RVU26D)

Open CMS sourceHow we calculate rates

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