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Billing code 27846: Ankle dislocationMedicare rate & RVUs

Reports operative exposure and reduction of an ankle dislocation, with internal fixation when performed, rather than closed reduction.

CMS RVU26DEffective Oct 1, 2026109 payment localities219 Medicare services in 2024

Medicare pays $675.03 for 27846 nationally in a facility.

Medicare rate · 27846

Ankle dislocation

Swap in your local Medicare rate.

Work RVUs
10.02
Total RVUs
20.21
Global days
090

National rate · 2026

$675.03

Facility setting, before claim adjustments.

See every locality for 27846 → · 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 27846 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 27846 covers

The surgeon exposes the ankle joint to reposition a dislocated talus and restore joint alignment. Internal fixation may be used to maintain the reduction when needed. Orthopedic and trauma surgeons typically perform this operation in a hospital operating room, often after an injury that cannot be managed with closed reduction or requires direct operative treatment. The record should establish the dislocation, the open approach, the reduction performed, and any fixation used.

Report this code for the open dislocation treatment, not for a closed reduction performed under anesthesia. Distinguish a separately treated ankle fracture by the fracture pattern and work documented; fracture treatment codes describe a different service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 27846 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

27846 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$612.77
Alaska*Unavailable$831.70
ArizonaUnavailable$657.27
ArkansasUnavailable$605.10
AtlantaUnavailable$693.28
AustinUnavailable$684.47
BakersfieldUnavailable$683.00
Baltimore/Surr. CntysUnavailable$715.70
BeaumontUnavailable$645.61
BrazoriaUnavailable$661.19

27846 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
27846 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 27846 rate is calculated

Each of 27846’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 · 27846

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.02Practice expense 8.28Malpractice 1.91

20.2100 adjusted RVUs×$33.4009 conversion factor=$675.03

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

Payment rules and modifiers for 27846

27846 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27846

Ankle dislocation

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 · 27846

Ankle dislocation

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

27846 without 50 · national facility

$675.03

Ankle dislocation

27846-50 · Bilateral: 150%

$1,012.55

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

27846 compared with similar codes

Compare codes

27846 vs 27840 vs 27842 vs 27848 vs 27810: national Medicare rates

Swap in your local Medicare rate.

  • 27846
    Ankle dislocation · 10.02 wRVU
    —
  • 27840
    Ankle dislocation · 4.65 wRVU
    —
  • 27842
    Ankle dislocation · 6.3 wRVU
    —
  • 27848
    Ankle dislocation · 11.39 wRVU
    —
  • 27810
    Ankle fracture treatment · 5.19 wRVU
    $562.14

How to choose

27840Ankle dislocation
Use 27840 for closed treatment without anesthesia. Use 27846 when the surgeon opens the site to reduce the dislocation.
27842Ankle dislocation
27842 describes closed treatment requiring anesthesia; 27846 describes open operative treatment.
27848Ankle dislocation
27848 is distinguished by fixation of the posterior lip of the tibia. Use 27846 when that specific treatment is not part of the procedure.
27810Ankle fracture treatment
27810 is an ankle-fracture treatment code, not the code for open reduction of an ankle dislocation. Select based on the injury and operative work documented.

Codes related to 27846

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

Codes related to 27846
CodeHow it relatesNational office range
Used instead
27840Ankle dislocationClosed ankle dislocation treatment when anesthesia is not required.No office rate
27842Ankle dislocationClosed ankle dislocation treatment requiring anesthesia.No office rate
Same family
27848Ankle dislocationOpen ankle dislocation treatment involving fixation of the posterior tibial lip.No office rate

27846 billing questions

How does 27846 differ from 27840 and 27842?

27846 is for operative exposure and reduction. Codes 27840 and 27842 describe closed treatment, with 27842 used when anesthesia is required.

Does 27846 include internal fixation?

Yes, fixation may be included when performed as part of the open dislocation treatment. Document the reduction and any stabilization used.

When should 27848 be considered instead?

Consider 27848 when the operative treatment includes fixation of the posterior lip of the tibia. The operative report should identify that specific fracture component and its treatment.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

How is 27846 handled when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral treatment, modifier 50 is paid at 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 27846PPRRVU2026_Oct_nonQPP.csv, line 3,071 (RVU26D)

Open CMS sourceHow we calculate rates

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