$295.62
Use 27767 for closed treatment of a posterior malleolus fracture without manipulation; 27769 requires open treatment.
On this page
CMS RVU26D · Effective 2026-10-01
27769 Ankle fracture repair Medicare reimbursement rates in Idaho
Report this code for operative treatment of a posterior malleolus ankle fracture through an open approach, with internal fixation when performed. Compare 27769 office and facility rates across CMS payment localities in Idaho.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27769 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$618.66
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27769: Open posterior malleolus fracture repair
Report this code for operative treatment of a posterior malleolus ankle fracture through an open approach, with internal fixation when performed.
This code describes open operative treatment of a fracture of the posterior malleolus, the back portion of the distal tibia at the ankle. An orthopedic surgeon exposes the fracture and treats it through the operative approach; internal fixation is included when used. The service is typically performed in a hospital or ambulatory surgery center, rather than as closed fracture care in an office.
Choose the code based on open treatment of the posterior malleolus, not merely on whether fixation is used. The operative report should identify the posterior malleolus fracture and document the open approach and treatment performed. The 90-day global period includes the day-before preoperative visit and 90 days of 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. For bilateral procedures, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 27769
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.89 · 49%
- Practice expense (office) RVU8.37 · 41%
- Malpractice RVU1.97 · 10%
227
Medicare services in 2024 · #4210 by national volume
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.
27769 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
Use 27768 for closed treatment with manipulation. Open operative treatment of the posterior malleolus is reported with 27769.
No office rate
For open treatment of a trimalleolar fracture with fixation of the posterior lip, compare 27823 rather than separately coding the same posterior fixation with 27769.
No office rate
27766 is for open treatment of a medial malleolus fracture; 27769 concerns the posterior malleolus.
Compare 27769 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
Unavailable
Facility
$618.66
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27769 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,046
- Code
- 27769
- Physician work
- 9.89
- Practice expense
- 8.37
- Malpractice
- 1.97
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.89 | × 1.000 | 9.8900 |
| Practice expense | 8.37 | × 0.920 | 7.7004 |
| Malpractice | 1.97 | × 0.473 | 0.9318 |
| Total RVUs | 18.5222 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$618.66
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.89 | 1 |
| Practice expense | 8.37 | 0.92 |
| Malpractice | 1.97 | 0.473 |
(9.89 × 1 + 8.37 × 0.92 + 1.97 × 0.473) × $33.4009 = $618.66
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27769 billing questions
How does 27769 differ from 27767 and 27768?
27769 is for open treatment of a posterior malleolus fracture. Codes 27767 and 27768 describe closed treatment, with manipulation distinguishing 27768.
Is internal fixation separately reported with 27769?
Internal fixation, when performed as part of the open fracture treatment, is included in 27769. Do not separately report fixation for that same fracture treatment.
Can 27769 be reported for a trimalleolar fracture?
For a trimalleolar fracture treated with fixation of the posterior lip, compare the service with 27823, which describes open treatment that includes posterior lip fixation. Do not separately report the same posterior fixation as 27769.
What documentation supports reporting 27769?
The operative report should establish that the fracture involved the posterior malleolus and was treated through an open approach. It should also describe the treatment performed and any internal fixation used.
How does Medicare handle bilateral treatment and multiple procedures?
For bilateral procedures, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and the others are reduced to 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,04327766,,Optx medial ankle fx,A,,7.69,8.18,NA,8.18,,1.49,17.36,17.36,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04427767,,Cltx post ankle fx,A,,2.57,6.58,,5.95,,0.48,9.63,9.00,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04527768,,Cltx post ankle fx w/mnpj,A,,5.01,7.16,NA,7.16,,1.07,13.24,13.24,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04627769,,Optx post ankle fx,A,,9.89,8.37,NA,8.37,,1.97,20.23,20.23,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04727780,,Treatment of fibula fracture,A,,2.76,7.26,,5.60,,0.56,10.58,8.92,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04827781,,Treatment of fibula fracture,A,,4.48,9.28,,6.80,,0.93,14.69,12.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04927784,,Treatment of fibula fracture,A,,9.43,8.86,NA,8.86,,1.86,20.15,20.15,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772