Billing code 27769: Ankle fracture repairMedicare rate & RVUs in Oklahoma
Report this code for operative treatment of a posterior malleolus ankle fracture through an open approach, with internal fixation when performed.
CMS doesn’t publish an office rate for 27769 in Oklahoma.
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 9 sections
What 27769 covers
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.
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 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $631.11 |
How the 27769 rate is calculated
Each of 27769’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 · 27769
RVUs × geographic indexes × conversion factor
Work9.89
9.89 RVUs× 1.000 GPCI
Practice expense8.37
8.37 RVUs× 1.000 GPCI
Malpractice1.97
1.97 RVUs× 1.000 GPCI
Adjusted RVUs
20.2300
Conversion factor
$33.4009
Medicare rate
$675.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27769
27769 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27769
Ankle fracture repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27769
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27769 without 50 · national facility
$675.70
Ankle fracture repair
27769-50 · Bilateral: 150%
$1,013.55
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).
27769 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27767Ankle fracture care
- Use 27767 for closed treatment of a posterior malleolus fracture without manipulation; 27769 requires open treatment.
- 27768Ankle fracture treatment
- Use 27768 for closed treatment with manipulation. Open operative treatment of the posterior malleolus is reported with 27769.
- 27823Ankle fracture repair
- 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.
- 27766Ankle fracture repair
- 27766 is for open treatment of a medial malleolus fracture; 27769 concerns the posterior malleolus.
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 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
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