Billing code 27766: Ankle fracture repairMedicare rate & RVUs in Oregon
Open surgical treatment of a medial malleolus fracture, typically with reduction and fixation, when the fracture requires operative exposure and stabilization.
CMS doesn’t publish an office rate for 27766 in Oregon.
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 27766 covers
An orthopedic surgeon uses an operative approach to expose and reduce a fracture of the medial malleolus, the inner side of the ankle. The surgeon may stabilize the fracture with screws or other fixation. This code fits operative treatment directed at the medial malleolus, such as repair of an isolated medial malleolar fracture, rather than closed treatment or repair of a different malleolus. These procedures are commonly performed in a hospital operating room or ambulatory surgery center.
Report the code when the operative record supports open treatment of the medial malleolar fracture; document the fracture site, operative approach, reduction, and fixation performed. The 90-day global period includes the day-before preoperative visit and 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. Modifier 50 for bilateral procedures is paid at 150%. Medicare does not pay an assistant at surgery; 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 27766 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $601.54 |
| Rest Of Oregon | Unavailable | $563.97 |
How the 27766 rate is calculated
Each of 27766’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 · 27766
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.69Practice expense 8.18Malpractice 1.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27766
27766 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27766
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) | 1 | Permitted with supporting documentation. |
| 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 · 27766
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
27766 without 50 · national facility
$579.84
Ankle fracture repair
27766-50 · Bilateral: 150%
$869.76
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).
27766 compared with similar codes
Compare codes
27766 vs 27760 vs 27762 vs 27792 vs 27814: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27760Ankle fracture care
- Use 27760 for closed treatment of a medial malleolus fracture without manipulation. Code 27766 describes operative open treatment.
- 27762Ankle fracture care
- Use 27762 when the medial malleolus fracture is treated closed with manipulation. Code 27766 applies when the surgeon opens the site for treatment.
- 27792Ankle fracture surgery
- 27792 is for open treatment of a distal fibular fracture, including the lateral malleolus. Code 27766 is for the medial malleolus.
- 27814Ankle fracture
- 27814 describes open treatment of a bimalleolar fracture. Code 27766 is for operative treatment of the medial malleolus rather than the combined bimalleolar pattern.
27766 billing questions
How is this code different from 27762?
27762 describes closed treatment of a medial malleolus fracture with manipulation. Use 27766 when the surgeon treats the fracture through an open operative approach.
Can fixation be reported separately?
Internal fixation performed as part of the open fracture treatment is included in this service. The operative note should describe the reduction and fixation performed.
When does 27814 apply instead?
27814 describes open treatment of a bimalleolar ankle fracture. Consider it for a fracture involving both the medial and lateral malleoli treated operatively, rather than coding this as an isolated medial malleolus repair.
How is bilateral treatment reported?
For bilateral medial malleolar procedures, CMS lists modifier 50 payment at 150%. The record should support operative treatment on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. When another procedure is performed in the same session, the standard multiple-procedure reduction applies.
Can an assistant surgeon be paid for this procedure?
CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are paid only with supporting documentation, and 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
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