Billing code 27829: Syndesmosis repairMedicare rate & RVUs in Oregon
Reports open reduction and stabilization of an unstable distal tibiofibular syndesmosis, commonly treated during surgery for an ankle fracture.
CMS doesn’t publish an office rate for 27829 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 27829 covers
The surgeon exposes and reduces a disrupted distal tibiofibular syndesmosis, the ligament-supported joint between the lower tibia and fibula above the ankle. Stabilization may use a screw or another fixation construct. Orthopedic surgeons and orthopedic trauma surgeons typically perform this operation in a hospital or ambulatory surgical setting, often while repairing an associated ankle fracture. The code concerns the syndesmotic disruption, not fixation of the malleolar fracture itself.
Report it when the operative record documents syndesmotic instability and the open reduction or stabilization performed. An ankle fracture repair alone does not establish that this additional work occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS permits payment for an assistant at surgery and co-surgeons; 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 27829 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $700.53 |
| Rest Of Oregon | Unavailable | $655.53 |
How the 27829 rate is calculated
Each of 27829’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 · 27829
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.58Practice expense 9.94Malpractice 1.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27829
27829 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27829
Syndesmosis 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) | 2 | Paid. |
| Co-surgeons (62) | 2 | 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 · 27829
Syndesmosis 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
27829 without 50 · national facility
$673.03
Syndesmosis repair
27829-50 · Bilateral: 150%
$1,009.55
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).
27829 compared with similar codes
Compare codes
27829 vs 27792 vs 27814 vs 27822 vs 27823: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27792Ankle fracture surgery
- Use 27792 for open treatment of a distal fibular fracture. Use 27829 for open treatment of distal tibiofibular syndesmotic disruption; both may be reported when both services are documented.
- 27814Ankle fracture
- Code 27814 describes open treatment of a bimalleolar ankle fracture. Code 27829 describes the separate syndesmotic disruption, not the malleolar fracture.
- 27822Ankle fracture surgery
- Code 27822 describes open treatment of a trimalleolar fracture without fixation of the posterior lip. Code 27829 identifies open treatment of the distal tibiofibular syndesmosis.
- 27823Ankle fracture repair
- Code 27823 describes trimalleolar fracture treatment with posterior-lip fixation. Choose 27829 for separately documented open syndesmotic reduction or stabilization.
27829 billing questions
When is 27829 appropriate with ankle fracture fixation?
Report it when the surgeon separately documents an unstable distal tibiofibular syndesmosis and performs open reduction or stabilization. The fracture repair alone does not describe this service.
How does 27829 differ from bimalleolar or trimalleolar fracture codes?
Those fracture codes describe treatment of the malleoli. Code 27829 describes open treatment of the distal tibiofibular syndesmotic disruption, which may be treated during the same operation.
Does 27829 include syndesmotic fixation hardware?
The service includes internal fixation when performed. Do not separately report the fixation construct as another service under this code.
What documentation supports reporting 27829?
The operative report should identify syndesmotic disruption or instability and describe its open reduction or stabilization, in addition to any associated fracture repair.
How does Medicare treat bilateral reporting and surgical assistance?
CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery and co-surgeon payment are permitted; 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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