$352.33–$389.02
Use 27760 for closed treatment of a medial malleolus fracture without manipulation. Code 27766 describes operative open treatment.
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CMS RVU26D · Effective 2026-10-01
27766 Ankle fracture repair Medicare reimbursement rates in Texas
Open surgical treatment of a medial malleolus fracture, typically with reduction and fixation, when the fracture requires operative exposure and stabilization. Compare 27766 office and facility rates across CMS payment localities in Texas.
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 27766 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 27766 pays more and less in Texas
Orthopedic surgery
About 27766: Open treatment of medial malleolus fracture
Open surgical treatment of a medial malleolus fracture, typically with reduction and fixation, when the fracture requires operative exposure and stabilization.
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.
CMS billing rules for 27766
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.69 · 44%
- Practice expense (office) RVU8.18 · 47%
- Malpractice RVU1.49 · 9%
1.5K
Medicare services in 2024 · #2699 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.
27766 compared with similar codes
Office rates for Texas, from the same CMS release.
$552.95–$606.44
Use 27762 when the medial malleolus fracture is treated closed with manipulation. Code 27766 applies when the surgeon opens the site for treatment.
No office rate
27792 is for open treatment of a distal fibular fracture, including the lateral malleolus. Code 27766 is for the medial malleolus.
No office rate
27814 describes open treatment of a bimalleolar fracture. Code 27766 is for operative treatment of the medial malleolus rather than the combined bimalleolar pattern.
Compare 27766 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $590.53 |
| Beaumont | Office Unavailable | Facility $551.72 |
| Brazoria | Office Unavailable | Facility $568.49 |
| Dallas | Office Unavailable | Facility $573.99 |
| Fort Worth | Office Unavailable | Facility $571.91 |
| Galveston | Office Unavailable | Facility $571.42 |
| Houston | Office Unavailable | Facility $598.69 |
| Rest Of Texas | Office Unavailable | Facility $561.08 |
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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 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.
3,04027759,,Treatment of tibia fracture,A,,14.09,10.43,NA,10.43,,2.97,27.49,27.49,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04127760,,Cltx medial ankle fx,A,,3.13,7.55,,5.85,,0.59,11.27,9.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04227762,,Cltx med ankle fx w/mnpj,A,,5.33,11.10,,8.15,,1.21,17.64,14.69,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04327766,,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