Billing code 27768: Ankle fracture treatmentMedicare rate & RVUs in Vermont
Closed treatment of a posterior malleolus fracture requiring manipulation to restore alignment, typically performed by an orthopedic surgeon in a facility setting.
CMS doesn’t publish an office rate for 27768 in Vermont.
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 27768 covers
This code describes closed management of a fracture involving the posterior portion of the distal tibia at the ankle when the clinician manipulates the fracture to improve alignment. An orthopedic surgeon typically performs the reduction, often using imaging to assess fracture position before and after manipulation. The fracture is managed without surgically exposing the bone; stabilization may follow the reduction.
Choose this code when the documented treatment includes manipulation, rather than closed care without manipulation or open fixation. The record should identify the posterior malleolus fracture and support the need for reduction, including the alignment findings and treatment performed. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral treatment reported with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; 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.
27768 in Vermont
| Payment locality | Office | Facility |
|---|---|---|
| Vermont | Unavailable | $422.18 |
How the 27768 rate is calculated
Each of 27768’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 · 27768
RVUs × geographic indexes × conversion factor
Work5.01
5.01 RVUs× 1.000 GPCI
Practice expense7.16
7.16 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
13.2400
Conversion factor
$33.4009
Medicare rate
$442.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27768
27768 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27768
Ankle fracture treatment
| 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 · 27768
Ankle fracture treatment
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
27768 without 50 · national facility
$442.23
Ankle fracture treatment
27768-50 · Bilateral: 150%
$663.35
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).
27768 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27767Ankle fracture care
- Both address closed treatment of a posterior malleolus fracture. Select 27768 when manipulation is performed; 27767 is for treatment without manipulation.
- 27769Ankle fracture repair
- 27769 describes open treatment of a posterior malleolus fracture. Use 27768 for closed treatment that includes manipulation.
- 27810Ankle fracture treatment
- 27810 applies to closed treatment with manipulation of a bimalleolar ankle fracture. This code is specific to a posterior malleolus fracture.
27768 billing questions
How does this differ from 27767?
Use 27768 when closed treatment includes manipulation of the posterior malleolus fracture. Code 27767 is the corresponding closed-treatment option without manipulation.
When would 27769 be more appropriate?
27769 is for open treatment of a posterior malleolus fracture. This code describes closed treatment with manipulation, without surgically exposing the fracture.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How is bilateral treatment handled?
When the procedure is performed bilaterally and reported with modifier 50, Medicare payment is 150%.
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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