Closed treatment of a medial malleolus fracture without manipulation — cast, splint, or boot immobilization applied to a nondisplaced fracture requiring no realignment.

Verified May 8, 2026 · 6 sources ↓

Medicare: $376.43
Work RVU: 3.13
Global, days: 90
Region: Foot & ankle

Drawn from CMSNIHAAPCFindacodeEmedny

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Imaging confirming fracture location (medial malleolus) and displacement status — nondisplaced or minimally displaced
Explicit statement that no manipulation was performed and fracture was in acceptable alignment at time of treatment
Type and description of immobilization applied (short leg cast, posterior splint, CAM boot, etc.)
Laterality documented — left or right ankle — to support LT/RT modifier assignment
Neurovascular status of the extremity at time of initial evaluation
Weight-bearing status and follow-up plan documented in the note

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

27760 covers closed (non-operative) management of a medial malleolus fracture when the fracture is already in acceptable alignment and manipulation is not required. Treatment typically involves immobilization via cast, splint, or walking boot to maintain position while the fracture heals. The 90-day global period covers all routine follow-up, cast changes, and fracture checks through day 90 — separate E/M visits for fracture management during that window must carry modifier 24 to be paid.

This code sits in a family of medial malleolus codes: 27762 is the without-manipulation companion when traction or manipulation is performed; 27766 is the open treatment with internal fixation. Billing 27760 when ORIF was actually performed — or when manipulation was required — is an upcoding error. The distinction between 27760 and 27762 hinges entirely on whether any manipulation or traction was performed, not on fracture severity.

For ICD-10 mapping, the laterality and displacement status must match the CPT selection. A displaced medial malleolus fracture treated with manipulation belongs under 27762, not 27760. Payers audit this pairing routinely — a nondisplaced fracture diagnosis (S82.51xA series) coding to 27760 is clean; a displaced fracture diagnosis coding to 27760 is a mismatch that triggers review.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (3.13) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.27) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	3.13
Practice expense RVU	7.55
Malpractice RVU	0.59
Total RVU	11.27
Medicare national rate	$376.43
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$376.43
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 27760 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

ICD-10 displacement mismatch — displaced fracture diagnosis paired with 27760 instead of 27762
Routine post-op E/M billed without modifier 24 during the 90-day global period
27760 billed when operative report or imaging documents manipulation or traction was performed
Missing laterality — claim submitted without LT or RT modifier when payer requires it
Duplicate claim or overlap with 27766 (open treatment) billed same encounter for same fracture

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What's the difference between 27760 and 27762?

27760 is for closed treatment without any manipulation — the fracture is already aligned. 27762 applies when manipulation or traction was required to achieve or maintain alignment. The operative or clinical note must explicitly state whether manipulation occurred.

02Can I bill a follow-up cast change or fracture check during the 90-day global?

No — routine fracture follow-up is bundled into the 90-day global. If you're billing an E/M for a problem unrelated to the fracture during that window, append modifier 24 and document the unrelated condition clearly.

03Do I need a modifier for laterality?

Many payers, including most commercial plans, require LT or RT on unilateral ankle procedures. Medicare does not require them on all claims but appending them is best practice and reduces administrative edits.

04When would modifier 58 apply to a 27760 claim?

If closed treatment fails and the patient returns within the global period for a planned open reduction (27766), bill 27766 with modifier 58 — staged or related procedure. Modifier 58 reopens a new global period for the operative code.

05Can 27760 be billed with other ankle fracture codes on the same day?

If the patient has a bimalleolar or trimalleolar fracture pattern and each component is being coded separately, modifier 51 applies to the secondary procedure. However, confirm NCCI edits between the applicable codes before billing — some combinations are bundled.

06What ICD-10 codes align correctly with 27760?

The S82.51x series (nondisplaced medial malleolus fracture, initial encounter) aligns with 27760. A displaced fracture code (S82.51xB or equivalent) paired with 27760 creates a clinical mismatch payers will flag.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures displacement status, whether manipulation was performed, the specific immobilization device applied, and laterality directly from dictation. This prevents the most common denial for 27760: a displaced-fracture ICD-10 code paired with the no-manipulation CPT, and flags immediately if the note language suggests manipulation occurred — which would require 27762 instead.

See how Mira captures CPT 27760 documentation