Closed treatment of a medial malleolus fracture requiring manual repositioning of bone fragments, with or without skin or skeletal traction.

Verified May 8, 2026 · 5 sources ↓

Medicare: $589.19
Total RVUs: 17.64
Global, days: 90
Region: Foot & ankle

Drawn from CMSNIHKzanow

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Explicit statement that manipulation/reduction was performed — absence defaults the claim to 27760
Pre- and post-reduction radiographic alignment findings documented in the record
Fracture location confirmed as medial malleolus, not distal fibula or bimalleolar pattern
Type of immobilization applied (short leg cast, splint, brace) and any traction technique used
Neurovascular status of the extremity documented before and after reduction
Mechanism of injury and clinical presentation supporting closed treatment rather than open reduction

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27762 covers closed (non-operative) management of a medial malleolus fracture that requires manipulation — meaning the fracture is manually reduced rather than accepted in its displaced position. Traction, whether skin or skeletal, may be applied as part of this treatment and does not change the code selection. The 90-day global period covers the reduction itself, all routine follow-up visits, cast checks, and removal through day 90. Any visit for an unrelated condition during that window requires modifier 24; a new problem addressed at a post-op visit needs modifier 25.

Distinguish 27762 from 27760, which is closed treatment without manipulation. The presence or absence of reduction is the deciding factor — if the operative note or clinical record doesn't explicitly state that manipulation was performed, payers will default to 27760. Document the pre- and post-reduction alignment, the technique used, and the type of immobilization applied.

This code carries a 90-day global under the CMS Physician Fee Schedule 2026. Site of service matters: HOPD and ASC payments differ — see the site-of-service comparison on this page. Isolated medial malleolus fractures are the core indication; if there is concurrent fibula fracture or syndesmotic injury requiring separate treatment, additional coding may apply with modifier 59 or XS to distinguish the services.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.33
Practice expense RVU	11.1
Malpractice RVU	1.21
Total RVU	17.64
Medicare national rate	$589.19
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	$589.19
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27762 get rejected.

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

Manipulation not documented — payer downcodes to 27760 (without manipulation)
Fracture type mismatch: bimalleolar or trimalleolar injury billed as isolated medial malleolus
Global period conflict — post-op E/M billed without modifier 24 for an unrelated condition
ICD-10 diagnosis code does not specify medial malleolus as the fracture site
Duplicate claim conflict when same-day imaging or casting codes are not properly separated

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 27762 from 27760?

Manipulation. 27760 is closed treatment without reduction; 27762 requires that the surgeon manually reduced the fracture. If your note doesn't say reduction was performed, the claim will be downcoded to 27760.

02Can 27762 and imaging codes be billed on the same day?

Yes. Pre- and post-reduction radiographs are separately billable and are not bundled into the fracture care code. Use the appropriate 73000-series code for the ankle views and bill them separately.

03Does skin or skeletal traction change the code?

No. 27762 includes 'with or without skin or skeletal traction.' Traction is bundled into this code and cannot be billed separately.

04What modifier is needed if I see this patient during the 90-day global for an unrelated problem?

Use modifier 24 on the E/M to indicate the visit is unrelated to the original fracture. Without it, the claim will be denied as included in the global period.

05If there is also a fibula fracture treated at the same encounter, how should that be coded?

Code the fibula fracture separately (e.g., 27786 or 27788 depending on whether manipulation was performed) and append modifier 59 or XS to distinguish it from the medial malleolus treatment. Document each fracture and its treatment distinctly in the operative/clinical note.

06Is 27762 ever appropriate for a Salter-Harris fracture of the distal tibia in a pediatric patient?

It has been used as a crosswalk in that context, but Salter-Harris physeal injuries have dedicated codes (e.g., 27824, 27825 range or physeal-specific codes). Verify with your payer and ensure the ICD-10 reflects the physeal injury to avoid mismatched diagnosis denials.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the manipulation technique, pre- and post-reduction alignment from dictation, traction type if applied, and immobilization method — then flags if the note lacks an explicit reduction statement, the single most common trigger for a 27760 downcode on audit.

See how Mira captures CPT 27762 documentation