Summary & Overview
CPT 27696: Repair of Medial and Lateral Ankle Collateral Ligaments
CPT code 27696 defines surgical repair of both the medial and lateral collateral ligaments after an acute ankle injury such as a dislocation or severe sprain. The code captures a definitive operative intervention intended to restore stability and relieve pain when collateral ligaments are disrupted. Nationally, this code is relevant to orthopedic and podiatric practices, hospital surgical departments, and ambulatory surgery centers that manage acute traumatic ankle injuries.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is typically performed, the common sites of service, and how the service is categorized for billing. The publication outlines benchmarks and payment considerations, highlights common modifiers used with surgical billing, and reviews typical documentation elements necessary to support medical necessity. It also situates the code within musculoskeletal surgical service lines, helping clinicians, coding professionals, and revenue cycle staff understand where CPT code 27696 fits in clinical workflows and payer interactions. Data not available in the input is explicitly noted where relevant.
Billing Code Overview
CPT code 27696 describes a surgical repair of both the medial and lateral collateral ligaments of the ankle that have been disrupted by an acute injury, such as a dislocation or severe sprain. The procedure is performed to restore joint stability, improve function, and relieve pain after traumatic ligament disruption.
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Service type: Surgical ligament repair involving both medial and lateral collateral ligaments of the ankle
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A Thirty-two-year-old male presents to the emergency department after a high-energy knee dislocation sustained during a motorcycle collision. He reports immediate severe medial and lateral knee pain, instability, and inability to bear weight. Examination reveals gross laxity on varus and valgus stress, swelling, and focal tenderness along both the medial and lateral collateral ligament complexes. Neurovascular exam is intact. Imaging (X-ray and MRI) confirms disruption of both the medial collateral ligament (MCL) and lateral collateral ligament (LCL) with associated capsular injury but without major intra-articular fracture.
The orthopedic surgeon schedules operative intervention for repair of both collateral ligaments to restore joint stability and relieve pain. The typical workflow includes preoperative evaluation, regional or general anesthesia, open or mini-open repair of the MCL and LCL (suturing and anchor fixation as indicated), intraoperative assessment of joint stability, closure, and postoperative immobilization with brace and planned outpatient physical therapy. Typical postoperative follow-up occurs in 1–2 weeks for wound check, then serial visits for range-of-motion and strengthening milestones. This procedure is most commonly performed in an ambulatory surgical center or hospital operating room under monitored anesthesia care or general anesthesia.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |