Summary & Overview
CPT 27766: Open Fixation of Medial Malleolus Fracture
CPT code 27766 denotes open treatment of a medial malleolus fracture with internal fixation using plates and/or screws. This operative code is used for definitive surgical stabilization to maintain alignment, prevent displacement, and reduce pain while the fracture heals. It is a commonly billed orthopedic procedure with relevance across acute care hospitals and ambulatory surgical centers that provide fracture care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure, typical settings where it is performed, and the common procedural rationale. The publication outlines billing and coding considerations for surgical fixation of the medial malleolus and presents national benchmarking and payer coverage patterns where available.
The report summarizes typical modifiers and related coding considerations, examines reimbursement benchmarks and payment policy updates that affect fracture fixation procedures, and highlights documentation elements that commonly influence claim adjudication. Data gaps in the input are noted where applicable; specific diagnosis coding and taxonomies are not provided in the source material. The content is intended for coding, billing, and clinical policy stakeholders seeking a compact national overview of CPT code 27766.
Billing Code Overview
CPT code 27766 describes an open surgical repair of a fracture of the medial malleolus with internal fixation using plates and/or screws. The provider performs an open incision to align and stabilize the medial malleolus fracture to maintain reduction during healing and to relieve pain.
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Service type: Open surgical fracture fixation (internal fixation)
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Typical site of service: Hospital operating room or ambulatory surgical center for orthopedic surgery
Clinical & Coding Specifications
Clinical Context
A 42-year-old male construction worker presents after an acute ankle inversion injury with severe medial ankle pain, swelling, and inability to bear weight. Radiographs and CT confirm a displaced fracture of the medial malleolus. After initial immobilization, analgesia, and preoperative evaluation, the patient is taken to the operating room for open reduction and internal fixation (ORIF) of the medial malleolus with placement of screws and a buttress plate to restore articular alignment and stability. The clinical workflow includes preoperative consent and imaging review, regional or general anesthesia, operative exposure through a medial ankle incision, fracture reduction, fixation with appropriately sized screws and plate(s), intraoperative fluoroscopic confirmation of alignment, wound closure, sterile dressing and posterior splint or short leg cast, and postoperative recovery with instructions for non-weight-bearing and follow-up radiographs and clinic visits for wound check and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left medial malleolus |
RT | Right side |