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    OpenPayerBilling CodesFracture and/or Dislocation Procedures on the Leg (Tibia and Fibula) and Ankle JointCPT cpt-27814-bimalleolar-ankle-fracture-fixation-open-reduction-internal-fixation
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    CPT 27814: Open Reduction Internal Fixation of Two Malleoli

    Medicare pays $728 on average nationally for this procedure.

    CPT code 27814 describes open reduction and internal fixation of two malleoli of the ankle (bimalleolar or equivalent), using plates and screws, wires, or pins for fixation; service type: surgical fixation of unstable ankle fractures; typical site of service: inpatient or outpatient hospital operating room or ambulatory surgery center for orthopedic trauma surgery.

    For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for Tennessee Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 42-year-old male presents to the emergency department after a fall from a ladder with acute right ankle pain, swelling, and inability to bear weight. Radiographs and CT demonstrate an unstable bimalleolar ankle fracture involving the lateral and medial malleoli with displacement and talar instability. After preoperative evaluation and informed consent, the patient is taken to the operating room for open reduction and internal fixation. Under general anesthesia in a sterile operating room environment, the orthopedic surgeon exposes the fractured malleoli, reduces the fragments anatomically, and secures them with a combination of a plate and screws for the lateral malleolus and screws or tension band wiring for the medial malleolus. Perioperative fluoroscopy confirms reduction and hardware placement. The patient is recovered in the PACU and discharged with immobilization, non-weight-bearing instructions, analgesics, and a planned follow-up within 10–14 days for wound check and suture removal, with progressive weight-bearing guided by radiographic healing.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27766Open treatment of bimalleolar ankle fracture, with or without internal or external fixation, when performed for fractures involving talar dome or posterior malleolusAlternative open fixation code used for certain bimalleolar patterns; may be considered when posterior malleolus is a primary focus.
    27822Open treatment of trimalleolar ankle fracture, with internal fixationPerformed when the posterior malleolus plus medial and lateral malleoli are fixed; may be used if a third malleolus is addressed.
    20680Removal of deep implant; complicated (e.g., plate, screw)May be performed at a later date if hardware removal is indicated for pain, infection, or intolerance.
    20550Injection; single tendon sheath, ligament, or ganglion cystUsed postoperatively in different contexts for diagnostic or therapeutic injections for residual pain (ancillary in some workflows).
    99024Postoperative follow-up visit, normally included in the global period (for reporting additional unrelated visits)Documentation of global period visit reporting when payer rules require separate reporting for unrelated services.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    261QR1100XResearch Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    251F00000XHome Infusion AgencyAgencies · Home Infusion
    103TA0700XAdult Development & Aging PsychologistA psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and…
    103TH0004XHealth PsychologistA psychologist who specializes in clinical health psychology that investigates and implements clinical services across diverse populations and setting…
    2355S0801XSpeech-Language AssistantSpeech, Language and Hearing Service Providers · Specialist/Technologist
    225000000XOrthotic FitterAn individual trained in the management of fitting prefabricated orthoses.

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    M25.571Pain in right ankle and joints of right foot
    M25.572Pain in left ankle and joints of left foot
    M79.671Pain in right foot
    M84.471APathological fracture, right ankle, initial encounter for fracture
    M84.472APathological fracture, left ankle, initial encounter for fracture
    M84.473APathological fracture, unspecified ankle, initial encounter for fracture
    M84.474APathological fracture, right foot, initial encounter for fracture
    M84.475APathological fracture, left foot, initial encounter for fracture
    M84.476APathological fracture, unspecified foot, initial encounter for fracture
    S82.831AOther fracture of upper and lower end of right fibula, initial encounter for closed fracture

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    9 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01

    Related Codes

    CPT-27750-CLOSED-TREATMENT-TIBIAL-SHAFT-FRACTURE-IMMOBILIZATION

    CPT 27750: Closed Treatment of Tibial Shaft Fracture

    CPT-27752-TIBIAL-SHAFT-FRACTURE-CLOSED-REDUCTION-MANIPULATION

    CPT 27752: Manipulation/Reduction of Tibial Shaft Fracture

    CPT-27756-PERCUTANEOUS-FIXATION-TIBIAL-SHAFT-FRACTURE

    CPT 27756: Percutaneous Fixation of Tibial Shaft Fracture

    CPT-27758-TIBIAL-SHAFT-ORIF-PLATE-AND-SCREW-FIXATION

    CPT 27758: Tibial Shaft Fracture Repair with Plates and Screws

    CPT-27759-TIBIAL-SHAFT-INTRAMEDULLARY-NAILING

    CPT 27759: Intramedullary Nailing of Tibial Shaft Fracture

    CPT-27760-MEDIAL-MALLEOLUS-FRACTURE-CLOSED-TREATMENT-NO-MANIPULATION

    CPT 27760: Closed Treatment of Medial Malleolus Fracture

    CPT-27762-MEDIAL-MALLEOLUS-FRACTURE-MANIPULATION

    CPT 27762: Closed Manipulation of Medial Malleolus Fracture

    CPT-27766-MEDIAL-MALLEOLUS-OPEN-FIXATION-PLATES-SCREWS

    CPT 27766: Open Reduction Internal Fixation of Medial Malleolus

    CPT-27767-POSTERIOR-MALLEOLUS-FRACTURE-STABILIZATION

    CPT 27767: Stabilization of Posterior Malleolus Fracture, Nonoperative

    CPT-27768-MEDIAL-MALLEOLUS-FRACTURE-CLOSED-MANIPULATION

    CPT 27768: Manipulation of Medial Malleolus Fracture

    Showing 1–10 of 36

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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