Summary & Overview
CPT 27829: Repair of Tibiofibular Ligaments with Tibia–Fibula Fixation
CPT code 27829 denotes open surgical repair of disrupted tibiofibular ligaments with fixation of the tibia and fibula using plates, screws, wires, or pins. This procedure is a key operative intervention for restoring stability to the distal tibiofibular joint, commonly performed in the setting of acute ankle fracture-dislocations or syndesmotic injuries that compromise lower‑extremity function. Nationally, the code is relevant for hospital and ambulatory surgical center billing, perioperative quality measurement, and bundle-based payment models focused on orthopedic trauma and ankle reconstruction.
The analysis covers major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers are commonly involved in reimbursement for such operative care. The publication outlines expected benchmarking elements and policy considerations that affect coverage and payment for surgical fixation of the distal tibiofibular joint, and it highlights where additional data are needed.
Intended takeaways include understanding what CPT code 27829 represents, how it is used in surgical billing and care settings, and what topics to review next for claims processing, coding audits, and payer-specific coverage rules. Data not available in the input are noted where relevant.
Billing Code Overview
CPT code 27829 describes a surgical repair of disrupted tibiofibular ligaments with internal fixation of the tibia and fibula using plates, screws, wires, or pins. This procedure addresses instability of the distal tibiofibular joint by restoring anatomic alignment and securing the bones with permanent or temporary fixation devices.
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Service type: Surgical operative procedure — open reduction and internal fixation of the distal tibiofibular joint (ankle region)
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Typical site of service: Hospital inpatient or outpatient operating room, or ambulatory surgery center, depending on clinical complexity and facility capabilities.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents after a high-energy ankle injury sustained during a soccer match with severe pain, swelling, and instability of the distal tibiofibular joint. Imaging (radiographs and CT) demonstrates a disrupted distal tibiofibular syndesmosis with widening and associated Weber B fibular fracture. Initial evaluation includes neurovascular exam, splinting, and pain control in the emergency department. Surgical repair is scheduled within 1–7 days once soft-tissue swelling is acceptable. In the operating room under general or regional anesthesia, the orthopedic surgeon exposes the distal tibiofibular joint, reduces the syndesmosis, and performs stabilization using plates and screws (or syndesmotic screws/pins/wires) to reapproximate and secure the tibia and fibula. Postoperative workflow includes pain management, immobilization in a splint or cast, radiographic confirmation of hardware position, discharge with instructions for non–weight bearing, and outpatient follow-up for wound checks and eventual physical therapy. Typical site of service is an inpatient or ambulatory surgery center (ASC) depending on comorbidities and facility resources.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for 27829 (document justification). |