2025 CPT code 27792

Open treatment of distal fibular fracture (lateral malleolus), including internal fixation, when performed.

Adhere to current CPT coding guidelines for fracture treatment, including the specific requirements for open reduction and internal fixation.

Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 54 (Surgical Care Only) may be used if the initial treating physician is not performing subsequent treatment, and modifier 76 (Repeat Procedure) may apply for re-reduction.

Medical necessity for 27792 is established when a patient presents with a distal fibular fracture that requires surgical intervention due to displacement, instability, or complications that cannot be managed with non-operative means. This typically involves significant displacement or angulation compromising stability or function.

The physician or qualified healthcare professional is responsible for pre-operative preparation, incision, fracture exploration, reduction, internal fixation (using plates, screws, wires, or pins), hemostasis, irrigation, wound closure, and application of a long leg cast, brace, or splint. Post-operative X-rays may be taken to verify alignment.

IMPORTANT For treatment of tibia and fibula shaft fractures, use codes 27750-27759.If only external fixation is used and not included in another code description, report the appropriate external fixation codes separately.

In simple words: This code covers surgery to fix a broken bone in the outer part of your ankle (the lower leg's smaller bone).The doctor makes a cut to see the break, puts the broken pieces back together, and uses metal to hold them in place. A cast or brace is then applied.

This CPT code, 27792, describes the open treatment of a distal fibular fracture, specifically at the lateral malleolus.The procedure involves surgical exposure of the fracture site, reduction of the fracture fragments, and internal fixation using plates, screws, wires, or pins.The code includes the application of a long leg cast, brace, or splint post-operatively.Note that treatment of tibia and fibula shaft fractures is coded differently (see codes 27750-27759).

Example 1: A patient presents with a distal fibular fracture sustained during a sports injury.Open reduction and internal fixation (ORIF) is performed with a plate and screws. A long leg cast is applied post-operatively., A patient sustains a lateral malleolus fracture in a motor vehicle accident.ORIF is performed using intramedullary nails. A long leg brace is applied for immobilization., A patient with a comminuted (multiple fragments) distal fibular fracture requires ORIF with multiple screws and a plate. The surgeon also addresses soft tissue damage. A long leg cast is applied and physical therapy is recommended.

* Pre-operative and post-operative X-rays demonstrating the fracture and reduction.* Operative report detailing the surgical procedure, including the type and amount of fixation material used.* Anesthesia record.* Medical records indicating the patient's injury mechanism and clinical presentation.* Documentation of the application of the long leg cast, brace, or splint.

** This code encompasses a range of complexities. The specific instruments, implants, and surgical techniques used may vary depending on the fracture pattern and the surgeon's preference. Appropriate documentation is essential for accurate coding.

  • Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
  • Payment Status: Active
  • Modifier TC rule: The technical component (TC) modifier is generally not applicable to 27792 since it's a complete surgical procedure.
  • Specialties:Orthopedic Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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