CPT code 29065: Cast application, shoulder to hand2026 Medicare rate & RVUs

Medicare pays $108.22 for 29065 nationally in the office and $64.46 in a hospital or facility. Local office rates run $95.01–$141.48.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 29065 covers

This service applies a rigid long-arm cast extending from the upper arm or shoulder region to the hand to immobilize the elbow and forearm. Orthopedic clinicians and emergency or urgent-care physicians commonly use it for injuries requiring control of elbow motion, such as selected elbow or forearm fractures, when a cast rather than a removable support is chosen. The code represents cast application, not fracture evaluation, reduction, or ongoing fracture management.

Select 29065 by the documented cast extent, not simply the diagnosis: the cast must reach from shoulder to hand. Record the indication, laterality, and extent. When fracture treatment is reported, the initial cast application is part of that treatment and should not be separately reported as 29065. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral application, modifier 50 is paid at 150%. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 29065 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

29065 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 29065 rate is calculated

Each of 29065’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 29065

The CMS indicators that decide how 29065 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

29065 compared with similar codes

How to choose

29075Cast applicationForearm to hand

Choose 29075 for a short-arm cast extending from the elbow to the fingers. Choose 29065 when the cast reaches from the shoulder region to the hand.

29085Gauntlet castHand and lower forearm

29085 describes a gauntlet cast covering the hand and lower forearm. It does not describe the shoulder-to-hand extent of 29065.

29105Splint applicationLong arm, shoulder to hand

Both describe long-arm immobilization, but 29105 is for a splint and 29065 is for a cast.

Codes related to 29065

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates