CPT code 29085: Gauntlet cast, hand and lower forearm2026 Medicare rate & RVUs in Puerto Rico

Reports application of a gauntlet-style cast over the hand and lower forearm when that extent of immobilization is needed for a wrist or hand injury.

CMS RVU26DEffective Oct 1, 2026One payment locality7.2K Medicare services in 2024

In Puerto Rico, Medicare pays $107.61 for 29085 in the office and $63.71 when it’s performed in a hospital or facility.

$107.61Office (non-facility)
$63.71Hospital or facility
+0.7%vs the national office rate ($106.88)

Check a contract rate as a % of Medicare · 29085 nationwide

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

We’ll open 29085 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 29085 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 29085 covers

CPT 29085 represents application of a gauntlet-style cast that covers the hand and lower forearm, leaving the elbow free. It is used when an injury requires immobilization across the wrist and hand, such as selected carpal or metacarpal injuries. Orthopedic clinicians commonly apply this cast in office, emergency, or facility settings. The coverage distinguishes it from a cast that extends from below the elbow to the hand and from a cast limited to a finger.

Select the code from the cast’s extent and configuration, not the diagnosis alone. Document the treated side, the areas immobilized, and why this cast was used; replacement of the cast is included in the service. When cast application is part of fracture treatment that already includes it, do not separately report 29085. The 0-day global includes same-day preoperative and postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to bilateral performance, paid at 150%. Assistant-at-surgery payment is restricted; 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.

How Puerto Rico compares for 29085

Across 109 of 109 payment localities, the office rate for 29085 runs from $93.98 in Arkansas to $139.86 in San Benito County, CA. Puerto Rico pays $107.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

29085 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$107.61
  2. Los Angeles, CA · California$119.64+$12.03
  3. Washington, DC area · District of Columbia$122.04+$14.43
  4. Miami, FL · Florida$118.05+$10.44
  5. Chicago, IL · Illinois$114.37+$6.76
  6. Manhattan, NY · New York$123.68+$16.07
  7. Alaska · Alaska$123.43+$15.82

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

29085 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$95.42$57.43
ArkansasArkansas$93.98$56.68
ArizonaArizona$103.85$61.77
Bakersfield, CACalifornia$112.35$64.77
Chico, CACalifornia$111.91$64.32
El Centro, CACalifornia$111.93$64.35
Fresno, CACalifornia$111.91$64.32
Hanford, CACalifornia$111.91$64.32

29085 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$93.98

$125.89

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
29085 office rate range by state
State / territoryOffice rate rangeLocalities
AK$123.431
AL$95.421
AR$93.981
AZ$103.851
CA$111.91–$139.8629
CO$110.731
CT$114.211
DC$122.041
DE$105.611
FL$106.35–$118.053
GA$100.01–$109.212
GU$114.651
HI$114.651
IA$97.441
ID$98.211
IL$103.53–$114.374
IN$98.801
KS$97.211
KY$98.311
LA$98.25–$103.292
MA$110.13–$121.652
MD$107.61–$122.043
ME$99.01–$104.252
MI$101.21–$107.992
MN$105.241
MO$96.65–$103.383
MS$95.321
MT$106.871
NC$100.051
ND$103.711
NE$97.931
NH$109.211
NJ$115.27–$120.742
NM$101.891
NV$106.061
NY$101.64–$127.105
OH$100.561
OK$97.861
OR$105.00–$114.092
PA$100.59–$111.422
PR$107.611
RI$109.261
SC$100.521
SD$103.331
TN$97.751
TX$99.92–$110.578
UT$101.951
VA$104.07–$122.042
VI$107.611
VT$103.511
WA$109.85–$123.932
WI$100.111
WV$99.601
WY$105.491

See 29085 in every payment locality

How the 29085 rate is calculated

Each of 29085’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.

How the rate is built · 29085

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.85

0.85 RVUs× 1.000 GPCI

Practice expense2.19

2.19 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

3.2000

Conversion factor

$33.4009

Medicare rate

$106.88

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,274

Code
29085
Physician work
0.85
Practice expense
2.19
Malpractice
0.16

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 29085 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.85× 1.0000.8500
Practice expense2.19× 1.0112.2141
Malpractice0.16× 0.9850.1576
Total RVUs3.2217
Conversion factor× 33.4009

Office rate, Puerto Rico$107.61

Office: (0.85 × 1 + 2.19 × 1.011 + 0.16 × 0.985) × $33.4009 = $107.61

Facility: (0.85 × 1 + 0.89 × 1.011 + 0.16 × 0.985) × $33.4009 = $63.71

Open 29085 in the RVU calculator

Payment rules and modifiers for 29085

The CMS indicators that decide how 29085 is paid alongside other services.

CMS payment indicators · 29085

Gauntlet cast, hand and lower forearm

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

29085 without 50 · national office

$106.88

Gauntlet cast, hand and lower forearm

29085-50 · Bilateral: 150%

$160.32

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 29085 has changed in Puerto Rico

29085 · Office / nonfacility

$107.61

Effective 2026-10-01

The base rate is $9.89 higher than on 2025-10-01, moving from $97.72 to $107.61 (10.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $97.72changed to$107.61

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.87 changed to 0.85
    • Practice expense RVU 1.98 changed to 2.19
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $98.55changed to$97.72

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.92 changed to 1.98

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $96.94changed to$98.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $98.68changed to$96.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.86 changed to 1.92
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $98.27changed to$98.68

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $97.30changed to$98.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.76 changed to 1.86
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $97.07changed to$97.30

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.75 changed to 1.76
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $97.13changed to$97.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.66 changed to 1.75
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $97.68changed to$97.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.69 changed to 1.66
    • Malpractice RVU 0.14 changed to 0.15
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $99.02changed to$97.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.73 changed to 1.69

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $87.21changed to$99.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.71 changed to 1.73
    • Malpractice RVU 0.15 changed to 0.14
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $75.89changed to$87.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $76.41changed to$75.89

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.72 changed to 1.71

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $76.03changed to$76.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $74.32changed to$76.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.69 changed to 1.72
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $73.92changed to$74.32

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.87 changed to 1.69
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $73.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$107.61$63.71RVU26D
2026-07-01$107.61$63.71RVU26C
2026-04-01$107.61$63.71RVU26B
2026-01-01$107.61$63.71RVU26A
2025-10-01$97.72$67.10RVU25D
2025-07-01$97.72$67.10RVU25C
2025-04-01$97.72$67.10RVU25B
2025-01-01$97.72$67.10RVU25A
2024-10-01$98.55$68.05RVU24D
2024-07-01$98.55$68.05RVU24C
2024-04-01$98.55$68.05RVU24B
2024-03-09$98.55$68.05RVU24AR
2024-01-01$96.94$66.94RVU24A
2023-10-01$98.68$68.28RVU23D
2023-07-01$98.27$68.11RVU23C
2023-04-01$98.27$68.11RVU23B
2023-01-01$98.27$68.11RVU23A
2022-10-01$97.30$68.70RVU22D
2022-07-01$97.30$68.70RVU22C
2022-04-01$97.30$68.70RVU22B
2022-01-01$97.30$68.70RVU22A
2021-10-01$97.07$68.23RVU21D
2021-07-01$97.07$68.23RVU21C
2021-04-01$97.07$68.23RVU21B
2021-01-01$97.07$68.23RVU21A
2020-10-01$97.13$69.49RVU20D
2020-07-01$97.13$69.49RVU20C
2020-04-01$97.13$69.49RVU20B
2020-01-01$97.13$69.49RVU20A
2019-10-01$97.68$69.37RVU19D
2019-07-01$97.68$69.37RVU19C
2019-04-01$97.68$69.37RVU19B
2019-01-01$97.68$69.37RVU19A
2018-10-01$99.02$70.02RVU18D
2018-07-01$99.02$70.02RVU18C
2018-04-01$99.02$70.02RVU18B
2018-01-01$99.02$70.02RVU18AR1
2017-10-01$87.21$63.25RVU17D
2017-07-01$87.21$63.25RVU17C
2017-04-01$87.21$63.25RVU17B
2017-01-01$87.21$63.25RVU17A
2016-10-01$75.89$55.95RVU16D
2016-07-01$75.89$55.95RVU16C
2016-04-01$75.89$55.95RVU16B
2016-01-01$75.89$55.95RVU16A
2015-10-01$76.41$56.40RVU15D
2015-07-01$76.41$56.40RVU15C
2015-04-01$76.03$56.12RVU15B
2015-01-01$76.03$56.12RVU15A
2014-10-01$74.32$55.23RVU14D
2014-07-01$74.32$55.23RVU14C
2014-04-01$74.32$55.23RVU14B
2014-01-01$74.32$55.23RVU14A
2013-10-01$73.92$53.85RVU13D
2013-07-01$73.92$53.85RVU13C
2013-04-01$73.92$53.85RVU13B
2013-01-01$73.92$53.85RVU13AR

Price 29085 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

29085 billing questions

How does 29085 differ from a short-arm cast?

Choose 29085 for a gauntlet-style cast covering the hand and lower forearm. A short-arm cast under 29075 extends from below the elbow to the hand.

Can 29085 be reported with fracture treatment?

Do not separately report the cast application when the fracture-treatment service already includes it. Report 29085 when the cast application is separately reportable.

Does the code include cast replacement?

Yes. Replacement of the cast is included in this service.

How is bilateral application reported?

For bilateral performance, report modifier 50. CMS pays the bilateral procedure at 150%.

What documentation supports selecting 29085?

Document the side treated, the cast’s coverage over the hand and lower forearm, and the clinical reason for that extent of immobilization.

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

Show the CMS file lines behind this rate
RVUs for 29085PPRRVU2026_Oct_nonQPP.csv, line 3,274 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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