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CPT code 29345: Long-leg cast, standard cast application2026 Medicare rate & RVUs in Puerto Rico

Reports application of a rigid long-leg cast that immobilizes the knee and lower leg, extending from the thigh to the foot.

CMS RVU26DEffective Oct 1, 2026One payment locality955 Medicare services in 2024

In Puerto Rico, Medicare pays $149.88 for 29345 in the office and $91.80 when it’s performed in a hospital or facility.

$149.88Office (non-facility)
$91.80Hospital or facility
+0.6%vs the national office rate ($148.97)

Check a contract rate as a % of Medicare · 29345 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 29345 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 29345 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 29345 covers

A long-leg cast immobilizes the knee along with the lower leg and foot, typically extending from the upper thigh to the foot. It may be used to stabilize a lower-extremity fracture or protect the leg after treatment of an injury involving the knee or lower leg. The service is performed by a clinician who applies and molds the cast; it may occur in an office, emergency department, or other treatment setting.

Report this code when the long-leg cast application is not included in a separately reported fracture-treatment service. Documentation should identify the treated side, clinical reason for immobilization, and the cast applied. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral application, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.

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 29345

Across 109 of 109 payment localities, the office rate for 29345 runs from $131.43 in Arkansas to $191.75 in San Benito County, CA. Puerto Rico pays $149.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

29345 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$149.88
  2. Los Angeles, CA · California$165.22+$15.34
  3. Washington, DC area · District of Columbia$169.25+$19.37
  4. Miami, FL · Florida$166.12+$16.24
  5. Chicago, IL · Illinois$161.01+$11.13
  6. Manhattan, NY · New York$172.30+$22.42
  7. Alaska · Alaska$174.09+$24.21

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

Every other payment area

29345 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$133.38$83.12
ArkansasArkansas$131.43$82.08
ArizonaArizona$144.79$89.12
Bakersfield, CACalifornia$155.52$92.55
Chico, CACalifornia$154.79$91.83
El Centro, CACalifornia$154.83$91.87
Fresno, CACalifornia$154.79$91.83
Hanford, CACalifornia$154.79$91.83

29345 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$131.43

$174.09

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

View every state and territory as a table
29345 office rate range by state
State / territoryOffice rate rangeLocalities
AK$174.091
AL$133.381
AR$131.431
AZ$144.791
CA$154.79–$191.7529
CO$153.661
CT$158.991
DC$169.251
DE$147.191
FL$149.18–$166.123
GA$140.43–$152.362
GU$158.261
HI$158.261
IA$135.701
ID$136.831
IL$145.63–$161.014
IN$137.601
KS$135.591
KY$137.741
LA$137.73–$144.572
MA$152.95–$168.232
MD$149.85–$169.253
ME$138.12–$144.912
MI$141.86–$151.622
MN$145.601
MO$135.70–$144.453
MS$133.561
MT$148.951
NC$139.501
ND$143.811
NE$136.291
NH$151.761
NJ$160.34–$167.572
NM$142.871
NV$147.611
NY$141.66–$177.205
OH$140.811
OK$136.921
OR$146.01–$157.972
PA$140.74–$155.342
PR$149.881
RI$152.021
SC$140.481
SD$143.201
TN$136.351
TX$139.84–$153.558
UT$142.411
VA$144.81–$169.252
VI$149.881
VT$143.731
WA$152.50–$171.122
WI$138.991
WV$140.331
WY$146.711

See 29345 in every payment locality

How the 29345 rate is calculated

Each of 29345’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 · 29345

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense2.83

2.83 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

4.4600

Conversion factor

$33.4009

Medicare rate

$148.97

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

3,287

Code
29345
Physician work
1.37
Practice expense
2.83
Malpractice
0.26

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 29345 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense2.83× 1.0112.8611
Malpractice0.26× 0.9850.2561
Total RVUs4.4872
Conversion factor× 33.4009

Office rate, Puerto Rico$149.88

Office: (1.37 × 1 + 2.83 × 1.011 + 0.26 × 0.985) × $33.4009 = $149.88

Facility: (1.37 × 1 + 1.11 × 1.011 + 0.26 × 0.985) × $33.4009 = $91.80

Open 29345 in the RVU calculator

Payment rules and modifiers for 29345

The CMS indicators that decide how 29345 is paid alongside other services.

CMS payment indicators · 29345

Long-leg cast, standard cast application

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

29345 without 50 · national office

$148.97

Long-leg cast, standard cast application

29345-50 · Bilateral: 150%

$223.46

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

Codes related to 29345

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

Codes related to 29345
CodeHow it relatesOffice range, Puerto Rico
Same family
29355Walking cast, long leg, thigh to toesWalking long-leg cast application; differs from the standard cast reported with 29345.$155.56
29358Cast brace, long leg, thigh to toesLong-leg cast brace application, rather than a standard long-leg cast.$184.29
Used instead
29365Cylinder cast, knee immobilizationCylinder cast application for knee immobilization without the same long-leg cast configuration.$139.85
29405Short leg cast, nonwalking castShort-leg cast application when immobilization does not extend above the knee.$88.41
29425Walking cast, short legWalking short-leg cast application when a below-knee walking cast is appropriate.$81.35

How 29345 has changed in Puerto Rico

29345 · Office / nonfacility

$149.88

Effective 2026-10-01

The base rate is $13.61 higher than on 2025-10-01, moving from $136.27 to $149.88 (10.0%).

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

    $136.27changed to$149.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.40 changed to 1.37
    • Practice expense RVU 2.53 changed to 2.83
    • Malpractice RVU 0.27 changed to 0.26
    • 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

    $137.90changed to$136.27

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.47 changed to 2.53
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $135.65changed to$137.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $138.77changed to$135.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.41 changed to 2.47
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $138.26changed to$138.77

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $137.89changed to$138.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.30 changed to 2.41
    • 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

    $137.64changed to$137.89

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.27 changed to 2.30
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $139.46changed to$137.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.18 changed to 2.27
    • Malpractice RVU 0.27 changed to 0.26
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $139.22changed to$139.46

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.20 changed to 2.18
    • Malpractice RVU 0.25 changed to 0.27
    • 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

    $140.88changed to$139.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.25 changed to 2.20

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $125.05changed to$140.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.24 changed to 2.25
    • Malpractice RVU 0.26 changed to 0.25
    • 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

    $109.40changed to$125.05

    • 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

    $110.15changed to$109.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.25 changed to 2.24
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $109.60changed to$110.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $107.71changed to$109.60

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.22 changed to 2.25
    • Malpractice RVU 0.26 changed to 0.27
    • 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

    $106.67changed to$107.71

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.46 changed to 2.22
    • Malpractice RVU 0.27 changed to 0.26
    • 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: $106.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$149.88$91.80RVU26D
2026-07-01$149.88$91.80RVU26C
2026-04-01$149.88$91.80RVU26B
2026-01-01$149.88$91.80RVU26A
2025-10-01$136.27$97.83RVU25D
2025-07-01$136.27$97.83RVU25C
2025-04-01$136.27$97.83RVU25B
2025-01-01$136.27$97.83RVU25A
2024-10-01$137.90$99.35RVU24D
2024-07-01$137.90$99.35RVU24C
2024-04-01$137.90$99.35RVU24B
2024-03-09$137.90$99.35RVU24AR
2024-01-01$135.65$97.73RVU24A
2023-10-01$138.77$100.85RVU23D
2023-07-01$138.26$100.64RVU23C
2023-04-01$138.26$100.64RVU23B
2023-01-01$138.26$100.64RVU23A
2022-10-01$137.89$101.27RVU22D
2022-07-01$137.89$101.27RVU22C
2022-04-01$137.89$101.27RVU22B
2022-01-01$137.89$101.27RVU22A
2021-10-01$137.64$101.76RVU21D
2021-07-01$137.64$101.76RVU21C
2021-04-01$137.64$101.76RVU21B
2021-01-01$137.64$101.76RVU21A
2020-10-01$139.46$103.81RVU20D
2020-07-01$139.46$103.81RVU20C
2020-04-01$139.46$103.81RVU20B
2020-01-01$139.46$103.81RVU20A
2019-10-01$139.22$103.65RVU19D
2019-07-01$139.22$103.65RVU19C
2019-04-01$139.22$103.65RVU19B
2019-01-01$139.22$103.65RVU19A
2018-10-01$140.88$104.62RVU18D
2018-07-01$140.88$104.62RVU18C
2018-04-01$140.88$104.62RVU18B
2018-01-01$140.88$104.62RVU18AR1
2017-10-01$125.05$94.64RVU17D
2017-07-01$125.05$94.64RVU17C
2017-04-01$125.05$94.64RVU17B
2017-01-01$125.05$94.64RVU17A
2016-10-01$109.40$84.15RVU16D
2016-07-01$109.40$84.15RVU16C
2016-04-01$109.40$84.15RVU16B
2016-01-01$109.40$84.15RVU16A
2015-10-01$110.15$84.82RVU15D
2015-07-01$110.15$84.82RVU15C
2015-04-01$109.60$84.39RVU15B
2015-01-01$109.60$84.39RVU15A
2014-10-01$107.71$83.41RVU14D
2014-07-01$107.71$83.41RVU14C
2014-04-01$107.71$83.41RVU14B
2014-01-01$107.71$83.41RVU14A
2013-10-01$106.67$81.06RVU13D
2013-07-01$106.67$81.06RVU13C
2013-04-01$106.67$81.06RVU13B
2013-01-01$106.67$81.06RVU13AR

Price 29345 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

29345 billing questions

How is this different from a walking long-leg cast?

Use 29345 for a standard long-leg cast. Code 29355 describes the walking version of the long-leg cast.

Can the cast application be reported with fracture treatment?

Do not separately report the cast application when it is included in the definitive fracture-treatment service. Report 29345 when the application is not included in another reported service.

What documentation supports 29345?

Document the reason for immobilization, the side treated, and that a long-leg cast was applied. The record should distinguish the standard cast from a walking cast, cast brace, or cylinder cast.

How is bilateral application reported?

For casts applied to both legs, report modifier 50; CMS pays the bilateral procedure at 150%.

How does the multiple procedure reduction affect payment?

When other procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Is an assistant or co-surgeon payable?

CMS does not pay an assistant at surgery for 29345 and does not permit co-surgeon or team-surgery billing.

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 29345PPRRVU2026_Oct_nonQPP.csv, line 3,287 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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