CPT code 29355: Walking cast, long leg, thigh to toes2026 Medicare rate & RVUs in Louisiana

Application of a long-leg walking cast extending from thigh to toes, selected when the cast is configured to permit ambulation during immobilization.

CMS RVU26DEffective Oct 1, 20262 payment localities91 Medicare services in 2024

Medicare pays $143.27–$150.28 for 29355 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. Which amount applies depends on the service address.

$143.27–$150.28Office (non-facility)
$92.13–$95.91Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Louisiana
  2. What 29355 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 29355 covers

This service covers applying a long-leg cast that extends from the thigh to the toes and is configured to permit walking. Orthopedic surgeons and other clinicians who manage musculoskeletal injuries may apply it in an office or other treatment setting when an injury requires immobilization across the knee and lower leg but the patient can ambulate in the cast. Selected lower-extremity fractures are a typical reason for this form of immobilization.

Report the code when the documented cast spans the thigh to the toes and has a walking configuration; a standard long-leg cast without that feature is distinguished by code 29345. Document the treated side, cast extent, walking design, and clinical reason for immobilization. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. For bilateral application, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily 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.

Where 29355 pays more and less in Louisiana

29355 office and facility rates by payment locality
Payment localityOfficeFacility
New Orleans, LA$150.28$95.91
Rest of Louisiana$143.27$92.13

How the 29355 rate is calculated

Each of 29355’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 · 29355

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.49

1.49 RVUs× 1.000 GPCI

Practice expense2.86

2.86 RVUs× 1.000 GPCI

Malpractice0.28

0.28 RVUs× 1.000 GPCI

Adjusted RVUs

4.6300

Conversion factor

$33.4009

Medicare rate

$154.65

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

Payment rules and modifiers for 29355

The CMS indicators that decide how 29355 is paid alongside other services.

CMS payment indicators · 29355

Walking cast, long leg, thigh to toes

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

29355 without 50 · national office

$154.65

Walking cast, long leg, thigh to toes

29355-50 · Bilateral: 150%

$231.98

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

29355 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 29355

    Walking cast, long leg, thigh to toes1.49 wRVU

    $154.65

  • 29345

    Long-leg cast, standard cast application1.37 wRVU

    $148.97−$5.68

  • 29358

    Cast brace, long leg, thigh to toes1.39 wRVU

    $183.04+$28.39

  • 29365

    Cylinder cast, knee immobilization1.15 wRVU

    $138.95−$15.70

  • 29425

    Walking cast, short leg0.78 wRVU

    $80.83−$73.82

How to choose

29345Long-leg castStandard cast application
Both involve a long-leg cast extending from thigh to toes. Choose 29355 when the cast is configured for walking; 29345 is for the standard long-leg cast.
29358Cast braceLong leg, thigh to toes
This code is for a long-leg walking cast. Code 29358 describes application of a long-leg cast brace, a different immobilization approach.
29365Cylinder castKnee immobilization
A cylinder cast is a different cast configuration from the long-leg walking cast reported with 29355.
29425Walking castShort leg
Code 29425 is for a short-leg walking cast. Use 29355 when the cast extends from the thigh to the toes.

29355 billing questions

How does this differ from code 29345?

Use 29355 when the long-leg cast is configured for walking. Code 29345 describes a long-leg cast without that walking designation.

What documentation supports reporting 29355?

Document that the cast extends from the thigh to the toes, is configured for walking, and is needed for the treated injury. Record the side treated.

Is same-day care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

How is bilateral application reported?

Report modifier 50 for bilateral application. CMS pays the bilateral procedure at 150%.

How does the multiple procedure rule affect payment?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

Can an assistant or surgical team be reported?

Assistant-at-surgery payment is statutorily restricted. Co-surgeons and team surgery are not permitted.

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 29355PPRRVU2026_Oct_nonQPP.csv, line 3,288 (RVU26D)

Open CMS sourceHow we calculate rates

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