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CPT code 29358: Cast brace, long leg, thigh to toes2026 Medicare rate & RVUs in Virginia

Reports application of a long-leg cast brace to stabilize the lower extremity when this brace configuration, rather than a standard cast, is used.

CMS RVU26DEffective Oct 1, 2026One payment locality26 Medicare services in 2024

In Virginia, Medicare pays $178.03 for 29358 in the office and $92.34 when it’s performed in a hospital or facility.

$178.03Office (non-facility)
$92.34Hospital or facility
−2.7%vs the national office rate ($183.04)

Check a contract rate as a % of Medicare · 29358 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 29358 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 29358 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 29358 covers

This service covers fitting and applying a long-leg cast brace that extends along the lower extremity from the thigh toward the toes. Orthopedic clinicians use this form of immobilization when the treatment plan calls for a cast-brace configuration; it is distinct from a conventional long-leg cast and a walker-type cast. The code describes the application, not a particular diagnosis or fracture-care service.

Select the code based on the device and extent documented. The record should identify the treated side, the long-leg cast-brace configuration, and the clinical reason for using it. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral reporting, modifier 50 is paid at 150%. When performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 Virginia compares for 29358

Across 109 of 109 payment localities, the office rate for 29358 runs from $160.44 in Arkansas to $239.75 in San Benito County, CA. Virginia pays $178.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

29358 in Virginia vs other payment areas
  1. Virginia · this page$178.03
  2. Los Angeles, CA · California$204.91+$26.88
  3. Washington, DC area · District of Columbia$209.23+$31.20
  4. Miami, FL · Florida$203.05+$25.02
  5. Chicago, IL · Illinois$196.54+$18.51
  6. Manhattan, NY · New York$212.25+$34.22
  7. Alaska · Alaska$210.15+$32.12

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

Every other payment area

29358 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$162.97$86.69
ArkansasArkansas$160.44$85.56
ArizonaArizona$177.71$93.23
Bakersfield, CACalifornia$192.32$96.77
Chico, CACalifornia$191.52$95.97
El Centro, CACalifornia$191.56$96.02
Fresno, CACalifornia$191.52$95.97
Hanford, CACalifornia$191.52$95.97

29358 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.

$160.44

$215.64

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

View every state and territory as a table
29358 office rate range by state
State / territoryOffice rate rangeLocalities
AK$210.151
AL$162.971
AR$160.441
AZ$177.711
CA$191.52–$239.7529
CO$189.601
CT$195.771
DC$209.231
DE$180.771
FL$182.32–$203.053
GA$171.19–$187.152
GU$196.351
HI$196.351
IA$166.411
ID$167.781
IL$177.45–$196.544
IN$168.791
KS$166.051
KY$168.131
LA$168.03–$176.872
MA$188.54–$208.502
MD$184.23–$209.233
ME$169.22–$178.322
MI$173.24–$185.242
MN$179.901
MO$165.27–$176.963
MS$162.871
MT$183.021
NC$171.041
ND$177.281
NE$167.241
NH$187.031
NJ$197.51–$206.932
NM$174.451
NV$181.551
NY$173.81–$218.305
OH$172.071
OK$167.301
OR$179.65–$195.392
PA$172.10–$190.952
PR$184.291
RI$187.061
SC$171.941
SD$176.611
TN$167.001
TX$170.93–$189.398
UT$174.431
VA$178.03–$209.232
VI$184.291
VT$176.981
WA$188.05–$212.402
WI$171.001
WV$170.581
WY$180.521

See 29358 in every payment locality

How the 29358 rate is calculated

Each of 29358’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 · 29358

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.39

1.39 RVUs× 1.000 GPCI

Practice expense3.80

3.80 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

5.4800

Conversion factor

$33.4009

Medicare rate

$183.04

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,289

Code
29358
Physician work
1.39
Practice expense
3.80
Malpractice
0.29

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 29358 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.39× 1.0001.3900
Practice expense3.80× 0.9833.7354
Malpractice0.29× 0.7060.2047
Total RVUs5.3301
Conversion factor× 33.4009

Office rate, Virginia$178.03

Office: (1.39 × 1 + 3.8 × 0.983 + 0.29 × 0.706) × $33.4009 = $178.03

Facility: (1.39 × 1 + 1.19 × 0.983 + 0.29 × 0.706) × $33.4009 = $92.34

Open 29358 in the RVU calculator

Payment rules and modifiers for 29358

The CMS indicators that decide how 29358 is paid alongside other services.

CMS payment indicators · 29358

Cast brace, 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

29358 without 50 · national office

$183.04

Cast brace, long leg, thigh to toes

29358-50 · Bilateral: 150%

$274.56

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 29358

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

Codes related to 29358
CodeHow it relatesOffice range, Virginia
Used instead
29345Long-leg cast, standard cast applicationConventional long-leg cast application when a cast brace is not used.$144.81
29355Walking cast, long leg, thigh to toesLong-leg cast application in the walker or ambulatory configuration.$150.27
29365Cylinder cast, knee immobilizationCylinder cast application when that cast configuration is selected instead.$135.11

How 29358 has changed in Virginia

29358 · Office / nonfacility

$178.03

Effective 2026-10-01

The base rate is $18.29 higher than on 2025-10-01, moving from $159.74 to $178.03 (11.4%).

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

    $159.74changed to$178.03

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.43 changed to 1.39
    • Practice expense RVU 3.34 changed to 3.80
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $161.69changed to$159.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.25 changed to 3.34
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $159.05changed to$161.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $161.25changed to$159.05

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.12 changed to 3.25
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $160.41changed to$161.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.96 changed to 3.12
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $160.39changed to$160.41

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.93 changed to 2.96
    • Malpractice RVU 0.28 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $160.87changed to$160.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.80 changed to 2.93
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $162.27changed to$160.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.84 changed to 2.80
    • Malpractice RVU 0.30 changed to 0.28
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $161.29changed to$162.27

    • Malpractice RVU 0.27 changed to 0.30

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $163.90changed to$161.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.90 changed to 2.84
    • Malpractice RVU 0.29 changed to 0.27

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $161.79changed to$163.90

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.87 changed to 2.90
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $161.12changed to$161.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.88 changed to 2.87
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $162.35changed to$161.12

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.89 changed to 2.88
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $161.54changed to$162.35

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $159.08changed to$161.54

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.85 changed to 2.89
    • Malpractice RVU 0.28 changed to 0.30
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $160.57changed to$159.08

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.15 changed to 2.85
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $160.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$178.03$92.34RVU26D
2026-07-01$178.03$92.34RVU26C
2026-04-01$178.03$92.34RVU26B
2026-01-01$178.03$92.34RVU26A
2025-10-01$159.74$98.63RVU25D
2025-07-01$159.74$98.63RVU25C
2025-04-01$159.74$98.63RVU25B
2025-01-01$159.74$98.63RVU25A
2024-10-01$161.69$100.44RVU24D
2024-07-01$161.69$100.44RVU24C
2024-04-01$161.69$100.44RVU24B
2024-03-09$161.69$100.44RVU24AR
2024-01-01$159.05$98.80RVU24A
2023-10-01$161.25$101.87RVU23D
2023-07-01$161.25$101.87RVU23C
2023-04-01$161.25$101.87RVU23B
2023-01-01$161.25$101.87RVU23A
2022-10-01$160.41$103.25RVU22D
2022-07-01$160.41$103.25RVU22C
2022-04-01$160.41$103.25RVU22B
2022-01-01$160.41$103.25RVU22A
2021-10-01$160.39$103.80RVU21D
2021-07-01$160.39$103.80RVU21C
2021-04-01$160.39$103.80RVU21B
2021-01-01$160.39$103.80RVU21A
2020-10-01$160.87$105.44RVU20D
2020-07-01$160.87$105.44RVU20C
2020-04-01$160.87$105.44RVU20B
2020-01-01$160.87$105.44RVU20A
2019-10-01$162.27$106.13RVU19D
2019-07-01$162.27$106.13RVU19C
2019-04-01$161.29$105.14RVU19B
2019-01-01$161.29$105.14RVU19A
2018-10-01$163.90$106.75RVU18D
2018-07-01$163.90$106.75RVU18C
2018-04-01$163.90$106.75RVU18B
2018-01-01$163.90$106.75RVU18AR1
2017-10-01$161.79$105.23RVU17D
2017-07-01$161.79$105.23RVU17C
2017-04-01$161.79$105.23RVU17B
2017-01-01$161.79$105.23RVU17A
2016-10-01$161.12$104.81RVU16D
2016-07-01$161.12$104.81RVU16C
2016-04-01$161.12$104.81RVU16B
2016-01-01$161.12$104.81RVU16A
2015-10-01$162.35$105.48RVU15D
2015-07-01$162.35$105.48RVU15C
2015-04-01$161.54$104.96RVU15B
2015-01-01$161.54$104.96RVU15A
2014-10-01$159.08$103.62RVU14D
2014-07-01$159.08$103.62RVU14C
2014-04-01$159.08$103.62RVU14B
2014-01-01$159.08$103.62RVU14A
2013-10-01$160.57$101.74RVU13D
2013-07-01$160.57$101.74RVU13C
2013-04-01$160.57$101.74RVU13B
2013-01-01$160.57$101.74RVU13AR

Price 29358 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

29358 billing questions

How is this different from 29345?

Use 29358 for application of a long-leg cast brace. Code 29345 describes application of a conventional long-leg cast.

How is this different from 29355?

Code 29355 is for a long-leg cast of the walker or ambulatory type. Choose 29358 when the documented device is a cast brace.

What documentation supports 29358?

Document the treated side, the long-leg cast-brace configuration, and why that form of stabilization was selected. The record should distinguish it from a standard or walker-type cast.

Can both legs be reported?

For bilateral performance, CMS lists modifier 50 and payment at 150%. Document application to both sides.

Does the code include same-day related care?

The code has a 0-day global period, which includes same-day preoperative and postoperative care. Other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are not permitted for this code.

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 29358PPRRVU2026_Oct_nonQPP.csv, line 3,289 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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