CPT code 29365: Cylinder cast, knee immobilization2026 Medicare rate & RVUs in Massachusetts
Report 29365 when a clinician applies a cylinder cast that immobilizes the knee while leaving the foot uncovered.
Medicare pays $142.92–$157.69 for 29365 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 29365 covers
A cylinder cast stabilizes the knee by extending around the leg above and below the joint, while leaving the foot free. Orthopedic clinicians and emergency physicians may apply one for selected knee injuries, including patellar fractures, when the treatment plan calls for cast immobilization rather than a brace or a cast that includes the foot. The service is typically performed in an office, emergency department, or other setting where the cast can be fitted and molded.
Select 29365 for the cylinder configuration, not solely because the knee is being treated. Document the indication, laterality, and cast extent so the record shows that the foot was left uncovered. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When bilateral casts are reported with modifier 50, CMS pays at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. 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.
Where 29365 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $157.69 | $89.89 |
| Rest of Massachusetts | $142.92 | $83.13 |
How the 29365 rate is calculated
Each of 29365’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 · 29365
RVUs × geographic indexes × conversion factor
Work1.15
1.15 RVUs× 1.000 GPCI
Practice expense2.78
2.78 RVUs× 1.000 GPCI
Malpractice0.23
0.23 RVUs× 1.000 GPCI
Adjusted RVUs
4.1600
Conversion factor
$33.4009
Medicare rate
$138.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29365
The CMS indicators that decide how 29365 is paid alongside other services.
CMS payment indicators · 29365
Cylinder cast, knee immobilization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
29365 without 50 · national office
$138.95
Cylinder cast, knee immobilization
29365-50 · Bilateral: 150%
$208.43
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).
29365 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29345Long-leg castStandard cast application
- Use 29365 for a cylinder cast around the knee with the foot uncovered. Use 29345 when the long leg cast extends to the foot.
- 29355Walking castLong leg, thigh to toes
- 29355 describes application of a long leg walking cast; 29365 describes a cylinder cast that leaves the foot uncovered.
- 29358Cast braceLong leg, thigh to toes
- 29358 is for application of a long leg cast brace. Choose 29365 when the applied cast is the cylinder type around the knee.
- 29305Hip spica castOne leg
- 29305 is for a one-leg hip spica cast, which includes the hip region. 29365 is limited to a cylinder cast for knee immobilization.
29365 billing questions
How does a cylinder cast differ from a long leg cast?
A cylinder cast immobilizes the knee while leaving the foot uncovered. A long leg cast extends to the foot; select based on the cast actually applied.
Can 29365 be reported for casts on both knees?
For bilateral cylinder casts, report modifier 50. CMS pays bilateral procedures at 150%.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports choosing 29365?
Record the knee-related indication, laterality, and cast configuration and extent, including that the foot remains uncovered.
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
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