CPT code 29440: Cast walker, added to prior cast2026 Medicare rate & RVUs

Report this service when a clinician adds a walking support to a cast that has already been applied, allowing the patient to bear weight on it.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $44.09 for 29440 nationally in the office and $25.72 in a hospital or facility. Local office rates run $39.94–$55.85.

Medicare rate · 29440

Cast walker, added to prior cast

Office or facility?

Work RVUs
0.56
Total RVUs
1.32
Global days
000

National rate · 2026

$44.09

Office setting, before claim adjustments.

See every locality for 29440 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 29440 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 29440 covers

This service modifies an existing cast by adding a walking support, such as a walker or walking heel, so the patient can bear weight on the cast. It is typically performed in an orthopedic or podiatry clinic or cast room when a lower-extremity cast is being converted for walking after its initial application.

Report 29440 for the addition to the previously applied cast, not for applying a new walking cast. Documentation should identify the existing cast, the support added, the treated side, and the clinical reason for the modification. 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 the others at 50%. For a bilateral service reported with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this service; 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 29440 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$39.94 to $55.85

$39.94$47.89$55.85
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

29440 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$40.40$24.33
Alaska$54.23$34.67
Arizona$43.11$25.31
Arkansas$39.94$24.16
Atlanta, GA$44.86$26.20
Austin, TX$45.31$25.88
Bakersfield, CA$46.07$25.93
Baltimore area, MD$46.52$26.80
Beaumont, TX$41.84$25.12
Brazoria, TX$43.66$25.45

29440 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.

$39.94

$54.23

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

View every state and territory as a table
29440 office rate range by state
State / territoryOffice rate rangeLocalities
AK$54.231
AL$40.401
AR$39.941
AZ$43.111
CA$45.91–$55.8529
CO$45.471
CT$46.641
DC$49.511
DE$43.731
FL$43.89–$47.613
GA$41.85–$44.862
GU$46.641
HI$46.641
IA$41.071
ID$41.311
IL$42.97–$46.504
IN$41.501
KS$40.981
KY$41.311
LA$41.29–$42.922
MA$45.31–$49.272
MD$44.42–$49.513
ME$41.56–$43.262
MI$42.24–$44.402
MN$43.601
MO$40.77–$42.953
MS$40.361
MT$44.091
NC$41.901
ND$43.101
NE$41.221
NH$44.851
NJ$47.18–$49.182
NM$42.461
NV$43.831
NY$42.41–$51.205
OH$42.041
OK$41.181
OR$43.50–$46.592
PA$42.05–$45.722
PR$44.321
RI$45.051
SC$42.041
SD$42.981
TN$41.161
TX$41.84–$45.318
UT$42.501
VA$43.20–$49.512
VI$44.321
VT$43.031
WA$45.19–$50.102
WI$41.941
WV$41.701
WY$43.651

How the 29440 rate is calculated

Each of 29440’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 · 29440

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.56

0.56 RVUs× 1.000 GPCI

Practice expense0.71

0.71 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.3200

Conversion factor

$33.4009

Medicare rate

$44.09

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

Payment rules and modifiers for 29440

The CMS indicators that decide how 29440 is paid alongside other services.

CMS payment indicators · 29440

Cast walker, added to prior cast

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

29440 without 50 · national office

$44.09

Cast walker, added to prior cast

29440-50 · Bilateral: 150%

$66.14

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

29440 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 29440

    Cast walker, added to prior cast0.56 wRVU

    $44.09

  • 29405

    Short leg cast, nonwalking cast0.78 wRVU

    $87.84+$43.75

  • 29425

    Walking cast, short leg0.78 wRVU

    $80.83+$36.74

  • 29435

    PTB cast, below knee1.15 wRVU

    $139.28+$95.19

How to choose

29405Short leg castNonwalking cast
Choose 29405 for application of a short leg cast. Choose 29440 when the cast is already applied and the service adds a walking support.
29425Walking castShort leg
29425 covers application of a short leg walking cast. 29440 covers adding a walker to a previously applied cast.
29435PTB castBelow knee
29435 is for application of a patellar tendon-bearing cast. It is not the code for adding a walking support to an existing cast.

29440 billing questions

How is 29440 different from applying a walking cast?

29440 adds a walking support to a cast that is already in place. Use the applicable cast-application code when the service is applying a new walking cast.

What should the record show?

Document the existing cast, the walking support added, the treated side, and why the cast was modified for weight bearing.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the service.

How is modifier 50 handled for bilateral service?

CMS pays a bilateral service reported with modifier 50 at 150%.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Medicare does not pay an assistant at surgery for 29440, and 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 29440PPRRVU2026_Oct_nonQPP.csv, line 3,294 (RVU26D)

Open CMS sourceHow we calculate rates

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