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CPT code 29445: Total contact cast, rigid leg cast2026 Medicare rate & RVUs in Dallas, TX

Reports application of a rigid total contact leg cast, commonly used to off-load a plantar foot ulcer by distributing pressure across the foot.

CMS RVU26DEffective Oct 1, 2026One payment locality16.2K Medicare services in 2024

In Dallas, TX, Medicare pays $131.57 for 29445 in the office and $89.99 when it’s performed in a hospital or facility.

$131.57Office (non-facility)
$89.99Hospital or facility
−0.5%vs the national office rate ($132.27)

Check a contract rate as a % of Medicare · 29445 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 29445 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Dallas, TX
  2. What 29445 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 29445 covers

A rigid total contact cast is molded closely around the foot and lower leg to distribute pressure and limit movement. Podiatrists, orthopedists, and wound care clinicians most often apply it to off-load a plantar foot ulcer, including a neuropathic ulcer, in an office or facility setting. The close-fitting cast can support protected ambulation while reducing pressure on the affected area.

Select this code when the service is application of a rigid total contact cast, rather than a standard short leg cast, walking cast, or patellar tendon-bearing cast. Document the treated side, clinical indication and cast type, including the total-contact technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When bilateral services are reported with modifier 50, payment is at 150%. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures are reduced to 50%. An assistant at surgery is not paid; 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 Dallas, TX compares for 29445

Across 109 of 109 payment localities, the office rate for 29445 runs from $119.51 in Arkansas to $165.38 in San Benito County, CA. Dallas, TX pays $131.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

29445 in Dallas, TX vs other payment areas
  1. Dallas, TX · this page$131.57
  2. Austin, TX · Texas$135.54+$3.97
  3. Beaumont, TX · Texas$125.72−$5.85
  4. Brazoria, TX · Texas$130.66−$0.91
  5. Fort Worth, TX · Texas$130.98−$0.59
  6. Galveston, TX · Texas$131.11−$0.46
  7. Houston, TX · Texas$134.77+$3.20

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

Every other payment area

29445 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$128.18$88.56
Los Angeles, CACalifornia$144.75$95.36
Washington, DC areaDistrict of Columbia$148.17$98.99
Miami, FLFlorida$145.25$101.78
Chicago, ILIllinois$141.66$99.70
Manhattan, NYNew York$150.83$102.32
AlaskaAlaska$162.71$118.25
AlabamaAlabama$120.93$84.40

29445 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.

$119.51

$162.71

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

View every state and territory as a table
29445 office rate range by state
State / territoryOffice rate rangeLocalities
AK$162.711
AL$120.931
AR$119.511
AZ$129.211
CA$136.63–$165.3829
CO$135.821
CT$140.031
DC$148.171
DE$131.071
FL$132.66–$145.253
GA$126.26–$134.862
GU$138.701
HI$138.701
IA$122.501
ID$123.351
IL$130.16–$141.664
IN$123.911
KS$122.481
KY$124.211
LA$124.23–$129.202
MA$135.42–$147.002
MD$133.11–$148.173
ME$124.34–$129.202
MI$127.26–$134.492
MN$129.521
MO$122.78–$129.043
MS$121.151
MT$132.251
NC$125.341
ND$128.301
NE$122.921
NH$134.201
NJ$141.45–$147.182
NM$128.011
NV$131.221
NY$126.91–$154.465
OH$126.451
OK$123.561
OR$130.01–$138.982
PA$126.37–$137.372
PR$132.911
RI$134.881
SC$126.141
SD$127.831
TN$123.031
TX$125.72–$135.548
UT$127.541
VA$129.16–$148.172
VI$132.911
VT$128.291
WA$135.00–$149.272
WI$124.811
WV$126.311
WY$130.531

See 29445 in every payment locality

How the 29445 rate is calculated

Each of 29445’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 · 29445

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.74

1.74 RVUs× 1.000 GPCI

Practice expense2.02

2.02 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

3.9600

Conversion factor

$33.4009

Medicare rate

$132.27

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

The exact Dallas, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,295

Code
29445
Physician work
1.74
Practice expense
2.02
Malpractice
0.20

GPCI2026.csv

99

Locality
Dallas, TX
Physician work
1.009
Practice expense
0.996
Malpractice
0.858
Office calculation for 29445 in Dallas, TX
ComponentRVULocality factorAdjusted
Physician work1.74× 1.0091.7557
Practice expense2.02× 0.9962.0119
Malpractice0.20× 0.8580.1716
Total RVUs3.9392
Conversion factor× 33.4009

Office rate, Dallas, TX$131.57

Office: (1.74 × 1.009 + 2.02 × 0.996 + 0.2 × 0.858) × $33.4009 = $131.57

Facility: (1.74 × 1.009 + 0.77 × 0.996 + 0.2 × 0.858) × $33.4009 = $89.99

Open 29445 in the RVU calculator

Payment rules and modifiers for 29445

The CMS indicators that decide how 29445 is paid alongside other services.

CMS payment indicators · 29445

Total contact cast, rigid leg 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

29445 without 50 · national office

$132.27

Total contact cast, rigid leg cast

29445-50 · Bilateral: 150%

$198.41

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 29445

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

Codes related to 29445
CodeHow it relatesOffice range, Dallas, TX
Used instead
29405Short leg cast, nonwalking castShort leg cast application without the rigid total contact cast distinction.$87.23
29425Walking cast, short legWalking short leg cast application when that cast type is used instead.$80.43
29435PTB cast, below kneePatellar tendon-bearing cast application for a different cast design and support approach.$138.12

How 29445 has changed in Dallas, TX

29445 · Office / nonfacility

$131.57

Effective 2026-10-01

The base rate is $5.39 higher than on 2025-10-01, moving from $126.18 to $131.57 (4.3%).

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

    $126.18changed to$131.57

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.78 changed to 1.74
    • Practice expense RVU 1.93 changed to 2.02
    • Malpractice RVU 0.18 changed to 0.20
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.996
    • Malpractice GPCI 0.877 changed to 0.858

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $129.43changed to$126.18

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.90 changed to 1.93
    • Malpractice RVU 0.20 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $127.32changed to$129.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $129.68changed to$127.32

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.85 changed to 1.90
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.017 changed to 1.011
    • Practice expense GPCI 1.017 changed to 1.007
    • Malpractice GPCI 0.711 changed to 0.877

  5. January 1, 2023

    RVU23A

    $130.35changed to$129.68

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.79 changed to 1.85
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.023 changed to 1.017
    • Practice expense GPCI 1.026 changed to 1.017
    • Malpractice GPCI 0.546 changed to 0.711

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $131.26changed to$130.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.78 changed to 1.79
    • Malpractice RVU 0.21 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $133.93changed to$131.26

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.72 changed to 1.78
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.018 changed to 1.023
    • Practice expense GPCI 1.020 changed to 1.026
    • Malpractice GPCI 0.657 changed to 0.546

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $134.41changed to$133.93

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.75 changed to 1.72
    • Malpractice RVU 0.20 changed to 0.22
    • Work GPCI 1.012 changed to 1.018
    • Practice expense GPCI 1.014 changed to 1.020
    • Malpractice GPCI 0.768 changed to 0.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $134.62changed to$134.41

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.76 changed to 1.75

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $137.92changed to$134.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.86 changed to 1.76
    • Work GPCI 1.015 changed to 1.012
    • Practice expense GPCI 1.012 changed to 1.014
    • Malpractice GPCI 0.770 changed to 0.768

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $137.96changed to$137.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.86
    • Work GPCI 1.018 changed to 1.015
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.772 changed to 0.770

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $139.74changed to$137.96

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.89 changed to 1.87
    • Malpractice RVU 0.22 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $139.05changed to$139.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $138.77changed to$139.05

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.86 changed to 1.89
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.013 changed to 1.009
    • Malpractice GPCI 0.803 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $139.89changed to$138.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.08 changed to 1.86
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.017 changed to 1.013
    • Malpractice GPCI 0.834 changed to 0.803

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $139.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$131.57$89.99RVU26D
2026-07-01$131.57$89.99RVU26C
2026-04-01$131.57$89.99RVU26B
2026-01-01$131.57$89.99RVU26A
2025-10-01$126.18$95.56RVU25D
2025-07-01$126.18$95.56RVU25C
2025-04-01$126.18$95.56RVU25B
2025-01-01$126.18$95.56RVU25A
2024-10-01$129.43$98.26RVU24D
2024-07-01$129.43$98.26RVU24C
2024-04-01$129.43$98.26RVU24B
2024-03-09$129.43$98.26RVU24AR
2024-01-01$127.32$96.65RVU24A
2023-10-01$129.68$98.32RVU23D
2023-07-01$129.68$98.32RVU23C
2023-04-01$129.68$98.32RVU23B
2023-01-01$129.68$98.32RVU23A
2022-10-01$130.35$99.82RVU22D
2022-07-01$130.35$99.82RVU22C
2022-04-01$130.35$99.82RVU22B
2022-01-01$130.35$99.82RVU22A
2021-10-01$131.26$101.19RVU21D
2021-07-01$131.26$101.19RVU21C
2021-04-01$131.26$101.19RVU21B
2021-01-01$131.26$101.19RVU21A
2020-10-01$133.93$105.21RVU20D
2020-07-01$133.93$105.21RVU20C
2020-04-01$133.93$105.21RVU20B
2020-01-01$133.93$105.21RVU20A
2019-10-01$134.41$105.54RVU19D
2019-07-01$134.41$105.54RVU19C
2019-04-01$134.41$105.54RVU19B
2019-01-01$134.41$105.54RVU19A
2018-10-01$134.62$106.15RVU18D
2018-07-01$134.62$106.15RVU18C
2018-04-01$134.62$106.15RVU18B
2018-01-01$134.62$106.15RVU18AR1
2017-10-01$137.92$107.05RVU17D
2017-07-01$137.92$107.05RVU17C
2017-04-01$137.92$107.05RVU17B
2017-01-01$137.92$107.05RVU17A
2016-10-01$137.96$106.89RVU16D
2016-07-01$137.96$106.89RVU16C
2016-04-01$137.96$106.89RVU16B
2016-01-01$137.96$106.89RVU16A
2015-10-01$139.74$108.20RVU15D
2015-07-01$139.74$108.20RVU15C
2015-04-01$139.05$107.66RVU15B
2015-01-01$139.05$107.66RVU15A
2014-10-01$138.77$107.92RVU14D
2014-07-01$138.77$107.92RVU14C
2014-04-01$138.77$107.92RVU14B
2014-01-01$138.77$107.92RVU14A
2013-10-01$139.89$106.32RVU13D
2013-07-01$139.89$106.32RVU13C
2013-04-01$139.89$106.32RVU13B
2013-01-01$139.89$106.32RVU13AR

Price 29445 for an earlier date of service

Where the Dallas, TX rate applies

Dallas, TX is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

29445 billing questions

When should I choose this code instead of 29405?

Use 29445 for a rigid total contact cast. Code 29405 describes application of a short leg cast without the total-contact distinction.

How does this differ from 29425?

Code 29425 is for a walking short leg cast. Choose 29445 when the service is specifically application of a rigid total contact cast, often for plantar pressure off-loading.

What documentation supports the code?

Record the indication, treated side, and that a rigid total contact cast was applied. For ulcer off-loading, identify the affected foot and ulcer site.

How is bilateral application reported?

For bilateral services, report modifier 50; CMS pays the bilateral procedure at 150%.

What same-day services are included or reduced?

Same-day preoperative and postoperative care is included in the 0-day global period. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%.

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 29445PPRRVU2026_Oct_nonQPP.csv, line 3,295 (RVU26D)
Geographic factors for Dallas, TXGPCI2026.csv, line 99 (RVU26D)

Open CMS sourceHow we calculate rates

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