CPT code 29740: Cast wedging, alignment adjustment2026 Medicare rate & RVUs
Report cast wedging when a clinician modifies an existing cast to adjust alignment, commonly during fracture care, without replacing the cast.
Medicare pays $109.55 for 29740 nationally in the office and $60.46 in a hospital or facility. Local office rates run $96.71–$139.23.
Medicare rate · 29740
Cast wedging, alignment adjustment
- Work RVUs
- 1.09
- Total RVUs
- 3.28
- Global days
- 000
National rate · 2026
$109.55
Office setting, before claim adjustments.
See every locality for 29740 →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.
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On this page 10 sections
What 29740 covers
Cast wedging modifies an existing cast to change the position or alignment of the underlying limb, often after reassessment of a fracture. The clinician makes a controlled cut in the cast, adjusts the opening or overlap to alter alignment, and secures the cast again. Orthopedic clinicians commonly perform this service during fracture follow-up when the cast can remain in place but its position needs correction.
Report 29740 for the cast adjustment, not for creating a window to reach the skin or repairing a damaged spica cast. Document the reason for the adjustment, the cast modification performed, and the clinical assessment supporting the alignment change. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and 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 29740 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
$96.71 to $139.23
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $98.14 | $55.18 |
| Alaska | $128.74 | $76.45 |
| Arizona | $106.46 | $58.88 |
| Arkansas | $96.71 | $54.54 |
| Atlanta, GA | $112.19 | $62.31 |
| Austin, TX | $112.61 | $60.66 |
| Bakersfield, CA | $113.69 | $59.88 |
| Baltimore area, MD | $116.68 | $64.00 |
| Beaumont, TX | $103.11 | $58.43 |
| Brazoria, TX | $107.64 | $58.98 |
| Chicago, IL | $119.65 | $70.31 |
| Chico, CA | $113.08 | $59.27 |
| Colorado | $112.59 | $60.35 |
| Connecticut | $116.89 | $64.01 |
| Dallas, TX | $108.58 | $59.67 |
| Delaware | $108.21 | $59.70 |
| Detroit, MI | $112.29 | $64.91 |
| East St. Louis, IL | $111.74 | $66.57 |
| El Centro, CA | $113.12 | $59.30 |
| Fort Lauderdale, FL | $116.35 | $66.61 |
| Fort Worth, TX | $108.01 | $59.60 |
| Fresno, CA | $113.08 | $59.27 |
| Galveston, TX | $108.12 | $59.37 |
| Hanford, CA | $113.08 | $59.27 |
| Hawaii, Guam, HI | $115.48 | $59.65 |
| Houston, TX | $112.15 | $63.39 |
| Idaho | $100.42 | $55.25 |
| Indiana | $100.97 | $55.46 |
| Iowa | $99.53 | $54.61 |
| Kansas | $99.59 | $55.21 |
| Kentucky | $101.63 | $57.98 |
| King County, WA | $124.97 | $64.72 |
| Los Angeles, CA | $120.62 | $62.54 |
| Madera, CA | $113.08 | $59.27 |
| Manhattan, NY | $126.85 | $69.80 |
| Marin County, CA | $136.02 | $66.79 |
| Merced, CA | $113.08 | $59.27 |
| Metropolitan Boston, MA | $123.00 | $64.38 |
| Metropolitan Kansas City, MO | $105.37 | $59.27 |
| Metropolitan Philadelphia, PA | $114.33 | $63.21 |
| Metropolitan St. Louis, MO | $106.41 | $59.67 |
| Miami, FL | $123.49 | $72.38 |
| Minnesota | $106.29 | $55.77 |
| Mississippi | $98.49 | $56.22 |
| Modesto, CA | $113.08 | $59.27 |
| Montana | $109.54 | $60.44 |
| Napa, CA | $129.16 | $64.44 |
| Nebraska | $99.92 | $54.60 |
| Nevada | $108.39 | $59.25 |
| New Hampshire | $111.33 | $60.22 |
| New Mexico | $105.57 | $60.55 |
| New Orleans, LA | $106.67 | $60.47 |
| North Carolina | $102.49 | $56.68 |
| North Dakota | $105.19 | $56.09 |
| Northern New Jersey | $122.88 | $65.92 |
| NYC suburbs and Long Island, NY | $130.62 | $72.24 |
| Ohio | $103.89 | $59.06 |
| Oklahoma | $100.88 | $57.03 |
| Oxnard, CA | $119.78 | $61.74 |
| Portland, OR | $115.56 | $61.01 |
| Poughkeepsie and northern NYC suburbs, NY | $118.99 | $65.22 |
| Puerto Rico | $110.17 | $60.53 |
| Queens, NY | $127.11 | $69.07 |
| Redding, CA | $113.08 | $59.27 |
| Rest of California | $113.08 | $59.27 |
| Rest of Florida | $110.36 | $63.42 |
| Rest of Georgia | $103.86 | $60.06 |
| Rest of Illinois | $107.97 | $63.14 |
| Rest of Louisiana | $101.68 | $58.23 |
| Rest of Maine | $101.51 | $56.34 |
| Rest of Maryland | $110.11 | $60.42 |
| Rest of Massachusetts | $112.13 | $60.43 |
| Rest of Michigan | $104.78 | $59.95 |
| Rest of Missouri | $100.28 | $57.96 |
| Rest of New Jersey | $117.78 | $64.16 |
| Rest of New York | $104.08 | $57.44 |
| Rest of Oregon | $107.11 | $58.21 |
| Rest of Pennsylvania | $103.76 | $58.68 |
| Rest of Texas | $105.49 | $58.89 |
| Rest of Washington | $111.76 | $60.06 |
| Rhode Island | $111.62 | $60.90 |
| Riverside, CA | $115.45 | $61.63 |
| Sacramento, CA | $118.18 | $61.08 |
| Salinas, CA | $117.74 | $60.83 |
| San Benito County, CA | $139.23 | $68.43 |
| San Diego, CA | $120.18 | $61.46 |
| San Francisco, CA | $135.77 | $66.54 |
| San Luis Obispo, CA | $115.91 | $59.99 |
| Santa Clara County, CA | $138.21 | $67.41 |
| Santa Cruz, CA | $121.06 | $61.40 |
| Santa Maria, CA | $118.09 | $60.84 |
| Santa Rosa, CA | $122.24 | $61.95 |
| South Carolina | $103.45 | $58.08 |
| South Dakota | $104.68 | $55.58 |
| Southern Maine, ME | $106.25 | $57.59 |
| Stockton, CA | $113.08 | $59.27 |
| Suburban Chicago, IL | $117.26 | $66.83 |
| Tennessee | $100.16 | $55.53 |
| Utah | $104.86 | $58.70 |
| Vallejo, CA | $128.80 | $64.08 |
| Vermont | $105.27 | $56.66 |
| Virgin Islands, VI | $110.17 | $60.53 |
| Virginia | $106.28 | $58.01 |
| Visalia, CA | $113.08 | $59.27 |
| Washington, DC area | $124.06 | $66.22 |
| West Virginia | $104.10 | $61.43 |
| Wisconsin | $101.71 | $54.67 |
| Wyoming | $107.64 | $58.55 |
| Yuba City, CA | $113.08 | $59.27 |
29740 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.
$96.71
$128.74
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $128.74 | 1 |
| AL | $98.14 | 1 |
| AR | $96.71 | 1 |
| AZ | $106.46 | 1 |
| CA | $113.08–$139.23 | 29 |
| CO | $112.59 | 1 |
| CT | $116.89 | 1 |
| DC | $124.06 | 1 |
| DE | $108.21 | 1 |
| FL | $110.36–$123.49 | 3 |
| GA | $103.86–$112.19 | 2 |
| GU | $115.48 | 1 |
| HI | $115.48 | 1 |
| IA | $99.53 | 1 |
| ID | $100.42 | 1 |
| IL | $107.97–$119.65 | 4 |
| IN | $100.97 | 1 |
| KS | $99.59 | 1 |
| KY | $101.63 | 1 |
| LA | $101.68–$106.67 | 2 |
| MA | $112.13–$123.00 | 2 |
| MD | $110.11–$124.06 | 3 |
| ME | $101.51–$106.25 | 2 |
| MI | $104.78–$112.29 | 2 |
| MN | $106.29 | 1 |
| MO | $100.28–$106.41 | 3 |
| MS | $98.49 | 1 |
| MT | $109.54 | 1 |
| NC | $102.49 | 1 |
| ND | $105.19 | 1 |
| NE | $99.92 | 1 |
| NH | $111.33 | 1 |
| NJ | $117.78–$122.88 | 2 |
| NM | $105.57 | 1 |
| NV | $108.39 | 1 |
| NY | $104.08–$130.62 | 5 |
| OH | $103.89 | 1 |
| OK | $100.88 | 1 |
| OR | $107.11–$115.56 | 2 |
| PA | $103.76–$114.33 | 2 |
| PR | $110.17 | 1 |
| RI | $111.62 | 1 |
| SC | $103.45 | 1 |
| SD | $104.68 | 1 |
| TN | $100.16 | 1 |
| TX | $103.11–$112.61 | 8 |
| UT | $104.86 | 1 |
| VA | $106.28–$124.06 | 2 |
| VI | $110.17 | 1 |
| VT | $105.27 | 1 |
| WA | $111.76–$124.97 | 2 |
| WI | $101.71 | 1 |
| WV | $104.10 | 1 |
| WY | $107.64 | 1 |
How the 29740 rate is calculated
Each of 29740’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 · 29740
RVUs × geographic indexes × conversion factor
Work1.09
1.09 RVUs× 1.000 GPCI
Practice expense1.97
1.97 RVUs× 1.000 GPCI
Malpractice0.22
0.22 RVUs× 1.000 GPCI
Adjusted RVUs
3.2800
Conversion factor
$33.4009
Medicare rate
$109.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29740
The CMS indicators that decide how 29740 is paid alongside other services.
CMS payment indicators · 29740
Cast wedging, alignment adjustment
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 51 · payment effect
With and without the modifier
29740 without 51 · national office
$109.55
Cast wedging, alignment adjustment
29740-51 · Second procedure: 50%
$54.78
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
29740 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 29750Cast wedgingClubfoot cast
- 29750 is specific to wedging a clubfoot cast. Use 29740 for other cast-wedging situations.
- 29730Cast adjustmentAccess opening
- 29730 describes making a window in a cast for access to an underlying site; 29740 changes cast alignment.
- 29720Cast repairBody spica or jacket
- 29720 is for repairing a spica body cast or jacket. It does not describe wedging a cast to adjust alignment.
29740 billing questions
How is 29740 different from 29750?
29740 is for wedging a cast to adjust alignment generally. Use 29750 for wedging a clubfoot cast.
Can cast wedging be reported with fracture care?
The code describes the cast adjustment itself. Document the alignment issue and the work performed; same-session procedures are subject to the CMS multiple procedure reduction.
Is cast wedging subject to a postoperative global period?
CMS assigns 29740 a 0-day global period. Same-day preoperative and postoperative care is included.
Should modifier 50 be appended for wedging both sides?
No. The descriptor or anatomy makes modifier 50 inappropriate for 29740.
Can an assistant or co-surgeon be paid for this service?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for 29740.
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
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