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CPT code 29740: Cast wedging, alignment adjustment2026 Medicare rate & RVUs in Puerto Rico

Report cast wedging when a clinician modifies an existing cast to adjust alignment, commonly during fracture care, without replacing the cast.

CMS RVU26DEffective Oct 1, 2026One payment locality14 Medicare services in 2024

In Puerto Rico, Medicare pays $110.17 for 29740 in the office and $60.53 when it’s performed in a hospital or facility.

$110.17Office (non-facility)
$60.53Hospital or facility
+0.6%vs the national office rate ($109.55)

Check a contract rate as a % of Medicare · 29740 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 29740 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 29740 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 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.

How Puerto Rico compares for 29740

Across 109 of 109 payment localities, the office rate for 29740 runs from $96.71 in Arkansas to $139.23 in San Benito County, CA. Puerto Rico pays $110.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

29740 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$110.17
  2. Los Angeles, CA · California$120.62+$10.45
  3. Washington, DC area · District of Columbia$124.06+$13.89
  4. Miami, FL · Florida$123.49+$13.32
  5. Chicago, IL · Illinois$119.65+$9.48
  6. Manhattan, NY · New York$126.85+$16.68
  7. Alaska · Alaska$128.74+$18.57

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

Every other payment area

29740 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$98.14$55.18
ArkansasArkansas$96.71$54.54
ArizonaArizona$106.46$58.88
Bakersfield, CACalifornia$113.69$59.88
Chico, CACalifornia$113.08$59.27
El Centro, CACalifornia$113.12$59.30
Fresno, CACalifornia$113.08$59.27
Hanford, CACalifornia$113.08$59.27

29740 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.

$96.71

$128.74

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

View every state and territory as a table
29740 office rate range by state
State / territoryOffice rate rangeLocalities
AK$128.741
AL$98.141
AR$96.711
AZ$106.461
CA$113.08–$139.2329
CO$112.591
CT$116.891
DC$124.061
DE$108.211
FL$110.36–$123.493
GA$103.86–$112.192
GU$115.481
HI$115.481
IA$99.531
ID$100.421
IL$107.97–$119.654
IN$100.971
KS$99.591
KY$101.631
LA$101.68–$106.672
MA$112.13–$123.002
MD$110.11–$124.063
ME$101.51–$106.252
MI$104.78–$112.292
MN$106.291
MO$100.28–$106.413
MS$98.491
MT$109.541
NC$102.491
ND$105.191
NE$99.921
NH$111.331
NJ$117.78–$122.882
NM$105.571
NV$108.391
NY$104.08–$130.625
OH$103.891
OK$100.881
OR$107.11–$115.562
PA$103.76–$114.332
PR$110.171
RI$111.621
SC$103.451
SD$104.681
TN$100.161
TX$103.11–$112.618
UT$104.861
VA$106.28–$124.062
VI$110.171
VT$105.271
WA$111.76–$124.972
WI$101.711
WV$104.101
WY$107.641

See 29740 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,311

Code
29740
Physician work
1.09
Practice expense
1.97
Malpractice
0.22

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 29740 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.09× 1.0001.0900
Practice expense1.97× 1.0111.9917
Malpractice0.22× 0.9850.2167
Total RVUs3.2984
Conversion factor× 33.4009

Office rate, Puerto Rico$110.17

Office: (1.09 × 1 + 1.97 × 1.011 + 0.22 × 0.985) × $33.4009 = $110.17

Facility: (1.09 × 1 + 0.5 × 1.011 + 0.22 × 0.985) × $33.4009 = $60.53

Open 29740 in the RVU calculator

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

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)0The 150% bilateral adjustment doesn’t apply.
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 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%).

When to use modifier 51

Codes related to 29740

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

Codes related to 29740
CodeHow it relatesOffice range, Puerto Rico
Used instead
29750Cast wedging, clubfoot castUse the clubfoot-specific cast-wedging code when the cast being wedged is for clubfoot.$118.53
29730Cast adjustment, access openingFor creating a cast window to access an underlying site, rather than changing cast alignment.$67.50
29799Unlisted casting, casting or strappingUnlisted casting or strapping code when no specific code describes the service performed.No office rate

How 29740 has changed in Puerto Rico

29740 · Office / nonfacility

$110.17

Effective 2026-10-01

The base rate is $10.93 higher than on 2025-10-01, moving from $99.24 to $110.17 (11.0%).

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

    $99.24changed to$110.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.12 changed to 1.09
    • Practice expense RVU 1.72 changed to 1.97
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $100.78changed to$99.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.67 changed to 1.72
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $99.13changed to$100.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $100.63changed to$99.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.62 changed to 1.67
    • Malpractice RVU 0.22 changed to 0.23
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $100.31changed to$100.63

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $100.68changed to$100.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.55 changed to 1.62
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $100.81changed to$100.68

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.54 changed to 1.55
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $102.10changed to$100.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.47 changed to 1.54
    • Malpractice RVU 0.23 changed to 0.22
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $102.28changed to$102.10

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.48 changed to 1.47
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. July 1, 2019

    RVU19C

    $101.92changed to$102.28

    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU19D.

  11. January 1, 2019

    RVU19A

    $103.26changed to$101.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.51 changed to 1.48
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU19B.

  12. January 1, 2018

    RVU18AR1

    $91.58changed to$103.26

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.50 changed to 1.51
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  13. January 1, 2017

    RVU17A

    $80.38changed to$91.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  14. January 1, 2016

    RVU16A

    $80.77changed to$80.38

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU16B, RVU16C, RVU16D.

  15. July 1, 2015

    RVU15C

    $80.37changed to$80.77

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  16. January 1, 2015

    RVU15A

    $78.71changed to$80.37

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.49 changed to 1.50
    • Malpractice RVU 0.17 changed to 0.24
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  17. January 1, 2014

    RVU14A

    $74.46changed to$78.71

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.51 changed to 1.49
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: $74.46

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$110.17$60.53RVU26D
2026-07-01$110.17$60.53RVU26C
2026-04-01$110.17$60.53RVU26B
2026-01-01$110.17$60.53RVU26A
2025-10-01$99.24$66.99RVU25D
2025-07-01$99.24$66.99RVU25C
2025-04-01$99.24$66.99RVU25B
2025-01-01$99.24$66.99RVU25A
2024-10-01$100.78$68.60RVU24D
2024-07-01$100.78$68.60RVU24C
2024-04-01$100.78$68.60RVU24B
2024-03-09$100.78$68.60RVU24AR
2024-01-01$99.13$67.48RVU24A
2023-10-01$100.63$69.54RVU23D
2023-07-01$100.31$69.47RVU23C
2023-04-01$100.31$69.47RVU23B
2023-01-01$100.31$69.47RVU23A
2022-10-01$100.68$70.68RVU22D
2022-07-01$100.68$70.68RVU22C
2022-04-01$100.68$70.68RVU22B
2022-01-01$100.68$70.68RVU22A
2021-10-01$100.81$70.92RVU21D
2021-07-01$100.81$70.92RVU21C
2021-04-01$100.81$70.92RVU21B
2021-01-01$100.81$70.92RVU21A
2020-10-01$102.10$72.99RVU20D
2020-07-01$102.10$72.99RVU20C
2020-04-01$102.10$72.99RVU20B
2020-01-01$102.10$72.99RVU20A
2019-10-01$102.28$73.25RVU19D
2019-07-01$102.28$73.25RVU19C
2019-04-01$101.92$72.89RVU19B
2019-01-01$101.92$72.89RVU19A
2018-10-01$103.26$73.53RVU18D
2018-07-01$103.26$73.53RVU18C
2018-04-01$103.26$73.53RVU18B
2018-01-01$103.26$73.53RVU18AR1
2017-10-01$91.58$66.38RVU17D
2017-07-01$91.58$66.38RVU17C
2017-04-01$91.58$66.38RVU17B
2017-01-01$91.58$66.38RVU17A
2016-10-01$80.38$59.68RVU16D
2016-07-01$80.38$59.68RVU16C
2016-04-01$80.38$59.68RVU16B
2016-01-01$80.38$59.68RVU16A
2015-10-01$80.77$60.00RVU15D
2015-07-01$80.77$60.00RVU15C
2015-04-01$80.37$59.70RVU15B
2015-01-01$80.37$59.70RVU15A
2014-10-01$78.71$58.63RVU14D
2014-07-01$78.71$58.63RVU14C
2014-04-01$78.71$58.63RVU14B
2014-01-01$78.71$58.63RVU14A
2013-10-01$74.46$54.62RVU13D
2013-07-01$74.46$54.62RVU13C
2013-04-01$74.46$54.62RVU13B
2013-01-01$74.46$54.62RVU13AR

Price 29740 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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
RVUs for 29740PPRRVU2026_Oct_nonQPP.csv, line 3,311 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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