Billing code 29046: Body castMedicare rate & RVUs
Report this service when a body cast extends over the head and torso and incorporates both thighs for the prescribed immobilization.
Medicare pays $364.07 for 29046 nationally in the office and $178.69 in a hospital or facility. Local office rates run $318.29–$484.40.
Medicare rate · 29046
Body cast
Swap in your local Medicare rate.
- Work RVUs
- 2.35
- Total RVUs
- 10.90
- Global days
- 000
National rate · 2026
$364.07
Office setting, before claim adjustments.
See every locality for 29046 → · 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.
On this page 10 sections
What 29046 covers
This service covers applying a body cast that extends from the shoulders toward the hips, includes the head, and incorporates both thighs. An orthopedic surgeon or other qualified clinician applies the cast when the treatment plan requires this specific extent of immobilization. The defining feature is the combination of head and bilateral thigh extensions, not simply a torso cast or a cast that includes one thigh.
Select the code from the cast’s documented extent. Record that the head and both thighs are included; a cast without the head extension or with only one thigh belongs to a different code in the family. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one 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 requires documented medical necessity; 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 29046 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
$318.29 to $484.40
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $323.42 | $161.22 |
| Alaska* | $413.64 | $216.21 |
| Arizona | $353.41 | $173.78 |
| Arkansas | $318.29 | $159.05 |
| Atlanta | $371.84 | $183.50 |
| Austin | $378.03 | $181.91 |
| Bakersfield | $385.17 | $182.00 |
| Baltimore/Surr. Cntys | $388.80 | $189.89 |
| Beaumont | $338.67 | $169.98 |
| Brazoria | $358.74 | $175.04 |
| Chicago | $386.73 | $200.43 |
| Chico | $383.84 | $180.67 |
| Colorado | $378.75 | $181.51 |
| Connecticut | $389.76 | $190.11 |
| Dallas | $361.42 | $176.79 |
| Dc + Md/Va Suburbs | $418.10 | $199.73 |
| Delaware | $359.61 | $176.46 |
| Detroit | $365.63 | $186.75 |
| East St. Louis | $358.76 | $188.22 |
| El Centro | $383.92 | $180.75 |
| Fort Lauderdale | $380.53 | $192.74 |
| Fort Worth | $358.93 | $176.15 |
| Fresno | $383.84 | $180.67 |
| Galveston | $360.05 | $175.98 |
| Hanford-Corcoran | $383.84 | $180.67 |
| Hawaii, Guam | $394.25 | $183.48 |
| Houston | $368.84 | $184.76 |
| Idaho | $334.06 | $163.51 |
| Indiana | $336.15 | $164.31 |
| Iowa | $331.49 | $161.87 |
| Kansas | $330.24 | $162.66 |
| Kentucky | $332.79 | $167.99 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $411.23 | $191.93 |
| Madera | $383.84 | $180.67 |
| Manhattan | $422.15 | $206.75 |
| Merced | $383.84 | $180.67 |
| Metropolitan Boston | $417.82 | $196.48 |
| Metropolitan Kansas City | $347.26 | $173.19 |
| Metropolitan Philadelphia | $379.63 | $186.65 |
| Metropolitan St. Louis | $351.16 | $174.69 |
| Miami | $399.63 | $206.66 |
| Minnesota | $360.60 | $169.85 |
| Mississippi | $322.42 | $162.81 |
| Modesto | $383.84 | $180.67 |
| Montana** | $364.04 | $178.66 |
| Napa | $446.84 | $202.52 |
| Nebraska | $333.34 | $162.24 |
| Nevada** | $361.66 | $176.10 |
| New Hampshire | $373.12 | $180.14 |
| New Mexico | $344.92 | $174.93 |
| New Orleans | $350.35 | $175.91 |
| North Carolina | $340.22 | $167.27 |
| North Dakota** | $354.55 | $169.17 |
| Northern Nj | $413.23 | $198.20 |
| Nyc Suburbs/Long Island | $433.78 | $213.37 |
| Ohio | $340.75 | $171.50 |
| Oklahoma | $331.65 | $166.11 |
| Oxnard-Thousand Oaks-Ventura | $409.28 | $190.17 |
| Portland | $391.14 | $185.19 |
| Poughkpsie/N Nyc Suburbs | $396.58 | $193.59 |
| Puerto Rico | $366.79 | $179.38 |
| Queens | $425.24 | $206.12 |
| Redding | $383.84 | $180.67 |
| Rest Of California | $383.84 | $180.67 |
| Rest Of Florida | $360.27 | $183.06 |
| Rest Of Georgia | $338.04 | $172.68 |
| Rest Of Illinois | $349.65 | $180.40 |
| Rest Of Louisiana | $332.40 | $168.34 |
| Rest Of Maine | $336.45 | $165.90 |
| Rest Of Maryland | $366.77 | $179.18 |
| Rest Of Massachusetts | $376.36 | $181.16 |
| Rest Of Michigan | $342.69 | $173.44 |
| Rest Of Missouri | $326.46 | $166.66 |
| Rest Of New Jersey | $393.56 | $191.13 |
| Rest Of New York | $345.83 | $169.72 |
| Rest Of Oregon | $358.23 | $173.60 |
| Rest Of Pennsylvania | $341.09 | $170.91 |
| Rest Of Texas | $348.77 | $172.85 |
| Rest Of Washington | $375.54 | $180.34 |
| Rhode Island | $372.72 | $181.23 |
| Riverside-San Bernardino-Ontario | $389.00 | $185.83 |
| Sacramento-Roseville-Folsom | $403.39 | $187.80 |
| Salinas | $401.92 | $187.07 |
| San Diego-Chula Vista-Carlsbad | $411.91 | $190.20 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $473.37 | $211.99 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $472.82 | $211.44 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $484.40 | $217.09 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $482.18 | $214.86 |
| San Luis Obispo-Paso Robles | $395.43 | $184.29 |
| Santa Cruz-Watsonville | $416.23 | $191.00 |
| Santa Maria-Santa Barbara | $403.57 | $187.43 |
| Santa Rosa-Petaluma | $420.44 | $192.80 |
| Seattle (King Cnty) | $426.25 | $198.79 |
| South Carolina | $341.18 | $169.89 |
| South Dakota** | $353.42 | $168.05 |
| Southern Maine | $355.73 | $172.02 |
| Stockton | $383.84 | $180.67 |
| Suburban Chicago | $384.27 | $193.89 |
| Tennessee | $332.12 | $163.61 |
| Utah | $346.26 | $172.01 |
| Vallejo | $446.06 | $201.73 |
| Vermont | $353.45 | $169.93 |
| Virgin Islands | $366.79 | $179.38 |
| Virginia | $354.77 | $172.55 |
| Visalia | $383.84 | $180.67 |
| West Virginia | $335.67 | $174.58 |
| Wisconsin | $341.65 | $164.07 |
| Wyoming** | $359.90 | $174.53 |
| Yuba City | $383.84 | $180.67 |
29046 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.
$318.29
$434.12
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 | $413.64 | 1 |
| AL | $323.42 | 1 |
| AR | $318.29 | 1 |
| AZ | $353.41 | 1 |
| CA | $383.84–$484.40 | 29 |
| CO | $378.75 | 1 |
| CT | $389.76 | 1 |
| DC | $418.10 | 1 |
| DE | $359.61 | 1 |
| FL | $360.27–$399.63 | 3 |
| GA | $338.04–$371.84 | 2 |
| GU | $394.25 | 1 |
| HI | $394.25 | 1 |
| IA | $331.49 | 1 |
| ID | $334.06 | 1 |
| IL | $349.65–$386.73 | 4 |
| IN | $336.15 | 1 |
| KS | $330.24 | 1 |
| KY | $332.79 | 1 |
| LA | $332.40–$350.35 | 2 |
| MA | $376.36–$417.82 | 2 |
| MD | $366.77–$418.10 | 3 |
| ME | $336.45–$355.73 | 2 |
| MI | $342.69–$365.63 | 2 |
| MN | $360.60 | 1 |
| MO | $326.46–$351.16 | 3 |
| MS | $322.42 | 1 |
| MT | $364.04 | 1 |
| NC | $340.22 | 1 |
| ND | $354.55 | 1 |
| NE | $333.34 | 1 |
| NH | $373.12 | 1 |
| NJ | $393.56–$413.23 | 2 |
| NM | $344.92 | 1 |
| NV | $361.66 | 1 |
| NY | $345.83–$433.78 | 5 |
| OH | $340.75 | 1 |
| OK | $331.65 | 1 |
| OR | $358.23–$391.14 | 2 |
| PA | $341.09–$379.63 | 2 |
| PR | $366.79 | 1 |
| RI | $372.72 | 1 |
| SC | $341.18 | 1 |
| SD | $353.42 | 1 |
| TN | $332.12 | 1 |
| TX | $338.67–$378.03 | 8 |
| UT | $346.26 | 1 |
| VA | $354.77–$418.10 | 2 |
| VI | $366.79 | 1 |
| VT | $353.45 | 1 |
| WA | $375.54–$426.25 | 2 |
| WI | $341.65 | 1 |
| WV | $335.67 | 1 |
| WY | $359.90 | 1 |
How the 29046 rate is calculated
Each of 29046’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 · 29046
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.35Practice expense 8.07Malpractice 0.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 29046
The CMS indicators that decide how 29046 is paid alongside other services.
CMS payment indicators · 29046
Body cast
| 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) | 0 | Not paid without supporting documentation. |
| 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
29046 without 51 · national office
$364.07
Body cast
29046-51 · Second procedure: 50%
$182.04
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%).
29046 compared with similar codes
Compare codes
29046 vs 29035 vs 29040 vs 29044: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29035Body cast
- Choose 29035 for a body cast incorporating both thighs without the head extension. This code includes the head as well as both thighs.
- 29040Body cast
- Choose 29040 when the body cast includes the head but not the thigh extensions. This code also incorporates both thighs.
- 29044Body cast
- Choose 29044 when the head and one thigh are included. This code describes the head and both thighs.
29046 billing questions
How does this code differ from a body cast that includes one thigh?
This code is for a cast that includes the head and both thighs. A head-and-one-thigh cast is described by 29044.
Should modifier 50 be appended because both thighs are included?
No. CMS identifies bilateral adjustment as inappropriate for this code; the bilateral cast extent is represented by the code itself.
What documentation supports selecting this code?
Document the cast’s extent, including the head and both thighs. That distinguishes it from head-only or one-thigh variants.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. The code has a 0-day global period.
What happens when this cast application is performed with another procedure?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
Can an assistant or another surgeon be reported for this service?
Assistant-at-surgery payment requires documentation of medical necessity. 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
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