Billing code 29055: Cast applicationMedicare rate & RVUs

Medicare pays $258.19 for 29055 nationally in the office and $131.27 in a hospital or facility. Local office rates run $225.73–$341.82.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 29055 covers

A shoulder spica cast stabilizes the shoulder and arm by extending around the shoulder and torso. Orthopedic physicians and other qualified clinicians typically use this configuration when an injury or treatment plan calls for more secure shoulder immobilization than a cast limited to the arm. The clinician applies and molds the cast to hold the prescribed position; the code describes the application, not the underlying injury treatment.

Choose this code when the cast applied is specifically a shoulder spica, rather than a Velpeau cast or a long-arm cast. Document the cast type, the body areas immobilized, and the clinical reason for that configuration. When cast application is included in separately reported fracture or dislocation treatment, do not unbundle it. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this cast application. 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 29055 pays more and less

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

109 of 109 payment localities

29055 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 29055 rate is calculated

Each of 29055’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.

Payment rules and modifiers for 29055

The CMS indicators that decide how 29055 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

29055 compared with similar codes

How to choose

29058Velpeau cast

This code identifies a shoulder spica cast. Code 29058 is for a plaster Velpeau cast; choose according to the configuration applied.

29065Cast application

Code 29065 describes a long-arm cast from shoulder to hand. Use 29055 when the cast is a shoulder spica extending around the shoulder and torso.

29049Figure-of-eight cast

Code 29049 is for a figure-of-eight cast, commonly used to immobilize a clavicle injury. It is not a shoulder spica.

Codes related to 29055

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

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

Open CMS sourceHow we calculate rates