Billing code 29405: Short leg castMedicare rate & RVUs
Reports application of a below-knee cast extending to the toes when a nonwalking short leg cast is needed and its application is separately reportable.
Medicare pays $87.84 for 29405 nationally in the office and $55.78 in a hospital or facility. Local office rates run $77.64–$114.09.
Medicare rate · 29405
Short leg cast
- Work RVUs
- 0.78
- Total RVUs
- 2.63
- Global days
- 000
National rate · 2026
$87.84
Office setting, before claim adjustments.
See every locality for 29405 →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 29405 covers
billing code 29405 represents applying a short leg cast that extends from below the knee to the toes and is not designed as a walking cast. Orthopedic clinicians, emergency physicians, and other qualified providers may apply one to immobilize an ankle or foot injury or condition. The code describes the cast application, not the underlying diagnosis or a separate fracture-treatment service.
Choose this code when the applied cast is a nonwalking short leg cast; use the walking-cast code when the cast is designed for ambulation. Document the indication, the cast’s extent and type, and whether it is intended for walking. Cast application may be included in a definitive fracture-treatment service, so report 29405 separately only when the applicable coding instructions support separate reporting. 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 is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 29405 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
$77.64 to $114.09
109 of 109 payment localities
29405 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.
$77.64
$102.94
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 | $102.66 | 1 |
| AL | $78.78 | 1 |
| AR | $77.64 | 1 |
| AZ | $85.44 | 1 |
| CA | $91.79–$114.09 | 29 |
| CO | $90.88 | 1 |
| CT | $93.70 | 1 |
| DC | $99.97 | 1 |
| DE | $86.85 | 1 |
| FL | $87.50–$96.84 | 3 |
| GA | $82.47–$89.71 | 2 |
| GU | $93.89 | 1 |
| HI | $93.89 | 1 |
| IA | $80.34 | 1 |
| ID | $80.96 | 1 |
| IL | $85.29–$93.94 | 4 |
| IN | $81.42 | 1 |
| KS | $80.18 | 1 |
| KY | $81.10 | 1 |
| LA | $81.06–$85.05 | 2 |
| MA | $90.42–$99.58 | 2 |
| MD | $88.44–$99.97 | 3 |
| ME | $81.61–$85.73 | 2 |
| MI | $83.41–$88.81 | 2 |
| MN | $86.45 | 1 |
| MO | $79.80–$85.10 | 3 |
| MS | $78.73 | 1 |
| MT | $87.84 | 1 |
| NC | $82.43 | 1 |
| ND | $85.27 | 1 |
| NE | $80.72 | 1 |
| NH | $89.66 | 1 |
| NJ | $94.59–$98.97 | 2 |
| NM | $83.95 | 1 |
| NV | $87.18 | 1 |
| NY | $83.68–$104.09 | 5 |
| OH | $82.88 | 1 |
| OK | $80.73 | 1 |
| OR | $86.32–$93.53 | 2 |
| PA | $82.89–$91.51 | 2 |
| PR | $88.41 | 1 |
| RI | $89.77 | 1 |
| SC | $82.83 | 1 |
| SD | $84.96 | 1 |
| TN | $80.61 | 1 |
| TX | $82.37–$90.73 | 8 |
| UT | $83.95 | 1 |
| VA | $85.59–$99.97 | 2 |
| VI | $88.41 | 1 |
| VT | $85.12 | 1 |
| WA | $90.19–$101.39 | 2 |
| WI | $82.43 | 1 |
| WV | $82.19 | 1 |
| WY | $86.72 | 1 |
How the 29405 rate is calculated
Each of 29405’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 · 29405
RVUs × geographic indexes × conversion factor
Work0.78
0.78 RVUs× 1.000 GPCI
Practice expense1.72
1.72 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
2.6300
Conversion factor
$33.4009
Medicare rate
$87.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29405
The CMS indicators that decide how 29405 is paid alongside other services.
CMS payment indicators · 29405
Short leg 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
29405 without 50 · national office
$87.84
Short leg cast
29405-50 · Bilateral: 150%
$131.76
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).
29405 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29425Walking cast
- 29405 is for a nonwalking short leg cast; 29425 is for a short leg cast designed for walking.
- 29435PTB cast
- 29435 identifies a patellar tendon-bearing cast, rather than the standard nonwalking short leg cast represented by 29405.
- 29440Cast walker
- 29440 describes adding a walker to a cast already applied. Use 29405 for applying the nonwalking short leg cast itself.
- 29445Total contact cast
- 29445 is for a rigid total-contact leg cast, not the standard short leg cast reported with 29405.
29405 billing questions
How do I distinguish 29405 from 29425?
Use 29405 for a nonwalking short leg cast. Use 29425 when the short leg cast is designed as a walking cast.
Can I report 29405 with fracture treatment?
Cast application may be included in the definitive fracture-treatment service. Report 29405 separately only when the applicable coding instructions support separate reporting.
What documentation supports 29405?
Document the reason for immobilization, the cast’s below-knee-to-toes extent, and that it is nonwalking. The record should distinguish it from a walking or specialized cast.
How does Medicare handle bilateral application?
For bilateral procedures reported with modifier 50, CMS pays 150% under the rule for this code.
Can an assistant surgeon or surgical team be billed?
Assistant-at-surgery payment is subject to a statutory restriction for 29405. Co-surgeons and team surgery are not permitted.
What happens when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid 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
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