Billing code 29049: Figure-of-eight castMedicare rate & RVUs in Florida
Application of a figure-of-eight cast to immobilize the shoulder girdle, commonly for clavicle injuries when this specific cast configuration is used.
Medicare pays $113.64–$126.82 for 29049 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 29049 covers
This service applies a rigid figure-of-eight cast around the shoulder girdle, commonly to immobilize a clavicle injury. The configuration holds the shoulders in position and differs from a shoulder spica or a Velpeau-style cast. An orthopedic physician or other qualified clinician may apply it in an office, emergency department, or other treatment setting when this cast design is selected.
Report the application when the figure-of-eight cast is separately performed, not as part of definitive fracture care that already includes cast application. The record should identify the treated condition, cast configuration, and application. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 29049 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$113.64 to $126.82
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $120.05 | $72.68 |
| Miami | $126.82 | $78.14 |
| Rest Of Florida | $113.64 | $68.93 |
How the 29049 rate is calculated
Each of 29049’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 · 29049
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.87Practice expense 2.35Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 29049
The CMS indicators that decide how 29049 is paid alongside other services.
CMS payment indicators · 29049
Figure-of-eight 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
29049 without 51 · national office
$113.90
Figure-of-eight cast
29049-51 · Second procedure: 50%
$56.95
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%).
29049 compared with similar codes
Compare codes
29049 vs 29200 vs 23500 vs 23505 vs 29058: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29200Chest strapping
- This code describes a cast in a figure-of-eight configuration. Code 29200 describes shoulder strapping, not cast application.
- 23500Clavicle fracture care
- Code 23500 describes closed treatment of a clavicular fracture without manipulation. When cast application is part of definitive fracture treatment, it is included rather than separately reported with this code.
- 23505Clavicle fracture
- Code 23505 describes closed treatment of a clavicular fracture with manipulation. The fracture-treatment service includes its cast application; use this code only for a separately performed figure-of-eight cast application.
- 29058Velpeau cast
- Code 29058 is for a Velpeau-style shoulder cast. Choose between the codes based on the cast configuration actually applied.
29049 billing questions
When should this code be chosen instead of shoulder strapping?
Use this code when the service is application of a figure-of-eight cast. Shoulder strapping is a different service and should not be reported as a cast application.
Can the cast application be reported separately with clavicle fracture care?
Cast application is included when it is part of definitive fracture treatment. Do not separately report this application code for the cast included in that treatment.
Should modifier 50 be appended for a bilateral clavicle injury?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
What documentation supports reporting this code?
Document the condition treated and that a figure-of-eight cast was applied. The record should distinguish this cast configuration from strapping or another shoulder cast.
What is included in the 0-day global period?
Same-day preoperative and postoperative care is included in the procedure.
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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