Billing code 29425: Walking castMedicare rate & RVUs in Guam
Reports application of a short-leg walking cast that stabilizes the ankle, foot, or distal lower leg while allowing the patient to ambulate.
Medicare pays $86.66 for 29425 in the office in Guam (Hawaii, Guam). 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 29425 covers
A short-leg walking cast extends from below the knee to the foot and includes a walking surface that permits ambulation while immobilizing the ankle, foot, or distal lower leg. Orthopedic clinicians commonly use this cast when a patient needs firm support during treatment of a selected injury or condition. The service may be performed in an office, emergency department, or hospital setting.
Report 29425 for application of the walking-cast configuration, rather than an ordinary short-leg cast without a walking feature or a walker added to a cast already in place. Document the indication, side, cast type, and clinical plan supporting ambulation in the cast. Medicare 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 receive the standard multiple-procedure reduction. For bilateral service, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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.
29425 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $86.66 | $52.86 |
How the 29425 rate is calculated
Each of 29425’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 · 29425
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.78Practice expense 1.55Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 29425
The CMS indicators that decide how 29425 is paid alongside other services.
CMS payment indicators · 29425
Walking 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
29425 without 50 · national office
$80.83
Walking cast
29425-50 · Bilateral: 150%
$121.25
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).
29425 compared with similar codes
Compare codes
29425 vs 29405 vs 29440 vs 29435: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29405Short leg cast
- Choose 29425 when the short-leg cast is configured for walking; choose 29405 for a short-leg cast without that walking-cast feature.
- 29440Cast walker
- 29440 is for adding a walker to a cast already in place. Code 29425 reports application of the short-leg walking cast itself.
- 29435PTB cast
- 29435 describes a patellar tendon-bearing cast design. Use 29425 for a short-leg walking cast when that specialized design is not applied.
29425 billing questions
How does 29425 differ from 29405?
29425 is for a short-leg cast configured for walking. Use 29405 for a short-leg cast that is not reported as a walking cast.
Should 29425 be used when a walker is added to an existing cast?
No. Code 29440 describes adding a walker to a cast that was previously applied; 29425 is for application of the short-leg walking cast.
What documentation supports 29425?
Record the clinical indication, the treated side, the type of cast applied, and the plan supporting ambulation in the cast.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included in the procedure's global period.
How is bilateral application reported?
When the service is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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