Billing code 29305: Hip spica castMedicare rate & RVUs in Illinois
Reports application of a hip spica cast immobilizing the trunk and one leg, commonly for pediatric femur or hip stabilization.
Medicare pays $274.69–$304.23 for 29305 in the office in Illinois, from Rest Of Illinois to Chicago. 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 29305 covers
This service covers applying a hip spica cast that stabilizes the pelvis and trunk along with one lower extremity. Orthopedic clinicians commonly use this immobilization for a child with a femoral shaft fracture or after hip reduction when the treatment plan requires the hip and one leg to remain immobilized. The cast is applied in settings equipped to provide the required positioning and casting care.
Report this code for the one-leg cast configuration, not simply because one leg is injured. The record should support the clinical reason for immobilization and show the cast’s extent; use the applicable sibling code when the cast includes more of the opposite leg. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures occur in the same 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 29305 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$274.69 to $304.23
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $304.23 | $170.63 |
| East St. Louis | $282.45 | $160.15 |
| Rest Of Illinois | $274.69 | $153.32 |
| Suburban Chicago | $301.39 | $164.86 |
How the 29305 rate is calculated
Each of 29305’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 · 29305
RVUs × geographic indexes × conversion factor
Work1.98
1.98 RVUs× 1.000 GPCI
Practice expense6.12
6.12 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
8.5200
Conversion factor
$33.4009
Medicare rate
$284.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29305
The CMS indicators that decide how 29305 is paid alongside other services.
CMS payment indicators · 29305
Hip spica 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
29305 without 51 · national office
$284.58
Hip spica cast
29305-51 · Second procedure: 50%
$142.29
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%).
29305 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 29325Hip spica cast
- Choose 29305 for a hip spica configuration involving one leg; choose 29325 when the cast extends to one and one-half legs.
- 29345Long-leg cast
- 29345 is for a long leg cast, rather than the trunk-and-one-leg immobilization of a hip spica cast.
- 29355Walking cast
- 29355 describes a long leg walking cast. It is not the code for a hip spica cast encompassing the trunk.
29305 billing questions
How is this code distinguished from 29325?
This code describes a hip spica cast involving one leg. Code 29325 is the sibling for a cast involving one and one-half legs; select according to the cast configuration documented.
Can modifier 50 be used when both hips or legs are treated?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy. Report the cast configuration that was actually applied.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. The CMS multiple-procedure reduction may apply when other procedures are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted under the listed CMS rules.
What documentation supports reporting this code?
Document the indication for immobilization, the clinical treatment plan, and that the hip spica cast encompasses the trunk and one leg. The cast extent supports choosing this code rather than its one-and-one-half-leg sibling.
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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