$80.34
Use 29435 for a below-knee cast designed to transfer weight through the patellar tendon region. Code 29405 describes short-leg cast application without that specific PTB design.
On this page
CMS RVU26D · Effective 2026-10-01
29435 PTB cast Medicare reimbursement rates in Iowa
Report application of a below-knee patellar tendon-bearing cast when its design transfers weight through the patellar tendon, such as in selected tibial fractures. Compare 29435 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 29435 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$126.56
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$73.38
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic casting
About 29435: Patellar tendon-bearing cast application
Report application of a below-knee patellar tendon-bearing cast when its design transfers weight through the patellar tendon, such as in selected tibial fractures.
This service involves applying a below-knee cast shaped to transfer weight-bearing load through the patellar tendon region rather than directly onto the lower leg. An orthopedic clinician may use this design for selected tibial fractures when protected or progressive weight bearing is part of the plan. The cast is distinct from an ordinary short-leg cast and from a walking cast that does not use the patellar tendon-bearing design.
Report the cast application when that service is separately reportable; cast application is included when the reported fracture-treatment service already includes it. Documentation should identify the treated side, the clinical indication, and the PTB cast design. Medicare 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 29435
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.15 · 28%
- Practice expense (office) RVU2.78 · 67%
- Malpractice RVU0.24 · 6%
71
Medicare services in 2024 · #5133 by national volume
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.
29435 compared with similar codes
Office rates for Iowa, from the same CMS release.
$74.62
Code 29425 is for a walking short-leg cast. Choose 29435 when the applied cast has the PTB design, rather than selecting by weight-bearing status alone.
$41.07
Code 29440 describes adding a walker to a previously applied cast. Code 29435 reports application of the PTB cast itself.
$122.50
Code 29445 is for a rigid total-contact leg cast. It is not the PTB application code unless the cast applied is specifically the PTB design.
Compare 29435 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$126.56
Facility
$73.38
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 29435 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,293
- Code
- 29435
- Physician work
- 1.15
- Practice expense
- 2.78
- Malpractice
- 0.24
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.15 | × 1.000 | 1.1500 |
| Practice expense | 2.78 | × 0.915 | 2.5437 |
| Malpractice | 0.24 | × 0.397 | 0.0953 |
| Total RVUs | 3.7890 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$126.56
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.15 | 1 |
| Practice expense | 2.78 | 0.915 |
| Malpractice | 0.24 | 0.397 |
(1.15 × 1 + 2.78 × 0.915 + 0.24 × 0.397) × $33.4009 = $126.56
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.15 | 1 |
| Practice expense | 1.04 | 0.915 |
| Malpractice | 0.24 | 0.397 |
(1.15 × 1 + 1.04 × 0.915 + 0.24 × 0.397) × $33.4009 = $73.38
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
29435 billing questions
How is a PTB cast different from a short-leg cast?
A PTB cast is shaped to transfer load through the patellar tendon region. Use the short-leg cast code when that specific design is not applied.
Is the cast application separately reported with fracture treatment?
Not when the fracture-treatment service reported already includes cast application. Report this application only when it is separately reportable.
What documentation supports this code?
Document the treated side, indication, and application of a below-knee cast designed to bear through the patellar tendon region.
How does Medicare handle bilateral application?
CMS lists this as a bilateral procedure: modifier 50 is paid at 150%.
What happens when this is performed with another procedure?
For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is restricted for this service. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,29029365,,Appl cylinder cast,A,,1.15,2.78,,1.08,,0.23,4.16,2.46,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29129405,,Appl short leg cast,A,,0.78,1.72,,0.76,,0.13,2.63,1.67,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29229425,,Appl short leg cast walking,A,,0.78,1.55,,0.66,,0.09,2.42,1.53,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29329435,,Appl patllr tdn bearing cast,A,,1.15,2.78,,1.04,,0.24,4.17,2.43,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29429440,,Adding walker to prev cast,A,,0.56,0.71,,0.16,,0.05,1.32,0.77,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29529445,,Appl rigid tot cntc leg cast,A,,1.74,2.02,,0.77,,0.20,3.96,2.71,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,29629450,,Application clubfoot cast,A,,2.03,2.12,,0.75,,0.21,4.36,2.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136