$126.07–$134.13
This code identifies a shoulder spica cast. Code 29058 is for a plaster Velpeau cast; choose according to the configuration applied.
On this page
CMS RVU26D · Effective 2026-10-01
29055 Cast application Medicare reimbursement rates in Missouri
Reports application of a shoulder spica cast to immobilize the shoulder and arm when this cast configuration is separately reportable. Compare 29055 office and facility rates across CMS payment localities in Missouri.
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 29055 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$231.96–$249.20
3 of 3 localities have a supported rate.
Facility setting
$122.56–$128.37
3 of 3 localities have a supported rate.
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.
Where 29055 pays more and less in Missouri
3 payment localities
$231.96 to $249.20
Orthopedic casting
About 29055: Shoulder spica cast application
Reports application of a shoulder spica cast to immobilize the shoulder and arm when this cast configuration is separately reportable.
A shoulder spica cast stabilizes the shoulder and arm by extending around the shoulder and torso. Orthopedic physicians and other qualified clinicians typically use this configuration when an injury or treatment plan calls for more secure shoulder immobilization than a cast limited to the arm. The clinician applies and molds the cast to hold the prescribed position; the code describes the application, not the underlying injury treatment.
Choose this code when the cast applied is specifically a shoulder spica, rather than a Velpeau cast or a long-arm cast. Document the cast type, the body areas immobilized, and the clinical reason for that configuration. When cast application is included in separately reported fracture or dislocation treatment, do not unbundle it. CMS 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate for this cast application. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 29055
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.74 · 23%
- Practice expense (office) RVU5.62 · 73%
- Malpractice RVU0.37 · 5%
36
Medicare services in 2024 · #5548 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.
29055 compared with similar codes
Office rates for Missouri, from the same CMS release.
$97.84–$104.67
Code 29065 describes a long-arm cast from shoulder to hand. Use 29055 when the cast is a shoulder spica extending around the shoulder and torso.
$102.90–$110.14
Code 29049 is for a figure-of-eight cast, commonly used to immobilize a clavicle injury. It is not a shoulder spica.
Compare 29055 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$246.45
Facility
$127.27
Metropolitan St. Louis →
Office / nonfacility
$249.20
Facility
$128.37
Rest Of Missouri →
Office / nonfacility
$231.96
Facility
$122.56
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29055 billing questions
How does this differ from a Velpeau cast?
Report 29055 for a shoulder spica configuration. Code 29058 identifies a plaster Velpeau cast; select the code that matches the cast actually applied.
Can I report this with fracture treatment?
Do not separately report the cast application when it is included in the separately reported fracture or dislocation treatment. Report 29055 when the application is separately reportable.
Should modifier 50 be used for both shoulders?
No. CMS identifies modifier 50 as inappropriate for this cast application.
What documentation supports 29055?
Record that a shoulder spica cast was applied, the areas it immobilized, and the clinical reason for that cast configuration.
How is this handled with other procedures in the same session?
CMS pays the highest-valued procedure in full and reduces other procedures in the session under the standard multiple-procedure rule. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
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.
3,26729044,,Appl bdy cst sho to hip 1thi,A,,2.07,7.50,,2.30,,0.43,10.00,4.80,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,26829046,,Appl bdy cst sho to hip b th,A,,2.35,8.07,,2.52,,0.48,10.90,5.35,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,26929049,,Appl cast figure-of-eight,A,,0.87,2.35,,0.95,,0.19,3.41,2.01,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,27029055,,Appl cast shoulder spica,A,,1.74,5.62,,1.82,,0.37,7.73,3.93,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,27129058,,Appl cast plaster velpeau,A,,1.28,2.60,,1.08,,0.26,4.14,2.62,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,27229065,,Appl cst sho to hand lng arm,A,,0.85,2.22,,0.91,,0.17,3.24,1.93,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,27329075,,Appl cst elbw fngr short arm,A,,0.75,2.03,,0.87,,0.14,2.92,1.76,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00