CPT code 29450: Clubfoot cast2026 Medicare rate & RVUs in Texas
Report this service for applying a corrective cast during treatment of clubfoot, commonly as part of serial casting by a pediatric orthopedic provider.
Medicare pays $138.76–$149.07 for 29450 in the office in Texas, from Beaumont to Austin. 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 29450 covers
This service covers applying a cast to treat clubfoot, a congenital foot deformity. It is commonly performed by an orthopedic surgeon or pediatric orthopedist during serial correction, including the Ponseti approach, in which the foot is gently manipulated and recast over successive visits. The cast maintains the correction achieved during that treatment session; it is not simply a routine short-leg cast for an unrelated injury.
Document the clubfoot diagnosis, the treated side, the corrective casting performed, and whether one or both feet were treated. The 0-day global period includes same-day preoperative and postoperative care. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; 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 29450 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$138.76 to $149.07
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $149.07 | $100.66 |
| Beaumont | $138.76 | $97.12 |
| Brazoria | $143.99 | $98.64 |
| Dallas | $144.96 | $99.38 |
| Fort Worth | $144.34 | $99.22 |
| Galveston | $144.47 | $99.03 |
| Houston | $148.31 | $102.87 |
| Rest Of Texas | $141.34 | $97.91 |
How the 29450 rate is calculated
Each of 29450’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 · 29450
RVUs × geographic indexes × conversion factor
Work2.03
2.03 RVUs× 1.000 GPCI
Practice expense2.12
2.12 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
4.3600
Conversion factor
$33.4009
Medicare rate
$145.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29450
The CMS indicators that decide how 29450 is paid alongside other services.
CMS payment indicators · 29450
Clubfoot 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
29450 without 50 · national office
$145.63
Clubfoot cast
29450-50 · Bilateral: 150%
$218.45
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).
29450 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29405Short leg cast
- Choose 29450 for corrective casting of clubfoot; 29405 is for short-leg cast application for other indications.
- 29425Walking cast
- 29425 identifies short-leg walking-cast application. It is not the clubfoot corrective-casting service described by 29450.
- 29440Cast walker
- 29440 is for adding a walker to a cast already applied; it does not describe applying a corrective clubfoot cast.
- 29445Total contact cast
- 29445 describes application of a rigid total-contact leg cast, rather than casting used for clubfoot correction.
29450 billing questions
When should 29450 be chosen instead of 29405?
Use 29450 for corrective casting of clubfoot. Code 29405 describes application of a short-leg cast for other indications, rather than serial clubfoot correction.
How is bilateral clubfoot casting reported?
Report modifier 50 when both feet are treated bilaterally. CMS pays the bilateral procedure at 150%.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Document the corrective casting service and treated side or sides.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 29450. Co-surgeons and team surgery are not permitted.
How does the multiple-procedure reduction affect 29450?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies a 50% reduction to the others.
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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