Billing code 29055: Cast applicationMedicare rate & RVUs in Washington
Reports application of a shoulder spica cast to immobilize the shoulder and arm when this cast configuration is separately reportable.
Medicare pays $265.94–$301.44 for 29055 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 29055 covers
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.
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 29055 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $265.94 | $132.29 |
| Seattle (King Cnty) | $301.44 | $145.71 |
How the 29055 rate is calculated
Each of 29055’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 · 29055
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.74Practice expense 5.62Malpractice 0.37
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 29055
The CMS indicators that decide how 29055 is paid alongside other services.
CMS payment indicators · 29055
Cast application
| 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
29055 without 51 · national office
$258.19
Cast application
29055-51 · Second procedure: 50%
$129.10
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%).
29055 compared with similar codes
Compare codes
29055 vs 29058 vs 29065 vs 29049: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29058Velpeau cast
- This code identifies a shoulder spica cast. Code 29058 is for a plaster Velpeau cast; choose according to the configuration applied.
- 29065Cast application
- 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.
- 29049Figure-of-eight cast
- Code 29049 is for a figure-of-eight cast, commonly used to immobilize a clavicle injury. It is not a shoulder spica.
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 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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