Billing code 29440: Cast walkerMedicare rate & RVUs in Washington
Report this service when a clinician adds a walking support to a cast that has already been applied, allowing the patient to bear weight on it.
Medicare pays $45.19–$50.10 for 29440 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 29440 covers
This service modifies an existing cast by adding a walking support, such as a walker or walking heel, so the patient can bear weight on the cast. It is typically performed in an orthopedic or podiatry clinic or cast room when a lower-extremity cast is being converted for walking after its initial application.
Report 29440 for the addition to the previously applied cast, not for applying a new walking cast. Documentation should identify the existing cast, the support added, the treated side, and the clinical reason for the modification. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For a bilateral service reported with modifier 50, payment is 150%. 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 29440 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $45.19 | $25.85 |
| Seattle (King Cnty) | $50.10 | $27.56 |
How the 29440 rate is calculated
Each of 29440’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 · 29440
RVUs × geographic indexes × conversion factor
Work0.56
0.56 RVUs× 1.000 GPCI
Practice expense0.71
0.71 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.3200
Conversion factor
$33.4009
Medicare rate
$44.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29440
The CMS indicators that decide how 29440 is paid alongside other services.
CMS payment indicators · 29440
Cast walker
| 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
29440 without 50 · national office
$44.09
Cast walker
29440-50 · Bilateral: 150%
$66.14
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).
29440 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 29405Short leg cast
- Choose 29405 for application of a short leg cast. Choose 29440 when the cast is already applied and the service adds a walking support.
- 29425Walking cast
- 29425 covers application of a short leg walking cast. 29440 covers adding a walker to a previously applied cast.
- 29435PTB cast
- 29435 is for application of a patellar tendon-bearing cast. It is not the code for adding a walking support to an existing cast.
29440 billing questions
How is 29440 different from applying a walking cast?
29440 adds a walking support to a cast that is already in place. Use the applicable cast-application code when the service is applying a new walking cast.
What should the record show?
Document the existing cast, the walking support added, the treated side, and why the cast was modified for weight bearing.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the service.
How is modifier 50 handled for bilateral service?
CMS pays a bilateral service reported with modifier 50 at 150%.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Medicare does not pay an assistant at surgery for 29440, and 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 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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