Summary & Overview
CPT 29086: Application and Fabrication of Finger Cast
CPT code 29086 is a nationally recognized billing code for the application and fabrication of a finger cast, often used in cases of fractures, contractures, or other musculoskeletal injuries requiring immobilization. This procedure is a routine intervention in orthopaedic and family medicine practices, typically performed in office or outpatient settings. The code is relevant for providers who treat finger injuries and need to ensure accurate billing and compliance with payer policies.
Major payers covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of payer coverage, clinical context, and related coding benchmarks. Readers will gain insight into the clinical indications for the procedure, typical sites of service, and how this code fits within broader musculoskeletal care. The summary also highlights associated diagnoses and related codes for comparative context, supporting informed decision-making for billing and policy teams.
Key updates include payer coverage details, clinical benchmarks, and policy considerations for CPT code 29086. The article is designed for healthcare administrators, billing professionals, and clinical leaders seeking clarity on coding, reimbursement, and regulatory trends for finger cast application procedures.
CPT Code Overview
CPT code 29086 describes the application of a cast to a finger, such as for a contracture, and includes the fabrication of the cast. This procedure is categorized under Surgical Procedures on the Musculoskeletal System – Body and Upper Extremity Application of Casts. It is commonly performed in an office or outpatient setting, such as Office – POS 11. The service is typically provided to stabilize finger injuries or conditions requiring immobilization, ensuring proper healing and function.
Clinical & Coding Specifications
Clinical Context
A patient presents to the office or outpatient clinic with a finger injury, such as a fracture or contracture. After clinical evaluation and imaging, the provider determines that immobilization is necessary. The provider fabricates and applies a finger cast to stabilize the affected area, ensuring proper alignment and healing. The procedure is typically performed by an orthopaedic surgeon, orthopaedic trauma specialist, or family medicine physician. The cast application is documented and coded as 29086.
Coding Specifications
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Modifiers:
Modifier Code Description When Used LTLeft side When the cast is applied to the left finger RTRight side When the cast is applied to the right finger -
Provider Taxonomies:
Taxonomy Code Specialty Name 207X00000XOrthopaedic Surgery 207XX0004XOrthopaedic Trauma 207N00000XFamily Medicine
Related Diagnoses
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S52.501A– Unspecified fracture of the lower end of right radius, initial encounter for closed fracture- Relevant when a finger cast is applied to stabilize a fracture near the wrist or hand.
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S52.502A– Unspecified fracture of the lower end of left radius, initial encounter for closed fracture- Indicates a left-sided injury requiring immobilization, possibly with a finger cast.
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S62.501A– Unspecified fracture of the right wrist and hand, initial encounter for closed fracture- Used when the finger cast is applied for a right wrist or hand fracture.
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S62.502A– Unspecified fracture of the left wrist and hand, initial encounter for closed fracture- Indicates a left wrist or hand fracture managed with a finger cast.
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M84.431A– Stress fracture, right radius, initial encounter- Applied when a stress fracture of the right radius necessitates finger immobilization.
Related CPT Codes
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29075– Application, cast; forearm to palm including thumb (gauntlet cast)- Used for immobilization of the forearm and thumb, typically for more extensive injuries than a finger cast. May be considered when the injury involves the forearm or thumb.
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29131– Application of finger splint; dynamic- Used for dynamic splinting of the finger, often as an alternative to casting. May be selected when less rigid immobilization is appropriate or for specific rehabilitation protocols.
Both codes are related to 29086 in the context of upper extremity immobilization. 29075 is used for broader immobilization, while 29131 is an alternative for finger injuries. These codes are not typically used together but may be considered as alternatives depending on injury severity and treatment plan.
National Reimbursement Benchmarks
Medicare's national mean rate for CPT code 29086 is $85.73, which is lower than the BUCA (average commercial) mean rate of $91.46. Commercial payers such as UnitedHealth Group and Cigna report higher mean rates, at $120.53 and $113.88 respectively, compared to both BUCA and Medicare.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range ($10.00), indicating less variability in reimbursement. In contrast, UnitedHealth Group and Cigna show the widest ranges ($70.33 and $67.25 respectively), reflecting greater variability in commercial rates. Aetna and Blue Cross Blue Shield have moderate dispersion, with ranges of $23.48 and $37.55.
The table and chart below present a detailed breakdown of national benchmarks for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.