CPT 29345 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 29345: Application of Long Leg Cast Including Knee, Leg, and Foot

CPT code 29345 is a nationally recognized billing code for the application of a long leg cast, encompassing the knee, leg, and foot, with or without a walking heel. This orthopedic procedure is essential for immobilizing lower extremity fractures and injuries, facilitating proper healing and recovery. The code is widely used in outpatient settings, including therapy clinics and surgical outpatient facilities, reflecting its importance in both routine and acute orthopedic care.

Major payers covering this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides a comprehensive overview of payer coverage, clinical benchmarks, and policy updates relevant to CPT code 29345. Readers will gain insight into the clinical context of long leg cast application, typical sites of service, and the role of this procedure in orthopedic practice. The summary also highlights related codes for cast removal and supplies, as well as common modifiers used in billing.

This article serves as a resource for understanding the national landscape of CPT code 29345, including payer policies, clinical indications, and coding practices. It is designed for healthcare professionals, administrators, and policy analysts seeking up-to-date information on orthopedic casting procedures.

AetnaBlue Cross Blue ShieldCigna HealthMedicareUnitedHealthcareCPT 29345orthopedic procedurecastinglong leg castoutpatient servicesclinical benchmarkspolicy updatesmedical billingfracture careorthopedic surgery

CPT Code Overview

CPT code 29345 describes the application of a long leg cast, which includes the knee, leg, and foot, with or without a walking heel. This procedure is commonly performed as part of orthopedic care for patients with fractures or injuries requiring immobilization of the lower extremity. The service is typically provided in an outpatient setting, such as therapy clinics or surgical outpatient facilities (POS 11 or 24). The application of a long leg cast is a critical intervention to ensure proper healing and stabilization of the affected limb.

Clinical & Coding Specifications

Clinical Context

A patient presents to the outpatient orthopedic clinic after sustaining a closed fracture of the tibia, such as a fracture of the lower end or shaft of the right or left tibia. The orthopedic provider evaluates the injury and determines that immobilization is required. The provider applies a long leg cast, which covers the knee, leg, and foot, to stabilize the fracture and facilitate healing. The procedure may include the addition of a walking heel, depending on the patient's mobility needs. The service is typically performed in an outpatient setting, such as a therapy or surgical outpatient facility.

Coding Specifications

Modifier Code	Description	Usage
`LT`	Left side	Used when the cast is applied to the left leg
`RT`	Right side	Used when the cast is applied to the right leg

Associated Provider Taxonomies:

207X00000X - Orthopedic Surgery

National Reimbursement Benchmarks

Nationally, the mean rate for CPT code 29345 under Medicare is $153.61, while the BUCA (Blue Cross Blue Shield, UnitedHealth Group, Cigna, Aetna) average commercial mean rate is $166.27. Commercial payers generally reimburse at higher rates than Medicare, with UnitedHealth Group and Cigna showing the highest mean rates among the major payers.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range at $16.00, indicating relatively consistent reimbursement. In contrast, UnitedHealth Group has the widest range at $127.28, reflecting substantial variability in commercial rates. Cigna and Blue Cross Blue Shield also show broad ranges, while Aetna and BUCA are moderately dispersed.

The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.

National Mean Rates by Payer for CPT Code `29345`

Related Codes

29305-APPLICATION-OF-HIP-SPICA

CPT 29305: Application of Hip Spica Cast

29425-APPLICATION-OF-SHORT-ARM-SPLINT-FOREARM-TO-HAND

CPT 29425: Application of Static Short Arm Splint (Forearm to Hand)

29435-LOWER-EXTREMITY-APPLICATION-OF-CAST-BELOW-KNEE-TO-HIP-LEVEL

CPT 29435: Lower Extremity Cast Application (Below Knee to Hip)

CPT-29445-TOTAL-CONTACT-WALKING-CAST-FOR-DIABETIC-ULCER-OFFLOADING

CPT 29445: Total Contact Walking Cast for Diabetic Foot Ulcer

29450-APPLICATION-OF-LONG-OR-SHORT-LEG-CLUBFOOT

CPT 29450: Application of Long or Short Leg Clubfoot Cast

29355-APPLICATION-OF-LONG-LEG-CAST-THIGH-TO

CPT 29355: Application of Long Leg Cast (Thigh to Toes)

CPT-29365-CYLINDER-CAST-LEG-KNEE-IMMOBILIZATION-FRACTURE

CPT 29365: Cylinder Cast for Leg and Knee Immobilization

CPT-29325-HIP-SPICA-BODY-CAST-APPLICATION

CPT 29325: Hip Spica / Trunk and Leg Body Cast Application

29440-APPLICATION-OF-RIGID-LEG-CAST-WALKING-OR-AMBULATORY

CPT 29440: Application of Rigid Leg Cast, Walking or Ambulatory Type

CPT-29405-SHORT-LEG-CAST-LOWER-LEG-FRACTURE-ANKLE-SPRAIN

CPT 29405: Short Leg Cast for Lower Leg Fracture or Severe Ankle Sprain

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Related CPT Codes

CPT Code	Description	Clinical Relationship
`29700-29750`	Cast removal or repair (applicable when cast applied by another physician group)	Used for subsequent cast removal or repair procedures after the initial application of a long leg cast (`29345`). These codes are commonly used in follow-up visits.
`Q4029` through `Q4032`	Splints and cast Q codes supplies applicable for CPT `29345`	These codes represent the supplies used for splints and casts during the application of a long leg cast. They are billed in addition to the procedure code when supply reimbursement is required.

29700-29750 codes are typically used together with 29345 during the course of treatment, especially when cast removal or repair is performed by a different provider group. Q4029 through Q4032 are used to document and bill for the supplies associated with the cast application.

Summary & Overview

CPT 29345: Application of Long Leg Cast Including Knee, Leg, and Foot

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

Related Codes