Summary & Overview

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

CPT code 29440 is a nationally recognized billing code for the application of a rigid leg cast, walking or ambulatory type. This procedure is a cornerstone in orthopedic care, used to immobilize and support the lower leg after fractures or injuries, enabling patients to maintain mobility during recovery. The service is most often performed in an office setting by orthopedic specialists.

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 context, and relevant policy updates for this code. Readers will gain insights into typical use cases, associated diagnoses, and related procedures, as well as current benchmarks and billing considerations. The summary also highlights common modifiers and taxonomies relevant to orthopedic practice, ensuring a clear understanding of how this code fits into broader clinical workflows.

This article is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date information on CPT code 29440. It offers a concise yet thorough review of the code's clinical significance, payer landscape, and its role in orthopedic treatment protocols.

AetnaBlue Cross Blue ShieldCigna HealthMedicareUnitedHealthcareCPT 29440orthopedicsrigid leg castambulatory castoffice proceduresmedical billingfracture careclinical benchmarkspolicy updatesorthopaedic surgery

CPT Code Overview

CPT code 29440 represents the application of a rigid leg cast, specifically a walking or ambulatory type. This procedure is commonly performed in the field of orthopedics to immobilize and support the lower leg following fractures or other injuries. The typical site of service for this procedure is the office setting (Place of Service 11), where orthopedic specialists provide care for patients requiring stabilization of the leg to facilitate healing and mobility.

Clinical & Coding Specifications

Clinical Context

A patient presents to the orthopedic office after sustaining a closed fracture of the lower leg, such as the tibia or fibula. The injury is confirmed through clinical assessment and imaging. The provider determines that immobilization is necessary for proper healing. The clinical workflow involves preparing the leg, applying a rigid walking or ambulatory cast, and instructing the patient on care and weight-bearing as appropriate. The procedure is performed in the office setting, and documentation includes laterality and fracture details.

Coding Specifications

Modifiers:
- LT: Indicates the procedure was performed on the left side.
- RT: Indicates the procedure was performed on the right side.
Provider Taxonomies:

Code Specialty Name
207X00000X Orthopaedic Surgery

Code	Specialty Name
`207X00000X`	Orthopaedic Surgery

National Reimbursement Benchmarks

For CPT code 29440, the national mean rate for Medicare is $45.50, while the average commercial benchmark (BUCA) is higher at $53.76. Among individual commercial payers, UnitedHealth Group has the highest mean rate at $69.35, and Aetna has the lowest at $36.03.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range ($4.00), indicating relatively consistent rates nationally. In contrast, UnitedHealth Group exhibits the widest range ($37.33), reflecting substantial variability in commercial reimbursement. Cigna and Blue Cross Blue Shield also display broad ranges ($33.50 and $22.89, respectively), while Aetna's range is more moderate ($15.79).

The table and chart below present a detailed breakdown of national mean rates and percentile distributions for each payer.

National Mean Rates by Payer for CPT 29440

Related Diagnoses

S82.401A: Unspecified fracture of lower end of right tibia, initial encounter for closed fracture
- Relevant for patients with a closed fracture of the right tibia requiring immobilization with a rigid leg cast.
S82.402A: Unspecified fracture of lower end of left tibia, initial encounter for closed fracture
- Indicates a closed fracture of the left tibia, appropriate for cast application.
S82.891A: Other fracture of right lower leg, initial encounter for closed fracture
- Used for other types of closed fractures in the right lower leg, necessitating a rigid cast.
S82.892A: Other fracture of left lower leg, initial encounter for closed fracture
- Applies to other closed fractures in the left lower leg, suitable for cast immobilization.
M84.461A: Pathological fracture, right tibia, initial encounter for fracture
- Indicates a pathological fracture of the right tibia, which may require cast application for stabilization.

Related CPT Codes

29405: Application of short leg cast (below knee to toes)
- Used for immobilization of lower leg injuries when a short cast is sufficient. May be an alternative to 29440 depending on injury location and severity.
29515: Application of short leg splint (calf to foot)
- Used for temporary immobilization or when a splint is preferred over a cast. Can precede or follow cast application.
29700: Removal or bivalving of cast
- Used when the rigid cast applied with 29440 needs to be removed or split for access or adjustment.
29705: Removal or bivalving of cast, other than described in 29700
- Used for cast removal procedures not covered by 29700. May be used in follow-up care after initial cast application.

These codes are commonly used together in the clinical workflow for fracture management, with cast application, splinting, and subsequent removal as needed.

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Summary & Overview

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

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