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    v1.0.31
    OpenPayerBilling CodesBody and Upper Extremity Application of CastsCPT cpt-29049-figure-of-eight-cast-application-upper-extremity
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    CPT 29049: Figure-of-Eight Cast Application for Arm Immobilization

    Medicare pays $118 and commercial payers pay $173 on average nationally for this procedure.

    CPT code 29049 describes the application of a figure-of-eight cast used to immobilize an upper extremity structure (typically the arm) after a surgical procedure; the service is a cast application usually performed in an operating room or procedure suite or other post-operative clinical setting where immobilization is applied following fracture repair or surgical stabilization.

    For related coverage guidance, see recent payer policy updates: Medical Necessity Guidelines Non-Emergency Transportation, Non-Emergent Transportation Medical Policy, Non-Emergency Facility to Facility Transfers.

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    National Reimbursement Benchmarks

    Medicare’s mean rate of $117.6 sits notably below BUCA’s average commercial mean of $173.2, indicating that commercial average reimbursement in this market is roughly $55.6 higher than Medicare for CPT 29049. This gap underscores a common commercial-to-Medicare spread for the procedure: BUCA’s mean aligns with higher commercial positioning while Medicare remains tightly clustered around its midpoint values. Dispersion measured by the interquartile range (P75–P25) varies meaningfully across payers. Blue Cross Blue Shield shows the widest IQR at $94.0 (P75 $262.0 minus P25 $168.3), followed by UnitedHealth Group at $94.9 (P75 $188.4 minus P25 $93.5) and Cigna at $91.9. Aetna is much tighter with an IQR of $57.5, and BUCA’s IQR is $86.0. Medicare’s IQR is smallest at $13.0, indicating the most concentrated rates among the listed payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old patient presents to the orthopedic clinic after closed reduction of an acute distal radius fracture of the right wrist sustained in a fall. Under regional anesthesia in a procedure room, the surgeon completes fracture reduction and applies a figure-of-eight plaster cast to immobilize the forearm and distal humerus segments for optimal alignment and to protect the reduction. The typical workflow includes: pre-procedure consent and history, closed reduction under local/regional or monitored anesthesia care, confirmation radiographs, application of the 29049 figure-of-eight cast by the provider or casting technician under direct supervision, patient instruction on cast care and activity restrictions, and scheduling follow-up visit with repeat radiographs within 7–14 days.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29055Application, cast, shoulder spicaAlternative immobilization when shoulder and proximal humerus stabilization is required instead of a figure-of-eight cast.
    29058Application, cast, plaster Velpeau

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207XX0004X
    207XS0117X
    2080P0006X
    152WC0802X
    246ZB0500X
    133N00000X
    1223X0400X

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    10 rows

    PolicyPayerEffective Date
    Medical Necessity Guidelines Non-Emergency TransportationMass General Brigham Health Plan2026-11-01
    Non-Emergent Transportation Medical PolicyHealth-New-England2026-11-01
    Non-Emergency Facility to Facility Transfershap_caresource_mi_coordinated_health2026-11-01
    Ambulance and Medical Transport Services (Ground, Air and Water) Corporate Medical Policybcbsvermont2026-10-01
    Emergency Air/Water Ambulance Services Medical GuidelineWPS Health Insurance2026-10-01
    Non-Emergent Ambulance ServicesConnectiCare2026-09-11
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01

    Related Codes

    CPT-29000-HALO-BODY-CAST-APPLICATION-CERVICAL-IMMOBILIZATION

    CPT 29000: Halo-Type Body Cast Application

    CPT-29010-RISSER-JACKET-PREOPERATIVE-SCOLIOSIS-LOCALIZER

    CPT 29010: Risser Jacket (Risser Localizer Cast) Application

    CPT-29015-RISSER-JACKET-PREOPERATIVE-SCOLIOSIS-CAST

    CPT 29015: Risser Localizer Jacket Application for Scoliosis

    CPT-29035-BODY-CAST-TRUNK-SPINE-IMMOBILIZATION

    CPT 29035: Thoracolumbosacral Body Cast for Postoperative Spinal Immobilization

    CPT-29040-MINERVA-BODY-CAST-CERVICAL-THORACIC-STABILIZATION

    CPT 29040: Minerva-Type Body Cast for Cervical and Trunk Stabilization

    CPT-29044-BODY-CAST-SHOULDERS-TO-HIPS-AND-ONE-THIGH

    CPT 29044: Body Cast, Shoulders to Hips and One Thigh

    CPT-29046-TRUNK-AND-SPINE-BODY-CAST-APPLICATION-SHOULDERS-TO-THIGHS

    CPT 29046: Body Cast, Shoulders to Thighs, Trunk/Spine Immobilization

    CPT-29055-SHOULDER-SPICA-SEMI-FULL-BODY-CAST

    CPT 29055: Shoulder Spica Semi–Full Body Cast

    CPT-29058-PLASTER-VELPEAU-UPPER-FOREARM-SHOULDER-CAST

    CPT 29058: Application of Plaster Velpeau Cast for Upper Forearm and Shoulder

    CPT-29065-LONG-ARM-CAST-APPLICATION-UPPER-LOWER-ARM

    CPT 29065: Application of Long Arm Cast for Upper/Lower Arm

    Showing 1–10 of 13

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    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.

    Alternative for upper arm/shoulder immobilization; used when axillary immobilization is preferred.
    29065Application, cast, shoulder to hand long armUsed when longer immobilization from shoulder to hand is required instead of the more localized figure-of-eight.
    29075Application, cast, elbow to finger short armUsed for forearm and wrist immobilization when a short arm cast is indicated rather than a figure-of-eight.
    29085Application, cast, hand & lower forearm gauntletUsed for hand and distal forearm injuries when a gauntlet cast is more appropriate.
    29086Application, cast, fingerUsed when isolated digit immobilization is required instead of an arm or forearm cast.