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CPT 29345: Long Leg Cast Application, Leg and Knee Immobilization
CPT code 29345 denotes application of a long leg cast to immobilize the leg and knee for fractures and deformity correction. This procedure is a fundamental orthopedic immobilization technique used across acute care and outpatient settings to stabilize fractures of the tibia, fibula, ankle, and related structures while protecting the knee joint. Nationally, proper coding and documentation of cast application affect care coordination, post-procedure management, and accurate claim adjudication for both facility and professional services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications tied to common ICD-10 fracture diagnoses, the typical sites of service where 29345 is billed, and related supply and follow-up codes such as cast removal and splint supply Q-codes. The publication outlines common billing considerations, related procedure groupings, and code relationships that influence coverage and claim routing.
This summary provides clinical context for when 29345 is appropriate, identifies linked services and supplies, and highlights information useful for coding accuracy, claims preparation, and administrative workflows. Data not available in the input is explicitly noted where applicable.
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Billing Code Overview
CPT code 29345 describes the application of a long leg cast that immobilizes the leg and knee. The cast extends from the thigh down over the foot while leaving the toes free and is used to treat fractures of the leg bones and to correct deformities of the knee, distal leg, ankle, and foot.
Service Type: Cast application / immobilization (long leg cast)
Typical Site of Service: Hospital inpatient or outpatient orthopedic department, emergency department, ambulatory surgery center, or other settings where orthopedic immobilization is provided.
National Reimbursement Benchmarks
Commercial averages sit above Medicare for CPT 29345, with BUCA’s mean of $322.20 notably higher than Medicare’s mean of $153.60. This highlights a substantial gap between an average commercial benchmark and the federal program, reflecting different negotiated pricing dynamics and payer mix for this code.
Dispersion varies meaningfully across payers when measured as P75 minus P25: Blue Cross Blue Shield has the widest interquartile spread at $189.20 (P75 $532.50 minus P25 $353.30), followed by BUCA at $150.30 (P75 $396.20 minus P25 $245.90). UnitedHealth Group shows a spread of $131.10, Cigna $108.80, and Aetna the tightest spread at $92.80. These ranges indicate where commercial reimbursement is most and least variable.