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    v1.0.31
    OpenPayerBilling CodesLower Extremity Application of CastsCPT cpt-29355-long-leg-ambulatory-cast-application
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    CPT 29355: Long Leg Ambulatory Cast Application

    Medicare pays $159 and commercial payers pay $327 on average nationally for this procedure.

    CPT code 29355 describes the application of a long leg ambulatory cast that immobilizes the leg and knee, extending from the thigh over the foot with toes left free and a shaped sole for a cast shoe or an applied footplate and rubber heel; service type: cast application/immobilization; typical site of service: outpatient orthopedic or emergency department setting where ambulatory immobilization for fractures or deformities is performed.

    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

    Nationally, Medicare’s mean rate of $159.3 sits noticeably below BUCA’s commercial average of $327.2, indicating that BUCA-level reimbursements are roughly double Medicare on average. Median and percentile comparisons reinforce that BUCA’s central tendency and upper quartile are materially higher than Medicare’s p75 of $166 and median of $159, reflecting stronger commercial pricing around this code versus the federal program.

    Dispersion varies by payer: Blue Cross Blue Shield has the widest interquartile spread (P75–P25 = $159.4), followed by UnitedHealth Group (P75–P25 = $138.9) and BUCA (P75–P25 = $153.1). Aetna and Cigna show tighter IQRs of $99.0 and $113.4 respectively, indicating more concentrated commercial pricing ranges. Medicare’s IQR is narrow at $17.0, reflecting the most compressed distribution among the payers listed.

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old patient presents to the orthopedic clinic after sustaining a closed tibial fracture during a fall. The provider evaluates the patient with history, physical exam, and radiographs confirming an acute closed fracture of the tibia. The patient is counseled that nonoperative immobilization is appropriate; the provider applies a long leg ambulatory cast (CPT 29355) that extends from the thigh to the foot with toes left free. The cast is molded to immobilize the knee and leg, and the cast bottom is formed to accept a cast shoe or a footplate with a rubber heel to permit protected ambulation when weight bearing is allowed. Typical workflow includes informed consent, pre-procedure neurovascular check, selection and application of stockinette and padding, placement of casting material with appropriate molding, post-application neurovascular check, patient education on cast care and weight-bearing status, and scheduling follow-up for cast checks and radiographic monitoring.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29345Application of short leg castAlternative immobilization for distal tibia or ankle fractures when knee immobilization is not required; may be chosen instead of 29355 depending on fracture location.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    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…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but 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…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207XX0004X
    207XS0117X
    133VN1006X
    202C00000X
    2471M1202X
    320900000X
    207QS1201X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    G82.20Paraplegia, unspecified
    M16.11Unilateral primary osteoarthritis, right hip
    M16.12Unilateral primary osteoarthritis, left hip
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M24.661Ankylosis, right knee
    M24.662Ankylosis, left knee
    M84.451APathological fracture, right femur, initial encounter for fracture
    M84.452APathological fracture, left femur, initial encounter for fracture
    M84.459APathological fracture, hip, unspecified, initial encounter for fracture

    Showing 1–10 of 29

    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-29305-HIP-SPICA-BODY-CAST-TRUNK-AND-ONE-LEG

    CPT 29305: Hip Spica Body Cast for Trunk and One Leg

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

    CPT 29325: Hip Spica Cast Application for Hip/Thigh Immobilization

    CPT-29345-LONG-LEG-CAST-APPLICATION-IMMOBILIZATION

    CPT 29345: Long Leg Cast Application, Knee and Leg Immobilization

    CPT-29358-LONG-LEG-BRACE-CAST-FEMUR-FRACTURE-IMMOBILIZATION

    CPT 29358: Long Leg Brace-Type Cast with Knee Motion for Femur Fracture

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

    CPT 29365: Thigh-to-Lower-Leg Cylinder Cast Immobilization

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

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

    CPT-29425-LOWER-LEG-CAST-APPLICATION-TIBIA-FIBULA-ANKLE

    CPT 29425: Lower Leg Cast Application with Walking Accommodation

    CPT-29435-WALKING-CAST-LOWER-LEG-TIBIA-FIBULA-FRACTURE

    CPT 29435: Lower Leg Walking Cast for Tibia/Fibula Shaft Fracture

    CPT-29440-REMOVABLE-WALKER-OR-HEEL-PAD-FOR-LEG-CAST

    CPT 29440: Removable Walker or Heel Pad Added to Leg Cast

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

    CPT 29445: Total Contact Cast for Diabetic Foot Ulcer

    Showing 1–10 of 11

    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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    29358Application of long leg brace type castA brace-type long leg immobilization option that may be used when a removable or prefabricated brace is appropriate instead of a traditional cast.