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CPT 29355: Long Leg Ambulatory Cast Application
Headline: CPT code 29355: Long Leg Ambulatory Cast Application for Lower Extremity Immobilization
CPT code 29355 covers the application of a long leg ambulatory cast that immobilizes the leg and knee, used to manage fractures and deformities while permitting ambulation with a cast shoe or footplate. This code captures a common, resource-focused procedural service in orthopedic and trauma care that influences facility and professional billing for outpatient fracture management nationwide. It is relevant to orthopedic surgeons, emergency and ambulatory clinic providers, and revenue cycle teams processing fracture-related encounters.
Major national payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, comparisons to closely related cast application codes, and information on typical billing considerations affecting reimbursement and documentation. The publication outlines expected diagnoses that commonly map to this service and identifies where clinicians will most often perform the procedure. It also summarizes what to review in claims and policy language when coding for long leg ambulatory casts, and highlights areas for attention in claims submission and audit preparedness. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 29355 describes the application of a long leg ambulatory cast that immobilizes the leg and knee. The cast extends from the thigh down over the foot while leaving the toes free. The provider forms the bottom of the cast to accommodate a cast shoe that straps on over the cast and permits ambulation when the patient can bear weight on that leg, or alternatively applies a footplate and rubber heel to the bottom of the cast.
Service type: Cast application – ambulatory long leg cast
Typical site of service: Hospital outpatient department, ambulatory surgery center, or clinic/office setting where cast application and outpatient fracture care are provided.
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.