CPT 29450: Manipulation and Serial Casting for Clubfoot
Medicare pays $150 and commercial payers pay $225 on average nationally for this procedure.
CPT code 29450 describes gentle manipulation of the foot with application of a temporary molded cast as part of serial casting for clubfoot deformity, a conservative orthopedic procedure used to progressively stretch ligaments and reposition the foot; service type: serial casting/orthopedic casting; typical site of service: outpatient orthopedic clinic or ambulatory surgery center where sequential casts are applied and changed.
For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for New Mexico Only).
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National Reimbursement Benchmarks
National averages place Medicare at a mean of $149.8 while BUCA’s average commercial rate is higher at $224.5, a spread of $74.7 that highlights commercial payers paying substantially above Medicare for CPT 29450. The difference suggests commercial portfolios on average reimburse roughly 50% more than Medicare for this code, with BUCA representing the mid-to-upper commercial band.
Dispersion measured by the interquartile range (P75−P25) varies notably: Blue Cross Blue Shield shows a wide IQR of $127.7, UnitedHealth Group and Cigna also display substantial dispersion at $141.1 and $127.7 respectively, while Aetna is tighter at $93.1. BUCA’s IQR is $117.4 and Medicare’s IQR is $12, indicating Medicare rates are the tightest around their median while several commercial payers exhibit much broader spread.