CPT Code Overview

CPT 29000 describes the application of a body cast (e.g., sheepskin lined rigid vest). This procedure falls under Surgery – Surgical procedures on the musculoskeletal system and involves fabricating and applying a rigid cast that encases the torso to immobilize the chest, shoulder girdle, or upper spine. The service is most commonly performed in an outpatient hospital or physician office setting.

Clinical Context

A 45-year-old patient presents to an outpatient orthopaedic clinic after a ground-level fall with acute right upper extremity pain and deformity. Radiographs in the office confirm an acute closed fracture of the right distal radius and an additional ulnar shaft fracture. The orthopaedic surgeon discusses treatment options and elects nonoperative immobilization. In the same visit, a body cast (sheepskin-lined rigid vest) is applied to stabilize the thorax and proximal upper extremity, accommodating the fracture pattern and pain control. The application is performed in an outpatient hospital or physician office procedural area with appropriate consent, documentation of time and materials, and specification of laterality when applicable.

Coding Specifications

• Modifiers:

• LT: Indicates the procedure was performed on the left side. Use when the body cast application is specific to the left-sided anatomy or documented as left.

• RT: Indicates the procedure was performed on the right side. Use when the body cast application is specific to the right and the medical record documents right-sided application.

• Provider Taxonomies:

• When to use each taxonomy:

• 207X00000X (Orthopaedic Surgery): Applied when the casting is performed by an orthopaedic surgeon providing general orthopaedic care.

• 207XX0004X (Orthopaedic Trauma): Applied when the casting is performed in the context of acute traumatic fractures managed by a trauma-focused orthopaedic specialist.

• 207XS0117X (Surgery of the Hand): Applied when the casting addresses upper extremity injuries managed by a hand surgery specialist.

Related Diagnoses

• S42.301A — Unspecified fracture of shaft of humerus, right arm, initial encounter for closed fracture

Clinical relevance: A humeral shaft fracture of the right arm may necessitate thoracic or shoulder-region immobilization; body cast application can be part of nonoperative stabilization.

• S52.501A — Unspecified fracture of the lower end of right radius, initial encounter for closed fracture

Clinical relevance: Distal radius fractures often require immobilization; a body cast may be selected when additional thoracic or proximal support is required.

• S52.201A — Unspecified fracture of shaft of right ulna, initial encounter for closed fracture

Clinical relevance: Ulnar shaft fractures of the right arm may be managed with immobilization; documentation linking the fracture to body cast application supports medical necessity.

• S42.401A — Unspecified fracture of lower end of right humerus, initial encounter for closed fracture

Clinical relevance: Distal humerus fractures may require stabilization extending into the torso or shoulder girdle; a body cast can be an immobilization option.

• S52.301A — Unspecified fracture of shaft of radius, right arm, initial encounter for closed fracture

Clinical relevance: Radial shaft fractures frequently require immobilization; a body cast may be applied when clinical factors indicate extended support.

Related CPT Codes

• 29010 and 29015: Risser jacket localizer/body applications are alternative techniques for trunk immobilization; may be considered in treatment planning when different immobilization methods are indicated.

• 29035 and 29040: Application of body cast from shoulder to hips are closely related anatomic variations or extents of body casting and may be used instead of 29000 when the cast spans shoulder to hips or when documentation specifies that extent. These codes may be used together in a workflow when different cast types are applied at separate encounters, or as alternatives depending on cast extent and documentation.

Medicare’s national mean allowed rate for 29000 sits slightly below the BUCA (average commercial) mean: Medicare at $480.15 versus BUCA at $358.32, indicating that Medicare is higher than the BUCA average in absolute terms. UnitedHealth Group posts the highest mean among commercial payers at $498.14, while Aetna reports the lowest mean at $221.86.

Rate dispersion (P75 minus P25) varies notably across payers. UnitedHealth Group shows the widest interquartile spread (604.00 - 300.67 = $303.33), followed by Cigna (533.33 - 283.33 = $250.00). The tightest distributions are Medicare (504.00 - 446.00 = $58.00) and Aetna (269.33 - 159.33 = $110.00). The table and chart below present the full percentile and mean breakdown by payer.