Summary & Overview
CPT 29058: Application of Plaster Velpeau Cast
CPT code 29058 is designated for the application of a plaster Velpeau cast, a specialized orthopedic procedure used to immobilize the shoulder and upper arm. This code is significant in clinical practice, as it addresses the need for effective stabilization following fractures or surgical interventions. The procedure is most often performed in outpatient settings, aligning with current healthcare delivery trends that emphasize efficient, ambulatory care.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, recognize and reimburse for this service. The publication provides a comprehensive overview of payer coverage, clinical benchmarks, and policy updates relevant to 29058. Readers will gain insight into the clinical indications for the Velpeau cast, typical sites of service, and how this procedure fits within broader orthopedic and trauma care pathways. The summary also highlights related CPT codes for other casting procedures, offering context for coding and billing professionals.
This article is designed to inform healthcare administrators, coding specialists, and clinicians about the national landscape for 29058, including payer policies, clinical context, and recent updates. It serves as a resource for understanding the role of the Velpeau cast in orthopedic practice and its implications for medical billing and reimbursement.
CPT Code Overview
CPT code 29058 represents the application of a plaster Velpeau cast, a procedure commonly performed in orthopedic settings to immobilize the shoulder and upper arm following injury or surgery. This service is classified as an orthopedic casting application and is typically provided in an outpatient setting, such as outpatient surgery centers. The Velpeau cast is used to stabilize fractures or injuries, ensuring proper healing and alignment. This procedure is integral to orthopedic care, supporting recovery and preventing further complications.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient clinic with a closed fracture of the lower end of the radius, such as an injury sustained from a fall. After clinical evaluation and radiographic confirmation, the orthopedic or emergency medicine physician determines that immobilization is required. The provider applies a plaster Velpeau cast to stabilize the fracture and restrict movement, ensuring proper healing. The procedure is performed in an outpatient setting, such as an ambulatory surgery center or hospital outpatient department. Documentation includes the site of injury, laterality, and the application technique.
Coding Specifications
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Modifiers:
Modifier Code Description When to Use LTLeft side When the cast is applied to the left limb RTRight side When the cast is applied to the right limb -
Provider Taxonomies:
Taxonomy Code Specialty Name 207X00000XOrthopaedic Surgery Physician 207XX0004XOrthopaedic Trauma Physician 207P00000XEmergency Medicine Physician -
Specialties Represented:
- Orthopaedic Surgery Physician: Specialists in surgical and non-surgical management of musculoskeletal injuries.
- Orthopaedic Trauma Physician: Focused on acute musculoskeletal trauma and fracture care.
- Emergency Medicine Physician: Provides acute care and initial management of fractures in emergency settings.
Related Diagnoses
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S52.501A- Unspecified fracture of the lower end of right radius, initial encounter for closed fracture- Indicates a closed fracture of the right distal radius, commonly requiring immobilization with a Velpeau cast.
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S52.502A- Unspecified fracture of the lower end of left radius, initial encounter for closed fracture- Represents a closed fracture of the left distal radius, also managed with casting.
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S62.501A- Unspecified fracture of the right hand, initial encounter for closed fracture- Used for closed fractures of the right hand, which may require a Velpeau cast for stabilization.
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S62.502A- Unspecified fracture of the left hand, initial encounter for closed fracture- Applies to closed fractures of the left hand, relevant for cast application.
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M84.431A- Stress fracture, right radius, initial encounter- Indicates a stress fracture of the right radius, where immobilization with a Velpeau cast may be clinically appropriate.
Related CPT Codes
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29055- APPLICATION CAST SHOULDER SPICA- Used for immobilizing the shoulder and upper arm, typically for proximal humerus or shoulder injuries. Alternative to
29058when more proximal immobilization is needed.
- Used for immobilizing the shoulder and upper arm, typically for proximal humerus or shoulder injuries. Alternative to
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29065- APPLICATION CAST SHOULDER TO HAND LONG ARM- Provides immobilization from shoulder to hand, used for extensive upper limb fractures. May be used instead of
29058for more comprehensive immobilization.
- Provides immobilization from shoulder to hand, used for extensive upper limb fractures. May be used instead of
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29075- APPLICATION CAST ELBOW TO FINGER SHORT ARM- Applied for forearm or wrist fractures, immobilizing from elbow to fingers. Can be used in similar clinical scenarios as
29058but for less restrictive immobilization.
- Applied for forearm or wrist fractures, immobilizing from elbow to fingers. Can be used in similar clinical scenarios as
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29085- APPLICATION CAST HAND & LOWER FOREARM GAUNTLET- Used for hand and lower forearm injuries, offering targeted immobilization. May be used together with or as an alternative to
29058depending on fracture location.
- Used for hand and lower forearm injuries, offering targeted immobilization. May be used together with or as an alternative to
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29086- APPLICATION CAST FINGER- Applied for finger fractures, providing localized immobilization. Not commonly used with
29058, but relevant for hand injuries.
- Applied for finger fractures, providing localized immobilization. Not commonly used with
National Reimbursement Benchmarks
For CPT code 29058, national mean rates show that UnitedHealth Group and Cigna have the highest average reimbursement, with UnitedHealth Group at $198.41 and Cigna at $188.26. The average commercial mean rate, represented by BUCA, is $149.73, which is slightly higher than the Medicare mean rate of $142.40. Blue Cross Blue Shield and Medicare are closely aligned in their mean rates, both around $142.
Rate dispersion varies significantly across payers. Medicare has the tightest range between the 25th and 75th percentiles ($15.00), indicating more consistent reimbursement. In contrast, UnitedHealth Group exhibits the widest dispersion ($119.66), followed by Cigna ($105.16), suggesting greater variability in commercial rates. The table and chart below present the full breakdown of national benchmarks for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.