Summary & Overview
CPT 29345: Application of Long Leg Cast Including Knee, Leg, and Foot
CPT code 29345 is a nationally recognized billing code for the application of a long leg cast, encompassing the knee, leg, and foot, with or without a walking heel. This orthopedic procedure is essential for immobilizing lower extremity fractures and injuries, facilitating proper healing and recovery. The code is widely used in outpatient settings, including therapy clinics and surgical outpatient facilities, reflecting its importance in both routine and acute orthopedic care.
Major payers covering this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides a comprehensive overview of payer coverage, clinical benchmarks, and policy updates relevant to CPT code 29345. Readers will gain insight into the clinical context of long leg cast application, typical sites of service, and the role of this procedure in orthopedic practice. The summary also highlights related codes for cast removal and supplies, as well as common modifiers used in billing.
This article serves as a resource for understanding the national landscape of CPT code 29345, including payer policies, clinical indications, and coding practices. It is designed for healthcare professionals, administrators, and policy analysts seeking up-to-date information on orthopedic casting procedures.
CPT Code Overview
CPT code 29345 describes the application of a long leg cast, which includes the knee, leg, and foot, with or without a walking heel. This procedure is commonly performed as part of orthopedic care for patients with fractures or injuries requiring immobilization of the lower extremity. The service is typically provided in an outpatient setting, such as therapy clinics or surgical outpatient facilities (POS 11 or 24). The application of a long leg cast is a critical intervention to ensure proper healing and stabilization of the affected limb.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient orthopedic clinic after sustaining a closed fracture of the tibia, such as a fracture of the lower end or shaft of the right or left tibia. The orthopedic provider evaluates the injury and determines that immobilization is required. The provider applies a long leg cast, which covers the knee, leg, and foot, to stabilize the fracture and facilitate healing. The procedure may include the addition of a walking heel, depending on the patient's mobility needs. The service is typically performed in an outpatient setting, such as a therapy or surgical outpatient facility.
Coding Specifications
| Modifier Code | Description | Usage |
|---|---|---|
LT | Left side | Used when the cast is applied to the left leg |
RT | Right side | Used when the cast is applied to the right leg |
Associated Provider Taxonomies:
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207X00000X- Orthopedic Surgery- Represents providers specializing in surgical treatment of musculoskeletal conditions.
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207XX0004X- Orthopaedic Trauma- Represents providers specializing in trauma-related orthopedic injuries.
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207XS0117X- Surgical Sports Medicine- Represents providers specializing in sports-related orthopedic surgery.
Related Diagnoses
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S82.401A- Unspecified fracture of lower end of right tibia, initial encounter for closed fracture- Relevant for patients with a closed fracture at the lower end of the right tibia requiring immobilization with a long leg cast.
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S82.402A- Unspecified fracture of lower end of left tibia, initial encounter for closed fracture- Indicates a closed fracture at the lower end of the left tibia, appropriate for long leg cast application.
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S82.301A- Unspecified fracture of shaft of right tibia, initial encounter for closed fracture- Used when the fracture is located at the shaft of the right tibia and immobilization is needed.
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S82.302A- Unspecified fracture of shaft of left tibia, initial encounter for closed fracture- Applies to closed fractures of the shaft of the left tibia, requiring a long leg cast.
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M84.461A- Pathological fracture, right tibia, initial encounter for fracture- Used for pathological fractures (e.g., due to underlying disease) of the right tibia, where a long leg cast is indicated for stabilization.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
29700-29750 | Cast removal or repair (applicable when cast applied by another physician group) | Used for subsequent cast removal or repair procedures after the initial application of a long leg cast (29345). These codes are commonly used in follow-up visits. |
Q4029 through Q4032 | Splints and cast Q codes supplies applicable for CPT 29345 | These codes represent the supplies used for splints and casts during the application of a long leg cast. They are billed in addition to the procedure code when supply reimbursement is required. |
29700-29750 codes are typically used together with 29345 during the course of treatment, especially when cast removal or repair is performed by a different provider group. Q4029 through Q4032 are used to document and bill for the supplies associated with the cast application.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 29345 under Medicare is $153.61, while the BUCA (Blue Cross Blue Shield, UnitedHealth Group, Cigna, Aetna) average commercial mean rate is $166.27. Commercial payers generally reimburse at higher rates than Medicare, with UnitedHealth Group and Cigna showing the highest mean rates among the major payers.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range at $16.00, indicating relatively consistent reimbursement. In contrast, UnitedHealth Group has the widest range at $127.28, reflecting substantial variability in commercial rates. Cigna and Blue Cross Blue Shield also show broad ranges, while Aetna and BUCA are moderately dispersed.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
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.