Summary & Overview
CPT 29700: Removal or Bivalving of Cast in Orthopaedic Surgery
CPT code 29700 represents the removal or bivalving of a cast, a routine yet essential procedure in orthopaedic care. This code is widely used across the United States in both facility and office settings, reflecting its importance in the management of fractures and other musculoskeletal injuries. The procedure is typically performed by orthopaedic surgeons and is a critical step in patient recovery, allowing for further evaluation, treatment changes, or improved comfort.
Major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare provide coverage for services billed under CPT code 29700. The publication offers a comprehensive overview of payer policies, clinical benchmarks, and recent updates relevant to this code. Readers will gain insight into the clinical context of cast removal, typical sites of service, and how this procedure fits within broader orthopaedic practice. The summary also highlights associated diagnoses and related CPT codes, providing a clear understanding of where 29700 is applied in patient care.
This article is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date information on CPT code 29700, including payer coverage, clinical indications, and procedural context.
CPT Code Overview
CPT code 29700 is used to report the removal or bivalving of a cast for single or multiple purposes. This procedure is commonly performed within the scope of orthopaedic surgery and the musculoskeletal system. Typical sites of service include facility settings such as hospital outpatient departments or ambulatory surgical centers, as well as office locations (Place of Service 11). The code is relevant for situations where a cast needs to be removed for clinical reasons, such as assessment, treatment modification, or patient comfort.
Clinical & Coding Specifications
Clinical Context
A patient presents to the orthopaedic clinic or hospital outpatient department with a healing fracture, such as a closed fracture of the patella, radius, calcaneus, clavicle, or tibia. The patient has previously received a cast for immobilization. During follow-up, the provider determines that removal or bivalving of the cast is necessary, either for clinical assessment, to relieve pressure, or to transition to another form of immobilization. The procedure is performed by an orthopaedic surgeon or qualified healthcare professional in a facility or office setting. The workflow includes patient evaluation, cast removal or bivalving, and post-procedure care instructions.
Coding Specifications
| Modifier Code | Description | When Used |
|---|---|
| 59 | Distinct Procedural Service | Used when cast removal is performed as a separate and distinct service from other procedures on the same day. |
| 76 | Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional | Used when cast removal is performed more than once by the same provider. |
- Associated Provider Taxonomies:
207X00000X— Orthopaedic Surgery (represents providers specializing in orthopaedic surgical care and musculoskeletal procedures)
Related Diagnoses
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S82.001A— Fracture of unspecified patella, initial encounter for closed fracture- Relevant when cast removal is performed for a healing patella fracture.
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S52.501A— Unspecified fracture of the lower end of right radius, initial encounter for closed fracture- Applies when the cast was placed for a distal radius fracture and is now being removed.
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S92.001A— Fracture of unspecified calcaneus, initial encounter for closed fracture- Used when cast removal is indicated for a calcaneal fracture.
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S42.001A— Fracture of unspecified part of right clavicle, initial encounter for closed fracture- Relevant for cast removal following immobilization of a clavicle fracture.
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S82.101A— Unspecified fracture of upper end of right tibia, initial encounter for closed fracture- Applies when cast removal is performed for a tibial fracture.
Related CPT Codes
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29705— Removal or revision of cast; short arm- Used when the cast being removed is a short arm cast. This code is an alternative to
29700when the anatomical location is specific to the forearm.
- Used when the cast being removed is a short arm cast. This code is an alternative to
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29710— Removal or revision of cast; long arm- Used when the cast being removed is a long arm cast. This code is an alternative to
29700for casts extending above the elbow.
- Used when the cast being removed is a long arm cast. This code is an alternative to
-
These codes (
29705,29710) are related to29700and may be used as alternatives depending on the type and location of the cast. They are not typically billed together for the same cast removal event.
National Reimbursement Benchmarks
Medicare's national mean rate for CPT code 29700 is $71.54, closely aligned with the BUCA (average commercial) mean rate of $70.27. Commercial payers such as UnitedHealth Group and Cigna report higher mean rates, at $93.65 and $90.51 respectively, while Aetna is notably lower at $50.15.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range ($7.00), indicating minimal variation in reimbursement. In contrast, UnitedHealth Group and Cigna show the widest dispersions ($50.67 and $52.17 respectively), reflecting greater variability in commercial rates. Blue Cross Blue Shield and BUCA also display moderate ranges ($27.93 and $35.79).
The table and chart below present a detailed breakdown of national benchmarks for CPT code 29700 across major payers.
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