Application of a body cast extending from the shoulder down to one thigh, covering the trunk and upper leg.

Verified May 8, 2026 · 5 sources ↓

Medicare: $334.01
Total RVUs: 10
Global, days: 0
Region: Multi-region

Drawn from CMSCgsmedicareAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Explicit documentation of cast extent: shoulder to thigh with laterality of the thigh specified
Clinical indication requiring shoulder-to-thigh immobilization (e.g., spinal instability, fracture pattern, post-surgical stabilization)
Operative or procedure note naming the treating provider who applied the cast
Skin and neurovascular status assessment before and after cast application
Patient instructions documented, including weight-bearing status and cast care

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 29044 describes application of a body cast that spans from the shoulder region to one thigh. This is a large-scale immobilization construct typically used following major spinal surgery, unstable thoracolumbar fractures, or conditions requiring rigid trunk and hip immobilization. The cast encompasses the torso and extends down a single lower extremity to the thigh, distinguishing it from shorter body jackets or spica casts with different extremity coverage.

The global period is 000, meaning normal pre- and post-service work is bundled but follow-up visits on subsequent days bill separately. This is not a 10- or 90-day global procedure. If cast removal, bivalving, or revision is performed on a later date, those services bill under their own codes. Documentation must make clear the anatomical extent of the cast — shoulder to thigh on the named side — and the clinical indication driving that specific construct.

Site of service matters for 29044. HOPD and ASC payment rates differ (see the Site of Service comparison table). When this cast is applied in an ambulatory or outpatient hospital setting, verify that the facility fee aligns with the expected payment. Modifier LT or RT is appropriate when laterality of the thigh component is clinically relevant and payer policy requires it.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	2.07
Practice expense RVU	7.5
Malpractice RVU	0.43
Total RVU	10
Medicare national rate	$334.01
Global period	0 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$334.01
HOPD (APC 5101) Hospital outpatient department	$166.02
ASC (PI P2) Ambulatory surgical center (freestanding)	$89.12

Common denial reasons

The recurring reasons claims for CPT 29044 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Insufficient documentation of cast extent — notes that don't specify the anatomical range from shoulder to thigh
Missing clinical indication that justifies a body cast versus a shorter or less extensive construct
Unbundling cast application from a same-day surgical procedure that already includes casting as part of its global package
Laterality ambiguity when payer requires LT or RT on the thigh component and it is absent
Site-of-service mismatch between the place-of-service code on the claim and where the cast was actually applied

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What distinguishes 29044 from other body cast codes like 29040 or 29046?

29040 covers a body jacket (no extremity extension). 29044 adds extension down one thigh. 29046 extends down both thighs. Choose the code that matches the actual distal extent of the cast applied — don't upcode to 29046 if only one leg is incorporated.

02Does the 000 global period mean I can bill separately for all follow-up visits?

Yes. A 000 global means only the day-of-service is bundled. Subsequent visits, cast checks, removals, and modifications on later dates bill under their own codes with no global restriction.

03Should I append LT or RT to 29044?

The cast itself is bilateral in the torso, but the thigh extension is unilateral. Append LT or RT to identify which thigh is incorporated. Some payers require it; others don't — check your MAC and commercial payer policies.

04Can 29044 be billed on the same day as a spinal surgical procedure?

Only if the surgical code's global package does not already include cast application as a bundled service. Check NCCI PTP edits for the specific surgical code paired with 29044 before billing both. If the modifier indicator allows it and the casting represents a separately identifiable service, modifier 59 or XS may apply.

05Is prior authorization typically required for 29044?

Payer requirements vary. Commercial insurers and some Medicaid plans may require authorization for large-construct casting, particularly in elective or post-surgical contexts. Verify with each payer before the service date, especially in outpatient facility settings where both the facility and professional claims must align.

06What if the cast needs to be revised or replaced on a different date?

A replacement or revision of the same cast type on a subsequent date bills with modifier 76 (same physician, repeat procedure) or 77 (different physician). Document the reason for replacement — skin breakdown, loss of reduction, clinical change — to support medical necessity.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the anatomical extent of the cast (shoulder to thigh, named side), the clinical indication driving that construct, skin and neurovascular checks pre- and post-application, and the treating provider's identity. That specificity prevents the most common denial trigger for 29044: a procedure note that says 'body cast applied' without documenting that it ran shoulder-to-thigh rather than a shorter construct.

See how Mira captures CPT 29044 documentation