Surgical · Hand

Application of a short arm cast extending from the elbow to the fingers, used to immobilize the forearm, wrist, and hand for fractures or other injuries requiring rigid stabilization.

Verified May 8, 2026 · 6 sources ↓

Medicare: $97.53
Total RVUs: 2.92
Global, days: 0
Region: Hand

Drawn from CMSAshtAAPCMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify anatomic extent: confirm cast runs from elbow to fingers, not just wrist/hand, to distinguish from 29085
Document the clinical indication: fracture site, dislocation, deformity, or therapeutic immobilization need
Record the type of cast material applied and any padding or stockinette layers used
Note laterality (right or left forearm) in the procedure documentation
Document that cast application was the primary service if fracture care codes are not being billed separately
If billed same-day as an E/M, document the separately identifiable evaluation in the note to support modifier 25

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 29075 covers the application of a short arm cast running from the elbow to the fingers. It is used most commonly for distal radius fractures, carpal fractures, and wrist injuries requiring rigid immobilization. The code is distinct from 29085 (wrist/hand cast) and 29065 (long arm cast), so anatomic extent documentation is critical to justify the correct code.

The global period is 000, meaning the procedure carries no pre- or post-operative period. An E/M visit on the same day is separately billable with modifier 25 when a significant, separately identifiable evaluation occurs. Cast supplies (casting materials) are separately reportable using the corresponding HCPCS Level II codes Q4009–Q4012 per the CMS Billing and Coding: Fracture Care article (A53322).

Billing context matters: fracture care codes (e.g., 25600 series) bundle the initial casting. Use 29075 only when the cast application is the primary service — such as when a different provider applies the cast, when casting follows initial treatment by another practitioner, or when the procedure is performed for therapeutic rather than fracture-care purposes. Some payers have restrictive coverage policies for casting codes when billed by non-physician providers; verify coverage before applying.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.75
Practice expense RVU	2.03
Malpractice RVU	0.14
Total RVU	2.92
Medicare national rate	$97.53
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	$97.53
HOPD (APC 5102) Hospital outpatient department	$285.75
ASC (PI P3) Ambulatory surgical center (freestanding)	$68.14

Common denial reasons

The recurring reasons claims for CPT 29075 get rejected.

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

Cast application bundled into fracture care code (e.g., 25600) when billed by the same provider on the same day
Missing or incorrect laterality modifier when payer requires RT or LT on unilateral upper extremity procedures
Wrong cast code selected — 29075 denied because note describes a wrist/hand cast (29085) or long arm cast (29065) rather than elbow-to-finger extent
HCPCS casting supply codes (Q4009–Q4012) not appended or billed incorrectly, causing claim mismatch
Same-day E/M denied without modifier 25 when cast application and evaluation billed together

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can I bill 29075 on the same day I bill a fracture care code like 25600?

No. Fracture care codes include the initial casting as part of their work. Billing 29075 separately on the same date by the same provider for the same injury will result in a bundling denial. Use 29075 as the primary code only when cast application is the standalone service — for example, when a different provider applies the cast after another clinician performed the fracture reduction.

02What HCPCS supply codes pair with 29075?

Per CMS Billing and Coding: Fracture Care (A53322), CPT 29075 pairs with HCPCS Level II codes Q4009 through Q4012 for casting materials. Select the specific Q code based on material type and size. Bill these supply codes on the same claim line to avoid a mismatch denial.

03Is a modifier required to bill an E/M on the same day as 29075?

Yes. Append modifier 25 to the E/M code to indicate a significant, separately identifiable evaluation occurred on the same date as the cast application. Without modifier 25, the E/M will bundle into the procedure and deny.

04How does 29075 differ from 29085?

29085 covers a cast of the wrist and hand only. 29075 extends from the elbow to the fingers — a longer construct that includes forearm immobilization. The operative note must clearly document the proximal extent to the elbow to support 29075 over 29085.

05What is the global period for 29075, and does it affect same-day billing?

29075 has a 000 global period — no pre-op or post-op days are included. There is no global window that would restrict same-day billing of unrelated services, but the standard bundling rules for same-day E/M (modifier 25 required) still apply.

06Can a hand therapist or CHT bill 29075?

A provider can report 29075 as long as they are qualified to perform the service and operating within their scope of practice. However, some payers apply strict coverage interpretations for casting codes billed by non-physician providers. Verify coverage with the specific payer before applying the cast.

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 cast's anatomic extent (elbow to fingers), laterality, casting material, clinical indication, and whether the application followed treatment by a different provider. That prevents the most common audit flag for 29075: a note that describes a wrist-only or partial cast being billed under the elbow-to-finger code, and ensures laterality modifiers LT/RT are populated automatically.

See how Mira captures CPT 29075 documentation