Application of a static long arm splint extending from the shoulder to the hand, used to immobilize the elbow and proximal forearm.

Verified May 8, 2026 · 6 sources ↓

Medicare: $97.20
Work RVU: 0.78
Global, days: 0
Region: Elbow

Drawn from CMSAAPCMerckmanualsBedrockbilling

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Diagnosis supported by ICD-10 code — fracture, dislocation, or soft-tissue injury requiring elbow immobilization
Laterality documented (left arm, right arm, or bilateral) to support LT/RT/50 modifier selection
Splint material specified (plaster or fiberglass) to support separate supply code billing
Extent of splint documented — shoulder to hand, confirming long arm application versus short arm
Neurovascular status check after application documented (capillary refill, distal sensation, finger motion)
Medical necessity narrative explaining why immobilization is required at this time

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 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 6 cited references ↓

CPT 29105 covers the application of a long arm splint running from the shoulder to the hand. The splint immobilizes the elbow and proximal forearm, limiting flexion and extension at the elbow. It's used for fractures, dislocations, and soft-tissue injuries requiring elbow immobilization — either as definitive treatment or as temporary stabilization before surgery. Material can be plaster or fiberglass; the code applies to either.

The global period is 000, meaning no pre- or post-operative work is bundled. If the same provider who placed the splint separately evaluates the patient on the same date for a significant, distinct reason, bill an E/M with modifier 25. Splint supply codes (e.g., A4570 or applicable Q-codes) may be billed separately depending on payer policy — check individual contracts, as Medicare coverage of supply codes under this code varies by setting.

Side laterality matters here. Use LT or RT to specify which arm was splinted. Modifier 50 applies when both arms are splinted in the same session, which is uncommon but does occur in bilateral upper extremity trauma. If a different provider applies a splint the same day after the first provider's work, modifier 77 distinguishes the repeat application.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (0.78) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.91) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	0.78
Practice expense RVU	1.96
Malpractice RVU	0.17
Total RVU	2.91
Medicare national rate	$97.20
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	$97.20
HOPD (APC 5101) Hospital outpatient department	$166.02
ASC (PI P3) Ambulatory surgical center (freestanding)	$65.79

Common denial reasons

The recurring reasons claims for CPT 29105 get rejected.

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

Laterality not documented or not coded — payer requires LT or RT on claims for unilateral procedures
Bundling with same-day E/M when modifier 25 is missing on the evaluation and management service
ICD-10 diagnosis does not support elbow-level immobilization — short arm injury billed under long arm code
Supply code billed without verifying payer coverage policy for separately reportable splint materials
Code billed in a global period of a related surgical procedure without modifier 79 when the splint is truly unrelated

Frequently asked questions

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

01What is the difference between 29105 and 29125?

29105 is a long arm splint running shoulder to hand, immobilizing the elbow. 29125 is a short arm static splint from the forearm to the hand, which does not cross the elbow. Use 29105 only when the elbow requires immobilization.

02Can I bill a separate E/M on the same day as 29105?

Yes, if the E/M is a significant, separately identifiable service. Append modifier 25 to the E/M code. The 000 global on 29105 does not bundle same-day evaluation, but modifier 25 is still required to avoid automatic bundling edits.

03Can I separately bill for the splint materials?

Possibly. Supply codes like A4570 may be separately reportable depending on payer. Medicare coverage of splint supply codes varies by setting — verify with the individual payer before billing. The CPT section guidelines note that supplies may be reported separately, but payer contracts govern actual payment.

04Does 29105 require a modifier for laterality?

Most payers require LT or RT for unilateral upper extremity procedures. Missing laterality is a common denial trigger. Use modifier 50 with confirmation from the payer for bilateral same-session application.

05What modifier applies if a long arm splint is applied during the global period of an unrelated surgery?

Use modifier 79 to indicate an unrelated procedure during the postoperative global period. Modifier 78 is for unplanned returns related to the original surgery — do not use 78 for a splint applied for an unrelated new injury.

06Is 29105 appropriate for temporary pre-surgical stabilization?

Yes. Long arm splints applied to stabilize a fracture or dislocation prior to definitive surgical repair are appropriately billed under 29105. Document the clinical rationale — that the splint is interim stabilization — and ensure the diagnosis code reflects the injury being managed.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the splint type (long arm, shoulder to hand), material (plaster or fiberglass), laterality, elbow position at application, and post-application neurovascular check from the provider's dictation. That documentation prevents the two most common 29105 denials: missing laterality and a diagnosis code that doesn't clinically support long arm — versus short arm — immobilization.

See how Mira captures CPT 29105 documentation