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29435

Application of patellar tendon bearing (PTB) cast

Orthopedics Casting/Splinting 5.92 Total RVUs
Quick Reference
For application of patellar tendon bearing cast

Relative Value Units (RVUs)

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Work RVU
3.20
Physician effort
PE RVU
2.40
Practice expense
MP RVU
0.32
Malpractice
Total RVU
5.92
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For application of patellar tendon bearing cast

Time Requirement
25-40 minutes typical procedure time

Common Scenarios

Tibial fracture requiring PTB cast
Distal tibia fracture requiring patellar tendon bearing cast
Ankle fracture requiring PTB cast
Post-operative PTB cast
Lower extremity injury requiring PTB immobilization

Documentation Requirements

  • Indication for PTB cast
  • Type of cast applied
  • Cast material used
  • PTB component
  • Patient positioning
  • Follow-up instructions

Coding Guidelines

Common Modifiers

50 Bilateral procedure when both legs casted same session
51 Multiple procedures performed same session
LT Left side procedure
RT Right side procedure

Bundling Rules

  • Includes PTB cast application
  • Includes cast materials
  • Includes PTB component
  • Removal of old cast coded separately
  • Follow-up visits within global period bundled
  • X-rays coded separately

Exclusions

  • 29405 (application of short leg cast)
  • 29425 (application of short leg cast; walking type)
  • 29445 (application of rigid total contact leg cast)
  • 29505 (application of long leg splint)

Coding Notes

PTB cast application
Global period is 10 days
Document indication and cast type
Cast removal bundled within global period

Clinical scenarios

Tibial fracture requiring PTB cast
Tibial fracture requiring PTB cast
When to use:For application of patellar tendon bearing cast
  • Indication for PTB cast
  • Type of cast applied
  • Cast material used
Distal tibia fracture requiring patellar tendon bearing cast
Distal tibia fracture requiring patellar tendon bearing cast
When to use:For application of patellar tendon bearing cast
  • Indication for PTB cast
  • Type of cast applied
  • Cast material used
Ankle fracture requiring PTB cast
Ankle fracture requiring PTB cast
When to use:For application of patellar tendon bearing cast
  • Indication for PTB cast
  • Type of cast applied
  • Cast material used

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Code Details

Code 29435
Category Orthopedics
Subcategory Casting/Splinting
Total RVUs 5.92

Medicare Pricing

PFS
2025 National Rate
$124.86
Facility
$85.39
Non-Facility
$124.86
RVU Breakdown
Work RVU:1.18PE RVU:2.44MP RVU:0.24Total RVU:3.86CF:$32.3465Global Days:000
OPPS Details
APC:5102Status:TCopayment:
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 29435?

CPT 29435 is the billing code for "Application of patellar tendon bearing (PTB) cast". For application of patellar tendon bearing cast

How much does Medicare pay for CPT 29435?

Medicare pays approximately $124.86 for CPT 29435 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

What are the RVUs for CPT 29435?

CPT 29435 has a total RVU of 5.92, broken down as: Work RVU 3.20, Practice Expense RVU 2.40, and Malpractice RVU 0.32. RVUs (Relative Value Units) determine Medicare reimbursement rates.

What documentation is required for CPT 29435?

Key documentation requirements for CPT 29435 include: Indication for PTB cast; Type of cast applied; Cast material used; PTB component. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 29435 be billed with other codes?

Bundling considerations for CPT 29435: Includes PTB cast application. Includes cast materials Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 29435?

Common modifiers for CPT 29435 include: 50 (Bilateral procedure when both legs casted same session), 51 (Multiple procedures performed same session), LT (Left side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 29435?

The typical time requirement for CPT 29435 is 25-40 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.

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