How much does Medicare pay for CPT 29425?

Medicare allowed an average of $72.75 per service and paid $56.20 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $284.41, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 29425?

Application of walking cast covering below knee to toe. It was billed 3,116 times to 1,980 Medicare beneficiaries by 93 providers in 2024.

Does 29425 pay differently in an office than a hospital?

Yes. The allowed amount averaged $73.09 in an office setting and $37.44 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 29425 most?

Podiatry, with 1,653 services from 43 clinicians. Next are Orthopedic Surgery, Physician Assistant, Nurse Practitioner.

CPT 29425

Application of walking cast covering below knee to toe

$72.75Medicare-allowed amount per service, averaged across 3,116 services

Providers submitted

$284.41

Asking price, not received

Medicare allowed

$72.75

The fee schedule figure

Medicare paid

$56.20

Balance is patient coinsurance

Providers submitted an average of $284.41 for this code and Medicare allowed $72.75 — 3.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $56.20 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $73.09
Hospital / facility: $37.44

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 3,087 services were billed in an office setting and 29 in a facility.

Services: 3,116
Beneficiaries: 1,980
Providers billing it: 93
Total allowed: $226,689

What Medicare pays for CPT 29425

Across 3,116 services billed by 93 providers to 1,980 beneficiaries, Medicare allowed an average of $72.75 per service. That is 1.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 29425

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	1,653	984	$75.55	43
Orthopedic Surgery	1,118	725	$72.31	34
Physician Assistant	217	176	$61.51	9
Nurse Practitioner	115	84	$56.86	6
Sports Medicine	13	11	$83.27	1

29425 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	523	$82.58	$57.47	12
Florida	405	$68.29	$53.84	8
Texas	309	$70.45	$55.85	11
Arizona	181	$71.81	$56.88	7
California	177	$85.21	$57.76	7
Connecticut	163	$73.04	$51.66	3
North Carolina	146	$64.58	$51.46	4
Missouri	143	$68.55	$57.47	3
Illinois	127	$77.70	$58.16	2
New York	90	$76.08	$52.24	4
Alabama	88	$64.24	$53.77	3
Michigan	87	$73.24	$57.54	2
Mississippi	86	$63.90	$54.27	3
Washington	72	$75.77	$55.28	3
Virginia	72	$71.98	$57.45	2
Georgia	70	$59.26	$50.93	3
Kansas	59	$68.30	$57.76	1
Maryland	43	$87.22	$57.85	2
Wisconsin	42	$70.18	$57.30	1
Louisiana	36	$69.69	$57.50	1
Indiana	30	$67.99	$56.84	1
Oklahoma	25	$69.45	$59.79	1
Oregon	23	$63.43	$51.32	1
Kentucky	19	$55.94	$56.65	1
South Carolina	18	$65.89	$61.59	1
Nevada	18	$69.76	$56.67	1
Minnesota	17	$43.86	$27.91	1
Arkansas	13	$57.48	$44.21	1
Hawaii	12	$77.47	$60.95	1
Colorado	11	$65.60	$50.88	1
Tennessee	11	$65.74	$61.22	1

Related codes

29405Application of short leg cast$75.18
29445Application of walking cast covering foot$91.92

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.