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See a sample rate comparisonCPT 29055 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Application;Shoulder Spica
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 29055 |
| Medicaid Fee Schedule | View Medicaid rates for 29055 |
National average reimbursement for CPT 29055 by major payers:
$281.68
$283.70
$307.28
$237.03
Compare published rates across providers.
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CPT 29055
5 of 25 sample ratesHigher to lower in this preview
Quality Surgicenter LLC
$1,500.00Published rateSurgery Center Of Scottsdale, LLC
Surgery Center Of Scottsdale LLC
$566.00Published rateScottsdale Mccormick Ranch Surgicenter LLC
Scottsdale Mccormick Ranch Surgicenter
$300.00Published rateBrookings Ambulatory Surgery Center, LLP
Brookings Ambulatory Surgery Center LLP
$125.00Published rateFemi-Care Surgery Center, LLC
Femicare Surgery Center LLC
$53.00Published rate
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See a sample payer proposalCPT 29055 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29055 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 29055 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 29000-CPT | Moderate | Application Of Halo Type Body, Application Of Halo Type Body Cast (See 20661-20663 Forinsertion) Application Of Halo Type Body Cast (See 20661-20663 For |
| 29035-CPT | Moderate | Shoulder-To-Hip Body Cast, Application Of A Body Cast That Fully Encases The Trunk From Shoulder To Hips. The Cast May Extend To One Or Both Thighs Or The Head As Well. |
| 29040-CPT | Moderate | Shoulder-To-Hip Body Cast, Application Of A Body Cast That Fully Encases The Trunk From Shoulder To Hips. The Cast May Extend To One Or Both Thighs Or The Head As Well. |
| 29055-CPT | Moderate | Application;Shoulder Spica |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29055 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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