Q4038 Cast supplies, short leg cast, adult (11 years +), fiberglass

HCPCS Code Q4038: Cast supplies, short leg cast, adult (11 years +), fiberglass

HCPCS code Q4038 identifies fiberglass cast supplies used to create a short leg cast for adult patients aged eleven years and older. Established as a temporary Q code, it allows practitioners to bill separately for casting materials. This supply code is distinct from the CPT code used for the clinical work of applying the cast. 1 2

Plain-language overview

Code Q4038 represents the fiberglass casting materials needed to construct a short leg cast for adult patients who are at least eleven years old, separate from the clinical labor of applying the cast. 1 2

What this code represents

The official descriptor for Q4038 is cast supplies for a short leg cast, adult (11 years +), fiberglass, categorizing it as a specific medical equipment and supply billing code. 1

Coding details

The code was established to separately bill for casting supplies after these material expenses were removed from the practice expense calculations of CPT codes for fracture management. 2

The clinical work and practice expenses involved in creating the cast or splint continue to be coded using the appropriate CPT code, while Q4038 strictly covers the supply materials. 2

Documentation considerations

In a clinical scenario for a fifth metatarsal fracture, Q4038 was billed alongside the CPT code for short leg cast application and an established patient office visit, underlining supply billing separation. 1

Coverage and utilization context

Medicare payments for Q4038 supplies vary geographically, with an average payment of thirty-nine dollars in Saint Louis, Missouri, compared to a national average of thirty-seven dollars. 3

A 2001 fee schedule listed the payment amount for Q4038 as $29.27, though payments for casting supplies in hospital outpatient departments remained unchanged by that specific memorandum. 2

What the sources add

While a clinical scenario lists an allowed amount of $58.77 for Q4038 in an outpatient hospital setting, a separate payment analysis reports lower average Medicare payments of $37 to $39. 1 3

The temporary Q codes were introduced to replace less specific coding for casting and splinting supplies used by physicians and other practitioners for fracture and dislocation reduction. 2

Sources

1. Fracture of the Fifth Metatarsal (Foot ... — cms.gov; accessed 2026-07-27.
2. Program Memorandum Intermediaries/Carriers — cms.gov; accessed 2026-07-27.
3. Cast supplies, short leg cast, adult (11 — patientfact.com; accessed 2026-07-27.