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CPT code 21076: Obturator prosthesis, surgical obturator2026 Medicare rate & RVUs in Iowa

Reports impression and preparation of a surgical obturator to cover a maxillary surgical defect, commonly in connection with maxillectomy.

CMS RVU26DEffective Oct 1, 2026One payment locality181 Medicare services in 2024

In Iowa, Medicare pays $849.89 for 21076 in the office and $583.08 when it’s performed in a hospital or facility.

$849.89Office (non-facility)
$583.08Hospital or facility
−7.6%vs the national office rate ($919.86)

Check a contract rate as a % of Medicare · 21076 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21076 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 21076 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 21076 covers

This service covers taking an impression and preparing a surgical obturator for a maxillary defect, commonly when a patient is undergoing maxillectomy. The device is intended for the surgical phase, helping separate the oral and nasal cavities after resection. A maxillofacial prosthodontist or other qualified dental or surgical specialist may perform the prosthetic work, often coordinating with the team treating an oral or maxillary tumor.

Report 21076 for the surgical obturator, not an interim device used during healing or a definitive device made after healing; those have separate codes. Document the defect and planned surgery, the impression and prosthetic work performed, and the device’s surgical purpose. Related postoperative visits for 10 days are included in the global period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Iowa compares for 21076

Across 109 of 109 payment localities, the office rate for 21076 runs from $832.53 in Arkansas to $1,140.88 in Alaska. Iowa pays $849.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

21076 in Iowa vs other payment areas
  1. Iowa · this page$849.89
  2. Los Angeles, CA · California$997.26+$147.37
  3. Washington, DC area · District of Columbia$1,025.84+$175.95
  4. Miami, FL · Florida$1,022.68+$172.79
  5. Chicago, IL · Illinois$997.29+$147.40
  6. Manhattan, NY · New York$1,049.75+$199.86
  7. Alaska · Alaska$1,140.88+$290.99

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

21076 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$842.21$587.07
ArkansasArkansas$832.53$582.05
ArizonaArizona$898.58$616.02
Bakersfield, CACalifornia$947.39$627.81
Chico, CACalifornia$942.44$622.86
El Centro, CACalifornia$942.72$623.14
Fresno, CACalifornia$942.44$622.86
Hanford, CACalifornia$942.44$622.86

21076 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$832.53

$1,140.88

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21076 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,140.881
AL$842.211
AR$832.531
AZ$898.581
CA$942.44–$1,130.9729
CO$940.251
CT$973.231
DC$1,025.841
DE$911.281
FL$929.11–$1,022.683
GA$884.40–$939.222
GU$954.951
HI$954.951
IA$849.891
ID$856.261
IL$914.07–$997.294
IN$859.981
KS$851.151
KY$867.661
LA$868.35–$902.222
MA$938.18–$1,014.562
MD$924.78–$1,025.843
ME$864.57–$895.432
MI$889.86–$943.162
MN$892.991
MO$859.41–$899.453
MS$845.881
MT$919.751
NC$871.081
ND$886.731
NE$852.251
NH$930.421
NJ$982.07–$1,019.562
NM$895.591
NV$910.971
NY$881.92–$1,076.415
OH$883.111
OK$861.681
OR$901.58–$960.022
PA$881.74–$956.012
PR$923.731
RI$936.241
SC$879.001
SD$882.821
TN$855.131
TX$877.42–$941.338
UT$888.521
VA$896.19–$1,025.842
VI$923.731
VT$888.031
WA$934.86–$1,028.532
WI$863.311
WV$887.901
WY$905.361

See 21076 in every payment locality

How the 21076 rate is calculated

Each of 21076’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21076

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.07

13.07 RVUs× 1.000 GPCI

Practice expense12.80

12.80 RVUs× 1.000 GPCI

Malpractice1.67

1.67 RVUs× 1.000 GPCI

Adjusted RVUs

27.5400

Conversion factor

$33.4009

Medicare rate

$919.86

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,861

Code
21076
Physician work
13.07
Practice expense
12.80
Malpractice
1.67

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 21076 in Iowa
ComponentRVULocality factorAdjusted
Physician work13.07× 1.00013.0700
Practice expense12.80× 0.91511.7120
Malpractice1.67× 0.3970.6630
Total RVUs25.4450
Conversion factor× 33.4009

Office rate, Iowa$849.89

Office: (13.07 × 1 + 12.8 × 0.915 + 1.67 × 0.397) × $33.4009 = $849.89

Facility: (13.07 × 1 + 4.07 × 0.915 + 1.67 × 0.397) × $33.4009 = $583.08

Open 21076 in the RVU calculator

Payment rules and modifiers for 21076

21076 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21076

Obturator prosthesis, surgical obturator

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21076

Obturator prosthesis, surgical obturator

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21076 without 51 · national office

$919.86

Obturator prosthesis, surgical obturator

21076-51 · Second procedure: 50%

$459.93

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 21076

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21076
CodeHow it relatesOffice range, Iowa
Same family
21079Obturator prosthesis, interim obturatorInterim obturator used during healing rather than a surgical-phase obturator.$1,410.03
21080Obturator prosthesis, definitive obturatorDefinitive obturator prepared after the surgical and healing phases.$1,601.81
21081Mandibular prosthesis, impression and custom preparationMaxillofacial prosthetic service for a mandibular resection prosthesis.$1,473.77
21085Oral splint, surgical useImpression and preparation of an oral surgical splint, not an obturator.$656.13

How 21076 has changed in Iowa

21076 · Office / nonfacility

$849.89

Effective 2026-10-01

The base rate is $42.69 higher than on 2025-10-01, moving from $807.20 to $849.89 (5.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $807.20changed to$849.89

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 13.40 changed to 13.07
    • Practice expense RVU 11.98 changed to 12.80
    • Malpractice RVU 1.35 changed to 1.67
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $807.28changed to$807.20

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.22 changed to 11.98
    • Malpractice RVU 1.33 changed to 1.35

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $794.10changed to$807.28

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $812.11changed to$794.10

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.98 changed to 11.22
    • Malpractice RVU 1.30 changed to 1.33
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $815.32changed to$812.11

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.63 changed to 10.98
    • Malpractice RVU 1.22 changed to 1.30
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $831.13changed to$815.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.93 changed to 10.63
    • Malpractice RVU 1.19 changed to 1.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $871.87changed to$831.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.31 changed to 10.93
    • Malpractice RVU 1.18 changed to 1.19
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $907.84changed to$871.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.95 changed to 11.31
    • Malpractice RVU 2.25 changed to 1.18
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $929.09changed to$907.84

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.65 changed to 11.95
    • Malpractice RVU 2.21 changed to 2.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $940.65changed to$929.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.09 changed to 12.65
    • Malpractice RVU 2.19 changed to 2.21
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $950.55changed to$940.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 13.42 changed to 13.09
    • Malpractice RVU 2.28 changed to 2.19
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $953.94changed to$950.55

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.43 changed to 13.42
    • Malpractice RVU 2.26 changed to 2.28

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $949.20changed to$953.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $940.42changed to$949.20

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 13.54 changed to 13.43
    • Malpractice RVU 1.63 changed to 2.26
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $916.25changed to$940.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.38 changed to 13.54
    • Malpractice RVU 1.70 changed to 1.63
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $916.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$849.89$583.08RVU26D
2026-07-01$849.89$583.08RVU26C
2026-04-01$849.89$583.08RVU26B
2026-01-01$849.89$583.08RVU26A
2025-10-01$807.20$655.70RVU25D
2025-07-01$807.20$655.70RVU25C
2025-04-01$807.20$655.70RVU25B
2025-01-01$807.20$655.70RVU25A
2024-10-01$807.28$658.97RVU24D
2024-07-01$807.28$658.97RVU24C
2024-04-01$807.28$658.97RVU24B
2024-03-09$807.28$658.97RVU24AR
2024-01-01$794.10$648.21RVU24A
2023-10-01$812.11$667.17RVU23D
2023-07-01$812.11$667.17RVU23C
2023-04-01$812.11$667.17RVU23B
2023-01-01$812.11$667.17RVU23A
2022-10-01$815.32$672.82RVU22D
2022-07-01$815.32$672.82RVU22C
2022-04-01$815.32$672.82RVU22B
2022-01-01$815.32$672.82RVU22A
2021-10-01$831.13$687.76RVU21D
2021-07-01$831.13$687.76RVU21C
2021-04-01$831.13$687.76RVU21B
2021-01-01$831.13$687.76RVU21A
2020-10-01$871.87$729.48RVU20D
2020-07-01$871.87$729.48RVU20C
2020-04-01$871.87$729.48RVU20B
2020-01-01$871.87$729.48RVU20A
2019-10-01$907.84$762.71RVU19D
2019-07-01$907.84$762.71RVU19C
2019-04-01$907.84$762.71RVU19B
2019-01-01$907.84$762.71RVU19A
2018-10-01$929.09$780.85RVU18D
2018-07-01$929.09$780.85RVU18C
2018-04-01$929.09$780.85RVU18B
2018-01-01$929.09$780.85RVU18AR1
2017-10-01$940.65$791.74RVU17D
2017-07-01$940.65$791.74RVU17C
2017-04-01$940.65$791.74RVU17B
2017-01-01$940.65$791.74RVU17A
2016-10-01$950.55$801.69RVU16D
2016-07-01$950.55$801.69RVU16C
2016-04-01$950.55$801.69RVU16B
2016-01-01$950.55$801.69RVU16A
2015-10-01$953.94$803.91RVU15D
2015-07-01$953.94$803.91RVU15C
2015-04-01$949.20$799.91RVU15B
2015-01-01$949.20$799.91RVU15A
2014-10-01$940.42$793.43RVU14D
2014-07-01$940.42$793.43RVU14C
2014-04-01$940.42$793.43RVU14B
2014-01-01$940.42$793.43RVU14A
2013-10-01$916.25$763.24RVU13D
2013-07-01$916.25$763.24RVU13C
2013-04-01$916.25$763.24RVU13B
2013-01-01$916.25$763.24RVU13AR

Price 21076 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Iowa

21076 billing questions

How is 21076 different from 21079?

21076 is for a surgical obturator intended for the surgical phase. Code 21079 describes an interim obturator used during healing.

When should 21080 be used instead?

Use 21080 for a definitive obturator, rather than the surgical-phase device reported with 21076.

Can the impression be billed separately from 21076?

The code covers the impression and preparation of the surgical obturator together. Document both parts of that prosthetic service.

What documentation supports 21076?

Record the maxillary defect and related surgery, the impression and preparation performed, and that the obturator is intended for the surgical phase.

Can modifier 50 be reported for bilateral work?

No. Modifier 50 is inappropriate for this service’s descriptor and anatomy.

What applies when other procedures are performed in the same session?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires documented medical necessity.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21076PPRRVU2026_Oct_nonQPP.csv, line 1,861 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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