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

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 Idaho, Medicare pays $856.26 for 21076 in the office and $588.00 when it’s performed in a hospital or facility.

$856.26Office (non-facility)
$588.00Hospital or facility
−6.9%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 Idaho
  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 Idaho 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. Idaho pays $856.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

21076 in Idaho vs other payment areas
  1. Idaho · this page$856.26
  2. Los Angeles, CA · California$997.26+$141.00
  3. Washington, DC area · District of Columbia$1,025.84+$169.58
  4. Miami, FL · Florida$1,022.68+$166.42
  5. Chicago, IL · Illinois$997.29+$141.03
  6. Manhattan, NY · New York$1,049.75+$193.49
  7. Alaska · Alaska$1,140.88+$284.62

Other areas in Idaho 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 Idaho 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

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 21076 in Idaho
ComponentRVULocality factorAdjusted
Physician work13.07× 1.00013.0700
Practice expense12.80× 0.92011.7760
Malpractice1.67× 0.4730.7899
Total RVUs25.6359
Conversion factor× 33.4009

Office rate, Idaho$856.26

Office: (13.07 × 1 + 12.8 × 0.92 + 1.67 × 0.473) × $33.4009 = $856.26

Facility: (13.07 × 1 + 4.07 × 0.92 + 1.67 × 0.473) × $33.4009 = $588.00

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, Idaho
Same family
21079Obturator prosthesis, interim obturatorInterim obturator used during healing rather than a surgical-phase obturator.$1,420.05
21080Obturator prosthesis, definitive obturatorDefinitive obturator prepared after the surgical and healing phases.$1,613.28
21081Mandibular prosthesis, impression and custom preparationMaxillofacial prosthetic service for a mandibular resection prosthesis.$1,484.36
21085Oral splint, surgical useImpression and preparation of an oral surgical splint, not an obturator.$660.75

How 21076 has changed in Idaho

21076 · Office / nonfacility

$856.26

Effective 2026-10-01

The base rate is $50.83 higher than on 2025-10-01, moving from $805.43 to $856.26 (6.3%).

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

    $805.43changed to$856.26

    • 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 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $805.59changed to$805.43

    • 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

    $792.44changed to$805.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $805.70changed to$792.44

    • 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 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $803.90changed to$805.70

    • 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 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $819.31changed to$803.90

    • 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

    $866.63changed to$819.31

    • 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
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $912.90changed to$866.63

    • 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
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $933.90changed to$912.90

    • 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

    $943.80changed to$933.90

    • 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 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $952.73changed to$943.80

    • 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 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $956.13changed to$952.73

    • 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

    $951.37changed to$956.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $947.09changed to$951.37

    • 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 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $928.18changed to$947.09

    • 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 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $928.18

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$856.26$588.00RVU26D
2026-07-01$856.26$588.00RVU26C
2026-04-01$856.26$588.00RVU26B
2026-01-01$856.26$588.00RVU26A
2025-10-01$805.43$654.76RVU25D
2025-07-01$805.43$654.76RVU25C
2025-04-01$805.43$654.76RVU25B
2025-01-01$805.43$654.76RVU25A
2024-10-01$805.59$658.09RVU24D
2024-07-01$805.59$658.09RVU24C
2024-04-01$805.59$658.09RVU24B
2024-03-09$805.59$658.09RVU24AR
2024-01-01$792.44$647.35RVU24A
2023-10-01$805.70$663.47RVU23D
2023-07-01$805.70$663.47RVU23C
2023-04-01$805.70$663.47RVU23B
2023-01-01$805.70$663.47RVU23A
2022-10-01$803.90$666.12RVU22D
2022-07-01$803.90$666.12RVU22C
2022-04-01$803.90$666.12RVU22B
2022-01-01$803.90$666.12RVU22A
2021-10-01$819.31$680.69RVU21D
2021-07-01$819.31$680.69RVU21C
2021-04-01$819.31$680.69RVU21B
2021-01-01$819.31$680.69RVU21A
2020-10-01$866.63$726.91RVU20D
2020-07-01$866.63$726.91RVU20C
2020-04-01$866.63$726.91RVU20B
2020-01-01$866.63$726.91RVU20A
2019-10-01$912.90$768.57RVU19D
2019-07-01$912.90$768.57RVU19C
2019-04-01$912.90$768.57RVU19B
2019-01-01$912.90$768.57RVU19A
2018-10-01$933.90$786.47RVU18D
2018-07-01$933.90$786.47RVU18C
2018-04-01$933.90$786.47RVU18B
2018-01-01$933.90$786.47RVU18AR1
2017-10-01$943.80$795.22RVU17D
2017-07-01$943.80$795.22RVU17C
2017-04-01$943.80$795.22RVU17B
2017-01-01$943.80$795.22RVU17A
2016-10-01$952.73$803.54RVU16D
2016-07-01$952.73$803.54RVU16C
2016-04-01$952.73$803.54RVU16B
2016-01-01$952.73$803.54RVU16A
2015-10-01$956.13$805.76RVU15D
2015-07-01$956.13$805.76RVU15C
2015-04-01$951.37$801.75RVU15B
2015-01-01$951.37$801.75RVU15A
2014-10-01$947.09$799.44RVU14D
2014-07-01$947.09$799.44RVU14C
2014-04-01$947.09$799.44RVU14B
2014-01-01$947.09$799.44RVU14A
2013-10-01$928.18$773.96RVU13D
2013-07-01$928.18$773.96RVU13C
2013-04-01$928.18$773.96RVU13B
2013-01-01$928.18$773.96RVU13AR

Price 21076 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

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 IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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