CPT code 21077: Orbital prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Washington, DC area
Reports the impression and custom preparation of an orbital prosthesis for a patient with loss or absence of orbital structures.
In Washington, DC area, Medicare pays $2,440.02 for 21077 in the office and $1,656.25 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 21077 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21077 covers
This service captures the patient’s orbital defect and prepares a custom prosthesis to restore the external appearance of the eye and surrounding orbital area. It is typically performed by a maxillofacial prosthodontist or other clinician with specialized facial prosthetic training, often after orbital exenteration for cancer or after traumatic loss. The prosthesis is distinct from a replacement for the globe alone because it addresses the broader orbital defect.
Report 21077 for the orbital prosthesis impression and custom preparation, supported by documentation of the defect and the patient-specific prosthetic work. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. 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 Washington, DC area compares for 21077
Across 109 of 109 payment localities, the office rate for 21077 runs from $1,996.12 in Arkansas to $2,749.42 in Alaska. Washington, DC area pays $2,440.02. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$2,440.02
- Los Angeles, CA · California$2,374.37−$65.65
- Miami, FL · Florida$2,425.09−$14.93
- Chicago, IL · Illinois$2,368.51−$71.51
- Manhattan, NY · New York$2,494.71+$54.69
- Alaska · Alaska$2,749.42+$309.40
- Alabama · Alabama$2,018.04−$421.98
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $1,996.12 | $1,424.59 |
| ArizonaArizona | $2,145.63 | $1,500.91 |
| Bakersfield, CACalifornia | $2,258.86 | $1,529.64 |
| Chico, CACalifornia | $2,247.52 | $1,518.31 |
| El Centro, CACalifornia | $2,248.15 | $1,518.93 |
| Fresno, CACalifornia | $2,247.52 | $1,518.31 |
| Hanford, CACalifornia | $2,247.52 | $1,518.31 |
| Madera, CACalifornia | $2,247.52 | $1,518.31 |
| Merced, CACalifornia | $2,247.52 | $1,518.31 |
| Modesto, CACalifornia | $2,247.52 | $1,518.31 |
| Napa, CACalifornia | $2,510.06 | $1,633.13 |
| Oxnard, CACalifornia | $2,354.00 | $1,567.56 |
| Redding, CACalifornia | $2,247.52 | $1,518.31 |
| Rest of CaliforniaCalifornia | $2,247.52 | $1,518.31 |
| Riverside, CACalifornia | $2,288.33 | $1,559.11 |
| Sacramento, CACalifornia | $2,333.43 | $1,559.64 |
| Salinas, CACalifornia | $2,324.06 | $1,552.93 |
| San Diego, CACalifornia | $2,359.64 | $1,563.89 |
| Marin County, CACalifornia | $2,628.37 | $1,690.23 |
| San Francisco, CACalifornia | $2,624.11 | $1,685.98 |
| San Benito County, CACalifornia | $2,685.55 | $1,726.12 |
| Santa Clara County, CACalifornia | $2,668.14 | $1,708.71 |
| San Luis Obispo, CACalifornia | $2,289.28 | $1,531.45 |
| Santa Cruz, CACalifornia | $2,367.46 | $1,559.06 |
| Santa Maria, CACalifornia | $2,327.57 | $1,551.77 |
| Santa Rosa, CACalifornia | $2,389.96 | $1,572.92 |
| Stockton, CACalifornia | $2,247.52 | $1,518.31 |
| Vallejo, CACalifornia | $2,503.92 | $1,627.00 |
| Visalia, CACalifornia | $2,247.52 | $1,518.31 |
| Yuba City, CACalifornia | $2,247.52 | $1,518.31 |
| ColoradoColorado | $2,241.65 | $1,533.72 |
| ConnecticutConnecticut | $2,316.79 | $1,600.21 |
| DelawareDelaware | $2,174.96 | $1,517.59 |
| Fort Lauderdale, FLFlorida | $2,307.60 | $1,633.60 |
| Rest of FloridaFlorida | $2,214.05 | $1,577.98 |
| Atlanta, GAGeorgia | $2,237.78 | $1,561.78 |
| Rest of GeorgiaGeorgia | $2,112.96 | $1,519.47 |
| Hawaii, Guam, HIHawaii | $2,274.06 | $1,517.56 |
| IowaIowa | $2,035.71 | $1,426.92 |
| IdahoIdaho | $2,050.09 | $1,437.97 |
| East St. Louis, ILIllinois | $2,243.10 | $1,630.98 |
| Rest of IllinoisIllinois | $2,179.81 | $1,572.35 |
| Suburban Chicago, ILIllinois | $2,324.37 | $1,641.06 |
| IndianaIndiana | $2,058.51 | $1,441.73 |
| KansasKansas | $2,038.43 | $1,436.96 |
| KentuckyKentucky | $2,075.35 | $1,483.86 |
| New Orleans, LALouisiana | $2,153.52 | $1,527.43 |
| Rest of LouisianaLouisiana | $2,076.85 | $1,488.02 |
| Metropolitan Boston, MAMassachusetts | $2,413.36 | $1,618.94 |
| Rest of MassachusettsMassachusetts | $2,237.37 | $1,536.76 |
| Baltimore area, MDMaryland | $2,311.90 | $1,597.98 |
| Rest of MarylandMaryland | $2,206.13 | $1,532.80 |
| Rest of MaineMaine | $2,068.75 | $1,456.63 |
| Southern Maine, MEMaine | $2,138.81 | $1,479.46 |
| Detroit, MIMichigan | $2,245.71 | $1,603.65 |
| Rest of MichiganMichigan | $2,125.45 | $1,517.99 |
| MinnesotaMinnesota | $2,133.75 | $1,449.11 |
| Metropolitan Kansas City, MOMissouri | $2,131.66 | $1,506.90 |
| Metropolitan St. Louis, MOMissouri | $2,147.42 | $1,514.01 |
| Rest of MissouriMissouri | $2,056.52 | $1,482.99 |
| MississippiMississippi | $2,026.12 | $1,453.25 |
| MontanaMontana | $2,193.52 | $1,528.17 |
| North CarolinaNorth Carolina | $2,083.50 | $1,462.73 |
| North DakotaNorth Dakota | $2,119.37 | $1,454.02 |
| NebraskaNebraska | $2,041.10 | $1,426.98 |
| New HampshireNew Hampshire | $2,217.92 | $1,525.30 |
| Northern New JerseyNew Jersey | $2,426.79 | $1,654.99 |
| Rest of New JerseyNew Jersey | $2,339.15 | $1,612.59 |
| New MexicoNew Mexico | $2,138.36 | $1,528.23 |
| NevadaNevada | $2,173.82 | $1,507.81 |
| NYC suburbs and Long Island, NYNew York | $2,554.87 | $1,763.77 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $2,361.71 | $1,633.15 |
| Queens, NYNew York | $2,496.09 | $1,709.65 |
| Rest of New YorkNew York | $2,108.02 | $1,475.94 |
| OhioOhio | $2,110.30 | $1,502.84 |
| OklahomaOklahoma | $2,061.95 | $1,467.79 |
| Portland, OROregon | $2,287.04 | $1,547.84 |
| Rest of OregonOregon | $2,152.69 | $1,490.00 |
| Metropolitan Philadelphia, PAPennsylvania | $2,277.51 | $1,584.89 |
| Rest of PennsylvaniaPennsylvania | $2,107.26 | $1,496.48 |
| Puerto RicoPuerto Rico | $2,202.57 | $1,529.91 |
| Rhode IslandRhode Island | $2,233.14 | $1,545.84 |
| South CarolinaSouth Carolina | $2,101.19 | $1,486.41 |
| South DakotaSouth Dakota | $2,110.60 | $1,445.26 |
| TennesseeTennessee | $2,047.42 | $1,442.62 |
| Austin, TXTexas | $2,238.00 | $1,534.07 |
| Beaumont, TXTexas | $2,097.49 | $1,492.03 |
| Brazoria, TXTexas | $2,166.26 | $1,506.90 |
| Dallas, TXTexas | $2,181.98 | $1,519.29 |
| Fort Worth, TXTexas | $2,173.90 | $1,517.87 |
| Galveston, TXTexas | $2,174.21 | $1,513.52 |
| Houston, TXTexas | $2,242.85 | $1,582.16 |
| Rest of TexasTexas | $2,132.10 | $1,500.69 |
| UtahUtah | $2,122.74 | $1,497.31 |
| VirginiaVirginia | $2,140.44 | $1,486.41 |
| Virgin Islands, VIUnited States Virgin Islands | $2,202.57 | $1,529.91 |
| VermontVermont | $2,122.19 | $1,463.49 |
| Rest of WashingtonWashington | $2,229.56 | $1,528.96 |
| King County, WAWashington | $2,446.14 | $1,629.76 |
| WisconsinWisconsin | $2,066.32 | $1,428.91 |
| West VirginiaWest Virginia | $2,120.56 | $1,542.37 |
| WyomingWyoming | $2,161.21 | $1,495.86 |
21077 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$1,996.12
$2,749.42
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,749.42 | 1 |
| AL | $2,018.04 | 1 |
| AR | $1,996.12 | 1 |
| AZ | $2,145.63 | 1 |
| CA | $2,247.52–$2,685.55 | 29 |
| CO | $2,241.65 | 1 |
| CT | $2,316.79 | 1 |
| DC | $2,440.02 | 1 |
| DE | $2,174.96 | 1 |
| FL | $2,214.05–$2,425.09 | 3 |
| GA | $2,112.96–$2,237.78 | 2 |
| GU | $2,274.06 | 1 |
| HI | $2,274.06 | 1 |
| IA | $2,035.71 | 1 |
| ID | $2,050.09 | 1 |
| IL | $2,179.81–$2,368.51 | 4 |
| IN | $2,058.51 | 1 |
| KS | $2,038.43 | 1 |
| KY | $2,075.35 | 1 |
| LA | $2,076.85–$2,153.52 | 2 |
| MA | $2,237.37–$2,413.36 | 2 |
| MD | $2,206.13–$2,440.02 | 3 |
| ME | $2,068.75–$2,138.81 | 2 |
| MI | $2,125.45–$2,245.71 | 2 |
| MN | $2,133.75 | 1 |
| MO | $2,056.52–$2,147.42 | 3 |
| MS | $2,026.12 | 1 |
| MT | $2,193.52 | 1 |
| NC | $2,083.50 | 1 |
| ND | $2,119.37 | 1 |
| NE | $2,041.10 | 1 |
| NH | $2,217.92 | 1 |
| NJ | $2,339.15–$2,426.79 | 2 |
| NM | $2,138.36 | 1 |
| NV | $2,173.82 | 1 |
| NY | $2,108.02–$2,554.87 | 5 |
| OH | $2,110.30 | 1 |
| OK | $2,061.95 | 1 |
| OR | $2,152.69–$2,287.04 | 2 |
| PA | $2,107.26–$2,277.51 | 2 |
| PR | $2,202.57 | 1 |
| RI | $2,233.14 | 1 |
| SC | $2,101.19 | 1 |
| SD | $2,110.60 | 1 |
| TN | $2,047.42 | 1 |
| TX | $2,097.49–$2,242.85 | 8 |
| UT | $2,122.74 | 1 |
| VA | $2,140.44–$2,440.02 | 2 |
| VI | $2,202.57 | 1 |
| VT | $2,122.19 | 1 |
| WA | $2,229.56–$2,446.14 | 2 |
| WI | $2,066.32 | 1 |
| WV | $2,120.56 | 1 |
| WY | $2,161.21 | 1 |
How the 21077 rate is calculated
Each of 21077’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 · 21077
RVUs × geographic indexes × conversion factor
Work32.86
32.86 RVUs× 1.000 GPCI
Practice expense29.07
29.07 RVUs× 1.000 GPCI
Malpractice3.75
3.75 RVUs× 1.000 GPCI
Adjusted RVUs
65.6800
Conversion factor
$33.4009
Medicare rate
$2,193.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,862
- Code
- 21077
- Physician work
- 32.86
- Practice expense
- 29.07
- Malpractice
- 3.75
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 32.86 | × 1.054 | 34.6344 |
| Practice expense | 29.07 | × 1.178 | 34.2445 |
| Malpractice | 3.75 | × 1.113 | 4.1738 |
| Total RVUs | 73.0526 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$2440.02
Office: (32.86 × 1.054 + 29.07 × 1.178 + 3.75 × 1.113) × $33.4009 = $2440.02
Facility: (32.86 × 1.054 + 9.15 × 1.178 + 3.75 × 1.113) × $33.4009 = $1656.25
Payment rules and modifiers for 21077
21077 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21077
Orbital prosthesis, impression and custom preparation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21077
Orbital prosthesis, impression and custom preparation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
21077 without 50 · national office
$2,193.77
Orbital prosthesis, impression and custom preparation
21077-50 · Bilateral: 150%
$3,290.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 21077 has changed in Washington, DC area
21077 · Office / nonfacility
$2440.02
Effective 2026-10-01
The base rate is $91.56 higher than on 2025-10-01, moving from $2348.46 to $2440.02 (3.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$2348.46changed to$2440.02
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 33.70 changed to 32.86
- Practice expense RVU 27.88 changed to 29.07
- Malpractice RVU 3.21 changed to 3.75
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$2364.36changed to$2348.46
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 26.51 changed to 27.88
- Malpractice RVU 3.26 changed to 3.21
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$2325.77changed to$2364.36
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$2410.69changed to$2325.77
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 26.06 changed to 26.51
- Malpractice RVU 3.18 changed to 3.26
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$2447.40changed to$2410.69
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 25.35 changed to 26.06
- Malpractice RVU 2.99 changed to 3.18
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$2482.58changed to$2447.40
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 25.80 changed to 25.35
- Malpractice RVU 2.89 changed to 2.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$2618.14changed to$2482.58
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 27.45 changed to 25.80
- Malpractice RVU 2.88 changed to 2.89
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$2805.01changed to$2618.14
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 29.38 changed to 27.45
- Malpractice RVU 5.72 changed to 2.88
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$2902.91changed to$2805.01
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 31.76 changed to 29.38
- Malpractice RVU 5.67 changed to 5.72
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$2955.49changed to$2902.91
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 33.21 changed to 31.76
- Malpractice RVU 5.52 changed to 5.67
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$2978.66changed to$2955.49
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 33.56 changed to 33.21
- Malpractice RVU 5.73 changed to 5.52
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$2990.96changed to$2978.66
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 33.67 changed to 33.56
- Malpractice RVU 5.66 changed to 5.73
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$2976.07changed to$2990.96
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$2907.29changed to$2976.07
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 33.93 changed to 33.67
- Malpractice RVU 4.14 changed to 5.66
- Work GPCI 1.050 changed to 1.051
- Practice expense GPCI 1.202 changed to 1.205
- Malpractice GPCI 1.205 changed to 1.280
Held through RVU15B.
January 1, 2014
RVU14A
$2833.31changed to$2907.29
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 35.92 changed to 33.93
- Malpractice RVU 4.33 changed to 4.14
- Work GPCI 1.049 changed to 1.050
- Practice expense GPCI 1.198 changed to 1.202
- Malpractice GPCI 1.130 changed to 1.205
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $2833.31
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $2,440.02 | $1,656.25 | RVU26D |
| 2026-07-01 | $2,440.02 | $1,656.25 | RVU26C |
| 2026-04-01 | $2,440.02 | $1,656.25 | RVU26B |
| 2026-01-01 | $2,440.02 | $1,656.25 | RVU26A |
| 2025-10-01 | $2,348.46 | $1,888.86 | RVU25D |
| 2025-07-01 | $2,348.46 | $1,888.86 | RVU25C |
| 2025-04-01 | $2,348.46 | $1,888.86 | RVU25B |
| 2025-01-01 | $2,348.46 | $1,888.86 | RVU25A |
| 2024-10-01 | $2,364.36 | $1,902.90 | RVU24D |
| 2024-07-01 | $2,364.36 | $1,902.90 | RVU24C |
| 2024-04-01 | $2,364.36 | $1,902.90 | RVU24B |
| 2024-03-09 | $2,364.36 | $1,902.90 | RVU24AR |
| 2024-01-01 | $2,325.77 | $1,871.84 | RVU24A |
| 2023-10-01 | $2,410.69 | $1,944.99 | RVU23D |
| 2023-07-01 | $2,410.69 | $1,944.99 | RVU23C |
| 2023-04-01 | $2,410.69 | $1,944.99 | RVU23B |
| 2023-01-01 | $2,410.69 | $1,944.99 | RVU23A |
| 2022-10-01 | $2,447.40 | $1,976.04 | RVU22D |
| 2022-07-01 | $2,447.40 | $1,976.04 | RVU22C |
| 2022-04-01 | $2,447.40 | $1,976.04 | RVU22B |
| 2022-01-01 | $2,447.40 | $1,976.04 | RVU22A |
| 2021-10-01 | $2,482.58 | $2,013.35 | RVU21D |
| 2021-07-01 | $2,482.58 | $2,013.35 | RVU21C |
| 2021-04-01 | $2,482.58 | $2,013.35 | RVU21B |
| 2021-01-01 | $2,482.58 | $2,013.35 | RVU21A |
| 2020-10-01 | $2,618.14 | $2,151.49 | RVU20D |
| 2020-07-01 | $2,618.14 | $2,151.49 | RVU20C |
| 2020-04-01 | $2,618.14 | $2,151.49 | RVU20B |
| 2020-01-01 | $2,618.14 | $2,151.49 | RVU20A |
| 2019-10-01 | $2,805.01 | $2,335.56 | RVU19D |
| 2019-07-01 | $2,805.01 | $2,335.56 | RVU19C |
| 2019-04-01 | $2,805.01 | $2,335.56 | RVU19B |
| 2019-01-01 | $2,805.01 | $2,335.56 | RVU19A |
| 2018-10-01 | $2,902.91 | $2,420.53 | RVU18D |
| 2018-07-01 | $2,902.91 | $2,420.53 | RVU18C |
| 2018-04-01 | $2,902.91 | $2,420.53 | RVU18B |
| 2018-01-01 | $2,902.91 | $2,420.53 | RVU18AR1 |
| 2017-10-01 | $2,955.49 | $2,461.62 | RVU17D |
| 2017-07-01 | $2,955.49 | $2,461.62 | RVU17C |
| 2017-04-01 | $2,955.49 | $2,461.62 | RVU17B |
| 2017-01-01 | $2,955.49 | $2,461.62 | RVU17A |
| 2016-10-01 | $2,978.66 | $2,480.35 | RVU16D |
| 2016-07-01 | $2,978.66 | $2,480.35 | RVU16C |
| 2016-04-01 | $2,978.66 | $2,480.35 | RVU16B |
| 2016-01-01 | $2,978.66 | $2,480.35 | RVU16A |
| 2015-10-01 | $2,990.96 | $2,497.77 | RVU15D |
| 2015-07-01 | $2,990.96 | $2,497.77 | RVU15C |
| 2015-04-01 | $2,976.07 | $2,485.34 | RVU15B |
| 2015-01-01 | $2,976.07 | $2,485.34 | RVU15A |
| 2014-10-01 | $2,907.29 | $2,427.61 | RVU14D |
| 2014-07-01 | $2,907.29 | $2,427.61 | RVU14C |
| 2014-04-01 | $2,907.29 | $2,427.61 | RVU14B |
| 2014-01-01 | $2,907.29 | $2,427.61 | RVU14A |
| 2013-10-01 | $2,833.31 | $2,334.82 | RVU13D |
| 2013-07-01 | $2,833.31 | $2,334.82 | RVU13C |
| 2013-04-01 | $2,833.31 | $2,334.82 | RVU13B |
| 2013-01-01 | $2,833.31 | $2,334.82 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
21077 billing questions
When should 21077 be chosen instead of an ocular prosthesis service?
Use 21077 for a custom prosthesis addressing an orbital defect, including surrounding external structures. A prosthesis replacing only the eye itself is not the orbital prosthesis described by this code.
How does 21077 differ from 21088?
21077 is specific to an orbital prosthesis. 21088 is for a facial prosthesis when the prosthetic site is facial rather than orbital.
Does the 90-day global period include related postoperative care?
Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral 21077 reported?
For bilateral orbital prostheses, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when 21077 is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% multiple-procedure reduction.
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
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