CPT code 21077: Orbital prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Puerto Rico

Reports the impression and custom preparation of an orbital prosthesis for a patient with loss or absence of orbital structures.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Puerto Rico, Medicare pays $2,202.57 for 21077 in the office and $1,529.91 when it’s performed in a hospital or facility.

$2,202.57Office (non-facility)

$1,529.91Hospital or facility

+0.4%vs the national office rate ($2,193.77)

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

Rate in Puerto Rico
What 21077 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

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 Puerto Rico 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. Puerto Rico pays $2,202.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

21077 in Puerto Rico vs other payment areas

Puerto Rico · this page$2,202.57
Los Angeles, CA · California$2,374.37+$171.80
Washington, DC area · District of Columbia$2,440.02+$237.45
Miami, FL · Florida$2,425.09+$222.52
Chicago, IL · Illinois$2,368.51+$165.94
Manhattan, NY · New York$2,494.71+$292.14
Alaska · Alaska$2,749.42+$546.85

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

Every other payment area

21077 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	$2,018.04	$1,435.86
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
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.

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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

21077 office rate range by state
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

See 21077 in every payment locality

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

Office or facility?

Your ZIP

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 Puerto Rico 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

Locality: Puerto Rico
Physician work: 1.000
Practice expense: 1.011
Malpractice: 0.985

Office calculation for 21077 in Puerto Rico
Component	RVU	Locality factor	Adjusted
Physician work	32.86	× 1.000	32.8600
Practice expense	29.07	× 1.011	29.3898
Malpractice	3.75	× 0.985	3.6938
Total RVUs			65.9435
Conversion factor			× 33.4009

Office rate, Puerto Rico$2202.57

Office: (32.86 × 1 + 29.07 × 1.011 + 3.75 × 0.985) × $33.4009 = $2202.57

Facility: (32.86 × 1 + 9.15 × 1.011 + 3.75 × 0.985) × $33.4009 = $1529.91

Open 21077 in the RVU calculator

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

Date of surgery

Date of a later visit

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.

24Unrelated E/M visit by the same physician
79Unrelated procedure (starts its own global period)
58Staged, more extensive, or therapy procedure that was planned
78Unplanned return to the operating room for a related complication

SurgeryVisit

Sep 23, 2026Jan 10, 2027

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).

When to use modifier 50

Codes related to 21077

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

Codes related to 21077
Code	How it relates	Office range, Puerto Rico
Same family
21086	Auricular prosthesis, impression and preparationImpression and custom preparation for an auricular prosthesis.	$1,633.88
21087	Nasal prosthesis, impression and custom preparationImpression and custom preparation for a nasal prosthesis.	$1,633.88
21088	Facial prosthesis, impression and preparationImpression and custom preparation for a facial prosthesis.	No office rate
21076	Obturator prosthesis, surgical obturatorImpression and preparation for a surgical obturator rather than an orbital prosthesis.	$923.73

How 21077 has changed in Puerto Rico

21077 · Office / nonfacility

$2202.57

Effective 2026-10-01

Compare with release effective

The base rate is $102.40 higher than on 2025-10-01, moving from $2100.17 to $2202.57 (4.9%).

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

January 1, 2026
RVU26A
$2100.17changed to$2202.57
- 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
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$2116.98changed to$2100.17
- 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
$2082.43changed to$2116.98
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$2138.20changed to$2082.43
- 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
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$2132.86changed to$2138.20
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$2152.54changed to$2132.86
- 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
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$2182.77changed to$2152.54
- 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
$2317.50changed to$2182.77
- 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
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$2484.84changed to$2317.50
- 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
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$2566.61changed to$2484.84
- 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
$2356.87changed to$2566.61
- 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
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$2113.84changed to$2356.87
- 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
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$2123.52changed to$2113.84
- 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
$2112.95changed to$2123.52
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$2088.52changed to$2112.95
- 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
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$2011.85changed to$2088.52
- 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
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $2011.85
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$2,202.57	$1,529.91	RVU26D
2026-07-01	$2,202.57	$1,529.91	RVU26C
2026-04-01	$2,202.57	$1,529.91	RVU26B
2026-01-01	$2,202.57	$1,529.91	RVU26A
2025-10-01	$2,100.17	$1,711.90	RVU25D
2025-07-01	$2,100.17	$1,711.90	RVU25C
2025-04-01	$2,100.17	$1,711.90	RVU25B
2025-01-01	$2,100.17	$1,711.90	RVU25A
2024-10-01	$2,116.98	$1,727.14	RVU24D
2024-07-01	$2,116.98	$1,727.14	RVU24C
2024-04-01	$2,116.98	$1,727.14	RVU24B
2024-03-09	$2,116.98	$1,727.14	RVU24AR
2024-01-01	$2,082.43	$1,698.95	RVU24A
2023-10-01	$2,138.20	$1,751.53	RVU23D
2023-07-01	$2,132.86	$1,749.26	RVU23C
2023-04-01	$2,132.86	$1,749.26	RVU23B
2023-01-01	$2,132.86	$1,749.26	RVU23A
2022-10-01	$2,152.54	$1,768.13	RVU22D
2022-07-01	$2,152.54	$1,768.13	RVU22C
2022-04-01	$2,152.54	$1,768.13	RVU22B
2022-01-01	$2,152.54	$1,768.13	RVU22A
2021-10-01	$2,182.77	$1,800.10	RVU21D
2021-07-01	$2,182.77	$1,800.10	RVU21C
2021-04-01	$2,182.77	$1,800.10	RVU21B
2021-01-01	$2,182.77	$1,800.10	RVU21A
2020-10-01	$2,317.50	$1,932.25	RVU20D
2020-07-01	$2,317.50	$1,932.25	RVU20C
2020-04-01	$2,317.50	$1,932.25	RVU20B
2020-01-01	$2,317.50	$1,932.25	RVU20A
2019-10-01	$2,484.84	$2,092.53	RVU19D
2019-07-01	$2,484.84	$2,092.53	RVU19C
2019-04-01	$2,484.84	$2,092.53	RVU19B
2019-01-01	$2,484.84	$2,092.53	RVU19A
2018-10-01	$2,566.61	$2,163.50	RVU18D
2018-07-01	$2,566.61	$2,163.50	RVU18C
2018-04-01	$2,566.61	$2,163.50	RVU18B
2018-01-01	$2,566.61	$2,163.50	RVU18AR1
2017-10-01	$2,356.87	$2,006.04	RVU17D
2017-07-01	$2,356.87	$2,006.04	RVU17C
2017-04-01	$2,356.87	$2,006.04	RVU17B
2017-01-01	$2,356.87	$2,006.04	RVU17A
2016-10-01	$2,113.84	$1,822.29	RVU16D
2016-07-01	$2,113.84	$1,822.29	RVU16C
2016-04-01	$2,113.84	$1,822.29	RVU16B
2016-01-01	$2,113.84	$1,822.29	RVU16A
2015-10-01	$2,123.52	$1,834.97	RVU15D
2015-07-01	$2,123.52	$1,834.97	RVU15C
2015-04-01	$2,112.95	$1,825.84	RVU15B
2015-01-01	$2,112.95	$1,825.84	RVU15A
2014-10-01	$2,088.52	$1,812.37	RVU14D
2014-07-01	$2,088.52	$1,812.37	RVU14C
2014-04-01	$2,088.52	$1,812.37	RVU14B
2014-01-01	$2,088.52	$1,812.37	RVU14A
2013-10-01	$2,011.85	$1,729.73	RVU13D
2013-07-01	$2,011.85	$1,729.73	RVU13C
2013-04-01	$2,011.85	$1,729.73	RVU13B
2013-01-01	$2,011.85	$1,729.73	RVU13AR

Price 21077 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

Aceitunas
Adjuntas
Aguada
Aguadilla
Aguas Buenas
Aguas Claras
Aguilita
Aibonito

Browse all communities in Puerto Rico

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

RVUs for 21077PPRRVU2026_Oct_nonQPP.csv, line 1,862 (RVU26D)

1,85921070,,[CPT descriptor omitted],A,,8.40,6.54,NA,6.54,,1.23,16.17,16.17,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86021073,,[CPT descriptor omitted],A,,3.36,9.03,,2.85,,0.48,12.87,6.69,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86121076,,[CPT descriptor omitted],A,,13.07,12.80,,4.07,,1.67,27.54,18.81,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86221077,,[CPT descriptor omitted],A,,32.86,29.07,,9.15,,3.75,65.68,45.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86321079,,[CPT descriptor omitted],A,,21.75,21.26,,6.72,,2.55,45.56,31.02,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86421080,,[CPT descriptor omitted],A,,24.43,24.45,,7.48,,2.91,51.79,34.82,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86521081,,[CPT descriptor omitted],A,,22.28,22.71,,6.95,,2.68,47.67,31.91,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

8802302,OR,99,REST OF OREGON,1.000,0.996,0.703

8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193

9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945

9109202,PR,20,PUERTO RICO,1.000,1.011,0.985

9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892

9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850

9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336

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What 21077 covers

How Puerto Rico compares for 21077

Every other payment area

21077 rates by state

How the 21077 rate is calculated

Payment rules and modifiers for 21077

What modifiers do to the payment

Codes related to 21077

How 21077 has changed in Puerto Rico

Where the Puerto Rico rate applies

21077 billing questions

When should 21077 be chosen instead of an ocular prosthesis service?

How does 21077 differ from 21088?

Does the 90-day global period include related postoperative care?

How is bilateral 21077 reported?

Can an assistant surgeon or co-surgeon be reported?

What happens when 21077 is performed with another procedure in the same session?

Where these rates come from

Did this answer your question about what 21077 pays in Puerto Rico?

Put 21077 and the rest of your codes on one sheet