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

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 South Carolina, Medicare pays $2,101.19 for 21077 in the office and $1,486.41 when it’s performed in a hospital or facility.

$2,101.19Office (non-facility)
$1,486.41Hospital or facility
−4.2%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.

We’ll open 21077 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 21077 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 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 South Carolina 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. South Carolina pays $2,101.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

21077 in South Carolina vs other payment areas
  1. South Carolina · this page$2,101.19
  2. Los Angeles, CA · California$2,374.37+$273.18
  3. Washington, DC area · District of Columbia$2,440.02+$338.83
  4. Miami, FL · Florida$2,425.09+$323.90
  5. Chicago, IL · Illinois$2,368.51+$267.32
  6. Manhattan, NY · New York$2,494.71+$393.52
  7. Alaska · Alaska$2,749.42+$648.23

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

Every other payment area

21077 in every other Medicare payment locality
Payment localityOfficeFacility
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

21077 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.

$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 / territoryOffice rate rangeLocalities
AK$2,749.421
AL$2,018.041
AR$1,996.121
AZ$2,145.631
CA$2,247.52–$2,685.5529
CO$2,241.651
CT$2,316.791
DC$2,440.021
DE$2,174.961
FL$2,214.05–$2,425.093
GA$2,112.96–$2,237.782
GU$2,274.061
HI$2,274.061
IA$2,035.711
ID$2,050.091
IL$2,179.81–$2,368.514
IN$2,058.511
KS$2,038.431
KY$2,075.351
LA$2,076.85–$2,153.522
MA$2,237.37–$2,413.362
MD$2,206.13–$2,440.023
ME$2,068.75–$2,138.812
MI$2,125.45–$2,245.712
MN$2,133.751
MO$2,056.52–$2,147.423
MS$2,026.121
MT$2,193.521
NC$2,083.501
ND$2,119.371
NE$2,041.101
NH$2,217.921
NJ$2,339.15–$2,426.792
NM$2,138.361
NV$2,173.821
NY$2,108.02–$2,554.875
OH$2,110.301
OK$2,061.951
OR$2,152.69–$2,287.042
PA$2,107.26–$2,277.512
PR$2,202.571
RI$2,233.141
SC$2,101.191
SD$2,110.601
TN$2,047.421
TX$2,097.49–$2,242.858
UT$2,122.741
VA$2,140.44–$2,440.022
VI$2,202.571
VT$2,122.191
WA$2,229.56–$2,446.142
WI$2,066.321
WV$2,120.561
WY$2,161.211

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?

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 South Carolina 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

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 21077 in South Carolina
ComponentRVULocality factorAdjusted
Physician work32.86× 1.00032.8600
Practice expense29.07× 0.92426.8607
Malpractice3.75× 0.8503.1875
Total RVUs62.9082
Conversion factor× 33.4009

Office rate, South Carolina$2101.19

Office: (32.86 × 1 + 29.07 × 0.924 + 3.75 × 0.85) × $33.4009 = $2101.19

Facility: (32.86 × 1 + 9.15 × 0.924 + 3.75 × 0.85) × $33.4009 = $1486.41

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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)0.10/0.69/0.21Share 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.

  • 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
CodeHow it relatesOffice range, South Carolina
Same family
21086Auricular prosthesis, impression and preparationImpression and custom preparation for an auricular prosthesis.$1,558.38
21087Nasal prosthesis, impression and custom preparationImpression and custom preparation for a nasal prosthesis.$1,558.38
21088Facial prosthesis, impression and preparationImpression and custom preparation for a facial prosthesis.No office rate
21076Obturator prosthesis, surgical obturatorImpression and preparation for a surgical obturator rather than an orbital prosthesis.$879.00

How 21077 has changed in South Carolina

21077 · Office / nonfacility

$2101.19

Effective 2026-10-01

The base rate is $102.92 higher than on 2025-10-01, moving from $1998.27 to $2101.19 (5.2%).

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

    $1998.27changed to$2101.19

    • 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 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $2016.13changed to$1998.27

    • 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.

  3. March 9, 2024

    RVU24AR

    $1983.22changed to$2016.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2025.32changed to$1983.22

    • 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 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $2030.31changed to$2025.32

    • 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 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2058.90changed to$2030.31

    • 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.

  7. January 1, 2021

    RVU21A

    $2179.61changed to$2058.90

    • 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
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $2294.17changed to$2179.61

    • 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 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $2368.80changed to$2294.17

    • 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.

  10. January 1, 2018

    RVU18AR1

    $2422.03changed to$2368.80

    • 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
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $2449.15changed to$2422.03

    • 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
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $2459.79changed to$2449.15

    • 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.

  13. July 1, 2015

    RVU15C

    $2447.55changed to$2459.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $2406.17changed to$2447.55

    • 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 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $2334.08changed to$2406.17

    • 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 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $2334.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,101.19$1,486.41RVU26D
2026-07-01$2,101.19$1,486.41RVU26C
2026-04-01$2,101.19$1,486.41RVU26B
2026-01-01$2,101.19$1,486.41RVU26A
2025-10-01$1,998.27$1,646.24RVU25D
2025-07-01$1,998.27$1,646.24RVU25C
2025-04-01$1,998.27$1,646.24RVU25B
2025-01-01$1,998.27$1,646.24RVU25A
2024-10-01$2,016.13$1,662.67RVU24D
2024-07-01$2,016.13$1,662.67RVU24C
2024-04-01$2,016.13$1,662.67RVU24B
2024-03-09$2,016.13$1,662.67RVU24AR
2024-01-01$1,983.22$1,635.54RVU24A
2023-10-01$2,025.32$1,677.01RVU23D
2023-07-01$2,025.32$1,677.01RVU23C
2023-04-01$2,025.32$1,677.01RVU23B
2023-01-01$2,025.32$1,677.01RVU23A
2022-10-01$2,030.31$1,685.95RVU22D
2022-07-01$2,030.31$1,685.95RVU22C
2022-04-01$2,030.31$1,685.95RVU22B
2022-01-01$2,030.31$1,685.95RVU22A
2021-10-01$2,058.90$1,716.09RVU21D
2021-07-01$2,058.90$1,716.09RVU21C
2021-04-01$2,058.90$1,716.09RVU21B
2021-01-01$2,058.90$1,716.09RVU21A
2020-10-01$2,179.61$1,832.96RVU20D
2020-07-01$2,179.61$1,832.96RVU20C
2020-04-01$2,179.61$1,832.96RVU20B
2020-01-01$2,179.61$1,832.96RVU20A
2019-10-01$2,294.17$1,938.87RVU19D
2019-07-01$2,294.17$1,938.87RVU19C
2019-04-01$2,294.17$1,938.87RVU19B
2019-01-01$2,294.17$1,938.87RVU19A
2018-10-01$2,368.80$2,003.71RVU18D
2018-07-01$2,368.80$2,003.71RVU18C
2018-04-01$2,368.80$2,003.71RVU18B
2018-01-01$2,368.80$2,003.71RVU18AR1
2017-10-01$2,422.03$2,048.25RVU17D
2017-07-01$2,422.03$2,048.25RVU17C
2017-04-01$2,422.03$2,048.25RVU17B
2017-01-01$2,422.03$2,048.25RVU17A
2016-10-01$2,449.15$2,072.00RVU16D
2016-07-01$2,449.15$2,072.00RVU16C
2016-04-01$2,449.15$2,072.00RVU16B
2016-01-01$2,449.15$2,072.00RVU16A
2015-10-01$2,459.79$2,086.52RVU15D
2015-07-01$2,459.79$2,086.52RVU15C
2015-04-01$2,447.55$2,076.14RVU15B
2015-01-01$2,447.55$2,076.14RVU15A
2014-10-01$2,406.17$2,042.62RVU14D
2014-07-01$2,406.17$2,042.62RVU14C
2014-04-01$2,406.17$2,042.62RVU14B
2014-01-01$2,406.17$2,042.62RVU14A
2013-10-01$2,334.08$1,955.84RVU13D
2013-07-01$2,334.08$1,955.84RVU13C
2013-04-01$2,334.08$1,955.84RVU13B
2013-01-01$2,334.08$1,955.84RVU13AR

Price 21077 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

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)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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