CPT code 21079: Obturator prosthesis, interim obturator2026 Medicare rate & RVUs in North Carolina

Reports impression and preparation of an interim obturator prosthesis, commonly used during healing after removal of part of the palate or upper jaw.

CMS RVU26DEffective Oct 1, 2026One payment locality493 Medicare services in 2024

In North Carolina, Medicare pays $1,443.42 for 21079 in the office and $990.31 when it’s performed in a hospital or facility.

$1,443.42Office (non-facility)

$990.31Hospital or facility

−5.1%vs the national office rate ($1,521.75)

Check a contract rate as a % of Medicare · 21079 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 North Carolina
What 21079 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

What 21079 covers

Code 21079 covers taking an impression and preparing an interim obturator prosthesis to help close a defect in the palate or upper jaw. A maxillofacial prosthodontist, dentist, or other qualified clinician may provide the service, often after maxillectomy while the surgical site is healing. The prosthesis can help separate the oral and nasal cavities and support speech and swallowing during this transitional period.

Choose this code for an interim obturator, rather than a surgical obturator placed at the time of surgery or a definitive obturator for longer-term use. Documentation should identify the defect, the interim purpose of the appliance, and the impression and preparation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and 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 North Carolina compares for 21079

Across 109 of 109 payment localities, the office rate for 21079 runs from $1,380.31 in Arkansas to $1,892.89 in Alaska. North Carolina pays $1,443.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

21079 in North Carolina vs other payment areas

North Carolina · this page$1,443.42
Los Angeles, CA · California$1,652.86+$209.44
Washington, DC area · District of Columbia$1,697.00+$253.58
Miami, FL · Florida$1,681.09+$237.67
Chicago, IL · Illinois$1,640.68+$197.26
Manhattan, NY · New York$1,733.19+$289.77
Alaska · Alaska$1,892.89+$449.47

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

Every other payment area

21079 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	$1,396.02	$971.07
ArkansasArkansas	$1,380.31	$963.14
ArizonaArizona	$1,487.47	$1,016.87
Bakersfield, CACalifornia	$1,570.42	$1,038.14
Chico, CACalifornia	$1,562.74	$1,030.47
El Centro, CACalifornia	$1,563.17	$1,030.90
Fresno, CACalifornia	$1,562.74	$1,030.47
Hanford, CACalifornia	$1,562.74	$1,030.47
Madera, CACalifornia	$1,562.74	$1,030.47
Merced, CACalifornia	$1,562.74	$1,030.47
Modesto, CACalifornia	$1,562.74	$1,030.47
Napa, CACalifornia	$1,751.42	$1,111.34
Oxnard, CACalifornia	$1,639.21	$1,065.18
Redding, CACalifornia	$1,562.74	$1,030.47
Rest of CaliforniaCalifornia	$1,562.74	$1,030.47
Riverside, CACalifornia	$1,590.47	$1,058.20
Sacramento, CACalifornia	$1,624.12	$1,059.31
Salinas, CACalifornia	$1,617.65	$1,054.78
San Diego, CACalifornia	$1,643.71	$1,062.87
Marin County, CACalifornia	$1,835.82	$1,151.06
San Francisco, CACalifornia	$1,832.93	$1,148.16
San Benito County, CACalifornia	$1,876.00	$1,175.70
Santa Clara County, CACalifornia	$1,864.16	$1,163.86
San Luis Obispo, CACalifornia	$1,593.28	$1,040.13
Santa Cruz, CACalifornia	$1,650.15	$1,060.09
Santa Maria, CACalifornia	$1,620.44	$1,054.18
Santa Rosa, CACalifornia	$1,665.92	$1,069.55
Stockton, CACalifornia	$1,562.74	$1,030.47
Vallejo, CACalifornia	$1,747.25	$1,107.16
Visalia, CACalifornia	$1,562.74	$1,030.47
Yuba City, CACalifornia	$1,562.74	$1,030.47
ColoradoColorado	$1,557.26	$1,040.53
ConnecticutConnecticut	$1,608.84	$1,085.79
DelawareDelaware	$1,508.25	$1,028.43
Fort Lauderdale, FLFlorida	$1,599.80	$1,107.83
Rest of FloridaFlorida	$1,533.34	$1,069.06
Atlanta, GAGeorgia	$1,552.41	$1,058.99
Rest of GeorgiaGeorgia	$1,461.41	$1,028.21
Hawaii, Guam, HIHawaii	$1,583.17	$1,030.99
IowaIowa	$1,410.03	$965.66
IdahoIdaho	$1,420.05	$973.25
East St. Louis, ILIllinois	$1,551.30	$1,104.50
Rest of IllinoisIllinois	$1,507.92	$1,064.52
Suburban Chicago, ILIllinois	$1,611.76	$1,112.99
IndianaIndiana	$1,426.13	$975.93
KansasKansas	$1,411.33	$972.30
KentuckyKentucky	$1,435.68	$1,003.94
New Orleans, LALouisiana	$1,491.43	$1,034.44
Rest of LouisianaLouisiana	$1,436.51	$1,006.71
Metropolitan Boston, MAMassachusetts	$1,679.92	$1,100.06
Rest of MassachusettsMassachusetts	$1,553.71	$1,042.33
Baltimore area, MDMaryland	$1,605.39	$1,084.29
Rest of MarylandMaryland	$1,530.55	$1,039.07
Rest of MaineMaine	$1,432.74	$985.94
Southern Maine, MEMaine	$1,483.93	$1,002.65
Detroit, MIMichigan	$1,555.32	$1,086.67
Rest of MichiganMichigan	$1,470.95	$1,027.56
MinnesotaMinnesota	$1,482.38	$982.64
Metropolitan Kansas City, MOMissouri	$1,476.47	$1,020.45
Metropolitan St. Louis, MOMissouri	$1,487.83	$1,025.49
Rest of MissouriMissouri	$1,421.54	$1,002.91
MississippiMississippi	$1,400.81	$982.67
MontanaMontana	$1,521.57	$1,035.93
North DakotaNorth Dakota	$1,471.15	$985.50
NebraskaNebraska	$1,414.09	$965.84
New HampshireNew Hampshire	$1,540.21	$1,034.65
Northern New JerseyNew Jersey	$1,686.92	$1,123.57
Rest of New JerseyNew Jersey	$1,624.39	$1,094.07
New MexicoNew Mexico	$1,479.93	$1,034.59
NevadaNevada	$1,508.23	$1,022.10
NYC suburbs and Long Island, NYNew York	$1,775.44	$1,198.00
Poughkeepsie and northern NYC suburbs, NYNew York	$1,639.78	$1,108.00
Queens, NYNew York	$1,735.12	$1,161.09
Rest of New YorkNew York	$1,460.94	$999.58
OhioOhio	$1,460.65	$1,017.25
OklahomaOklahoma	$1,426.77	$993.09
Portland, OROregon	$1,590.39	$1,050.83
Rest of OregonOregon	$1,493.61	$1,009.90
Metropolitan Philadelphia, PAPennsylvania	$1,580.37	$1,074.81
Rest of PennsylvaniaPennsylvania	$1,458.83	$1,013.01
Puerto RicoPuerto Rico	$1,528.28	$1,037.29
Rhode IslandRhode Island	$1,549.78	$1,048.11
South CarolinaSouth Carolina	$1,455.00	$1,006.26
South DakotaSouth Dakota	$1,465.19	$979.54
TennesseeTennessee	$1,417.69	$976.24
Austin, TXTexas	$1,554.67	$1,040.86
Beaumont, TXTexas	$1,451.79	$1,009.85
Brazoria, TXTexas	$1,502.43	$1,021.15
Dallas, TXTexas	$1,513.35	$1,029.64
Fort Worth, TXTexas	$1,507.35	$1,028.50
Galveston, TXTexas	$1,507.94	$1,025.69
Houston, TXTexas	$1,554.61	$1,072.36
Rest of TexasTexas	$1,477.27	$1,016.39
UtahUtah	$1,470.45	$1,013.94
VirginiaVirginia	$1,484.63	$1,007.24
Virgin Islands, VIUnited States Virgin Islands	$1,528.28	$1,037.29
VermontVermont	$1,472.57	$991.78
Rest of WashingtonWashington	$1,548.47	$1,037.08
King County, WAWashington	$1,703.68	$1,107.78
WisconsinWisconsin	$1,432.98	$967.73
West VirginiaWest Virginia	$1,465.43	$1,043.40
WyomingWyoming	$1,499.60	$1,013.95

21079 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.

$1,380.31

$1,892.89

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

View every state and territory as a table

21079 office rate range by state
State / territory	Office rate range	Localities
AK	$1,892.89	1
AL	$1,396.02	1
AR	$1,380.31	1
AZ	$1,487.47	1
CA	$1,562.74–$1,876.00	29
CO	$1,557.26	1
CT	$1,608.84	1
DC	$1,697.00	1
DE	$1,508.25	1
FL	$1,533.34–$1,681.09	3
GA	$1,461.41–$1,552.41	2
GU	$1,583.17	1
HI	$1,583.17	1
IA	$1,410.03	1
ID	$1,420.05	1
IL	$1,507.92–$1,640.68	4
IN	$1,426.13	1
KS	$1,411.33	1
KY	$1,435.68	1
LA	$1,436.51–$1,491.43	2
MA	$1,553.71–$1,679.92	2
MD	$1,530.55–$1,697.00	3
ME	$1,432.74–$1,483.93	2
MI	$1,470.95–$1,555.32	2
MN	$1,482.38	1
MO	$1,421.54–$1,487.83	3
MS	$1,400.81	1
MT	$1,521.57	1
NC	$1,443.42	1
ND	$1,471.15	1
NE	$1,414.09	1
NH	$1,540.21	1
NJ	$1,624.39–$1,686.92	2
NM	$1,479.93	1
NV	$1,508.23	1
NY	$1,460.94–$1,775.44	5
OH	$1,460.65	1
OK	$1,426.77	1
OR	$1,493.61–$1,590.39	2
PA	$1,458.83–$1,580.37	2
PR	$1,528.28	1
RI	$1,549.78	1
SC	$1,455.00	1
SD	$1,465.19	1
TN	$1,417.69	1
TX	$1,451.79–$1,554.67	8
UT	$1,470.45	1
VA	$1,484.63–$1,697.00	2
VI	$1,528.28	1
VT	$1,472.57	1
WA	$1,548.47–$1,703.68	2
WI	$1,432.98	1
WV	$1,465.43	1
WY	$1,499.60	1

See 21079 in every payment locality

How the 21079 rate is calculated

Each of 21079’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 · 21079

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work21.75

21.75 RVUs× 1.000 GPCI

Practice expense21.26

21.26 RVUs× 1.000 GPCI

Malpractice2.55

2.55 RVUs× 1.000 GPCI

Adjusted RVUs

45.5600

Conversion factor

$33.4009

Medicare rate

$1,521.75

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,863

Code: 21079
Physician work: 21.75
Practice expense: 21.26
Malpractice: 2.55

GPCI2026.csv

Locality: North Carolina
Physician work: 1.000
Practice expense: 0.933
Malpractice: 0.639

Office calculation for 21079 in North Carolina
Component	RVU	Locality factor	Adjusted
Physician work	21.75	× 1.000	21.7500
Practice expense	21.26	× 0.933	19.8356
Malpractice	2.55	× 0.639	1.6294
Total RVUs			43.2150
Conversion factor			× 33.4009

Office rate, North Carolina$1443.42

Office: (21.75 × 1 + 21.26 × 0.933 + 2.55 × 0.639) × $33.4009 = $1443.42

Facility: (21.75 × 1 + 6.72 × 0.933 + 2.55 × 0.639) × $33.4009 = $990.31

Open 21079 in the RVU calculator

Payment rules and modifiers for 21079

21079 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21079

Obturator prosthesis, interim obturator

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)	0	The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)	1	Not paid (statutory restriction).
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 · 21079

Obturator prosthesis, interim obturator

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 51 · payment effect

With and without the modifier

21079 without 51 · national office

$1,521.75

Obturator prosthesis, interim obturator

21079-51 · Second procedure: 50%

$760.88

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 21079

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

Codes related to 21079
Code	How it relates	Office range, North Carolina
Same family
21076	Obturator prosthesis, surgical obturatorSurgical obturator impression and preparation, rather than an interim prosthesis.	$871.08
21080	Obturator prosthesis, definitive obturatorDefinitive obturator impression and preparation for longer-term use.	$1,640.03
21081	Mandibular prosthesis, impression and custom preparationImpression and preparation for a mandibular resection prosthesis.	$1,509.08

How 21079 has changed in North Carolina

21079 · Office / nonfacility

$1443.42

Effective 2026-10-01

Compare with release effective

The base rate is $69.19 higher than on 2025-10-01, moving from $1374.23 to $1443.42 (5.0%).

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
$1374.23changed to$1443.42
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 22.31 changed to 21.75
- Practice expense RVU 20.25 changed to 21.26
- Malpractice RVU 2.14 changed to 2.55
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1378.28changed to$1374.23
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 19.07 changed to 20.25
- Malpractice RVU 2.16 changed to 2.14
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1355.78changed to$1378.28
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1395.06changed to$1355.78
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 18.67 changed to 19.07
- Malpractice RVU 2.09 changed to 2.16
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$1414.24changed to$1395.06
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 18.24 changed to 18.67
- Malpractice RVU 1.99 changed to 2.09
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1429.46changed to$1414.24
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 18.41 changed to 18.24
- Malpractice RVU 1.92 changed to 1.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1507.46changed to$1429.46
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 19.37 changed to 18.41
- Malpractice RVU 1.91 changed to 1.92
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1588.88changed to$1507.46
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 20.57 changed to 19.37
- Malpractice RVU 3.78 changed to 1.91
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1632.22changed to$1588.88
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 21.93 changed to 20.57
- Malpractice RVU 3.76 changed to 3.78
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$1658.92changed to$1632.22
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 22.73 changed to 21.93
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1669.47changed to$1658.92
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 23.01 changed to 22.73
- Malpractice RVU 3.80 changed to 3.76
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1675.51changed to$1669.47
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 23.06 changed to 23.01
- Malpractice RVU 3.74 changed to 3.80
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1667.17changed to$1675.51
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1640.81changed to$1667.17
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 23.13 changed to 23.06
- Malpractice RVU 2.74 changed to 3.74
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$1608.15changed to$1640.81
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 24.77 changed to 23.13
- Malpractice RVU 2.87 changed to 2.74
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $1608.15
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$1,443.42	$990.31	RVU26D
2026-07-01	$1,443.42	$990.31	RVU26C
2026-04-01	$1,443.42	$990.31	RVU26B
2026-01-01	$1,443.42	$990.31	RVU26A
2025-10-01	$1,374.23	$1,103.45	RVU25D
2025-07-01	$1,374.23	$1,103.45	RVU25C
2025-04-01	$1,374.23	$1,103.45	RVU25B
2025-01-01	$1,374.23	$1,103.45	RVU25A
2024-10-01	$1,378.28	$1,110.41	RVU24D
2024-07-01	$1,378.28	$1,110.41	RVU24C
2024-04-01	$1,378.28	$1,110.41	RVU24B
2024-03-09	$1,378.28	$1,110.41	RVU24AR
2024-01-01	$1,355.78	$1,092.29	RVU24A
2023-10-01	$1,395.06	$1,131.19	RVU23D
2023-07-01	$1,395.06	$1,131.19	RVU23C
2023-04-01	$1,395.06	$1,131.19	RVU23B
2023-01-01	$1,395.06	$1,131.19	RVU23A
2022-10-01	$1,414.24	$1,150.25	RVU22D
2022-07-01	$1,414.24	$1,150.25	RVU22C
2022-04-01	$1,414.24	$1,150.25	RVU22B
2022-01-01	$1,414.24	$1,150.25	RVU22A
2021-10-01	$1,429.46	$1,170.74	RVU21D
2021-07-01	$1,429.46	$1,170.74	RVU21C
2021-04-01	$1,429.46	$1,170.74	RVU21B
2021-01-01	$1,429.46	$1,170.74	RVU21A
2020-10-01	$1,507.46	$1,249.02	RVU20D
2020-07-01	$1,507.46	$1,249.02	RVU20C
2020-04-01	$1,507.46	$1,249.02	RVU20B
2020-01-01	$1,507.46	$1,249.02	RVU20A
2019-10-01	$1,588.88	$1,326.84	RVU19D
2019-07-01	$1,588.88	$1,326.84	RVU19C
2019-04-01	$1,588.88	$1,326.84	RVU19B
2019-01-01	$1,588.88	$1,326.84	RVU19A
2018-10-01	$1,632.22	$1,365.77	RVU18D
2018-07-01	$1,632.22	$1,365.77	RVU18C
2018-04-01	$1,632.22	$1,365.77	RVU18B
2018-01-01	$1,632.22	$1,365.77	RVU18AR1
2017-10-01	$1,658.92	$1,386.61	RVU17D
2017-07-01	$1,658.92	$1,386.61	RVU17C
2017-04-01	$1,658.92	$1,386.61	RVU17B
2017-01-01	$1,658.92	$1,386.61	RVU17A
2016-10-01	$1,669.47	$1,395.43	RVU16D
2016-07-01	$1,669.47	$1,395.43	RVU16C
2016-04-01	$1,669.47	$1,395.43	RVU16B
2016-01-01	$1,669.47	$1,395.43	RVU16A
2015-10-01	$1,675.51	$1,398.14	RVU15D
2015-07-01	$1,675.51	$1,398.14	RVU15C
2015-04-01	$1,667.17	$1,391.18	RVU15B
2015-01-01	$1,667.17	$1,391.18	RVU15A
2014-10-01	$1,640.81	$1,368.58	RVU14D
2014-07-01	$1,640.81	$1,368.58	RVU14C
2014-04-01	$1,640.81	$1,368.58	RVU14B
2014-01-01	$1,640.81	$1,368.58	RVU14A
2013-10-01	$1,608.15	$1,325.55	RVU13D
2013-07-01	$1,608.15	$1,325.55	RVU13C
2013-04-01	$1,608.15	$1,325.55	RVU13B
2013-01-01	$1,608.15	$1,325.55	RVU13AR

Price 21079 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

Aberdeen
Advance
Ahoskie
Alamance
Albemarle
Alexis
Alliance
Altamahaw

Browse all communities in North Carolina

21079 billing questions

How is an interim obturator different from a surgical obturator?

Use 21079 for an interim prosthesis used during healing. Code 21076 describes impression and preparation for a surgical obturator.

How does an interim obturator differ from a definitive obturator?

Code 21079 is for the transitional appliance used during healing; 21080 is for a definitive obturator.

Can the impression and prosthesis preparation be billed separately?

The code represents the impression and preparation service for the interim obturator. Do not separately report those same included steps as independent services.

Should modifier 50 be appended for a bilateral defect?

No. CMS identifies bilateral adjustment as inappropriate for this code, and modifier 50 should not be used.

Can an assistant surgeon or co-surgeon be paid for this service?

CMS applies a statutory restriction to assistant-at-surgery payment and does not permit co-surgeons or team surgery for this code.

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

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 21079PPRRVU2026_Oct_nonQPP.csv, line 1,863 (RVU26D)

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

1,86621082,,[CPT descriptor omitted],A,,20.32,22.14,,7.02,,2.40,44.86,29.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210

8113292,NY,04,QUEENS,1.064,1.182,1.442

8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703

8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639

8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406

8515202,OH,00,OHIO,1.000,0.913,1.008

8604312,OK,00,OKLAHOMA,1.000,0.893,0.777

Open CMS source How we calculate rates

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What 21079 covers

How North Carolina compares for 21079

Every other payment area

21079 rates by state

How the 21079 rate is calculated

Payment rules and modifiers for 21079

What modifiers do to the payment

Codes related to 21079

How 21079 has changed in North Carolina

Where the North Carolina rate applies

21079 billing questions

How is an interim obturator different from a surgical obturator?

How does an interim obturator differ from a definitive obturator?

Can the impression and prosthesis preparation be billed separately?

Should modifier 50 be appended for a bilateral defect?

Can an assistant surgeon or co-surgeon be paid for this service?

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

Where these rates come from

Did this answer your question about what 21079 pays in North Carolina?

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