CPT code 21079: Obturator prosthesis, interim obturator2026 Medicare rate & RVUs in Rhode Island

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 Rhode Island, Medicare pays $1,549.78 for 21079 in the office and $1,048.11 when it’s performed in a hospital or facility.

$1,549.78Office (non-facility)
$1,048.11Hospital or facility
+1.8%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.

We’ll open 21079 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 21079 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 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 Rhode Island 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. Rhode Island pays $1,549.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

21079 in Rhode Island vs other payment areas
  1. Rhode Island · this page$1,549.78
  2. Los Angeles, CA · California$1,652.86+$103.08
  3. Washington, DC area · District of Columbia$1,697.00+$147.22
  4. Miami, FL · Florida$1,681.09+$131.31
  5. Chicago, IL · Illinois$1,640.68+$90.90
  6. Manhattan, NY · New York$1,733.19+$183.41
  7. Alaska · Alaska$1,892.89+$343.11

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

21079 in every other Medicare payment locality
Payment localityOfficeFacility
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

21079 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.

$1,380.31

$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 / territoryOffice rate rangeLocalities
AK$1,892.891
AL$1,396.021
AR$1,380.311
AZ$1,487.471
CA$1,562.74–$1,876.0029
CO$1,557.261
CT$1,608.841
DC$1,697.001
DE$1,508.251
FL$1,533.34–$1,681.093
GA$1,461.41–$1,552.412
GU$1,583.171
HI$1,583.171
IA$1,410.031
ID$1,420.051
IL$1,507.92–$1,640.684
IN$1,426.131
KS$1,411.331
KY$1,435.681
LA$1,436.51–$1,491.432
MA$1,553.71–$1,679.922
MD$1,530.55–$1,697.003
ME$1,432.74–$1,483.932
MI$1,470.95–$1,555.322
MN$1,482.381
MO$1,421.54–$1,487.833
MS$1,400.811
MT$1,521.571
NC$1,443.421
ND$1,471.151
NE$1,414.091
NH$1,540.211
NJ$1,624.39–$1,686.922
NM$1,479.931
NV$1,508.231
NY$1,460.94–$1,775.445
OH$1,460.651
OK$1,426.771
OR$1,493.61–$1,590.392
PA$1,458.83–$1,580.372
PR$1,528.281
RI$1,549.781
SC$1,455.001
SD$1,465.191
TN$1,417.691
TX$1,451.79–$1,554.678
UT$1,470.451
VA$1,484.63–$1,697.002
VI$1,528.281
VT$1,472.571
WA$1,548.47–$1,703.682
WI$1,432.981
WV$1,465.431
WY$1,499.601

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?

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 Rhode Island 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

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 21079 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work21.75× 1.01922.1632
Practice expense21.26× 1.03321.9616
Malpractice2.55× 0.8922.2746
Total RVUs46.3994
Conversion factor× 33.4009

Office rate, Rhode Island$1549.78

Office: (21.75 × 1.019 + 21.26 × 1.033 + 2.55 × 0.892) × $33.4009 = $1549.78

Facility: (21.75 × 1.019 + 6.72 × 1.033 + 2.55 × 0.892) × $33.4009 = $1048.11

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

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

Obturator prosthesis, interim obturator

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

How 21079 has changed in Rhode Island

21079 · Office / nonfacility

$1549.78

Effective 2026-10-01

The base rate is $70.76 higher than on 2025-10-01, moving from $1479.02 to $1549.78 (4.8%).

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

    $1479.02changed to$1549.78

    • 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
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1481.80changed to$1479.02

    • 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.

  3. March 9, 2024

    RVU24AR

    $1457.62changed to$1481.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1498.73changed to$1457.62

    • 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
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $1517.35changed to$1498.73

    • 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
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1533.75changed to$1517.35

    • 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.

  7. January 1, 2021

    RVU21A

    $1626.03changed to$1533.75

    • 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
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1740.22changed to$1626.03

    • 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
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1789.00changed to$1740.22

    • 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.

  10. January 1, 2018

    RVU18AR1

    $1797.48changed to$1789.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 22.73 changed to 21.93
    • Work GPCI 1.025 changed to 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1787.16changed to$1797.48

    • 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
    • Work GPCI 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1793.86changed to$1787.16

    • 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.

  13. July 1, 2015

    RVU15C

    $1784.93changed to$1793.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1783.19changed to$1784.93

    • 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
    • Work GPCI 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1783.19

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,549.78$1,048.11RVU26D
2026-07-01$1,549.78$1,048.11RVU26C
2026-04-01$1,549.78$1,048.11RVU26B
2026-01-01$1,549.78$1,048.11RVU26A
2025-10-01$1,479.02$1,175.21RVU25D
2025-07-01$1,479.02$1,175.21RVU25C
2025-04-01$1,479.02$1,175.21RVU25B
2025-01-01$1,479.02$1,175.21RVU25A
2024-10-01$1,481.80$1,181.25RVU24D
2024-07-01$1,481.80$1,181.25RVU24C
2024-04-01$1,481.80$1,181.25RVU24B
2024-03-09$1,481.80$1,181.25RVU24AR
2024-01-01$1,457.62$1,161.97RVU24A
2023-10-01$1,498.73$1,201.55RVU23D
2023-07-01$1,498.73$1,201.55RVU23C
2023-04-01$1,498.73$1,201.55RVU23B
2023-01-01$1,498.73$1,201.55RVU23A
2022-10-01$1,517.35$1,219.23RVU22D
2022-07-01$1,517.35$1,219.23RVU22C
2022-04-01$1,517.35$1,219.23RVU22B
2022-01-01$1,517.35$1,219.23RVU22A
2021-10-01$1,533.75$1,241.57RVU21D
2021-07-01$1,533.75$1,241.57RVU21C
2021-04-01$1,533.75$1,241.57RVU21B
2021-01-01$1,533.75$1,241.57RVU21A
2020-10-01$1,626.03$1,334.53RVU20D
2020-07-01$1,626.03$1,334.53RVU20C
2020-04-01$1,626.03$1,334.53RVU20B
2020-01-01$1,626.03$1,334.53RVU20A
2019-10-01$1,740.22$1,444.68RVU19D
2019-07-01$1,740.22$1,444.68RVU19C
2019-04-01$1,740.22$1,444.68RVU19B
2019-01-01$1,740.22$1,444.68RVU19A
2018-10-01$1,789.00$1,488.50RVU18D
2018-07-01$1,789.00$1,488.50RVU18C
2018-04-01$1,789.00$1,488.50RVU18B
2018-01-01$1,789.00$1,488.50RVU18AR1
2017-10-01$1,797.48$1,489.77RVU17D
2017-07-01$1,797.48$1,489.77RVU17C
2017-04-01$1,797.48$1,489.77RVU17B
2017-01-01$1,797.48$1,489.77RVU17A
2016-10-01$1,787.16$1,476.87RVU16D
2016-07-01$1,787.16$1,476.87RVU16C
2016-04-01$1,787.16$1,476.87RVU16B
2016-01-01$1,787.16$1,476.87RVU16A
2015-10-01$1,793.86$1,479.80RVU15D
2015-07-01$1,793.86$1,479.80RVU15C
2015-04-01$1,784.93$1,472.44RVU15B
2015-01-01$1,784.93$1,472.44RVU15A
2014-10-01$1,783.19$1,474.63RVU14D
2014-07-01$1,783.19$1,474.63RVU14C
2014-04-01$1,783.19$1,474.63RVU14B
2014-01-01$1,783.19$1,474.63RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 21079 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

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)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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