CPT code 21080: Obturator prosthesis, definitive obturator2026 Medicare rate & RVUs in Riverside, CA

Impression and preparation of a definitive obturator prosthesis to restore an acquired maxillary defect, commonly after resection and healing.

CMS RVU26DEffective Oct 1, 2026One payment locality521 Medicare services in 2024

In Riverside, CA, Medicare pays $1,808.63 for 21080 in the office and $1,187.40 when it’s performed in a hospital or facility.

$1,808.63Office (non-facility)
$1,187.40Hospital or facility
+4.6%vs the national office rate ($1,729.83)

Check a contract rate as a % of Medicare · 21080 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 21080 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Riverside, CA
  2. What 21080 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 21080 covers

This service covers taking an impression and preparing a definitive obturator prosthesis for a patient with an acquired maxillary or palatal defect, often following maxillectomy. The custom appliance closes the opening between the oral and nasal cavities and can support speech and swallowing. A maxillofacial prosthodontist or dentist with maxillofacial prosthetic expertise typically performs the work in a dental prosthetics clinic or hospital outpatient setting. The definitive stage is generally selected after the surgical defect has healed or stabilized, rather than for an appliance used immediately after surgery or during interim healing.

Report this code for the definitive obturator service, not the surgical or interim obturator stage. Documentation should identify the defect and clinical stage and describe the impression and preparation performed. CMS assigns a 90-day major-surgery global period, including 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 others at 50%. Bilateral adjustment 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 Riverside, CA compares for 21080

Across 109 of 109 payment localities, the office rate for 21080 runs from $1,567.54 in Arkansas to $2,147.27 in Alaska. Riverside, CA pays $1,808.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

21080 in Riverside, CA vs other payment areas
  1. Riverside, CA · this page$1,808.63
  2. Bakersfield, CA · California$1,785.73−$22.90
  3. Chico, CA · California$1,777.00−$31.63
  4. El Centro, CA · California$1,777.49−$31.14
  5. Fresno, CA · California$1,777.00−$31.63
  6. Hanford, CA · California$1,777.00−$31.63
  7. Los Angeles, CA · California$1,880.08+$71.45

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

Every other payment area

21080 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$1,777.00$1,155.78
Merced, CACalifornia$1,777.00$1,155.78
Modesto, CACalifornia$1,777.00$1,155.78
Napa, CACalifornia$1,993.11$1,246.05
Oxnard, CACalifornia$1,864.67$1,194.69
Redding, CACalifornia$1,777.00$1,155.78
Rest of CaliforniaCalifornia$1,777.00$1,155.78
Sacramento, CACalifornia$1,847.22$1,188.02

21080 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.

$1,567.54

$2,147.27

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

View every state and territory as a table
21080 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,147.271
AL$1,585.571
AR$1,567.541
AZ$1,690.521
CA$1,777.00–$2,135.4529
CO$1,770.601
CT$1,829.451
DC$1,930.241
DE$1,714.301
FL$1,742.79–$1,911.933
GA$1,660.30–$1,764.882
GU$1,800.791
HI$1,800.791
IA$1,601.811
ID$1,613.281
IL$1,713.51–$1,865.504
IN$1,620.261
KS$1,603.221
KY$1,630.921
LA$1,631.84–$1,694.872
MA$1,766.44–$1,911.032
MD$1,739.82–$1,930.243
ME$1,627.76–$1,686.622
MI$1,671.32–$1,767.932
MN$1,685.091
MO$1,614.61–$1,690.833
MS$1,590.951
MT$1,729.641
NC$1,640.031
ND$1,672.101
NE$1,606.491
NH$1,751.171
NJ$1,847.03–$1,918.512
NM$1,681.591
NV$1,714.421
NY$1,660.13–$2,019.705
OH$1,659.561
OK$1,620.781
OR$1,697.70–$1,808.652
PA$1,657.52–$1,796.762
PR$1,737.361
RI$1,761.791
SC$1,653.191
SD$1,665.291
TN$1,610.521
TX$1,649.43–$1,767.758
UT$1,670.921
VA$1,687.37–$1,930.242
VI$1,737.361
VT$1,673.651
WA$1,760.49–$1,938.222
WI$1,628.271
WV$1,664.741
WY$1,704.561

See 21080 in every payment locality

How the 21080 rate is calculated

Each of 21080’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 · 21080

RVUs × geographic indexes × conversion factor

Office or facility?

Work24.43

24.43 RVUs× 1.000 GPCI

Practice expense24.45

24.45 RVUs× 1.000 GPCI

Malpractice2.91

2.91 RVUs× 1.000 GPCI

Adjusted RVUs

51.7900

Conversion factor

$33.4009

Medicare rate

$1,729.83

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

The exact Riverside, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,864

Code
21080
Physician work
24.43
Practice expense
24.45
Malpractice
2.91

GPCI2026.csv

20

Locality
Riverside, CA
Physician work
1.018
Practice expense
1.096
Malpractice
0.853
Office calculation for 21080 in Riverside, CA
ComponentRVULocality factorAdjusted
Physician work24.43× 1.01824.8697
Practice expense24.45× 1.09626.7972
Malpractice2.91× 0.8532.4822
Total RVUs54.1492
Conversion factor× 33.4009

Office rate, Riverside, CA$1808.63

Office: (24.43 × 1.018 + 24.45 × 1.096 + 2.91 × 0.853) × $33.4009 = $1808.63

Facility: (24.43 × 1.018 + 7.48 × 1.096 + 2.91 × 0.853) × $33.4009 = $1187.40

Open 21080 in the RVU calculator

Payment rules and modifiers for 21080

21080 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21080

Obturator prosthesis, definitive 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 · 21080

Obturator prosthesis, definitive 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

21080 without 51 · national office

$1,729.83

Obturator prosthesis, definitive obturator

21080-51 · Second procedure: 50%

$864.92

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 21080 has changed in Riverside, CA

21080 · Office / nonfacility

$1808.63

Effective 2026-10-01

The base rate is $91.26 higher than on 2025-10-01, moving from $1717.37 to $1808.63 (5.3%).

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

    $1717.37changed to$1808.63

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 25.06 changed to 24.43
    • Practice expense RVU 23.36 changed to 24.45
    • Malpractice RVU 2.41 changed to 2.91
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.892 changed to 0.853

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1725.06changed to$1717.37

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 22.19 changed to 23.36
    • Malpractice RVU 2.42 changed to 2.41

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1696.91changed to$1725.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1750.27changed to$1696.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 22.10 changed to 22.19
    • Malpractice RVU 2.40 changed to 2.42
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.924 changed to 0.892
  5. January 1, 2023

    RVU23A

    $1772.51changed to$1750.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 21.91 changed to 22.10
    • Malpractice RVU 2.25 changed to 2.40
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.955 changed to 0.924

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1785.35changed to$1772.51

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 22.01 changed to 21.91
    • Malpractice RVU 2.22 changed to 2.25
    • Malpractice GPCI 0.896 changed to 0.955

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1864.22changed to$1785.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 22.61 changed to 22.01
    • Malpractice RVU 2.17 changed to 2.22
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.830 changed to 0.896

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1944.86changed to$1864.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 23.50 changed to 22.61
    • Malpractice RVU 4.17 changed to 2.17
    • Work GPCI 1.021 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.753 changed to 0.830

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1982.70changed to$1944.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 24.78 changed to 23.50
    • Malpractice RVU 4.21 changed to 4.17
    • Work GPCI 1.020 changed to 1.021
    • Malpractice GPCI 0.689 changed to 0.753

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $2005.20changed to$1982.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 25.58 changed to 24.78
    • Malpractice RVU 4.17 changed to 4.21
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.626 changed to 0.689

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$2005.20

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,808.63$1,187.40RVU26D
2026-07-01$1,808.63$1,187.40RVU26C
2026-04-01$1,808.63$1,187.40RVU26B
2026-01-01$1,808.63$1,187.40RVU26A
2025-10-01$1,717.37$1,338.02RVU25D
2025-07-01$1,717.37$1,338.02RVU25C
2025-04-01$1,717.37$1,338.02RVU25B
2025-01-01$1,717.37$1,338.02RVU25A
2024-10-01$1,725.06$1,348.50RVU24D
2024-07-01$1,725.06$1,348.50RVU24C
2024-04-01$1,725.06$1,348.50RVU24B
2024-03-09$1,725.06$1,348.50RVU24AR
2024-01-01$1,696.91$1,326.49RVU24A
2023-10-01$1,750.27$1,378.41RVU23D
2023-07-01$1,750.27$1,378.41RVU23C
2023-04-01$1,750.27$1,378.41RVU23B
2023-01-01$1,750.27$1,378.41RVU23A
2022-10-01$1,772.51$1,401.01RVU22D
2022-07-01$1,772.51$1,401.01RVU22C
2022-04-01$1,772.51$1,401.01RVU22B
2022-01-01$1,772.51$1,401.01RVU22A
2021-10-01$1,785.35$1,420.80RVU21D
2021-07-01$1,785.35$1,420.80RVU21C
2021-04-01$1,785.35$1,420.80RVU21B
2021-01-01$1,785.35$1,420.80RVU21A
2020-10-01$1,864.22$1,502.77RVU20D
2020-07-01$1,864.22$1,502.77RVU20C
2020-04-01$1,864.22$1,502.77RVU20B
2020-01-01$1,864.22$1,502.77RVU20A
2019-10-01$1,944.86$1,582.96RVU19D
2019-07-01$1,944.86$1,582.96RVU19C
2019-04-01$1,944.86$1,582.96RVU19B
2019-01-01$1,944.86$1,582.96RVU19A
2018-10-01$1,982.70$1,620.04RVU18D
2018-07-01$1,982.70$1,620.04RVU18C
2018-04-01$1,982.70$1,620.04RVU18B
2018-01-01$1,982.70$1,620.04RVU18AR1
2017-10-01$2,005.20$1,635.77RVU17D
2017-07-01$2,005.20$1,635.77RVU17C
2017-04-01$2,005.20$1,635.77RVU17B
2017-01-01$2,005.20$1,635.77RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
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 21080 for an earlier date of service

Where the Riverside, CA rate applies

Riverside, CA is a Medicare payment area, not a city. Our Census mapping connects it to 127 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Ontario
  • Riverside
  • San Bernardino
  • Adelanto
  • Aguanga
  • Anza
  • Apple Valley
  • Baker

Browse all communities in California

21080 billing questions

When should this code be chosen over 21079?

Use 21080 for the definitive obturator stage. Code 21079 describes an interim obturator used during the healing period.

How does 21080 differ from 21076?

21080 is for a definitive obturator; 21076 is for a surgical obturator used in the surgical stage.

What documentation supports reporting 21080?

Document the acquired maxillary or palatal defect, its clinical stage, and the impression and preparation work for the definitive appliance.

Can modifier 50 be used for bilateral obturator work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the global period affect related care?

The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care through day 90.

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

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure is 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 21080PPRRVU2026_Oct_nonQPP.csv, line 1,864 (RVU26D)
Geographic factors for Riverside, CAGPCI2026.csv, line 20 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 21080 pays in Riverside, CA?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 21080 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet