CPT code 21081: Mandibular prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Guam
Reports impression-taking and custom preparation of a prosthesis for a patient with a mandibular resection, rather than an obturator or other facial prosthesis.
Medicare pays $1,658.45 for 21081 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 21081 covers
A maxillofacial prosthodontist or other qualified clinician uses this service to take an impression and custom-prepare a prosthesis for a patient with a surgically resected portion of the mandible. The work is associated with reconstruction or prosthetic management after jaw resection and may be performed in a hospital-based service or a clinical prosthetics setting. The clinical record should identify the mandibular defect and the prosthesis being prepared.
Select this code for the mandibular resection prosthesis, not an obturator for a palatal or maxillary defect. Document the resection site, impression work, and customization performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.
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.
21081 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $1,658.45 | $1,059.94 |
How the 21081 rate is calculated
Each of 21081’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 · 21081
RVUs × geographic indexes × conversion factor
Work22.28
22.28 RVUs× 1.000 GPCI
Practice expense22.71
22.71 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
47.6700
Conversion factor
$33.4009
Medicare rate
$1,592.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21081
21081 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21081
Mandibular 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 21081
Mandibular 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21081 without 51 · national office
$1,592.22
Mandibular prosthesis, impression and custom preparation
21081-51 · Second procedure: 50%
$796.11
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%).
21081 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21076Obturator prosthesisSurgical obturator
- 21076 describes custom preparation of a surgical obturator for a maxillary defect. Use 21081 for a mandibular resection prosthesis.
- 21079Obturator prosthesisInterim obturator
- 21079 is for an interim obturator. It does not describe preparation of a mandibular resection prosthesis.
- 21080Obturator prosthesisDefinitive obturator
- 21080 is for a definitive obturator; 21081 is for a prosthesis associated with mandibular resection.
- 21082Palatal prosthesisAugmentation for tongue contact
- 21082 describes a palatal augmentation prosthesis. Choose 21081 when the custom-prepared prosthesis is for mandibular resection.
21081 billing questions
When should I choose 21081 instead of an obturator code?
Use 21081 for impression and custom preparation of a prosthesis for a mandibular resection. Obturator codes describe prostheses for defects requiring an obturator, not a mandibular resection prosthesis.
What documentation supports 21081?
Document the mandibular resection defect, the planned mandibular prosthesis, and the impression and custom preparation performed.
Does 21081 have a global period?
Yes. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.
Can I append modifier 50?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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
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