CPT code 21081: Mandibular prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Iowa

Reports impression-taking and custom preparation of a prosthesis for a patient with a mandibular resection, rather than an obturator or other facial prosthesis.

CMS RVU26DEffective Oct 1, 2026One payment locality335 Medicare services in 2024

In Iowa, Medicare pays $1,473.77 for 21081 in the office and $992.11 when it’s performed in a hospital or facility.

$1,473.77Office (non-facility)
$992.11Hospital or facility
−7.4%vs the national office rate ($1,592.22)

Check a contract rate as a % of Medicare · 21081 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 21081 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 21081 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 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.

How Iowa compares for 21081

Across 109 of 109 payment localities, the office rate for 21081 runs from $1,441.85 in Arkansas to $1,973.42 in Alaska. Iowa pays $1,473.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

21081 in Iowa vs other payment areas
  1. Iowa · this page$1,473.77
  2. Los Angeles, CA · California$1,731.47+$257.70
  3. Washington, DC area · District of Columbia$1,777.54+$303.77
  4. Miami, FL · Florida$1,760.19+$286.42
  5. Chicago, IL · Illinois$1,717.14+$243.37
  6. Manhattan, NY · New York$1,815.19+$341.42
  7. Alaska · Alaska$1,973.42+$499.65

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

Every other payment area

21081 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,458.55$997.96
ArkansasArkansas$1,441.85$989.68
ArizonaArizona$1,555.82$1,045.74
Bakersfield, CACalifornia$1,644.18$1,067.25
Chico, CACalifornia$1,636.16$1,059.22
El Centro, CACalifornia$1,636.60$1,059.67
Fresno, CACalifornia$1,636.16$1,059.22
Hanford, CACalifornia$1,636.16$1,059.22

21081 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.

$1,441.85

$1,973.42

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

View every state and territory as a table
21081 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,973.421
AL$1,458.551
AR$1,441.851
AZ$1,555.821
CA$1,636.16–$1,967.8229
CO$1,630.091
CT$1,684.311
DC$1,777.541
DE$1,577.801
FL$1,603.87–$1,760.193
GA$1,527.49–$1,624.582
GU$1,658.451
HI$1,658.451
IA$1,473.771
ID$1,484.361
IL$1,576.63–$1,717.144
IN$1,490.841
KS$1,475.001
KY$1,500.411
LA$1,501.23–$1,559.642
MA$1,626.16–$1,760.042
MD$1,601.42–$1,777.543
ME$1,497.70–$1,552.362
MI$1,537.78–$1,627.082
MN$1,551.201
MO$1,485.22–$1,555.993
MS$1,463.421
MT$1,592.041
NC$1,509.081
ND$1,539.051
NE$1,478.141
NH$1,612.131
NJ$1,700.46–$1,766.562
NM$1,547.251
NV$1,578.031
NY$1,527.71–$1,859.925
OH$1,526.941
OK$1,491.101
OR$1,562.60–$1,665.412
PA$1,525.10–$1,653.992
PR$1,599.221
RI$1,621.721
SC$1,521.151
SD$1,532.781
TN$1,481.751
TX$1,517.60–$1,627.508
UT$1,537.581
VA$1,553.01–$1,777.542
VI$1,599.221
VT$1,540.421
WA$1,620.70–$1,785.242
WI$1,498.421
WV$1,531.431
WY$1,568.951

See 21081 in every payment locality

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

Office or facility?

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.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,865

Code
21081
Physician work
22.28
Practice expense
22.71
Malpractice
2.68

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 21081 in Iowa
ComponentRVULocality factorAdjusted
Physician work22.28× 1.00022.2800
Practice expense22.71× 0.91520.7797
Malpractice2.68× 0.3971.0640
Total RVUs44.1236
Conversion factor× 33.4009

Office rate, Iowa$1473.77

Office: (22.28 × 1 + 22.71 × 0.915 + 2.68 × 0.397) × $33.4009 = $1473.77

Facility: (22.28 × 1 + 6.95 × 0.915 + 2.68 × 0.397) × $33.4009 = $992.11

Open 21081 in the RVU calculator

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

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)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 · 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.

  • 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

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%).

When to use modifier 51

How 21081 has changed in Iowa

21081 · Office / nonfacility

$1473.77

Effective 2026-10-01

The base rate is $59.36 higher than on 2025-10-01, moving from $1414.41 to $1473.77 (4.2%).

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

    $1414.41changed to$1473.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 22.85 changed to 22.28
    • Practice expense RVU 21.75 changed to 22.71
    • Malpractice RVU 2.23 changed to 2.68
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1428.97changed to$1414.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 20.87 changed to 21.75
    • Malpractice RVU 2.24 changed to 2.23

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1405.64changed to$1428.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1444.32changed to$1405.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 20.68 changed to 20.87
    • Malpractice RVU 2.16 changed to 2.24
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $1457.11changed to$1444.32

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 20.26 changed to 20.68
    • Malpractice RVU 2.07 changed to 2.16
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1476.70changed to$1457.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 20.53 changed to 20.26
    • Malpractice RVU 2.00 changed to 2.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1541.03changed to$1476.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 20.96 changed to 20.53
    • Malpractice RVU 1.98 changed to 2.00
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1595.58changed to$1541.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 21.82 changed to 20.96
    • Malpractice RVU 3.86 changed to 1.98
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1632.53changed to$1595.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 23.01 changed to 21.82
    • Malpractice RVU 3.85 changed to 3.86

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1655.40changed to$1632.53

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 23.85 changed to 23.01
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1662.65changed to$1655.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 24.19 changed to 23.85
    • Malpractice RVU 3.88 changed to 3.85
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1667.91changed to$1662.65

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 24.20 changed to 24.19
    • Malpractice RVU 3.82 changed to 3.88

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1659.61changed to$1667.91

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1645.25changed to$1659.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 24.37 changed to 24.20
    • Malpractice RVU 2.82 changed to 3.82
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1605.72changed to$1645.25

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 25.93 changed to 24.37
    • Malpractice RVU 2.95 changed to 2.82
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1605.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,473.77$992.11RVU26D
2026-07-01$1,473.77$992.11RVU26C
2026-04-01$1,473.77$992.11RVU26B
2026-01-01$1,473.77$992.11RVU26A
2025-10-01$1,414.41$1,117.02RVU25D
2025-07-01$1,414.41$1,117.02RVU25C
2025-04-01$1,414.41$1,117.02RVU25B
2025-01-01$1,414.41$1,117.02RVU25A
2024-10-01$1,428.97$1,129.31RVU24D
2024-07-01$1,428.97$1,129.31RVU24C
2024-04-01$1,428.97$1,129.31RVU24B
2024-03-09$1,428.97$1,129.31RVU24AR
2024-01-01$1,405.64$1,110.87RVU24A
2023-10-01$1,444.32$1,147.05RVU23D
2023-07-01$1,444.32$1,147.05RVU23C
2023-04-01$1,444.32$1,147.05RVU23B
2023-01-01$1,444.32$1,147.05RVU23A
2022-10-01$1,457.11$1,160.50RVU22D
2022-07-01$1,457.11$1,160.50RVU22C
2022-04-01$1,457.11$1,160.50RVU22B
2022-01-01$1,457.11$1,160.50RVU22A
2021-10-01$1,476.70$1,183.32RVU21D
2021-07-01$1,476.70$1,183.32RVU21C
2021-04-01$1,476.70$1,183.32RVU21B
2021-01-01$1,476.70$1,183.32RVU21A
2020-10-01$1,541.03$1,253.64RVU20D
2020-07-01$1,541.03$1,253.64RVU20C
2020-04-01$1,541.03$1,253.64RVU20B
2020-01-01$1,541.03$1,253.64RVU20A
2019-10-01$1,595.58$1,310.22RVU19D
2019-07-01$1,595.58$1,310.22RVU19C
2019-04-01$1,595.58$1,310.22RVU19B
2019-01-01$1,595.58$1,310.22RVU19A
2018-10-01$1,632.53$1,345.85RVU18D
2018-07-01$1,632.53$1,345.85RVU18C
2018-04-01$1,632.53$1,345.85RVU18B
2018-01-01$1,632.53$1,345.85RVU18AR1
2017-10-01$1,655.40$1,366.97RVU17D
2017-07-01$1,655.40$1,366.97RVU17C
2017-04-01$1,655.40$1,366.97RVU17B
2017-01-01$1,655.40$1,366.97RVU17A
2016-10-01$1,662.65$1,372.32RVU16D
2016-07-01$1,662.65$1,372.32RVU16C
2016-04-01$1,662.65$1,372.32RVU16B
2016-01-01$1,662.65$1,372.32RVU16A
2015-10-01$1,667.91$1,375.88RVU15D
2015-07-01$1,667.91$1,375.88RVU15C
2015-04-01$1,659.61$1,369.04RVU15B
2015-01-01$1,659.61$1,369.04RVU15A
2014-10-01$1,645.25$1,357.99RVU14D
2014-07-01$1,645.25$1,357.99RVU14C
2014-04-01$1,645.25$1,357.99RVU14B
2014-01-01$1,645.25$1,357.99RVU14A
2013-10-01$1,605.72$1,306.95RVU13D
2013-07-01$1,605.72$1,306.95RVU13C
2013-04-01$1,605.72$1,306.95RVU13B
2013-01-01$1,605.72$1,306.95RVU13AR

Price 21081 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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
RVUs for 21081PPRRVU2026_Oct_nonQPP.csv, line 1,865 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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