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CPT code 21083: Palatal lift prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Washington, DC area

Reports impression and custom preparation of a palatal lift prosthesis to elevate a weak or poorly mobile soft palate and improve velopharyngeal closure.

CMS RVU26DEffective Oct 1, 2026One payment locality23 Medicare services in 2024

In Washington, DC area, Medicare pays $1,580.30 for 21083 in the office and $996.41 when it’s performed in a hospital or facility.

$1,580.30Office (non-facility)
$996.41Hospital or facility
+12.0%vs the national office rate ($1,411.52)

Check a contract rate as a % of Medicare · 21083 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 21083 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 21083 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 21083 covers

A palatal lift prosthesis raises the soft palate when it cannot move adequately, helping close the passage between the nose and mouth during speech. It is used for velopharyngeal dysfunction, including weakness or paralysis of the palate, and is typically prepared by a dental or maxillofacial prosthetic provider. The service involves taking an impression and custom-preparing the device for the patient; it is distinct from a prosthesis that adds bulk to the palate.

Report this code when the service is for a custom palatal lift, not a palatal augmentation or another oral prosthesis. Documentation should identify the functional problem and support the need for the lift, along with the impression and custom 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 are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 Washington, DC area compares for 21083

Across 109 of 109 payment localities, the office rate for 21083 runs from $1,276.40 in Arkansas to $1,762.29 in San Benito County, CA. Washington, DC area pays $1,580.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

21083 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$1,580.30
  2. Los Angeles, CA · California$1,543.61−$36.69
  3. Miami, FL · Florida$1,550.02−$30.28
  4. Chicago, IL · Illinois$1,512.04−$68.26
  5. Manhattan, NY · New York$1,608.99+$28.69
  6. Alaska · Alaska$1,739.54+$159.24
  7. Alabama · Alabama$1,291.45−$288.85

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

21083 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$1,276.40$850.62
ArizonaArizona$1,379.14$898.84
Bakersfield, CACalifornia$1,463.89$920.64
Chico, CACalifornia$1,457.42$914.17
El Centro, CACalifornia$1,457.78$914.52
Fresno, CACalifornia$1,457.42$914.17
Hanford, CACalifornia$1,457.42$914.17
Madera, CACalifornia$1,457.42$914.17

21083 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$1,276.40

$1,739.54

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

View every state and territory as a table
21083 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,739.541
AL$1,291.451
AR$1,276.401
AZ$1,379.141
CA$1,457.42–$1,762.2929
CO$1,449.001
CT$1,493.941
DC$1,580.301
DE$1,398.891
FL$1,416.13–$1,550.023
GA$1,348.30–$1,439.172
GU$1,479.031
HI$1,479.031
IA$1,307.861
ID$1,316.861
IL$1,389.78–$1,512.044
IN$1,322.771
KS$1,307.671
KY$1,326.371
LA$1,326.59–$1,379.212
MA$1,444.81–$1,567.602
MD$1,420.49–$1,580.303
ME$1,327.51–$1,378.732
MI$1,358.76–$1,435.622
MN$1,381.861
MO$1,311.35–$1,377.473
MS$1,293.841
MT$1,411.381
NC$1,337.981
ND$1,369.061
NE$1,312.201
NH$1,431.801
NJ$1,509.10–$1,569.912
NM$1,366.761
NV$1,400.301
NY$1,354.67–$1,647.605
OH$1,350.111
OK$1,319.351
OR$1,387.44–$1,482.352
PA$1,349.17–$1,465.822
PR$1,418.291
RI$1,439.241
SC$1,346.651
SD$1,364.061
TN$1,313.601
TX$1,342.33–$1,445.958
UT$1,361.481
VA$1,378.40–$1,580.302
VI$1,418.291
VT$1,369.091
WA$1,440.36–$1,591.552
WI$1,332.141
WV$1,349.001
WY$1,392.941

See 21083 in every payment locality

How the 21083 rate is calculated

Each of 21083’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 · 21083

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.79

18.79 RVUs× 1.000 GPCI

Practice expense21.33

21.33 RVUs× 1.000 GPCI

Malpractice2.14

2.14 RVUs× 1.000 GPCI

Adjusted RVUs

42.2600

Conversion factor

$33.4009

Medicare rate

$1,411.52

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,867

Code
21083
Physician work
18.79
Practice expense
21.33
Malpractice
2.14

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 21083 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work18.79× 1.05419.8047
Practice expense21.33× 1.17825.1267
Malpractice2.14× 1.1132.3818
Total RVUs47.3132
Conversion factor× 33.4009

Office rate, Washington, DC area$1580.30

Office: (18.79 × 1.054 + 21.33 × 1.178 + 2.14 × 1.113) × $33.4009 = $1580.30

Facility: (18.79 × 1.054 + 6.49 × 1.178 + 2.14 × 1.113) × $33.4009 = $996.41

Open 21083 in the RVU calculator

Payment rules and modifiers for 21083

21083 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21083

Palatal lift 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 · 21083

Palatal lift 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

21083 without 51 · national office

$1,411.52

Palatal lift prosthesis, impression and custom preparation

21083-51 · Second procedure: 50%

$705.76

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 21083

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

Codes related to 21083
CodeHow it relatesOffice range, Washington, DC area
Same family
21082Palatal prosthesis, augmentation for tongue contactPalatal prosthesis sibling that adds contour rather than lifting the palate.$1,675.70
21084Speech aid prosthesis, impression and custom preparationRelated custom prosthetic service for a speech aid.$1,801.06
21080Obturator prosthesis, definitive obturatorDefinitive obturator service for a different oral prosthetic need.$1,930.24
21079Obturator prosthesis, interim obturatorInterim obturator service, rather than a palatal lift.$1,697.00

How 21083 has changed in Washington, DC area

21083 · Office / nonfacility

$1580.30

Effective 2026-10-01

The base rate is $56.51 higher than on 2025-10-01, moving from $1523.79 to $1580.30 (3.7%).

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

    $1523.79changed to$1580.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 19.27 changed to 18.79
    • Practice expense RVU 20.63 changed to 21.33
    • Malpractice RVU 1.84 changed to 2.14
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1530.42changed to$1523.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 19.67 changed to 20.63
    • Malpractice RVU 1.85 changed to 1.84

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1505.44changed to$1530.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1554.94changed to$1505.44

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 19.21 changed to 19.67
    • Malpractice RVU 1.80 changed to 1.85
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $1575.01changed to$1554.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 18.61 changed to 19.21
    • Malpractice RVU 1.70 changed to 1.80
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1589.24changed to$1575.01

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 18.70 changed to 18.61
    • Malpractice RVU 1.64 changed to 1.70

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1664.82changed to$1589.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.51 changed to 18.70
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1772.44changed to$1664.82

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 20.66 changed to 19.51
    • Malpractice RVU 3.29 changed to 1.64
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1831.15changed to$1772.44

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 22.10 changed to 20.66
    • Malpractice RVU 3.25 changed to 3.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1865.94changed to$1831.15

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 22.96 changed to 22.10
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1881.15changed to$1865.94

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 23.31 changed to 22.96
    • Malpractice RVU 3.28 changed to 3.25
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1890.86changed to$1881.15

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 23.42 changed to 23.31
    • Malpractice RVU 3.24 changed to 3.28

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1881.45changed to$1890.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1798.42changed to$1881.45

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 23.62 changed to 23.42
    • Malpractice RVU 1.31 changed to 3.24
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1766.75changed to$1798.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 25.18 changed to 23.62
    • Malpractice RVU 1.37 changed to 1.31
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1766.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,580.30$996.41RVU26D
2026-07-01$1,580.30$996.41RVU26C
2026-04-01$1,580.30$996.41RVU26B
2026-01-01$1,580.30$996.41RVU26A
2025-10-01$1,523.79$1,127.43RVU25D
2025-07-01$1,523.79$1,127.43RVU25C
2025-04-01$1,523.79$1,127.43RVU25B
2025-01-01$1,523.79$1,127.43RVU25A
2024-10-01$1,530.42$1,133.24RVU24D
2024-07-01$1,530.42$1,133.24RVU24C
2024-04-01$1,530.42$1,133.24RVU24B
2024-03-09$1,530.42$1,133.24RVU24AR
2024-01-01$1,505.44$1,114.74RVU24A
2023-10-01$1,554.94$1,156.31RVU23D
2023-07-01$1,554.94$1,156.31RVU23C
2023-04-01$1,554.94$1,156.31RVU23B
2023-01-01$1,554.94$1,156.31RVU23A
2022-10-01$1,575.01$1,173.37RVU22D
2022-07-01$1,575.01$1,173.37RVU22C
2022-04-01$1,575.01$1,173.37RVU22B
2022-01-01$1,575.01$1,173.37RVU22A
2021-10-01$1,589.24$1,194.62RVU21D
2021-07-01$1,589.24$1,194.62RVU21C
2021-04-01$1,589.24$1,194.62RVU21B
2021-01-01$1,589.24$1,194.62RVU21A
2020-10-01$1,664.82$1,276.16RVU20D
2020-07-01$1,664.82$1,276.16RVU20C
2020-04-01$1,664.82$1,276.16RVU20B
2020-01-01$1,664.82$1,276.16RVU20A
2019-10-01$1,772.44$1,385.07RVU19D
2019-07-01$1,772.44$1,385.07RVU19C
2019-04-01$1,772.44$1,385.07RVU19B
2019-01-01$1,772.44$1,385.07RVU19A
2018-10-01$1,831.15$1,437.70RVU18D
2018-07-01$1,831.15$1,437.70RVU18C
2018-04-01$1,831.15$1,437.70RVU18B
2018-01-01$1,831.15$1,437.70RVU18AR1
2017-10-01$1,865.94$1,462.03RVU17D
2017-07-01$1,865.94$1,462.03RVU17C
2017-04-01$1,865.94$1,462.03RVU17B
2017-01-01$1,865.94$1,462.03RVU17A
2016-10-01$1,881.15$1,475.59RVU16D
2016-07-01$1,881.15$1,475.59RVU16C
2016-04-01$1,881.15$1,475.59RVU16B
2016-01-01$1,881.15$1,475.59RVU16A
2015-10-01$1,890.86$1,483.41RVU15D
2015-07-01$1,890.86$1,483.41RVU15C
2015-04-01$1,881.45$1,476.03RVU15B
2015-01-01$1,881.45$1,476.03RVU15A
2014-10-01$1,798.42$1,396.68RVU14D
2014-07-01$1,798.42$1,396.68RVU14C
2014-04-01$1,798.42$1,396.68RVU14B
2014-01-01$1,798.42$1,396.68RVU14A
2013-10-01$1,766.75$1,348.96RVU13D
2013-07-01$1,766.75$1,348.96RVU13C
2013-04-01$1,766.75$1,348.96RVU13B
2013-01-01$1,766.75$1,348.96RVU13AR

Price 21083 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

21083 billing questions

How is a palatal lift different from palatal augmentation?

A lift raises a poorly mobile soft palate to help close the velopharyngeal passage. Palatal augmentation changes the palate’s contour to improve contact with the tongue.

What documentation supports reporting this code?

Document the palatal functional deficit and why a lift is needed, plus the impression and custom preparation performed for the patient.

Should modifier 50 be reported?

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

How does the 90-day global period affect billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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 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 21083PPRRVU2026_Oct_nonQPP.csv, line 1,867 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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