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

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 Kentucky, Medicare pays $1,326.37 for 21083 in the office and $885.72 when it’s performed in a hospital or facility.

$1,326.37Office (non-facility)
$885.72Hospital or facility
−6.0%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 Kentucky
  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 Kentucky 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. Kentucky pays $1,326.37. The RVUs are the same everywhere; the geographic indexes change the dollars.

21083 in Kentucky vs other payment areas
  1. Kentucky · this page$1,326.37
  2. Los Angeles, CA · California$1,543.61+$217.24
  3. Washington, DC area · District of Columbia$1,580.30+$253.93
  4. Miami, FL · Florida$1,550.02+$223.65
  5. Chicago, IL · Illinois$1,512.04+$185.67
  6. Manhattan, NY · New York$1,608.99+$282.62
  7. Alaska · Alaska$1,739.54+$413.17

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

Every other payment area

21083 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,291.45$857.73
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

21083 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.

$1,276.40

$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 Kentucky 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

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 21083 in Kentucky
ComponentRVULocality factorAdjusted
Physician work18.79× 1.00018.7900
Practice expense21.33× 0.88918.9624
Malpractice2.14× 0.9151.9581
Total RVUs39.7105
Conversion factor× 33.4009

Office rate, Kentucky$1326.37

Office: (18.79 × 1 + 21.33 × 0.889 + 2.14 × 0.915) × $33.4009 = $1326.37

Facility: (18.79 × 1 + 6.49 × 0.889 + 2.14 × 0.915) × $33.4009 = $885.72

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

How 21083 has changed in Kentucky

21083 · Office / nonfacility

$1326.37

Effective 2026-10-01

The base rate is $63.48 higher than on 2025-10-01, moving from $1262.89 to $1326.37 (5.0%).

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

    $1262.89changed to$1326.37

    • 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
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1271.90changed to$1262.89

    • 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

    $1251.14changed to$1271.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1274.37changed to$1251.14

    • 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
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913
  5. January 1, 2023

    RVU23A

    $1275.17changed to$1274.37

    • 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
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1286.74changed to$1275.17

    • 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

    $1359.55changed to$1286.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.51 changed to 18.70
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1446.80changed to$1359.55

    • 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
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1489.65changed to$1446.80

    • 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

    $1507.53changed to$1489.65

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 22.96 changed to 22.10
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1511.08changed to$1507.53

    • 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
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1518.84changed to$1511.08

    • 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

    $1511.28changed to$1518.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1464.46changed to$1511.28

    • 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
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1436.86changed to$1464.46

    • 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
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1436.86

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,326.37$885.72RVU26D
2026-07-01$1,326.37$885.72RVU26C
2026-04-01$1,326.37$885.72RVU26B
2026-01-01$1,326.37$885.72RVU26A
2025-10-01$1,262.89$971.26RVU25D
2025-07-01$1,262.89$971.26RVU25C
2025-04-01$1,262.89$971.26RVU25B
2025-01-01$1,262.89$971.26RVU25A
2024-10-01$1,271.90$979.68RVU24D
2024-07-01$1,271.90$979.68RVU24C
2024-04-01$1,271.90$979.68RVU24B
2024-03-09$1,271.90$979.68RVU24AR
2024-01-01$1,251.14$963.69RVU24A
2023-10-01$1,274.37$987.71RVU23D
2023-07-01$1,274.37$987.71RVU23C
2023-04-01$1,274.37$987.71RVU23B
2023-01-01$1,274.37$987.71RVU23A
2022-10-01$1,275.17$992.79RVU22D
2022-07-01$1,275.17$992.79RVU22C
2022-04-01$1,275.17$992.79RVU22B
2022-01-01$1,275.17$992.79RVU22A
2021-10-01$1,286.74$1,009.29RVU21D
2021-07-01$1,286.74$1,009.29RVU21C
2021-04-01$1,286.74$1,009.29RVU21B
2021-01-01$1,286.74$1,009.29RVU21A
2020-10-01$1,359.55$1,081.34RVU20D
2020-07-01$1,359.55$1,081.34RVU20C
2020-04-01$1,359.55$1,081.34RVU20B
2020-01-01$1,359.55$1,081.34RVU20A
2019-10-01$1,446.80$1,163.91RVU19D
2019-07-01$1,446.80$1,163.91RVU19C
2019-04-01$1,446.80$1,163.91RVU19B
2019-01-01$1,446.80$1,163.91RVU19A
2018-10-01$1,489.65$1,202.32RVU18D
2018-07-01$1,489.65$1,202.32RVU18C
2018-04-01$1,489.65$1,202.32RVU18B
2018-01-01$1,489.65$1,202.32RVU18AR1
2017-10-01$1,507.53$1,213.89RVU17D
2017-07-01$1,507.53$1,213.89RVU17C
2017-04-01$1,507.53$1,213.89RVU17B
2017-01-01$1,507.53$1,213.89RVU17A
2016-10-01$1,511.08$1,217.60RVU16D
2016-07-01$1,511.08$1,217.60RVU16C
2016-04-01$1,511.08$1,217.60RVU16B
2016-01-01$1,511.08$1,217.60RVU16A
2015-10-01$1,518.84$1,223.99RVU15D
2015-07-01$1,518.84$1,223.99RVU15C
2015-04-01$1,511.28$1,217.90RVU15B
2015-01-01$1,511.28$1,217.90RVU15A
2014-10-01$1,464.46$1,173.01RVU14D
2014-07-01$1,464.46$1,173.01RVU14C
2014-04-01$1,464.46$1,173.01RVU14B
2014-01-01$1,464.46$1,173.01RVU14A
2013-10-01$1,436.86$1,133.11RVU13D
2013-07-01$1,436.86$1,133.11RVU13C
2013-04-01$1,436.86$1,133.11RVU13B
2013-01-01$1,436.86$1,133.11RVU13AR

Price 21083 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

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 KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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