CPT code 21084: Speech aid prosthesis, impression and custom preparation2026 Medicare rate & RVUs in Washington, DC area
Reported for an impression and custom preparation of a speech aid prosthesis that helps address velopharyngeal insufficiency affecting speech.
In Washington, DC area, Medicare pays $1,801.06 for 21084 in the office and $1,148.70 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 21084 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21084 covers
A maxillofacial prosthodontist or other qualified dental or medical professional takes an impression and custom-prepares an intraoral speech aid prosthesis. A common design uses a speech bulb extending toward the nasopharynx to help improve closure when the soft palate cannot adequately separate the oral and nasal passages. The service may be provided in an outpatient clinic or hospital setting for congenital or acquired velopharyngeal dysfunction.
Select this code when the documented service is custom preparation of a speech aid prosthesis, rather than a palatal lift, palatal augmentation prosthesis, or obturator. The record should identify the speech-related functional problem, relevant anatomy and findings, and 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. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. 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 21084
Across 109 of 109 payment localities, the office rate for 21084 runs from $1,458.01 in Arkansas to $2,003.75 in San Benito County, CA. Washington, DC area pays $1,801.06. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$1,801.06
- Los Angeles, CA · California$1,758.03−$43.03
- Miami, FL · Florida$1,770.86−$30.20
- Chicago, IL · Illinois$1,727.83−$73.23
- Manhattan, NY · New York$1,835.16+$34.10
- Alaska · Alaska$1,990.84+$189.78
- Alabama · Alabama$1,474.98−$326.08
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $1,458.01 | $982.30 |
| ArizonaArizona | $1,573.92 | $1,037.30 |
| Bakersfield, CACalifornia | $1,668.17 | $1,061.22 |
| Chico, CACalifornia | $1,660.61 | $1,053.66 |
| El Centro, CACalifornia | $1,661.02 | $1,054.07 |
| Fresno, CACalifornia | $1,660.61 | $1,053.66 |
| Hanford, CACalifornia | $1,660.61 | $1,053.66 |
| Madera, CACalifornia | $1,660.61 | $1,053.66 |
| Merced, CACalifornia | $1,660.61 | $1,053.66 |
| Modesto, CACalifornia | $1,660.61 | $1,053.66 |
| Napa, CACalifornia | $1,868.42 | $1,138.53 |
| Oxnard, CACalifornia | $1,744.29 | $1,089.71 |
| Redding, CACalifornia | $1,660.61 | $1,053.66 |
| Rest of CaliforniaCalifornia | $1,660.61 | $1,053.66 |
| Riverside, CACalifornia | $1,687.81 | $1,080.86 |
| Sacramento, CACalifornia | $1,727.78 | $1,083.72 |
| Salinas, CACalifornia | $1,720.94 | $1,079.10 |
| San Diego, CACalifornia | $1,750.12 | $1,087.79 |
| Marin County, CACalifornia | $1,960.90 | $1,180.06 |
| San Francisco, CACalifornia | $1,958.06 | $1,177.22 |
| San Benito County, CACalifornia | $2,003.75 | $1,205.19 |
| Santa Clara County, CACalifornia | $1,992.14 | $1,193.58 |
| San Luis Obispo, CACalifornia | $1,694.79 | $1,064.03 |
| Santa Cruz, CACalifornia | $1,758.13 | $1,085.28 |
| Santa Maria, CACalifornia | $1,724.31 | $1,078.59 |
| Santa Rosa, CACalifornia | $1,775.06 | $1,095.01 |
| Stockton, CACalifornia | $1,660.61 | $1,053.66 |
| Vallejo, CACalifornia | $1,864.33 | $1,134.44 |
| Visalia, CACalifornia | $1,660.61 | $1,053.66 |
| Yuba City, CACalifornia | $1,660.61 | $1,053.66 |
| ColoradoColorado | $1,651.97 | $1,062.74 |
| ConnecticutConnecticut | $1,703.98 | $1,107.55 |
| DelawareDelaware | $1,596.28 | $1,049.14 |
| Fort Lauderdale, FLFlorida | $1,688.40 | $1,127.41 |
| Rest of FloridaFlorida | $1,617.62 | $1,088.20 |
| Atlanta, GAGeorgia | $1,642.29 | $1,079.64 |
| Rest of GeorgiaGeorgia | $1,540.77 | $1,046.79 |
| Hawaii, Guam, HIHawaii | $1,684.34 | $1,054.69 |
| IowaIowa | $1,492.67 | $985.95 |
| IdahoIdaho | $1,502.99 | $993.51 |
| East St. Louis, ILIllinois | $1,631.67 | $1,122.18 |
| Rest of IllinoisIllinois | $1,588.44 | $1,082.84 |
| Suburban Chicago, ILIllinois | $1,701.64 | $1,132.90 |
| IndianaIndiana | $1,509.64 | $996.28 |
| KansasKansas | $1,492.86 | $992.24 |
| KentuckyKentucky | $1,515.26 | $1,022.94 |
| New Orleans, LALouisiana | $1,575.05 | $1,053.93 |
| Rest of LouisianaLouisiana | $1,515.67 | $1,025.56 |
| Metropolitan Boston, MAMassachusetts | $1,785.64 | $1,124.42 |
| Rest of MassachusettsMassachusetts | $1,647.49 | $1,064.35 |
| Baltimore area, MDMaryland | $1,700.13 | $1,105.91 |
| Rest of MarylandMaryland | $1,620.60 | $1,060.17 |
| Rest of MaineMaine | $1,515.43 | $1,005.95 |
| Southern Maine, MEMaine | $1,572.62 | $1,023.82 |
| Detroit, MIMichigan | $1,640.05 | $1,105.65 |
| Rest of MichiganMichigan | $1,552.20 | $1,046.60 |
| MinnesotaMinnesota | $1,574.86 | $1,005.01 |
| Metropolitan Kansas City, MOMissouri | $1,560.18 | $1,040.17 |
| Metropolitan St. Louis, MOMissouri | $1,572.60 | $1,045.40 |
| Rest of MissouriMissouri | $1,498.72 | $1,021.35 |
| MississippiMississippi | $1,478.30 | $1,001.49 |
| MontanaMontana | $1,610.42 | $1,056.64 |
| North CarolinaNorth Carolina | $1,527.19 | $1,010.50 |
| North DakotaNorth Dakota | $1,560.99 | $1,007.20 |
| NebraskaNebraska | $1,497.44 | $986.30 |
| New HampshireNew Hampshire | $1,632.75 | $1,056.25 |
| Northern New JerseyNew Jersey | $1,789.59 | $1,147.19 |
| Rest of New JerseyNew Jersey | $1,721.11 | $1,116.38 |
| New MexicoNew Mexico | $1,561.40 | $1,053.57 |
| NevadaNevada | $1,597.44 | $1,043.10 |
| NYC suburbs and Long Island, NYNew York | $1,879.25 | $1,220.80 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,736.59 | $1,130.20 |
| Queens, NYNew York | $1,839.04 | $1,184.46 |
| Rest of New YorkNew York | $1,546.04 | $1,019.95 |
| OhioOhio | $1,542.10 | $1,036.49 |
| OklahomaOklahoma | $1,506.91 | $1,012.38 |
| Portland, OROregon | $1,689.17 | $1,073.91 |
| Rest of OregonOregon | $1,582.61 | $1,031.04 |
| Metropolitan Philadelphia, PAPennsylvania | $1,672.48 | $1,095.99 |
| Rest of PennsylvaniaPennsylvania | $1,540.81 | $1,032.44 |
| Puerto RicoPuerto Rico | $1,618.08 | $1,058.20 |
| Rhode IslandRhode Island | $1,641.72 | $1,069.66 |
| South CarolinaSouth Carolina | $1,537.65 | $1,025.95 |
| South DakotaSouth Dakota | $1,555.15 | $1,001.36 |
| TennesseeTennessee | $1,499.59 | $996.20 |
| Austin, TXTexas | $1,648.64 | $1,062.74 |
| Beaumont, TXTexas | $1,533.12 | $1,029.17 |
| Brazoria, TXTexas | $1,590.92 | $1,042.12 |
| Dallas, TXTexas | $1,602.14 | $1,050.57 |
| Fort Worth, TXTexas | $1,595.28 | $1,049.25 |
| Galveston, TXTexas | $1,596.52 | $1,046.61 |
| Houston, TXTexas | $1,642.28 | $1,092.37 |
| Rest of TexasTexas | $1,561.95 | $1,036.41 |
| UtahUtah | $1,554.38 | $1,033.82 |
| VirginiaVirginia | $1,572.53 | $1,028.16 |
| Virgin Islands, VIUnited States Virgin Islands | $1,618.08 | $1,058.20 |
| VermontVermont | $1,561.39 | $1,013.14 |
| Rest of WashingtonWashington | $1,642.28 | $1,059.15 |
| King County, WAWashington | $1,812.37 | $1,132.87 |
| WisconsinWisconsin | $1,519.42 | $988.89 |
| West VirginiaWest Virginia | $1,542.44 | $1,061.20 |
| WyomingWyoming | $1,588.88 | $1,035.09 |
21084 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.
$1,458.01
$1,990.84
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,990.84 | 1 |
| AL | $1,474.98 | 1 |
| AR | $1,458.01 | 1 |
| AZ | $1,573.92 | 1 |
| CA | $1,660.61–$2,003.75 | 29 |
| CO | $1,651.97 | 1 |
| CT | $1,703.98 | 1 |
| DC | $1,801.06 | 1 |
| DE | $1,596.28 | 1 |
| FL | $1,617.62–$1,770.86 | 3 |
| GA | $1,540.77–$1,642.29 | 2 |
| GU | $1,684.34 | 1 |
| HI | $1,684.34 | 1 |
| IA | $1,492.67 | 1 |
| ID | $1,502.99 | 1 |
| IL | $1,588.44–$1,727.83 | 4 |
| IN | $1,509.64 | 1 |
| KS | $1,492.86 | 1 |
| KY | $1,515.26 | 1 |
| LA | $1,515.67–$1,575.05 | 2 |
| MA | $1,647.49–$1,785.64 | 2 |
| MD | $1,620.60–$1,801.06 | 3 |
| ME | $1,515.43–$1,572.62 | 2 |
| MI | $1,552.20–$1,640.05 | 2 |
| MN | $1,574.86 | 1 |
| MO | $1,498.72–$1,572.60 | 3 |
| MS | $1,478.30 | 1 |
| MT | $1,610.42 | 1 |
| NC | $1,527.19 | 1 |
| ND | $1,560.99 | 1 |
| NE | $1,497.44 | 1 |
| NH | $1,632.75 | 1 |
| NJ | $1,721.11–$1,789.59 | 2 |
| NM | $1,561.40 | 1 |
| NV | $1,597.44 | 1 |
| NY | $1,546.04–$1,879.25 | 5 |
| OH | $1,542.10 | 1 |
| OK | $1,506.91 | 1 |
| OR | $1,582.61–$1,689.17 | 2 |
| PA | $1,540.81–$1,672.48 | 2 |
| PR | $1,618.08 | 1 |
| RI | $1,641.72 | 1 |
| SC | $1,537.65 | 1 |
| SD | $1,555.15 | 1 |
| TN | $1,499.59 | 1 |
| TX | $1,533.12–$1,648.64 | 8 |
| UT | $1,554.38 | 1 |
| VA | $1,572.53–$1,801.06 | 2 |
| VI | $1,618.08 | 1 |
| VT | $1,561.39 | 1 |
| WA | $1,642.28–$1,812.37 | 2 |
| WI | $1,519.42 | 1 |
| WV | $1,542.44 | 1 |
| WY | $1,588.88 | 1 |
How the 21084 rate is calculated
Each of 21084’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 · 21084
RVUs × geographic indexes × conversion factor
Work21.92
21.92 RVUs× 1.000 GPCI
Practice expense23.80
23.80 RVUs× 1.000 GPCI
Malpractice2.50
2.50 RVUs× 1.000 GPCI
Adjusted RVUs
48.2200
Conversion factor
$33.4009
Medicare rate
$1,610.59
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
1,868
- Code
- 21084
- Physician work
- 21.92
- Practice expense
- 23.80
- Malpractice
- 2.50
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.92 | × 1.054 | 23.1037 |
| Practice expense | 23.80 | × 1.178 | 28.0364 |
| Malpractice | 2.50 | × 1.113 | 2.7825 |
| Total RVUs | 53.9226 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$1801.06
Office: (21.92 × 1.054 + 23.8 × 1.178 + 2.5 × 1.113) × $33.4009 = $1801.06
Facility: (21.92 × 1.054 + 7.22 × 1.178 + 2.5 × 1.113) × $33.4009 = $1148.70
Payment rules and modifiers for 21084
21084 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21084
Speech aid 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 · 21084
Speech aid 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
21084 without 51 · national office
$1,610.59
Speech aid prosthesis, impression and custom preparation
21084-51 · Second procedure: 50%
$805.30
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%).
How 21084 has changed in Washington, DC area
21084 · Office / nonfacility
$1801.06
Effective 2026-10-01
The base rate is $65.57 higher than on 2025-10-01, moving from $1735.49 to $1801.06 (3.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$1735.49changed to$1801.06
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 22.48 changed to 21.92
- Practice expense RVU 22.98 changed to 23.80
- Malpractice RVU 2.14 changed to 2.50
- 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.
January 1, 2025
RVU25A
$1743.89changed to$1735.49
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 21.89 changed to 22.98
- Malpractice RVU 2.17 changed to 2.14
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1715.43changed to$1743.89
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1772.01changed to$1715.43
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 21.39 changed to 21.89
- Malpractice RVU 2.10 changed to 2.17
- 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
January 1, 2023
RVU23A
$1795.33changed to$1772.01
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 20.72 changed to 21.39
- Malpractice RVU 1.99 changed to 2.10
- 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.
January 1, 2022
RVU22A
$1813.52changed to$1795.33
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 20.87 changed to 20.72
- Malpractice RVU 1.92 changed to 1.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1903.22changed to$1813.52
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 21.88 changed to 20.87
- Malpractice RVU 1.91 changed to 1.92
- 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.
January 1, 2020
RVU20A
$2029.48changed to$1903.22
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 23.23 changed to 21.88
- Malpractice RVU 3.83 changed to 1.91
- 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.
July 1, 2019
RVU19C
$2027.21changed to$2029.48
- Malpractice RVU 3.78 changed to 3.83
Held through RVU19D.
January 1, 2019
RVU19A
$2098.75changed to$2027.21
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 24.92 changed to 23.23
- Malpractice RVU 3.79 changed to 3.78
Held through RVU19B.
January 1, 2018
RVU18AR1
$2137.18changed to$2098.75
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 25.86 changed to 24.92
- Malpractice RVU 3.80 changed to 3.79
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$2160.92changed to$2137.18
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 26.40 changed to 25.86
- Malpractice RVU 3.84 changed to 3.80
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$2161.20changed to$2160.92
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 26.29 changed to 26.40
- Malpractice RVU 3.78 changed to 3.84
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$2150.44changed to$2161.20
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$2098.45changed to$2150.44
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 26.32 changed to 26.29
- Malpractice RVU 2.77 changed to 3.78
- 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.
January 1, 2014
RVU14A
$2059.56changed to$2098.45
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 28.11 changed to 26.32
- Malpractice RVU 2.90 changed to 2.77
- 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.
January 1, 2013
RVU13AR
Earliest loaded release: $2059.56
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,801.06 | $1,148.70 | RVU26D |
| 2026-07-01 | $1,801.06 | $1,148.70 | RVU26C |
| 2026-04-01 | $1,801.06 | $1,148.70 | RVU26B |
| 2026-01-01 | $1,801.06 | $1,148.70 | RVU26A |
| 2025-10-01 | $1,735.49 | $1,302.11 | RVU25D |
| 2025-07-01 | $1,735.49 | $1,302.11 | RVU25C |
| 2025-04-01 | $1,735.49 | $1,302.11 | RVU25B |
| 2025-01-01 | $1,735.49 | $1,302.11 | RVU25A |
| 2024-10-01 | $1,743.89 | $1,310.20 | RVU24D |
| 2024-07-01 | $1,743.89 | $1,310.20 | RVU24C |
| 2024-04-01 | $1,743.89 | $1,310.20 | RVU24B |
| 2024-03-09 | $1,743.89 | $1,310.20 | RVU24AR |
| 2024-01-01 | $1,715.43 | $1,288.82 | RVU24A |
| 2023-10-01 | $1,772.01 | $1,336.76 | RVU23D |
| 2023-07-01 | $1,772.01 | $1,336.76 | RVU23C |
| 2023-04-01 | $1,772.01 | $1,336.76 | RVU23B |
| 2023-01-01 | $1,772.01 | $1,336.76 | RVU23A |
| 2022-10-01 | $1,795.33 | $1,356.91 | RVU22D |
| 2022-07-01 | $1,795.33 | $1,356.91 | RVU22C |
| 2022-04-01 | $1,795.33 | $1,356.91 | RVU22B |
| 2022-01-01 | $1,795.33 | $1,356.91 | RVU22A |
| 2021-10-01 | $1,813.52 | $1,381.81 | RVU21D |
| 2021-07-01 | $1,813.52 | $1,381.81 | RVU21C |
| 2021-04-01 | $1,813.52 | $1,381.81 | RVU21B |
| 2021-01-01 | $1,813.52 | $1,381.81 | RVU21A |
| 2020-10-01 | $1,903.22 | $1,475.79 | RVU20D |
| 2020-07-01 | $1,903.22 | $1,475.79 | RVU20C |
| 2020-04-01 | $1,903.22 | $1,475.79 | RVU20B |
| 2020-01-01 | $1,903.22 | $1,475.79 | RVU20A |
| 2019-10-01 | $2,029.48 | $1,601.73 | RVU19D |
| 2019-07-01 | $2,029.48 | $1,601.73 | RVU19C |
| 2019-04-01 | $2,027.21 | $1,599.45 | RVU19B |
| 2019-01-01 | $2,027.21 | $1,599.45 | RVU19A |
| 2018-10-01 | $2,098.75 | $1,662.36 | RVU18D |
| 2018-07-01 | $2,098.75 | $1,662.36 | RVU18C |
| 2018-04-01 | $2,098.75 | $1,662.36 | RVU18B |
| 2018-01-01 | $2,098.75 | $1,662.36 | RVU18AR1 |
| 2017-10-01 | $2,137.18 | $1,693.04 | RVU17D |
| 2017-07-01 | $2,137.18 | $1,693.04 | RVU17C |
| 2017-04-01 | $2,137.18 | $1,693.04 | RVU17B |
| 2017-01-01 | $2,137.18 | $1,693.04 | RVU17A |
| 2016-10-01 | $2,160.92 | $1,710.93 | RVU16D |
| 2016-07-01 | $2,160.92 | $1,710.93 | RVU16C |
| 2016-04-01 | $2,160.92 | $1,710.93 | RVU16B |
| 2016-01-01 | $2,160.92 | $1,710.93 | RVU16A |
| 2015-10-01 | $2,161.20 | $1,715.21 | RVU15D |
| 2015-07-01 | $2,161.20 | $1,715.21 | RVU15C |
| 2015-04-01 | $2,150.44 | $1,706.67 | RVU15B |
| 2015-01-01 | $2,150.44 | $1,706.67 | RVU15A |
| 2014-10-01 | $2,098.45 | $1,664.41 | RVU14D |
| 2014-07-01 | $2,098.45 | $1,664.41 | RVU14C |
| 2014-04-01 | $2,098.45 | $1,664.41 | RVU14B |
| 2014-01-01 | $2,098.45 | $1,664.41 | RVU14A |
| 2013-10-01 | $2,059.56 | $1,607.94 | RVU13D |
| 2013-07-01 | $2,059.56 | $1,607.94 | RVU13C |
| 2013-04-01 | $2,059.56 | $1,607.94 | RVU13B |
| 2013-01-01 | $2,059.56 | $1,607.94 | RVU13AR |
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
21084 billing questions
How is this different from a palatal lift prosthesis?
A speech aid prosthesis commonly uses a bulb to help close the velopharyngeal gap. A palatal lift raises a mobile but weak soft palate; select based on the prosthesis designed and the patient's functional problem.
When would an obturator code be more appropriate?
Use an obturator code when the prosthesis is designed to close an oral or palatal defect, such as a defect after maxillary surgery. Code 21084 describes custom preparation of a speech aid prosthesis for a speech-related functional problem.
What should the documentation establish?
Document the speech-related dysfunction, pertinent palate and velopharyngeal findings, the impression taken, and the custom prosthesis preparation performed.
How does the 90-day global period affect related care?
The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. Assistant-at-surgery payment requires documentation of medical necessity.
Can modifier 50 or co-surgeon billing be used?
The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. Co-surgeons and team surgery are not permitted.
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
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