CPT code 21084: Speech aid prosthesis, impression and custom preparation2026 Medicare rate & RVUs in North Carolina

Reported for an impression and custom preparation of a speech aid prosthesis that helps address velopharyngeal insufficiency affecting speech.

CMS RVU26DEffective Oct 1, 2026One payment locality32 Medicare services in 2024

In North Carolina, Medicare pays $1,527.19 for 21084 in the office and $1,010.50 when it’s performed in a hospital or facility.

$1,527.19Office (non-facility)

$1,010.50Hospital or facility

−5.2%vs the national office rate ($1,610.59)

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

Rate in North Carolina
What 21084 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

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 North Carolina 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. North Carolina pays $1,527.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

21084 in North Carolina vs other payment areas

North Carolina · this page$1,527.19
Los Angeles, CA · California$1,758.03+$230.84
Washington, DC area · District of Columbia$1,801.06+$273.87
Miami, FL · Florida$1,770.86+$243.67
Chicago, IL · Illinois$1,727.83+$200.64
Manhattan, NY · New York$1,835.16+$307.97
Alaska · Alaska$1,990.84+$463.65

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

Every other payment area

21084 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	$1,474.98	$990.42
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 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.

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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

21084 office rate range by state
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

See 21084 in every payment locality

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

Office or facility?

Your ZIP

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 North Carolina 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

Locality: North Carolina
Physician work: 1.000
Practice expense: 0.933
Malpractice: 0.639

Office calculation for 21084 in North Carolina
Component	RVU	Locality factor	Adjusted
Physician work	21.92	× 1.000	21.9200
Practice expense	23.80	× 0.933	22.2054
Malpractice	2.50	× 0.639	1.5975
Total RVUs			45.7229
Conversion factor			× 33.4009

Office rate, North Carolina$1527.19

Office: (21.92 × 1 + 23.8 × 0.933 + 2.5 × 0.639) × $33.4009 = $1527.19

Facility: (21.92 × 1 + 7.22 × 0.933 + 2.5 × 0.639) × $33.4009 = $1010.50

Open 21084 in the RVU calculator

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

Date of surgery

Date of a later visit

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

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%).

When to use modifier 51

Codes related to 21084

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

Codes related to 21084
Code	How it relates	Office range, North Carolina
Used instead
21083	Palatal lift prosthesis, impression and custom preparationPalatal lift prosthesis for a different approach to velopharyngeal dysfunction.	$1,337.98
21080	Obturator prosthesis, definitive obturatorDefinitive obturator preparation for a maxillary defect requiring obturation.	$1,640.03
Same family
21082	Palatal prosthesis, augmentation for tongue contactCustom palatal augmentation prosthesis, selected for a different oral function.	$1,419.88
21079	Obturator prosthesis, interim obturatorInterim obturator preparation rather than speech aid prosthesis preparation.	$1,443.42

How 21084 has changed in North Carolina

21084 · Office / nonfacility

$1527.19

Effective 2026-10-01

Compare with release effective

The base rate is $65.69 higher than on 2025-10-01, moving from $1461.50 to $1527.19 (4.5%).

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

January 1, 2026
RVU26A
$1461.50changed to$1527.19
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1471.08changed to$1461.50
- 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
$1447.07changed to$1471.08
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1486.52changed to$1447.07
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$1499.76changed to$1486.52
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1515.05changed to$1499.76
- 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
$1597.84changed to$1515.05
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1685.51changed to$1597.84
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$1684.26changed to$1685.51
- Malpractice RVU 3.78 changed to 3.83
Held through RVU19D.
January 1, 2019
RVU19A
$1739.31changed to$1684.26
- 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
$1770.65changed to$1739.31
- 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
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1789.54changed to$1770.65
- 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
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1790.66changed to$1789.54
- 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
$1781.75changed to$1790.66
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1753.85changed to$1781.75
- 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
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$1719.98changed to$1753.85
- 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
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $1719.98
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$1,527.19	$1,010.50	RVU26D
2026-07-01	$1,527.19	$1,010.50	RVU26C
2026-04-01	$1,527.19	$1,010.50	RVU26B
2026-01-01	$1,527.19	$1,010.50	RVU26A
2025-10-01	$1,461.50	$1,124.83	RVU25D
2025-07-01	$1,461.50	$1,124.83	RVU25C
2025-04-01	$1,461.50	$1,124.83	RVU25B
2025-01-01	$1,461.50	$1,124.83	RVU25A
2024-10-01	$1,471.08	$1,134.17	RVU24D
2024-07-01	$1,471.08	$1,134.17	RVU24C
2024-04-01	$1,471.08	$1,134.17	RVU24B
2024-03-09	$1,471.08	$1,134.17	RVU24AR
2024-01-01	$1,447.07	$1,115.66	RVU24A
2023-10-01	$1,486.52	$1,154.17	RVU23D
2023-07-01	$1,486.52	$1,154.17	RVU23C
2023-04-01	$1,486.52	$1,154.17	RVU23B
2023-01-01	$1,486.52	$1,154.17	RVU23A
2022-10-01	$1,499.76	$1,170.59	RVU22D
2022-07-01	$1,499.76	$1,170.59	RVU22C
2022-04-01	$1,499.76	$1,170.59	RVU22B
2022-01-01	$1,499.76	$1,170.59	RVU22A
2021-10-01	$1,515.05	$1,190.92	RVU21D
2021-07-01	$1,515.05	$1,190.92	RVU21C
2021-04-01	$1,515.05	$1,190.92	RVU21B
2021-01-01	$1,515.05	$1,190.92	RVU21A
2020-10-01	$1,597.84	$1,272.28	RVU20D
2020-07-01	$1,597.84	$1,272.28	RVU20C
2020-04-01	$1,597.84	$1,272.28	RVU20B
2020-01-01	$1,597.84	$1,272.28	RVU20A
2019-10-01	$1,685.51	$1,355.02	RVU19D
2019-07-01	$1,685.51	$1,355.02	RVU19C
2019-04-01	$1,684.26	$1,353.77	RVU19B
2019-01-01	$1,684.26	$1,353.77	RVU19A
2018-10-01	$1,739.31	$1,402.14	RVU18D
2018-07-01	$1,739.31	$1,402.14	RVU18C
2018-04-01	$1,739.31	$1,402.14	RVU18B
2018-01-01	$1,739.31	$1,402.14	RVU18AR1
2017-10-01	$1,770.65	$1,427.50	RVU17D
2017-07-01	$1,770.65	$1,427.50	RVU17C
2017-04-01	$1,770.65	$1,427.50	RVU17B
2017-01-01	$1,770.65	$1,427.50	RVU17A
2016-10-01	$1,789.54	$1,442.24	RVU16D
2016-07-01	$1,789.54	$1,442.24	RVU16C
2016-04-01	$1,789.54	$1,442.24	RVU16B
2016-01-01	$1,789.54	$1,442.24	RVU16A
2015-10-01	$1,790.66	$1,446.46	RVU15D
2015-07-01	$1,790.66	$1,446.46	RVU15C
2015-04-01	$1,781.75	$1,439.26	RVU15B
2015-01-01	$1,781.75	$1,439.26	RVU15A
2014-10-01	$1,753.85	$1,418.39	RVU14D
2014-07-01	$1,753.85	$1,418.39	RVU14C
2014-04-01	$1,753.85	$1,418.39	RVU14B
2014-01-01	$1,753.85	$1,418.39	RVU14A
2013-10-01	$1,719.98	$1,370.53	RVU13D
2013-07-01	$1,719.98	$1,370.53	RVU13C
2013-04-01	$1,719.98	$1,370.53	RVU13B
2013-01-01	$1,719.98	$1,370.53	RVU13AR

Price 21084 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

Aberdeen
Advance
Ahoskie
Alamance
Albemarle
Alexis
Alliance
Altamahaw

Browse all communities in North Carolina

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

Show the CMS file lines behind this rate

RVUs for 21084PPRRVU2026_Oct_nonQPP.csv, line 1,868 (RVU26D)

1,86521081,,[CPT descriptor omitted],A,,22.28,22.71,,6.95,,2.68,47.67,31.91,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86621082,,[CPT descriptor omitted],A,,20.32,22.14,,7.02,,2.40,44.86,29.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86721083,,[CPT descriptor omitted],A,,18.79,21.33,,6.49,,2.14,42.26,27.42,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86821084,,[CPT descriptor omitted],A,,21.92,23.80,,7.22,,2.50,48.22,31.64,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,86921085,,[CPT descriptor omitted],A,,8.77,11.42,,3.03,,1.07,21.26,12.87,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,87021086,,[CPT descriptor omitted],A,,24.26,21.70,,6.71,,2.76,48.72,33.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,87121087,,[CPT descriptor omitted],A,,24.26,21.70,,6.71,,2.76,48.72,33.73,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210

8113292,NY,04,QUEENS,1.064,1.182,1.442

8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703

8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639

8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406

8515202,OH,00,OHIO,1.000,0.913,1.008

8604312,OK,00,OKLAHOMA,1.000,0.893,0.777

Open CMS source How we calculate rates

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What 21084 covers

How North Carolina compares for 21084

Every other payment area

21084 rates by state

How the 21084 rate is calculated

Payment rules and modifiers for 21084

What modifiers do to the payment

Codes related to 21084

How 21084 has changed in North Carolina

Where the North Carolina rate applies

21084 billing questions

How is this different from a palatal lift prosthesis?

When would an obturator code be more appropriate?

What should the documentation establish?

How does the 90-day global period affect related care?

How are other procedures in the same session paid?

Can modifier 50 or co-surgeon billing be used?

Where these rates come from

Did this answer your question about what 21084 pays in North Carolina?

Put 21084 and the rest of your codes on one sheet