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

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 Austin, TX, Medicare pays $1,648.64 for 21084 in the office and $1,062.74 when it’s performed in a hospital or facility.

$1,648.64Office (non-facility)
$1,062.74Hospital or facility
+2.4%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.

We’ll open 21084 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Austin, TX
  2. What 21084 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 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 Austin, TX 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. Austin, TX pays $1,648.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

21084 in Austin, TX vs other payment areas
  1. Austin, TX · this page$1,648.64
  2. Beaumont, TX · Texas$1,533.12−$115.52
  3. Brazoria, TX · Texas$1,590.92−$57.72
  4. Dallas, TX · Texas$1,602.14−$46.50
  5. Fort Worth, TX · Texas$1,595.28−$53.36
  6. Galveston, TX · Texas$1,596.52−$52.12
  7. Houston, TX · Texas$1,642.28−$6.36

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

Every other payment area

21084 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$1,561.95$1,036.41
Los Angeles, CACalifornia$1,758.03$1,102.90
Washington, DC areaDistrict of Columbia$1,801.06$1,148.70
Miami, FLFlorida$1,770.86$1,194.37
Chicago, ILIllinois$1,727.83$1,171.27
Manhattan, NYNew York$1,835.16$1,191.66
AlaskaAlaska$1,990.84$1,401.06
AlabamaAlabama$1,474.98$990.42

21084 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.

$1,458.01

$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 / territoryOffice rate rangeLocalities
AK$1,990.841
AL$1,474.981
AR$1,458.011
AZ$1,573.921
CA$1,660.61–$2,003.7529
CO$1,651.971
CT$1,703.981
DC$1,801.061
DE$1,596.281
FL$1,617.62–$1,770.863
GA$1,540.77–$1,642.292
GU$1,684.341
HI$1,684.341
IA$1,492.671
ID$1,502.991
IL$1,588.44–$1,727.834
IN$1,509.641
KS$1,492.861
KY$1,515.261
LA$1,515.67–$1,575.052
MA$1,647.49–$1,785.642
MD$1,620.60–$1,801.063
ME$1,515.43–$1,572.622
MI$1,552.20–$1,640.052
MN$1,574.861
MO$1,498.72–$1,572.603
MS$1,478.301
MT$1,610.421
NC$1,527.191
ND$1,560.991
NE$1,497.441
NH$1,632.751
NJ$1,721.11–$1,789.592
NM$1,561.401
NV$1,597.441
NY$1,546.04–$1,879.255
OH$1,542.101
OK$1,506.911
OR$1,582.61–$1,689.172
PA$1,540.81–$1,672.482
PR$1,618.081
RI$1,641.721
SC$1,537.651
SD$1,555.151
TN$1,499.591
TX$1,533.12–$1,648.648
UT$1,554.381
VA$1,572.53–$1,801.062
VI$1,618.081
VT$1,561.391
WA$1,642.28–$1,812.372
WI$1,519.421
WV$1,542.441
WY$1,588.881

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?

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 Austin, TX 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

96

Locality
Austin, TX
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office calculation for 21084 in Austin, TX
ComponentRVULocality factorAdjusted
Physician work21.92× 1.00221.9638
Practice expense23.80× 1.05825.1804
Malpractice2.50× 0.8862.2150
Total RVUs49.3592
Conversion factor× 33.4009

Office rate, Austin, TX$1648.64

Office: (21.92 × 1.002 + 23.8 × 1.058 + 2.5 × 0.886) × $33.4009 = $1648.64

Facility: (21.92 × 1.002 + 7.22 × 1.058 + 2.5 × 0.886) × $33.4009 = $1062.74

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

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 · 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.

  • 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
CodeHow it relatesOffice range, Austin, TX
Used instead
21083Palatal lift prosthesis, impression and custom preparationPalatal lift prosthesis for a different approach to velopharyngeal dysfunction.$1,445.95
21080Obturator prosthesis, definitive obturatorDefinitive obturator preparation for a maxillary defect requiring obturation.$1,767.75
Same family
21082Palatal prosthesis, augmentation for tongue contactCustom palatal augmentation prosthesis, selected for a different oral function.$1,533.47
21079Obturator prosthesis, interim obturatorInterim obturator preparation rather than speech aid prosthesis preparation.$1,554.67

How 21084 has changed in Austin, TX

21084 · Office / nonfacility

$1648.64

Effective 2026-10-01

The base rate is $80.71 higher than on 2025-10-01, moving from $1567.93 to $1648.64 (5.1%).

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

    $1567.93changed to$1648.64

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1576.51changed to$1567.93

    • 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.

  3. March 9, 2024

    RVU24AR

    $1550.78changed to$1576.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1576.78changed to$1550.78

    • 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 1.053 changed to 1.046
    • Malpractice GPCI 0.727 changed to 0.914

  5. January 1, 2023

    RVU23A

    $1574.41changed to$1576.78

    • 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 1.059 changed to 1.053
    • Malpractice GPCI 0.539 changed to 0.727

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1591.69changed to$1574.41

    • 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.

  7. January 1, 2021

    RVU21A

    $1676.84changed to$1591.69

    • 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 1.040 changed to 1.059
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1768.04changed to$1676.84

    • 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 1.021 changed to 1.040
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $1766.69changed to$1768.04

    • Malpractice RVU 3.78 changed to 3.83

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $1827.14changed to$1766.69

    • 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.

  11. January 1, 2018

    RVU18AR1

    $1856.66changed to$1827.14

    • 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
    • Practice expense GPCI 1.020 changed to 1.021
    • Malpractice GPCI 0.757 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $1873.39changed to$1856.66

    • 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 1.019 changed to 1.020
    • Malpractice GPCI 0.766 changed to 0.757

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $1874.47changed to$1873.39

    • 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.

  14. July 1, 2015

    RVU15C

    $1865.14changed to$1874.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $1836.67changed to$1865.14

    • 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 1.014 changed to 1.019
    • Malpractice GPCI 0.759 changed to 0.766

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $1803.93changed to$1836.67

    • 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 1.009 changed to 1.014
    • Malpractice GPCI 0.751 changed to 0.759

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $1803.93

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,648.64$1,062.74RVU26D
2026-07-01$1,648.64$1,062.74RVU26C
2026-04-01$1,648.64$1,062.74RVU26B
2026-01-01$1,648.64$1,062.74RVU26A
2025-10-01$1,567.93$1,187.63RVU25D
2025-07-01$1,567.93$1,187.63RVU25C
2025-04-01$1,567.93$1,187.63RVU25B
2025-01-01$1,567.93$1,187.63RVU25A
2024-10-01$1,576.51$1,195.94RVU24D
2024-07-01$1,576.51$1,195.94RVU24C
2024-04-01$1,576.51$1,195.94RVU24B
2024-03-09$1,576.51$1,195.94RVU24AR
2024-01-01$1,550.78$1,176.42RVU24A
2023-10-01$1,576.78$1,199.26RVU23D
2023-07-01$1,576.78$1,199.26RVU23C
2023-04-01$1,576.78$1,199.26RVU23B
2023-01-01$1,576.78$1,199.26RVU23A
2022-10-01$1,574.41$1,198.77RVU22D
2022-07-01$1,574.41$1,198.77RVU22C
2022-04-01$1,574.41$1,198.77RVU22B
2022-01-01$1,574.41$1,198.77RVU22A
2021-10-01$1,591.69$1,221.80RVU21D
2021-07-01$1,591.69$1,221.80RVU21C
2021-04-01$1,591.69$1,221.80RVU21B
2021-01-01$1,591.69$1,221.80RVU21A
2020-10-01$1,676.84$1,312.77RVU20D
2020-07-01$1,676.84$1,312.77RVU20C
2020-04-01$1,676.84$1,312.77RVU20B
2020-01-01$1,676.84$1,312.77RVU20A
2019-10-01$1,768.04$1,405.60RVU19D
2019-07-01$1,768.04$1,405.60RVU19C
2019-04-01$1,766.69$1,404.25RVU19B
2019-01-01$1,766.69$1,404.25RVU19A
2018-10-01$1,827.14$1,457.38RVU18D
2018-07-01$1,827.14$1,457.38RVU18C
2018-04-01$1,827.14$1,457.38RVU18B
2018-01-01$1,827.14$1,457.38RVU18AR1
2017-10-01$1,856.66$1,480.71RVU17D
2017-07-01$1,856.66$1,480.71RVU17C
2017-04-01$1,856.66$1,480.71RVU17B
2017-01-01$1,856.66$1,480.71RVU17A
2016-10-01$1,873.39$1,492.86RVU16D
2016-07-01$1,873.39$1,492.86RVU16C
2016-04-01$1,873.39$1,492.86RVU16B
2016-01-01$1,873.39$1,492.86RVU16A
2015-10-01$1,874.47$1,497.32RVU15D
2015-07-01$1,874.47$1,497.32RVU15C
2015-04-01$1,865.14$1,489.87RVU15B
2015-01-01$1,865.14$1,489.87RVU15A
2014-10-01$1,836.67$1,470.52RVU14D
2014-07-01$1,836.67$1,470.52RVU14C
2014-04-01$1,836.67$1,470.52RVU14B
2014-01-01$1,836.67$1,470.52RVU14A
2013-10-01$1,803.93$1,423.56RVU13D
2013-07-01$1,803.93$1,423.56RVU13C
2013-04-01$1,803.93$1,423.56RVU13B
2013-01-01$1,803.93$1,423.56RVU13AR

Price 21084 for an earlier date of service

Where the Austin, TX rate applies

Austin, TX is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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)
Geographic factors for Austin, TXGPCI2026.csv, line 96 (RVU26D)

Open CMS sourceHow we calculate rates

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