CPT code 21085: Oral splint, surgical use2026 Medicare rate & RVUs in Portland, OR
Reports impression-taking and preparation of an oral surgical splint used to support planned oral or maxillofacial surgery.
In Portland, OR, Medicare pays $747.98 for 21085 in the office and $436.64 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 21085 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 21085 covers
This service covers taking the impression and preparing an oral surgical splint for a patient undergoing oral or maxillofacial surgery. Oral and maxillofacial surgeons and prosthodontists may provide it in an office or facility setting. A common clinical context is orthognathic surgery, where a custom splint helps transfer or maintain a planned relationship between the jaws during treatment.
Report 21085 when the documented service is for an oral surgical splint, rather than an obturator, speech aid, or other maxillofacial prosthesis. The record should identify the surgical purpose and support the impression and preparation performed. The code has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same 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 Portland, OR compares for 21085
Across 109 of 109 payment localities, the office rate for 21085 runs from $638.99 in Arkansas to $894.34 in San Benito County, CA. Portland, OR pays $747.98. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Portland, OR · this page$747.98
- Rest of Oregon · Oregon$697.96−$50.02
- Los Angeles, CA · California$779.91+$31.93
- Washington, DC area · District of Columbia$797.86+$49.88
- Miami, FL · Florida$780.39+$32.41
- Chicago, IL · Illinois$760.34+$12.36
- Manhattan, NY · New York$811.59+$63.61
Other areas in Oregon first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $865.31 | $566.86 |
| AlabamaAlabama | $646.91 | $401.71 |
| ArkansasArkansas | $638.99 | $398.27 |
| ArizonaArizona | $693.13 | $421.59 |
| Bakersfield, CACalifornia | $738.31 | $431.18 |
| Chico, CACalifornia | $735.12 | $427.98 |
| El Centro, CACalifornia | $735.30 | $428.16 |
| Fresno, CACalifornia | $735.12 | $427.98 |
| Hanford, CACalifornia | $735.12 | $427.98 |
| Madera, CACalifornia | $735.12 | $427.98 |
| Merced, CACalifornia | $735.12 | $427.98 |
| Modesto, CACalifornia | $735.12 | $427.98 |
| Napa, CACalifornia | $832.27 | $462.92 |
| Oxnard, CACalifornia | $774.25 | $443.02 |
| Redding, CACalifornia | $735.12 | $427.98 |
| Rest of CaliforniaCalifornia | $735.12 | $427.98 |
| Riverside, CACalifornia | $746.74 | $439.60 |
| Sacramento, CACalifornia | $766.24 | $440.33 |
| Salinas, CACalifornia | $763.25 | $438.46 |
| San Diego, CACalifornia | $777.28 | $442.13 |
| Marin County, CACalifornia | $874.99 | $479.86 |
| San Francisco, CACalifornia | $873.77 | $478.64 |
| San Benito County, CACalifornia | $894.34 | $490.24 |
| Santa Clara County, CACalifornia | $889.37 | $485.27 |
| San Luis Obispo, CACalifornia | $751.52 | $432.33 |
| Santa Cruz, CACalifornia | $781.68 | $441.20 |
| Santa Maria, CACalifornia | $765.04 | $438.29 |
| Santa Rosa, CACalifornia | $789.28 | $445.15 |
| Stockton, CACalifornia | $735.12 | $427.98 |
| Vallejo, CACalifornia | $830.52 | $461.17 |
| Visalia, CACalifornia | $735.12 | $427.98 |
| Yuba City, CACalifornia | $735.12 | $427.98 |
| ColoradoColorado | $730.20 | $432.03 |
| ConnecticutConnecticut | $752.84 | $451.03 |
| DelawareDelaware | $703.38 | $426.51 |
| Fort Lauderdale, FLFlorida | $743.94 | $460.06 |
| Rest of FloridaFlorida | $711.30 | $443.39 |
| Atlanta, GAGeorgia | $724.27 | $439.55 |
| Rest of GeorgiaGeorgia | $675.77 | $425.80 |
| Hawaii, Guam, HIHawaii | $747.31 | $428.69 |
| IowaIowa | $656.13 | $399.72 |
| IdahoIdaho | $660.75 | $402.94 |
| East St. Louis, ILIllinois | $715.83 | $458.01 |
| Rest of IllinoisIllinois | $697.04 | $441.19 |
| Suburban Chicago, ILIllinois | $750.04 | $462.24 |
| IndianaIndiana | $663.89 | $404.11 |
| KansasKansas | $655.76 | $402.43 |
| KentuckyKentucky | $664.73 | $415.60 |
| New Orleans, LALouisiana | $692.46 | $428.76 |
| Rest of LouisianaLouisiana | $664.74 | $416.73 |
| Metropolitan Boston, MAMassachusetts | $792.18 | $457.58 |
| Rest of MassachusettsMassachusetts | $727.75 | $432.67 |
| Baltimore area, MDMaryland | $751.11 | $450.41 |
| Rest of MarylandMaryland | $714.68 | $431.08 |
| Rest of MaineMaine | $666.08 | $408.26 |
| Southern Maine, MEMaine | $693.48 | $415.77 |
| Detroit, MIMichigan | $721.27 | $450.84 |
| Rest of MichiganMichigan | $681.53 | $425.68 |
| MinnesotaMinnesota | $696.00 | $407.64 |
| Metropolitan Kansas City, MOMissouri | $686.01 | $422.87 |
| Metropolitan St. Louis, MOMissouri | $691.87 | $425.08 |
| Rest of MissouriMissouri | $656.54 | $414.97 |
| MississippiMississippi | $647.76 | $406.47 |
| MontanaMontana | $710.03 | $429.80 |
| North CarolinaNorth Carolina | $671.65 | $410.19 |
| North DakotaNorth Dakota | $688.87 | $408.64 |
| NebraskaNebraska | $658.50 | $399.85 |
| New HampshireNew Hampshire | $721.27 | $429.55 |
| Northern New JerseyNew Jersey | $792.02 | $466.95 |
| Rest of New JerseyNew Jersey | $760.38 | $454.36 |
| New MexicoNew Mexico | $685.63 | $428.65 |
| NevadaNevada | $704.52 | $424.00 |
| NYC suburbs and Long Island, NYNew York | $831.57 | $498.37 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $767.03 | $460.17 |
| Queens, NYNew York | $814.07 | $482.83 |
| Rest of New YorkNew York | $680.42 | $414.19 |
| OhioOhio | $677.20 | $421.35 |
| OklahomaOklahoma | $661.32 | $411.07 |
| Metropolitan Philadelphia, PAPennsylvania | $737.91 | $446.19 |
| Rest of PennsylvaniaPennsylvania | $676.86 | $419.61 |
| Puerto RicoPuerto Rico | $713.76 | $430.45 |
| Rhode IslandRhode Island | $724.40 | $434.92 |
| South CarolinaSouth Carolina | $675.75 | $416.82 |
| South DakotaSouth Dakota | $686.37 | $406.14 |
| TennesseeTennessee | $658.85 | $404.11 |
| Austin, TXTexas | $728.74 | $432.25 |
| Beaumont, TXTexas | $673.24 | $418.22 |
| Brazoria, TXTexas | $701.15 | $423.44 |
| Dallas, TXTexas | $706.14 | $427.03 |
| Fort Worth, TXTexas | $702.79 | $426.48 |
| Galveston, TXTexas | $703.63 | $425.36 |
| Houston, TXTexas | $723.21 | $444.94 |
| Rest of TexasTexas | $687.18 | $421.24 |
| UtahUtah | $683.57 | $420.15 |
| VirginiaVirginia | $693.11 | $417.64 |
| Virgin Islands, VIUnited States Virgin Islands | $713.76 | $430.45 |
| VermontVermont | $688.63 | $411.20 |
| Rest of WashingtonWashington | $725.59 | $430.50 |
| King County, WAWashington | $804.80 | $460.95 |
| WisconsinWisconsin | $669.35 | $400.89 |
| West VirginiaWest Virginia | $675.54 | $432.02 |
| WyomingWyoming | $700.81 | $420.58 |
21085 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.
$638.99
$865.31
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 | $865.31 | 1 |
| AL | $646.91 | 1 |
| AR | $638.99 | 1 |
| AZ | $693.13 | 1 |
| CA | $735.12–$894.34 | 29 |
| CO | $730.20 | 1 |
| CT | $752.84 | 1 |
| DC | $797.86 | 1 |
| DE | $703.38 | 1 |
| FL | $711.30–$780.39 | 3 |
| GA | $675.77–$724.27 | 2 |
| GU | $747.31 | 1 |
| HI | $747.31 | 1 |
| IA | $656.13 | 1 |
| ID | $660.75 | 1 |
| IL | $697.04–$760.34 | 4 |
| IN | $663.89 | 1 |
| KS | $655.76 | 1 |
| KY | $664.73 | 1 |
| LA | $664.74–$692.46 | 2 |
| MA | $727.75–$792.18 | 2 |
| MD | $714.68–$797.86 | 3 |
| ME | $666.08–$693.48 | 2 |
| MI | $681.53–$721.27 | 2 |
| MN | $696.00 | 1 |
| MO | $656.54–$691.87 | 3 |
| MS | $647.76 | 1 |
| MT | $710.03 | 1 |
| NC | $671.65 | 1 |
| ND | $688.87 | 1 |
| NE | $658.50 | 1 |
| NH | $721.27 | 1 |
| NJ | $760.38–$792.02 | 2 |
| NM | $685.63 | 1 |
| NV | $704.52 | 1 |
| NY | $680.42–$831.57 | 5 |
| OH | $677.20 | 1 |
| OK | $661.32 | 1 |
| OR | $697.96–$747.98 | 2 |
| PA | $676.86–$737.91 | 2 |
| PR | $713.76 | 1 |
| RI | $724.40 | 1 |
| SC | $675.75 | 1 |
| SD | $686.37 | 1 |
| TN | $658.85 | 1 |
| TX | $673.24–$728.74 | 8 |
| UT | $683.57 | 1 |
| VA | $693.11–$797.86 | 2 |
| VI | $713.76 | 1 |
| VT | $688.63 | 1 |
| WA | $725.59–$804.80 | 2 |
| WI | $669.35 | 1 |
| WV | $675.54 | 1 |
| WY | $700.81 | 1 |
How the 21085 rate is calculated
Each of 21085’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 · 21085
RVUs × geographic indexes × conversion factor
Work8.77
8.77 RVUs× 1.000 GPCI
Practice expense11.42
11.42 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
21.2600
Conversion factor
$33.4009
Medicare rate
$710.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Portland, OR inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,869
- Code
- 21085
- Physician work
- 8.77
- Practice expense
- 11.42
- Malpractice
- 1.07
GPCI2026.csv
87
- Locality
- Portland, OR
- Physician work
- 1.016
- Practice expense
- 1.111
- Malpractice
- 0.744
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.77 | × 1.016 | 8.9103 |
| Practice expense | 11.42 | × 1.111 | 12.6876 |
| Malpractice | 1.07 | × 0.744 | 0.7961 |
| Total RVUs | 22.3940 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Portland, OR$747.98
Office: (8.77 × 1.016 + 11.42 × 1.111 + 1.07 × 0.744) × $33.4009 = $747.98
Facility: (8.77 × 1.016 + 3.03 × 1.111 + 1.07 × 0.744) × $33.4009 = $436.64
Payment rules and modifiers for 21085
21085 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21085
Oral splint, surgical use
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21085
Oral splint, surgical use
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21085 without 51 · national office
$710.10
Oral splint, surgical use
21085-51 · Second procedure: 50%
$355.05
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 21085 has changed in Portland, OR
21085 · Office / nonfacility
$747.98
Effective 2026-10-01
The base rate is $45.64 higher than on 2025-10-01, moving from $702.34 to $747.98 (6.5%).
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
$702.34changed to$747.98
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 8.99 changed to 8.77
- Practice expense RVU 10.88 changed to 11.42
- Malpractice RVU 0.88 changed to 1.07
- Work GPCI 1.013 changed to 1.016
- Practice expense GPCI 1.103 changed to 1.111
- Malpractice GPCI 0.688 changed to 0.744
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$710.38changed to$702.34
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 10.53 changed to 10.88
- Malpractice RVU 0.90 changed to 0.88
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$698.78changed to$710.38
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$705.29changed to$698.78
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 10.27 changed to 10.53
- Malpractice RVU 0.88 changed to 0.90
- Work GPCI 1.018 changed to 1.013
- Practice expense GPCI 1.083 changed to 1.103
- Malpractice GPCI 0.612 changed to 0.688
January 1, 2023
RVU23A
$701.19changed to$705.29
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.99 changed to 10.27
- Malpractice RVU 0.85 changed to 0.88
- Work GPCI 1.022 changed to 1.018
- Practice expense GPCI 1.063 changed to 1.083
- Malpractice GPCI 0.535 changed to 0.612
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$708.11changed to$701.19
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 10.04 changed to 9.99
- Malpractice RVU 0.81 changed to 0.85
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$740.83changed to$708.11
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 10.23 changed to 10.04
- Malpractice RVU 0.85 changed to 0.81
- Work GPCI 1.016 changed to 1.022
- Practice expense GPCI 1.059 changed to 1.063
- Malpractice GPCI 0.659 changed to 0.535
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$770.78changed to$740.83
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 10.57 changed to 10.23
- Malpractice RVU 1.49 changed to 0.85
- Work GPCI 1.010 changed to 1.016
- Practice expense GPCI 1.054 changed to 1.059
- Malpractice GPCI 0.783 changed to 0.659
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$787.01changed to$770.78
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.02 changed to 10.57
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$794.92changed to$787.01
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.37 changed to 11.02
- Malpractice RVU 1.51 changed to 1.49
- Work GPCI 1.008 changed to 1.010
- Practice expense GPCI 1.052 changed to 1.054
- Malpractice GPCI 0.746 changed to 0.783
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$795.45changed to$794.92
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 11.54 changed to 11.37
- Malpractice RVU 1.52 changed to 1.51
- Work GPCI 1.005 changed to 1.008
- Practice expense GPCI 1.049 changed to 1.052
- Malpractice GPCI 0.708 changed to 0.746
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$799.45changed to$795.45
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 11.57 changed to 11.54
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$795.47changed to$799.45
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$837.82changed to$795.47
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 11.67 changed to 11.57
- Malpractice RVU 3.20 changed to 1.52
- Practice expense GPCI 1.047 changed to 1.049
- Malpractice GPCI 0.667 changed to 0.708
Held through RVU15B.
January 1, 2014
RVU14A
$823.34changed to$837.82
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 12.52 changed to 11.67
- Malpractice RVU 3.35 changed to 3.20
- Practice expense GPCI 1.044 changed to 1.047
- Malpractice GPCI 0.625 changed to 0.667
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $823.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $747.98 | $436.64 | RVU26D |
| 2026-07-01 | $747.98 | $436.64 | RVU26C |
| 2026-04-01 | $747.98 | $436.64 | RVU26B |
| 2026-01-01 | $747.98 | $436.64 | RVU26A |
| 2025-10-01 | $702.34 | $486.84 | RVU25D |
| 2025-07-01 | $702.34 | $486.84 | RVU25C |
| 2025-04-01 | $702.34 | $486.84 | RVU25B |
| 2025-01-01 | $702.34 | $486.84 | RVU25A |
| 2024-10-01 | $710.38 | $491.55 | RVU24D |
| 2024-07-01 | $710.38 | $491.55 | RVU24C |
| 2024-04-01 | $710.38 | $491.55 | RVU24B |
| 2024-03-09 | $710.38 | $491.55 | RVU24AR |
| 2024-01-01 | $698.78 | $483.53 | RVU24A |
| 2023-10-01 | $705.29 | $493.16 | RVU23D |
| 2023-07-01 | $705.29 | $493.16 | RVU23C |
| 2023-04-01 | $705.29 | $493.16 | RVU23B |
| 2023-01-01 | $705.29 | $493.16 | RVU23A |
| 2022-10-01 | $701.19 | $492.98 | RVU22D |
| 2022-07-01 | $701.19 | $492.98 | RVU22C |
| 2022-04-01 | $701.19 | $492.98 | RVU22B |
| 2022-01-01 | $701.19 | $492.98 | RVU22A |
| 2021-10-01 | $708.11 | $501.14 | RVU21D |
| 2021-07-01 | $708.11 | $501.14 | RVU21C |
| 2021-04-01 | $708.11 | $501.14 | RVU21B |
| 2021-01-01 | $708.11 | $501.14 | RVU21A |
| 2020-10-01 | $740.83 | $536.36 | RVU20D |
| 2020-07-01 | $740.83 | $536.36 | RVU20C |
| 2020-04-01 | $740.83 | $536.36 | RVU20B |
| 2020-01-01 | $740.83 | $536.36 | RVU20A |
| 2019-10-01 | $770.78 | $567.94 | RVU19D |
| 2019-07-01 | $770.78 | $567.94 | RVU19C |
| 2019-04-01 | $770.78 | $567.94 | RVU19B |
| 2019-01-01 | $770.78 | $567.94 | RVU19A |
| 2018-10-01 | $787.01 | $584.39 | RVU18D |
| 2018-07-01 | $787.01 | $584.39 | RVU18C |
| 2018-04-01 | $787.01 | $584.39 | RVU18B |
| 2018-01-01 | $787.01 | $584.39 | RVU18AR1 |
| 2017-10-01 | $794.92 | $589.91 | RVU17D |
| 2017-07-01 | $794.92 | $589.91 | RVU17C |
| 2017-04-01 | $794.92 | $589.91 | RVU17B |
| 2017-01-01 | $794.92 | $589.91 | RVU17A |
| 2016-10-01 | $795.45 | $589.63 | RVU16D |
| 2016-07-01 | $795.45 | $589.63 | RVU16C |
| 2016-04-01 | $795.45 | $589.63 | RVU16B |
| 2016-01-01 | $795.45 | $589.63 | RVU16A |
| 2015-10-01 | $799.45 | $591.75 | RVU15D |
| 2015-07-01 | $799.45 | $591.75 | RVU15C |
| 2015-04-01 | $795.47 | $588.81 | RVU15B |
| 2015-01-01 | $795.47 | $588.81 | RVU15A |
| 2014-10-01 | $837.82 | $633.41 | RVU14D |
| 2014-07-01 | $837.82 | $633.41 | RVU14C |
| 2014-04-01 | $837.82 | $633.41 | RVU14B |
| 2014-01-01 | $837.82 | $633.41 | RVU14A |
| 2013-10-01 | $823.34 | $610.93 | RVU13D |
| 2013-07-01 | $823.34 | $610.93 | RVU13C |
| 2013-04-01 | $823.34 | $610.93 | RVU13B |
| 2013-01-01 | $823.34 | $610.93 | RVU13AR |
Where the Portland, OR rate applies
Portland, OR is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Oregon. Some span more than one payment area; confirm with the service ZIP.
- Portland
- Aloha
- Banks
- Barlow
- Beavercreek
- Beaverton
- Bethany
- Boring
21085 billing questions
How is 21085 different from 21076?
Use 21085 for an oral surgical splint. Code 21076 describes impression and preparation for a surgical obturator, a different type of maxillofacial prosthesis.
Does 21085 cover both the impression and splint preparation?
Yes. The service combines impression-taking and preparation of the oral surgical splint; document the work performed and its surgical purpose.
Can modifier 50 be used for a splint involving both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included.
When can an assistant-at-surgery be paid?
Only when medical necessity for the assistant is documented. 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
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