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CPT code 21088: Facial prosthesis, impression and preparation2026 Medicare rate & RVUs

Reports impression-taking and custom preparation for a facial prosthesis replacing an external facial defect, such as one following surgery or trauma.

CMS RVU26DEffective Oct 1, 2026109 payment localities21 Medicare services in 2024

Medicare rate · 21088

Facial prosthesis, impression and preparation

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
090

National rate · 2026

—

Not priced in the facility setting.

See every locality for 21088 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 21088 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21088 covers

This service involves taking impressions and custom-preparing a prosthesis to replace missing external facial tissue. It is used for facial defects that are not the specific orbital, ear, or nasal prostheses described by separate codes. A maxillofacial prosthodontist or other clinician with maxillofacial prosthetic expertise typically performs the work, often after surgery or trauma has left a facial defect.

Medicare assigns CPT 21088 physician fee schedule status C: there is no national payment amount, and the Medicare Administrative Contractor sets payment for each claim. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of 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.

Where 21088 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21088 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

21088 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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.

View every state and territory as a table
21088 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21088 rate is calculated

Each of 21088’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 · 21088

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21088

21088 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21088

Facial prosthesis, impression and preparation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures0No multiple-procedure reduction.
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 · 21088

Facial prosthesis, impression and 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

21088 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 21088

    Facial prosthesis, impression and preparation0 wRVU

    Not priced

  • 21077

    Orbital prosthesis, impression and custom preparation32.86 wRVU

    $2,193.77

  • 21086

    Auricular prosthesis, impression and preparation24.26 wRVU

    $1,627.29

  • 21087

    Nasal prosthesis, impression and custom preparation24.26 wRVU

    $1,627.29

  • 21089

    Unlisted prosthesis, maxillofacial procedure0 wRVU

    Not priced

How to choose

21077Orbital prosthesisImpression and custom preparation
21077 applies to an orbital prosthesis. Use 21088 for a facial prosthesis outside that specific anatomic category.
21086Auricular prosthesisImpression and preparation
21086 is for an auricular prosthesis; 21088 describes a facial prosthesis rather than an ear prosthesis.
21087Nasal prosthesisImpression and custom preparation
21087 is for a nasal prosthesis. 21088 is for a facial prosthesis not specifically classified as nasal.
21089Unlisted prosthesisMaxillofacial procedure
21089 is the unlisted maxillofacial prosthetic procedure code. Use 21088 when the work is impression and custom preparation for a facial prosthesis.

Codes related to 21088

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

Codes related to 21088
CodeHow it relatesNational office range
Same family
21077Orbital prosthesis, impression and custom preparationImpression and custom preparation for an orbital prosthesis.$1,996.12–$2,749.42
21086Auricular prosthesis, impression and preparationImpression and custom preparation for an auricular prosthesis.$1,480.38–$2,038.17
21087Nasal prosthesis, impression and custom preparationImpression and custom preparation for a nasal prosthesis.$1,480.38–$2,038.17
21076Obturator prosthesis, surgical obturatorImpression and preparation for a surgical obturator prosthesis.$832.53–$1,140.88
Used instead
21089Unlisted prosthesis, maxillofacial procedureFor a maxillofacial prosthetic procedure not represented by a listed code.No office rate

21088 billing questions

When should 21088 be chosen over an orbital, nasal, or auricular prosthesis code?

Use 21088 for impression and custom preparation of a facial prosthesis that is not specifically orbital, nasal, or auricular. Those anatomic prostheses have separate codes.

Does 21088 include the impression and custom preparation?

Yes. The code describes both impression-taking and custom preparation for the facial prosthesis.

Does Medicare publish a national payment amount for 21088?

No. Its physician fee schedule status is C, so the Medicare Administrative Contractor sets payment for each claim.

What global period applies to 21088?

It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 or an assistant surgeon be reported?

Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; 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

Open CMS sourceHow we calculate rates

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