CPT code 21089: Unlisted prosthesis, maxillofacial procedure2026 Medicare rate & RVUs in Missouri
Reports a maxillofacial prosthetic procedure when no listed CPT code describes the service, rather than a coded impression-and-preparation service for a named prosthesis.
CMS doesn’t publish an office rate for 21089 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 8 sections
What 21089 covers
Code 21089 identifies an unlisted maxillofacial prosthetic procedure. It is used when the prosthetic work is not described by a more specific listed CPT service. Nearby listed services cover impression and preparation for a surgical obturator, mandibular resection prosthesis, oral surgical splint, nasal prosthesis, and facial prosthesis. Those listed codes apply when the service performed is the corresponding impression-and-preparation service; 21089 is not a general substitute for them. The code identifies neither a named prosthesis nor a fixed unit of service.
Medicare assigns 21089 physician fee schedule status C: CMS publishes no national payment amount, and the Medicare Administrative Contractor prices each claim. The contractor also sets the global period. Report the code for maxillofacial prosthetic work that lacks a more specific listed CPT code.
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 21089 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 21089 rate is calculated
Each of 21089’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 · 21089
RVUs × geographic indexes × conversion factor
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 21089
The CMS indicators that decide how 21089 is paid alongside other services.
CMS payment indicators · 21089
Unlisted prosthesis, maxillofacial procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
21089 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21088Facial prosthesisImpression and preparation
- 21088 covers impression and preparation for a facial prosthesis. Use 21089 when the maxillofacial prosthetic work is not described by that or another listed service.
- 21081Mandibular prosthesisImpression and custom preparation
- 21081 covers impression and preparation for a mandibular resection prosthesis. Code 21089 is for maxillofacial prosthetic work without a more specific listed code.
- 21085Oral splintSurgical use
- 21085 covers impression and preparation for an oral surgical splint. It is not the unlisted code for other maxillofacial prosthetic work.
21089 billing questions
When should I report 21089 instead of a listed prosthesis code?
Use 21089 when the maxillofacial prosthetic work is not described by a more specific listed CPT service. Listed codes cover specified impression-and-preparation services, such as those for a facial prosthesis or oral surgical splint.
Is 21089 an impression-and-preparation code?
No. Nearby codes describe impression and preparation for specified prostheses; 21089 identifies an unlisted maxillofacial prosthetic procedure.
Does 21089 have a national Medicare payment amount?
No. Its physician fee schedule status is C, so the Medicare Administrative Contractor prices each claim.
Who sets the global period for 21089?
The Medicare contractor sets the global period for this code.
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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