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CMS RVU26D · Effective 2026-10-01

21081 Mandibular prosthesis Medicare reimbursement rates

Reports impression-taking and custom preparation of a prosthesis for a patient with a mandibular resection, rather than an obturator or other facial prosthesis. Compare 21081 office and facility rates across CMS payment localities.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 21081?

The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.

Office / nonfacility

$1441.85–$1973.42

109 of 109 localities have a supported rate.

Lowest: Arkansas

Highest: Alaska*

A spread of $531.57 per service.

Facility setting

$989.68–$1412.81

109 of 109 localities have a supported rate.

Lowest: Arkansas

Highest: Alaska*

A spread of $423.13 per service.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 21081 in your payment locality →

Where 21081 pays more and less

109 payment localities

$1441.85 to $1973.42

$1441.85$1707.63$1973.42
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Maxillofacial prosthetics

About 21081: Mandibular resection prosthesis preparation

Reports impression-taking and custom preparation of a prosthesis for a patient with a mandibular resection, rather than an obturator or other facial prosthesis.

A maxillofacial prosthodontist or other qualified clinician uses this service to take an impression and custom-prepare a prosthesis for a patient with a surgically resected portion of the mandible. The work is associated with reconstruction or prosthetic management after jaw resection and may be performed in a hospital-based service or a clinical prosthetics setting. The clinical record should identify the mandibular defect and the prosthesis being prepared.

Select this code for the mandibular resection prosthesis, not an obturator for a palatal or maxillary defect. Document the resection site, impression work, and customization performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.

CMS billing rules for 21081

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU22.28 · 47%
  • Practice expense (office) RVU22.71 · 48%
  • Malpractice RVU2.68 · 6%

335

Medicare services in 2024 · #3902 by national volume

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.

21081 compared with similar codes

Office rate ranges across all CMS payment localities, from the same CMS release.

21076

Obturator prosthesis

Surgical obturator

$832.53–$1,140.88

21076 describes custom preparation of a surgical obturator for a maxillary defect. Use 21081 for a mandibular resection prosthesis.

21079

Obturator prosthesis

Interim obturator

$1,380.31–$1,892.89

21079 is for an interim obturator. It does not describe preparation of a mandibular resection prosthesis.

21080

Obturator prosthesis

Definitive obturator

$1,567.54–$2,147.27

21080 is for a definitive obturator; 21081 is for a prosthesis associated with mandibular resection.

21082

Palatal prosthesis

Augmentation for tongue contact

$1,355.22–$1,862.68

21082 describes a palatal augmentation prosthesis. Choose 21081 when the custom-prepared prosthesis is for mandibular resection.

See how rates vary across the country

21081 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$1,441.85

$1,973.42

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$1,973.421
AL$1,458.551
AR$1,441.851
AZ$1,555.821
CA$1,636.16–$1,967.8229
CO$1,630.091
CT$1,684.311
DC$1,777.541
DE$1,577.801
FL$1,603.87–$1,760.193
GA$1,527.49–$1,624.582
GU$1,658.451
HI$1,658.451
IA$1,473.771
ID$1,484.361
IL$1,576.63–$1,717.144
IN$1,490.841
KS$1,475.001
KY$1,500.411
LA$1,501.23–$1,559.642
MA$1,626.16–$1,760.042
MD$1,601.42–$1,777.543
ME$1,497.70–$1,552.362
MI$1,537.78–$1,627.082
MN$1,551.201
MO$1,485.22–$1,555.993
MS$1,463.421
MT$1,592.041
NC$1,509.081
ND$1,539.051
NE$1,478.141
NH$1,612.131
NJ$1,700.46–$1,766.562
NM$1,547.251
NV$1,578.031
NY$1,527.71–$1,859.925
OH$1,526.941
OK$1,491.101
OR$1,562.60–$1,665.412
PA$1,525.10–$1,653.992
PR$1,599.221
RI$1,621.721
SC$1,521.151
SD$1,532.781
TN$1,481.751
TX$1,517.60–$1,627.508
UT$1,537.581
VA$1,553.01–$1,777.542
VI$1,599.221
VT$1,540.421
WA$1,620.70–$1,785.242
WI$1,498.421
WV$1,531.431
WY$1,568.951

Compare 21081 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

109 of 109 payment localities

21081 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama

Office

$1458.55

Facility

$997.96
Alaska*

Office

$1973.42

Facility

$1412.81
Arizona

Office

$1555.82

Facility

$1045.74
Arkansas

Office

$1441.85

Facility

$989.68
Atlanta

Office

$1624.58

Facility

$1089.76
Austin

Office

$1627.50

Facility

$1070.57
Bakersfield

Office

$1644.18

Facility

$1067.25
Baltimore/Surr. Cntys

Office

$1680.72

Facility

$1115.89
Beaumont

Office

$1517.60

Facility

$1038.57
Brazoria

Office

$1571.65

Facility

$1049.99
Chicago

Office

$1717.14

Facility

$1188.11
Chico

Office

$1636.16

Facility

$1059.22
Colorado

Office

$1630.09

Facility

$1070.01
Connecticut

Office

$1684.31

Facility

$1117.38
Dallas

Office

$1583.17

Facility

$1058.88
Dc + Md/Va Suburbs

Office

$1777.54

Facility

$1157.44
Delaware

Office

$1577.80

Facility

$1057.72
Detroit

Office

$1627.08

Facility

$1119.10
East St. Louis

Office

$1622.31

Facility

$1138.02
El Centro

Office

$1636.60

Facility

$1059.67
Fort Lauderdale

Office

$1674.41

Facility

$1141.17
Fort Worth

Office

$1576.75

Facility

$1057.72
Fresno

Office

$1636.16

Facility

$1059.22
Galveston

Office

$1577.47

Facility

$1054.75
Hanford-Corcoran

Office

$1636.16

Facility

$1059.22
Hawaii, Guam

Office

$1658.45

Facility

$1059.94
Houston

Office

$1626.52

Facility

$1103.81
Idaho

Office

$1484.36

Facility

$1000.08
Indiana

Office

$1490.84

Facility

$1002.87
Iowa

Office

$1473.77

Facility

$992.11
Kansas

Office

$1475.00

Facility

$999.14
Kentucky

Office

$1500.41

Facility

$1032.45
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

Office

$1731.47

Facility

$1108.74
Madera

Office

$1636.16

Facility

$1059.22
Manhattan

Office

$1815.19

Facility

$1203.51
Merced

Office

$1636.16

Facility

$1059.22
Metropolitan Boston

Office

$1760.04

Facility

$1131.52
Metropolitan Kansas City

Office

$1543.89

Facility

$1049.60
Metropolitan Philadelphia

Office

$1653.99

Facility

$1106.01
Metropolitan St. Louis

Office

$1555.99

Facility

$1054.86
Miami

Office

$1760.19

Facility

$1212.21
Minnesota

Office

$1551.20

Facility

$1009.54
Mississippi

Office

$1463.42

Facility

$1010.19
Modesto

Office

$1636.16

Facility

$1059.22
Montana**

Office

$1592.04

Facility

$1065.64
Napa

Office

$1836.28

Facility

$1142.48
Nebraska

Office

$1478.14

Facility

$992.27
Nevada**

Office

$1578.03

Facility

$1051.11
New Hampshire

Office

$1612.13

Facility

$1064.15
New Mexico

Office

$1547.25

Facility

$1064.55
New Orleans

Office

$1559.64

Facility

$1064.30
North Carolina

Office

$1509.08

Facility

$1017.95
North Dakota**

Office

$1539.05

Facility

$1012.65
Northern Nj

Office

$1766.56

Facility

$1155.93
Nyc Suburbs/Long Island

Office

$1859.92

Facility

$1234.04
Ohio

Office

$1526.94

Facility

$1046.34
Oklahoma

Office

$1491.10

Facility

$1021.02
Oxnard-Thousand Oaks-Ventura

Office

$1717.36

Facility

$1095.16
Portland

Office

$1665.41

Facility

$1080.58
Poughkpsie/N Nyc Suburbs

Office

$1716.57

Facility

$1140.16
Puerto Rico

Office

$1599.22

Facility

$1067.03
Queens

Office

$1817.47

Facility

$1195.26
Redding

Office

$1636.16

Facility

$1059.22
Rest Of California

Office

$1636.16

Facility

$1059.22
Rest Of Florida

Office

$1603.87

Facility

$1100.63
Rest Of Georgia

Office

$1527.49

Facility

$1057.94
Rest Of Illinois

Office

$1576.63

Facility

$1096.02
Rest Of Louisiana

Office

$1501.23

Facility

$1035.37
Rest Of Maine

Office

$1497.70

Facility

$1013.42
Rest Of Maryland

Office

$1601.42

Facility

$1068.71
Rest Of Massachusetts

Office

$1626.16

Facility

$1071.86
Rest Of Michigan

Office

$1537.78

Facility

$1057.17
Rest Of Missouri

Office

$1485.22

Facility

$1031.46
Rest Of New Jersey

Office

$1700.46

Facility

$1125.63
Rest Of New York

Office

$1527.71

Facility

$1027.63
Rest Of Oregon

Office

$1562.60

Facility

$1038.31
Rest Of Pennsylvania

Office

$1525.10

Facility

$1041.86
Rest Of Texas

Office

$1544.85

Facility

$1045.30
Rest Of Washington

Office

$1620.70

Facility

$1066.41
Rhode Island

Office

$1621.72

Facility

$1077.95
Riverside-San Bernardino-Ontario

Office

$1665.28

Facility

$1088.34
Sacramento-Roseville-Folsom

Office

$1701.12

Facility

$1088.92
Salinas

Office

$1694.36

Facility

$1084.27
San Diego-Chula Vista-Carlsbad

Office

$1722.22

Facility

$1092.65
San Francisco-Oakland-Berkeley (Marin Cnty)

Office

$1925.49

Facility

$1183.27
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

Office

$1922.45

Facility

$1180.22
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

Office

$1967.82

Facility

$1208.75
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

Office

$1955.37

Facility

$1196.31
San Luis Obispo-Paso Robles

Office

$1668.77

Facility

$1069.21
Santa Cruz-Watsonville

Office

$1729.40

Facility

$1089.82
Santa Maria-Santa Barbara

Office

$1697.44

Facility

$1083.66
Santa Rosa-Petaluma

Office

$1745.96

Facility

$1099.54
Seattle (King Cnty)

Office

$1785.24

Facility

$1139.35
South Carolina

Office

$1521.15

Facility

$1034.75
South Dakota**

Office

$1532.78

Facility

$1006.39
Southern Maine

Office

$1552.36

Facility

$1030.70
Stockton

Office

$1636.16

Facility

$1059.22
Suburban Chicago

Office

$1687.02

Facility

$1146.40
Tennessee

Office

$1481.75

Facility

$1003.25
Utah

Office

$1537.58

Facility

$1042.76
Vallejo

Office

$1831.89

Facility

$1138.10
Vermont

Office

$1540.42

Facility

$1019.28
Virgin Islands

Office

$1599.22

Facility

$1067.03
Virginia

Office

$1553.01

Facility

$1035.56
Visalia

Office

$1636.16

Facility

$1059.22
West Virginia

Office

$1531.43

Facility

$1073.99
Wisconsin

Office

$1498.42

Facility

$994.13
Wyoming**

Office

$1568.95

Facility

$1042.55
Yuba City

Office

$1636.16

Facility

$1059.22

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21081 billing questions

When should I choose 21081 instead of an obturator code?

Use 21081 for impression and custom preparation of a prosthesis for a mandibular resection. Obturator codes describe prostheses for defects requiring an obturator, not a mandibular resection prosthesis.

What documentation supports 21081?

Document the mandibular resection defect, the planned mandibular prosthesis, and the impression and custom preparation performed.

Does 21081 have a global period?

Yes. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.

Can I append modifier 50?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 21081PPRRVU2026_Oct_nonQPP.csv, line 1,865 (RVU26D)