Billing code 21087: Nasal prosthesisMedicare rate & RVUs
Captures the nasal defect and custom-prepares a nasal prosthesis, typically for a patient with acquired nasal loss or deformity after cancer, trauma, or surgery.
Medicare pays $1,627.29 for 21087 nationally in the office and $1,126.61 in a hospital or facility. Local office rates run $1,480.38–$2,038.17.
Medicare rate · 21087
Nasal prosthesis
Swap in your local Medicare rate.
- Work RVUs
- 24.26
- Total RVUs
- 48.72
- Global days
- 090
National rate · 2026
$1,627.29
Office setting, before claim adjustments.
See every locality for 21087 → · 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.
On this page 10 sections
What 21087 covers
This service covers taking an impression of the nasal area and custom-preparing a prosthesis to replace or restore the external nose. It is used for acquired defects, such as after tumor removal or trauma, when a patient needs a prosthetic rather than surgical reconstruction. A maxillofacial prosthodontist, oral and maxillofacial surgeon, or another clinician with relevant prosthetic expertise may perform the work in an office or facility setting.
Report the code for the nasal prosthetic service, not for surgical repair of the nose. Documentation should identify the defect and clinical need and support 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. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Report the nasal service without modifier 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.
Where 21087 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$1480.38 to $2038.17
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,496.68 | $1,058.59 |
| Alaska* | $2,038.17 | $1,504.94 |
| Arizona | $1,591.55 | $1,106.39 |
| Arkansas | $1,480.38 | $1,050.30 |
| Atlanta | $1,659.85 | $1,151.16 |
| Austin | $1,660.44 | $1,130.72 |
| Bakersfield | $1,676.22 | $1,127.48 |
| Baltimore/Surr. Cntys | $1,715.02 | $1,177.79 |
| Beaumont | $1,555.51 | $1,099.90 |
| Brazoria | $1,606.97 | $1,110.80 |
| Chicago | $1,755.97 | $1,252.79 |
| Chico | $1,667.87 | $1,119.13 |
| Colorado | $1,663.21 | $1,130.49 |
| Connecticut | $1,718.67 | $1,179.43 |
| Dallas | $1,618.59 | $1,119.92 |
| Dc + Md/Va Suburbs | $1,810.48 | $1,220.68 |
| Delaware | $1,613.33 | $1,118.66 |
| Detroit | $1,665.16 | $1,182.01 |
| East St. Louis | $1,662.78 | $1,202.16 |
| El Centro | $1,668.33 | $1,119.59 |
| Fort Lauderdale | $1,711.20 | $1,204.01 |
| Fort Worth | $1,612.55 | $1,118.88 |
| Fresno | $1,667.87 | $1,119.13 |
| Galveston | $1,612.84 | $1,115.67 |
| Hanford-Corcoran | $1,667.87 | $1,119.13 |
| Hawaii, Guam | $1,687.78 | $1,118.51 |
| Houston | $1,663.36 | $1,166.19 |
| Idaho | $1,520.73 | $1,060.10 |
| Indiana | $1,527.00 | $1,062.87 |
| Iowa | $1,510.10 | $1,051.97 |
| Kansas | $1,511.99 | $1,059.37 |
| Kentucky | $1,539.00 | $1,093.90 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,762.18 | $1,169.87 |
| Madera | $1,667.87 | $1,119.13 |
| Manhattan | $1,850.59 | $1,268.80 |
| Merced | $1,667.87 | $1,119.13 |
| Metropolitan Boston | $1,790.98 | $1,193.17 |
| Metropolitan Kansas City | $1,580.96 | $1,110.82 |
| Metropolitan Philadelphia | $1,689.39 | $1,168.18 |
| Metropolitan St. Louis | $1,592.69 | $1,116.04 |
| Miami | $1,797.96 | $1,276.75 |
| Minnesota | $1,583.41 | $1,068.21 |
| Mississippi | $1,502.48 | $1,071.40 |
| Modesto | $1,667.87 | $1,119.13 |
| Montana** | $1,627.11 | $1,126.43 |
| Napa | $1,863.47 | $1,203.58 |
| Nebraska | $1,514.14 | $1,052.02 |
| Nevada** | $1,612.62 | $1,111.44 |
| New Hampshire | $1,645.49 | $1,124.28 |
| New Mexico | $1,585.66 | $1,126.54 |
| New Orleans | $1,597.07 | $1,125.93 |
| North Carolina | $1,545.45 | $1,078.32 |
| North Dakota** | $1,572.53 | $1,071.85 |
| Northern Nj | $1,800.58 | $1,219.79 |
| Nyc Suburbs/Long Island | $1,895.14 | $1,299.83 |
| Ohio | $1,564.97 | $1,107.85 |
| Oklahoma | $1,529.18 | $1,082.07 |
| Oxnard-Thousand Oaks-Ventura | $1,747.14 | $1,155.34 |
| Portland | $1,697.11 | $1,140.85 |
| Poughkpsie/N Nyc Suburbs | $1,751.97 | $1,203.73 |
| Puerto Rico | $1,633.88 | $1,127.69 |
| Queens | $1,851.81 | $1,260.01 |
| Redding | $1,667.87 | $1,119.13 |
| Rest Of California | $1,667.87 | $1,119.13 |
| Rest Of Florida | $1,641.77 | $1,163.12 |
| Rest Of Georgia | $1,566.71 | $1,120.11 |
| Rest Of Illinois | $1,616.14 | $1,159.01 |
| Rest Of Louisiana | $1,540.07 | $1,096.97 |
| Rest Of Maine | $1,534.46 | $1,073.84 |
| Rest Of Maryland | $1,636.53 | $1,129.85 |
| Rest Of Massachusetts | $1,659.96 | $1,132.74 |
| Rest Of Michigan | $1,576.13 | $1,119.01 |
| Rest Of Missouri | $1,524.87 | $1,093.29 |
| Rest Of New Jersey | $1,735.33 | $1,188.59 |
| Rest Of New York | $1,563.67 | $1,088.03 |
| Rest Of Oregon | $1,597.01 | $1,098.34 |
| Rest Of Pennsylvania | $1,562.79 | $1,103.16 |
| Rest Of Texas | $1,581.38 | $1,106.24 |
| Rest Of Washington | $1,654.21 | $1,126.99 |
| Rhode Island | $1,656.65 | $1,139.45 |
| Riverside-San Bernardino-Ontario | $1,697.91 | $1,149.16 |
| Sacramento-Roseville-Folsom | $1,731.83 | $1,149.54 |
| Salinas | $1,724.88 | $1,144.59 |
| San Diego-Chula Vista-Carlsbad | $1,751.44 | $1,152.63 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,951.57 | $1,245.61 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,948.43 | $1,242.47 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,994.01 | $1,272.03 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,981.20 | $1,259.22 |
| San Luis Obispo-Paso Robles | $1,699.04 | $1,128.77 |
| Santa Cruz-Watsonville | $1,757.37 | $1,149.04 |
| Santa Maria-Santa Barbara | $1,727.52 | $1,143.73 |
| Santa Rosa-Petaluma | $1,774.08 | $1,159.25 |
| Seattle (King Cnty) | $1,815.47 | $1,201.13 |
| South Carolina | $1,558.38 | $1,095.75 |
| South Dakota** | $1,566.08 | $1,065.40 |
| Southern Maine | $1,586.75 | $1,090.58 |
| Stockton | $1,667.87 | $1,119.13 |
| Suburban Chicago | $1,723.70 | $1,209.50 |
| Tennessee | $1,518.65 | $1,063.54 |
| Utah | $1,574.40 | $1,103.76 |
| Vallejo | $1,858.95 | $1,199.06 |
| Vermont | $1,574.50 | $1,078.83 |
| Virgin Islands | $1,633.88 | $1,127.69 |
| Virginia | $1,587.87 | $1,095.70 |
| Visalia | $1,667.87 | $1,119.13 |
| West Virginia | $1,572.08 | $1,136.99 |
| Wisconsin | $1,533.06 | $1,053.41 |
| Wyoming** | $1,603.32 | $1,102.64 |
| Yuba City | $1,667.87 | $1,119.13 |
21087 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.
$1,480.38
$2,038.17
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 | $2,038.17 | 1 |
| AL | $1,496.68 | 1 |
| AR | $1,480.38 | 1 |
| AZ | $1,591.55 | 1 |
| CA | $1,667.87–$1,994.01 | 29 |
| CO | $1,663.21 | 1 |
| CT | $1,718.67 | 1 |
| DC | $1,810.48 | 1 |
| DE | $1,613.33 | 1 |
| FL | $1,641.77–$1,797.96 | 3 |
| GA | $1,566.71–$1,659.85 | 2 |
| GU | $1,687.78 | 1 |
| HI | $1,687.78 | 1 |
| IA | $1,510.10 | 1 |
| ID | $1,520.73 | 1 |
| IL | $1,616.14–$1,755.97 | 4 |
| IN | $1,527.00 | 1 |
| KS | $1,511.99 | 1 |
| KY | $1,539.00 | 1 |
| LA | $1,540.07–$1,597.07 | 2 |
| MA | $1,659.96–$1,790.98 | 2 |
| MD | $1,636.53–$1,810.48 | 3 |
| ME | $1,534.46–$1,586.75 | 2 |
| MI | $1,576.13–$1,665.16 | 2 |
| MN | $1,583.41 | 1 |
| MO | $1,524.87–$1,592.69 | 3 |
| MS | $1,502.48 | 1 |
| MT | $1,627.11 | 1 |
| NC | $1,545.45 | 1 |
| ND | $1,572.53 | 1 |
| NE | $1,514.14 | 1 |
| NH | $1,645.49 | 1 |
| NJ | $1,735.33–$1,800.58 | 2 |
| NM | $1,585.66 | 1 |
| NV | $1,612.62 | 1 |
| NY | $1,563.67–$1,895.14 | 5 |
| OH | $1,564.97 | 1 |
| OK | $1,529.18 | 1 |
| OR | $1,597.01–$1,697.11 | 2 |
| PA | $1,562.79–$1,689.39 | 2 |
| PR | $1,633.88 | 1 |
| RI | $1,656.65 | 1 |
| SC | $1,558.38 | 1 |
| SD | $1,566.08 | 1 |
| TN | $1,518.65 | 1 |
| TX | $1,555.51–$1,663.36 | 8 |
| UT | $1,574.40 | 1 |
| VA | $1,587.87–$1,810.48 | 2 |
| VI | $1,633.88 | 1 |
| VT | $1,574.50 | 1 |
| WA | $1,654.21–$1,815.47 | 2 |
| WI | $1,533.06 | 1 |
| WV | $1,572.08 | 1 |
| WY | $1,603.32 | 1 |
How the 21087 rate is calculated
Each of 21087’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 · 21087
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 24.26Practice expense 21.70Malpractice 2.76
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21087
21087 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21087
Nasal prosthesis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21087
Nasal prosthesis
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21087 without 51 · national office
$1,627.29
Nasal prosthesis
21087-51 · Second procedure: 50%
$813.65
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%).
21087 compared with similar codes
Compare codes
21087 vs 21086 vs 21088 vs 21089: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21086Auricular prosthesis
- 21086 is for an auricular prosthesis. Choose 21087 when the prosthesis is for the nose.
- 21088Impres&prep facial prosth
- 21088 addresses a facial prosthesis, while 21087 is specific to a nasal prosthesis.
- 21089Unlisted maxlfcl prosth px
- 21089 is for an unlisted maxillofacial prosthetic procedure. Use 21087 when the service is the specifically described nasal prosthesis work.
21087 billing questions
When is 21087 appropriate instead of a facial prosthesis code?
Use 21087 when the custom prosthesis is for the nose. A prosthesis replacing a broader facial area is represented by 21088.
Does this code describe surgical reconstruction of the nose?
No. It covers impression work and custom preparation of a nasal prosthesis, rather than operative repair or reconstruction.
What documentation supports reporting 21087?
Document the nasal defect, the reason a prosthesis is needed, and the impression and custom-preparation work performed.
Should modifier 50 be appended for a nasal prosthesis?
No. Report the nasal prosthetic service without modifier 50.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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