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CMS RVU26D · Effective 2026-10-01

21077 in Beaumont

Office / nonfacility

$2097.49

Base rate per service

Facility setting

$1492.03

Base rate per service

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.

Maxillofacial prosthetics

About 21077: Custom orbital prosthesis impression and preparation

Reports the impression and custom preparation of an orbital prosthesis for a patient with loss or absence of orbital structures.

This service captures the patient’s orbital defect and prepares a custom prosthesis to restore the external appearance of the eye and surrounding orbital area. It is typically performed by a maxillofacial prosthodontist or other clinician with specialized facial prosthetic training, often after orbital exenteration for cancer or after traumatic loss. The prosthesis is distinct from a replacement for the globe alone because it addresses the broader orbital defect.

Report 21077 for the orbital prosthesis impression and custom preparation, supported by documentation of the defect and the patient-specific prosthetic work. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 21077

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 procedure with modifier 50 is paid at 150%.
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 RVU32.86 · 50%
  • Practice expense (office) RVU29.07 · 44%
  • Malpractice RVU3.75 · 6%

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.

21077 compared with similar codes

Office rates for Beaumont, from the same CMS release.

21086

Auricular prosthesis

Impression and preparation

$1,555.51

Use 21086 for an auricular prosthesis replacing external ear structures; 21077 is for an orbital defect.

21087

Nasal prosthesis

Impression and custom preparation

$1,555.51

Use 21087 for a nasal prosthesis. 21077 applies when the prosthetic site is the orbit.

21088

Impres&prep facial prosth

No office rate

Use 21088 for a facial prosthesis when the site is not specifically orbital; 21077 identifies the orbital prosthesis service.

21076

Obturator prosthesis

Surgical obturator

$877.42

21076 is for a surgical obturator, used in relation to a surgical defect of the palate or maxilla, not an orbital prosthesis.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 21077 is $2238.00—$140.51 higher than the $2097.49 rate in Beaumont. Both use the same code, release and participation basis.

21077 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $2097.49

  2. Austin

    $2238.00

    $140.51 higher than Beaumont

  3. Brazoria

    $2166.26

    $68.77 higher than Beaumont

  4. Dallas

    $2181.98

    $84.49 higher than Beaumont

  5. Fort Worth

    $2173.90

    $76.41 higher than Beaumont

  6. Galveston

    $2174.21

    $76.72 higher than Beaumont

  7. Houston

    $2242.85

    $145.36 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 21077 ranges from $1996.12 in Arkansas to $2749.42 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 21077

    Office

    $2132.10

    Facility

    $1500.69

    $34.61 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 21077

    Office

    $2374.37

    Facility

    $1587.27

    $276.88 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 21077

    Office

    $2440.02

    Facility

    $1656.25

    $342.53 higher than Beaumont for the office setting.

  • Miami

    Florida · 21077

    Office

    $2425.09

    Facility

    $1732.47

    $327.60 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 21077

    Office

    $2368.51

    Facility

    $1699.84

    $271.02 higher than Beaumont for the office setting.

  • Manhattan

    New York · 21077

    Office

    $2494.71

    Facility

    $1721.58

    $397.22 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 21077

    Office

    $2749.42

    Facility

    $2040.83

    $651.93 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 21077

    Office

    $2018.04

    Facility

    $1435.86

    $79.45 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 21077

    Office

    $1996.12

    Facility

    $1424.59

    $101.37 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 21077

    Office

    $2145.63

    Facility

    $1500.91

    $48.14 higher than Beaumont for the office setting.

  • Bakersfield

    California · 21077

    Office

    $2258.86

    Facility

    $1529.64

    $161.37 higher than Beaumont for the office setting.

  • Chico

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • El Centro

    California · 21077

    Office

    $2248.15

    Facility

    $1518.93

    $150.66 higher than Beaumont for the office setting.

  • Fresno

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Madera

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Merced

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Modesto

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Napa

    California · 21077

    Office

    $2510.06

    Facility

    $1633.13

    $412.57 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21077

    Office

    $2354.00

    Facility

    $1567.56

    $256.51 higher than Beaumont for the office setting.

  • Redding

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Rest Of California

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21077

    Office

    $2288.33

    Facility

    $1559.11

    $190.84 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21077

    Office

    $2333.43

    Facility

    $1559.64

    $235.94 higher than Beaumont for the office setting.

  • Salinas

    California · 21077

    Office

    $2324.06

    Facility

    $1552.93

    $226.57 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21077

    Office

    $2359.64

    Facility

    $1563.89

    $262.15 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21077

    Office

    $2628.37

    Facility

    $1690.23

    $530.88 higher than Beaumont for the office setting.

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

    California · 21077

    Office

    $2624.11

    Facility

    $1685.98

    $526.62 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 21077

    Office

    $2685.55

    Facility

    $1726.12

    $588.06 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 21077

    Office

    $2668.14

    Facility

    $1708.71

    $570.65 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21077

    Office

    $2289.28

    Facility

    $1531.45

    $191.79 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 21077

    Office

    $2367.46

    Facility

    $1559.06

    $269.97 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 21077

    Office

    $2327.57

    Facility

    $1551.77

    $230.08 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 21077

    Office

    $2389.96

    Facility

    $1572.92

    $292.47 higher than Beaumont for the office setting.

  • Stockton

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Vallejo

    California · 21077

    Office

    $2503.92

    Facility

    $1627.00

    $406.43 higher than Beaumont for the office setting.

  • Visalia

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Yuba City

    California · 21077

    Office

    $2247.52

    Facility

    $1518.31

    $150.03 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 21077

    Office

    $2241.65

    Facility

    $1533.72

    $144.16 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 21077

    Office

    $2316.79

    Facility

    $1600.21

    $219.30 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 21077

    Office

    $2174.96

    Facility

    $1517.59

    $77.47 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 21077

    Office

    $2307.60

    Facility

    $1633.60

    $210.11 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 21077

    Office

    $2214.05

    Facility

    $1577.98

    $116.56 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 21077

    Office

    $2237.78

    Facility

    $1561.78

    $140.29 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 21077

    Office

    $2112.96

    Facility

    $1519.47

    $15.47 higher than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 21077

    Office

    $2274.06

    Facility

    $1517.56

    $176.57 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 21077

    Office

    $2035.71

    Facility

    $1426.92

    $61.78 lower than Beaumont for the office setting.

  • Idaho

    Idaho · 21077

    Office

    $2050.09

    Facility

    $1437.97

    $47.40 lower than Beaumont for the office setting.

  • East St. Louis

    Illinois · 21077

    Office

    $2243.10

    Facility

    $1630.98

    $145.61 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 21077

    Office

    $2179.81

    Facility

    $1572.35

    $82.32 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 21077

    Office

    $2324.37

    Facility

    $1641.06

    $226.88 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 21077

    Office

    $2058.51

    Facility

    $1441.73

    $38.98 lower than Beaumont for the office setting.

  • Kansas

    Kansas · 21077

    Office

    $2038.43

    Facility

    $1436.96

    $59.06 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 21077

    Office

    $2075.35

    Facility

    $1483.86

    $22.14 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 21077

    Office

    $2153.52

    Facility

    $1527.43

    $56.03 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 21077

    Office

    $2076.85

    Facility

    $1488.02

    $20.64 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 21077

    Office

    $2413.36

    Facility

    $1618.94

    $315.87 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21077

    Office

    $2237.37

    Facility

    $1536.76

    $139.88 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21077

    Office

    $2311.90

    Facility

    $1597.98

    $214.41 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 21077

    Office

    $2206.13

    Facility

    $1532.80

    $108.64 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 21077

    Office

    $2068.75

    Facility

    $1456.63

    $28.74 lower than Beaumont for the office setting.

  • Southern Maine

    Maine · 21077

    Office

    $2138.81

    Facility

    $1479.46

    $41.32 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 21077

    Office

    $2245.71

    Facility

    $1603.65

    $148.22 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 21077

    Office

    $2125.45

    Facility

    $1517.99

    $27.96 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 21077

    Office

    $2133.75

    Facility

    $1449.11

    $36.26 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 21077

    Office

    $2131.66

    Facility

    $1506.90

    $34.17 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 21077

    Office

    $2147.42

    Facility

    $1514.01

    $49.93 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 21077

    Office

    $2056.52

    Facility

    $1482.99

    $40.97 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 21077

    Office

    $2026.12

    Facility

    $1453.25

    $71.37 lower than Beaumont for the office setting.

  • Montana**

    Montana · 21077

    Office

    $2193.52

    Facility

    $1528.17

    $96.03 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 21077

    Office

    $2083.50

    Facility

    $1462.73

    $13.99 lower than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 21077

    Office

    $2119.37

    Facility

    $1454.02

    $21.88 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 21077

    Office

    $2041.10

    Facility

    $1426.98

    $56.39 lower than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 21077

    Office

    $2217.92

    Facility

    $1525.30

    $120.43 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 21077

    Office

    $2426.79

    Facility

    $1654.99

    $329.30 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 21077

    Office

    $2339.15

    Facility

    $1612.59

    $241.66 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 21077

    Office

    $2138.36

    Facility

    $1528.23

    $40.87 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 21077

    Office

    $2173.82

    Facility

    $1507.81

    $76.33 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21077

    Office

    $2554.87

    Facility

    $1763.77

    $457.38 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21077

    Office

    $2361.71

    Facility

    $1633.15

    $264.22 higher than Beaumont for the office setting.

  • Queens

    New York · 21077

    Office

    $2496.09

    Facility

    $1709.65

    $398.60 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 21077

    Office

    $2108.02

    Facility

    $1475.94

    $10.53 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 21077

    Office

    $2110.30

    Facility

    $1502.84

    $12.81 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 21077

    Office

    $2061.95

    Facility

    $1467.79

    $35.54 lower than Beaumont for the office setting.

  • Portland

    Oregon · 21077

    Office

    $2287.04

    Facility

    $1547.84

    $189.55 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 21077

    Office

    $2152.69

    Facility

    $1490.00

    $55.20 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21077

    Office

    $2277.51

    Facility

    $1584.89

    $180.02 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21077

    Office

    $2107.26

    Facility

    $1496.48

    $9.77 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 21077

    Office

    $2202.57

    Facility

    $1529.91

    $105.08 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 21077

    Office

    $2233.14

    Facility

    $1545.84

    $135.65 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 21077

    Office

    $2101.19

    Facility

    $1486.41

    $3.70 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 21077

    Office

    $2110.60

    Facility

    $1445.26

    $13.11 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 21077

    Office

    $2047.42

    Facility

    $1442.62

    $50.07 lower than Beaumont for the office setting.

  • Utah

    Utah · 21077

    Office

    $2122.74

    Facility

    $1497.31

    $25.25 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 21077

    Office

    $2140.44

    Facility

    $1486.41

    $42.95 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21077

    Office

    $2202.57

    Facility

    $1529.91

    $105.08 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 21077

    Office

    $2122.19

    Facility

    $1463.49

    $24.70 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 21077

    Office

    $2229.56

    Facility

    $1528.96

    $132.07 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 21077

    Office

    $2446.14

    Facility

    $1629.76

    $348.65 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 21077

    Office

    $2066.32

    Facility

    $1428.91

    $31.17 lower than Beaumont for the office setting.

  • West Virginia

    West Virginia · 21077

    Office

    $2120.56

    Facility

    $1542.37

    $23.07 higher than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 21077

    Office

    $2161.21

    Facility

    $1495.86

    $63.72 higher than Beaumont for the office setting.

See how rates vary across the country

21077 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$1,996.12

$2,749.42

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$2,749.421
AL$2,018.041
AR$1,996.121
AZ$2,145.631
CA$2,247.52–$2,685.5529
CO$2,241.651
CT$2,316.791
DC$2,440.021
DE$2,174.961
FL$2,214.05–$2,425.093
GA$2,112.96–$2,237.782
GU$2,274.061
HI$2,274.061
IA$2,035.711
ID$2,050.091
IL$2,179.81–$2,368.514
IN$2,058.511
KS$2,038.431
KY$2,075.351
LA$2,076.85–$2,153.522
MA$2,237.37–$2,413.362
MD$2,206.13–$2,440.023
ME$2,068.75–$2,138.812
MI$2,125.45–$2,245.712
MN$2,133.751
MO$2,056.52–$2,147.423
MS$2,026.121
MT$2,193.521
NC$2,083.501
ND$2,119.371
NE$2,041.101
NH$2,217.921
NJ$2,339.15–$2,426.792
NM$2,138.361
NV$2,173.821
NY$2,108.02–$2,554.875
OH$2,110.301
OK$2,061.951
OR$2,152.69–$2,287.042
PA$2,107.26–$2,277.512
PR$2,202.571
RI$2,233.141
SC$2,101.191
SD$2,110.601
TN$2,047.421
TX$2,097.49–$2,242.858
UT$2,122.741
VA$2,140.44–$2,440.022
VI$2,202.571
VT$2,122.191
WA$2,229.56–$2,446.142
WI$2,066.321
WV$2,120.561
WY$2,161.211

Explore 21077 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 21077 in Beaumont, the physician’s office rate is $2097.49 and the facility-setting rate is $1492.03: a difference of $605.46.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 21077 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$2307.24

$2097.49 × 110% = $2307.24

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21077 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

1,862

Code
21077
Physician work
32.86
Practice expense
29.07
Malpractice
3.75

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 21077 in Beaumont
ComponentRVULocality factorAdjusted
Physician work32.86× 1.00032.8600
Practice expense29.07× 0.91026.4537
Malpractice3.75× 0.9293.4838
Total RVUs62.7974
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$2097.49

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 21077 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work32.861
Practice expense29.070.91
Malpractice3.750.929

(32.86 × 1 + 29.07 × 0.91 + 3.75 × 0.929) × $33.4009 = $2097.49

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work32.861
Practice expense9.150.91
Malpractice3.750.929

(32.86 × 1 + 9.15 × 0.91 + 3.75 × 0.929) × $33.4009 = $1492.03

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

21077 · Office / nonfacility

$2097.49

Effective 2026-10-01

The base rate is $94.74 higher than on 2025-10-01, moving from $2002.75 to $2097.49 (4.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $2002.75changed to$2097.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 33.70 changed to 32.86
    • Practice expense RVU 27.88 changed to 29.07
    • Malpractice RVU 3.21 changed to 3.75
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $2002.75

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$2097.49$1492.03RVU26D
2026-07-01$2097.49$1492.03RVU26C
2026-04-01$2097.49$1492.03RVU26B
2026-01-01$2097.49$1492.03RVU26A
2025-10-01$2002.75$1654.58RVU25D
2025-07-01$2002.75$1654.58RVU25C
2025-04-01$2002.75$1654.58RVU25B
2025-01-01$2002.75$1654.58RVU25A

21077 billing questions

When should 21077 be chosen instead of an ocular prosthesis service?

Use 21077 for a custom prosthesis addressing an orbital defect, including surrounding external structures. A prosthesis replacing only the eye itself is not the orbital prosthesis described by this code.

How does 21077 differ from 21088?

21077 is specific to an orbital prosthesis. 21088 is for a facial prosthesis when the prosthetic site is facial rather than orbital.

Does the 90-day global period include related postoperative care?

Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral 21077 reported?

For bilateral orbital prostheses, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

What happens when 21077 is performed with another procedure in the same session?

The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% multiple-procedure reduction.

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 21077PPRRVU2026_Oct_nonQPP.csv, line 1,862 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet