$942.44
Choose 21076 for a surgical obturator; choose 21079 for an interim obturator used during healing.
On this page
CMS RVU26D · Effective 2026-10-01
21079 in Fresno
Office / nonfacility
$1562.74
Base rate per service
Facility setting
$1030.47
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 21079: Interim obturator impression and preparation
Reports impression and preparation of an interim obturator prosthesis, commonly used during healing after removal of part of the palate or upper jaw.
Code 21079 covers taking an impression and preparing an interim obturator prosthesis to help close a defect in the palate or upper jaw. A maxillofacial prosthodontist, dentist, or other qualified clinician may provide the service, often after maxillectomy while the surgical site is healing. The prosthesis can help separate the oral and nasal cavities and support speech and swallowing during this transitional period.
Choose this code for an interim obturator, rather than a surgical obturator placed at the time of surgery or a definitive obturator for longer-term use. Documentation should identify the defect, the interim purpose of the appliance, and the impression and 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 one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 21079
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.75 · 48%
- Practice expense (office) RVU21.26 · 47%
- Malpractice RVU2.55 · 6%
493
Medicare services in 2024 · #3579 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.
21079 compared with similar codes
Office rates for Fresno, from the same CMS release.
$1,777.00
Choose 21080 for a definitive obturator. Code 21079 describes the interim prosthesis used during the healing period.
$1,636.16
Code 21081 concerns a mandibular resection prosthesis, while 21079 is for an interim obturator addressing a palatal or upper-jaw defect.
The same code, a different location
How does Fresno compare?
In Bakersfield, the office rate for 21079 is $1570.42—$7.68 higher than the $1562.74 rate in Fresno. Both use the same code, release and participation basis.
21079 across payment areas
Same release and payment basis · bars start at $0
Fresno · This locality
$1562.74
$1570.42
$7.68 higher than Fresno
$1562.74
The same base rate than Fresno
$1563.17
$0.43 higher than Fresno
$1562.74
The same base rate than Fresno
$90.12 higher than Fresno
$1562.74
The same base rate than Fresno
Other payment areas listed in California 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, 21079 ranges from $1380.31 in Arkansas to $1892.89 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
Merced
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Modesto
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Napa
California · 21079
Office
$1751.42
Facility
$1111.34
$188.68 higher than Fresno for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 21079
Office
$1639.21
Facility
$1065.18
$76.47 higher than Fresno for the office setting.
Redding
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Rest Of California
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Riverside-San Bernardino-Ontario
California · 21079
Office
$1590.47
Facility
$1058.20
$27.73 higher than Fresno for the office setting.
Sacramento-Roseville-Folsom
California · 21079
Office
$1624.12
Facility
$1059.31
$61.38 higher than Fresno for the office setting.
Salinas
California · 21079
Office
$1617.65
Facility
$1054.78
$54.91 higher than Fresno for the office setting.
San Diego-Chula Vista-Carlsbad
California · 21079
Office
$1643.71
Facility
$1062.87
$80.97 higher than Fresno for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21079
Office
$1835.82
Facility
$1151.06
$273.08 higher than Fresno for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21079
Office
$1832.93
Facility
$1148.16
$270.19 higher than Fresno for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21079
Office
$1876.00
Facility
$1175.70
$313.26 higher than Fresno for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21079
Office
$1864.16
Facility
$1163.86
$301.42 higher than Fresno for the office setting.
San Luis Obispo-Paso Robles
California · 21079
Office
$1593.28
Facility
$1040.13
$30.54 higher than Fresno for the office setting.
Santa Cruz-Watsonville
California · 21079
Office
$1650.15
Facility
$1060.09
$87.41 higher than Fresno for the office setting.
Santa Maria-Santa Barbara
California · 21079
Office
$1620.44
Facility
$1054.18
$57.70 higher than Fresno for the office setting.
Santa Rosa-Petaluma
California · 21079
Office
$1665.92
Facility
$1069.55
$103.18 higher than Fresno for the office setting.
Stockton
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Vallejo
California · 21079
Office
$1747.25
Facility
$1107.16
$184.51 higher than Fresno for the office setting.
Visalia
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Yuba City
California · 21079
Office
$1562.74
Facility
$1030.47
The same base rate than Fresno for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 21079
Office
$1697.00
Facility
$1124.90
$134.26 higher than Fresno for the office setting.
Miami
Florida · 21079
Office
$1681.09
Facility
$1175.53
$118.35 higher than Fresno for the office setting.
Chicago
Illinois · 21079
Office
$1640.68
Facility
$1152.60
$77.94 higher than Fresno for the office setting.
Manhattan
New York · 21079
Office
$1733.19
Facility
$1168.86
$170.45 higher than Fresno for the office setting.
Alaska*
Alaska · 21079
Office
$1892.89
Facility
$1375.68
$330.15 higher than Fresno for the office setting.
Alabama
Alabama · 21079
Office
$1396.02
Facility
$971.07
$166.72 lower than Fresno for the office setting.
Arkansas
Arkansas · 21079
Office
$1380.31
Facility
$963.14
$182.43 lower than Fresno for the office setting.
Arizona
Arizona · 21079
Office
$1487.47
Facility
$1016.87
$75.27 lower than Fresno for the office setting.
Colorado
Colorado · 21079
Office
$1557.26
Facility
$1040.53
$5.48 lower than Fresno for the office setting.
Connecticut
Connecticut · 21079
Office
$1608.84
Facility
$1085.79
$46.10 higher than Fresno for the office setting.
Delaware
Delaware · 21079
Office
$1508.25
Facility
$1028.43
$54.49 lower than Fresno for the office setting.
Fort Lauderdale
Florida · 21079
Office
$1599.80
Facility
$1107.83
$37.06 higher than Fresno for the office setting.
Rest Of Florida
Florida · 21079
Office
$1533.34
Facility
$1069.06
$29.40 lower than Fresno for the office setting.
Atlanta
Georgia · 21079
Office
$1552.41
Facility
$1058.99
$10.33 lower than Fresno for the office setting.
Rest Of Georgia
Georgia · 21079
Office
$1461.41
Facility
$1028.21
$101.33 lower than Fresno for the office setting.
Hawaii, Guam
Hawaii · 21079
Office
$1583.17
Facility
$1030.99
$20.43 higher than Fresno for the office setting.
Iowa
Iowa · 21079
Office
$1410.03
Facility
$965.66
$152.71 lower than Fresno for the office setting.
Idaho
Idaho · 21079
Office
$1420.05
Facility
$973.25
$142.69 lower than Fresno for the office setting.
East St. Louis
Illinois · 21079
Office
$1551.30
Facility
$1104.50
$11.44 lower than Fresno for the office setting.
Rest Of Illinois
Illinois · 21079
Office
$1507.92
Facility
$1064.52
$54.82 lower than Fresno for the office setting.
Suburban Chicago
Illinois · 21079
Office
$1611.76
Facility
$1112.99
$49.02 higher than Fresno for the office setting.
Indiana
Indiana · 21079
Office
$1426.13
Facility
$975.93
$136.61 lower than Fresno for the office setting.
Kansas
Kansas · 21079
Office
$1411.33
Facility
$972.30
$151.41 lower than Fresno for the office setting.
Kentucky
Kentucky · 21079
Office
$1435.68
Facility
$1003.94
$127.06 lower than Fresno for the office setting.
New Orleans
Louisiana · 21079
Office
$1491.43
Facility
$1034.44
$71.31 lower than Fresno for the office setting.
Rest Of Louisiana
Louisiana · 21079
Office
$1436.51
Facility
$1006.71
$126.23 lower than Fresno for the office setting.
Metropolitan Boston
Massachusetts · 21079
Office
$1679.92
Facility
$1100.06
$117.18 higher than Fresno for the office setting.
Rest Of Massachusetts
Massachusetts · 21079
Office
$1553.71
Facility
$1042.33
$9.03 lower than Fresno for the office setting.
Baltimore/Surr. Cntys
Maryland · 21079
Office
$1605.39
Facility
$1084.29
$42.65 higher than Fresno for the office setting.
Rest Of Maryland
Maryland · 21079
Office
$1530.55
Facility
$1039.07
$32.19 lower than Fresno for the office setting.
Rest Of Maine
Maine · 21079
Office
$1432.74
Facility
$985.94
$130.00 lower than Fresno for the office setting.
Southern Maine
Maine · 21079
Office
$1483.93
Facility
$1002.65
$78.81 lower than Fresno for the office setting.
Detroit
Michigan · 21079
Office
$1555.32
Facility
$1086.67
$7.42 lower than Fresno for the office setting.
Rest Of Michigan
Michigan · 21079
Office
$1470.95
Facility
$1027.56
$91.79 lower than Fresno for the office setting.
Minnesota
Minnesota · 21079
Office
$1482.38
Facility
$982.64
$80.36 lower than Fresno for the office setting.
Metropolitan Kansas City
Missouri · 21079
Office
$1476.47
Facility
$1020.45
$86.27 lower than Fresno for the office setting.
Metropolitan St. Louis
Missouri · 21079
Office
$1487.83
Facility
$1025.49
$74.91 lower than Fresno for the office setting.
Rest Of Missouri
Missouri · 21079
Office
$1421.54
Facility
$1002.91
$141.20 lower than Fresno for the office setting.
Mississippi
Mississippi · 21079
Office
$1400.81
Facility
$982.67
$161.93 lower than Fresno for the office setting.
Montana**
Montana · 21079
Office
$1521.57
Facility
$1035.93
$41.17 lower than Fresno for the office setting.
North Carolina
North Carolina · 21079
Office
$1443.42
Facility
$990.31
$119.32 lower than Fresno for the office setting.
North Dakota**
North Dakota · 21079
Office
$1471.15
Facility
$985.50
$91.59 lower than Fresno for the office setting.
Nebraska
Nebraska · 21079
Office
$1414.09
Facility
$965.84
$148.65 lower than Fresno for the office setting.
New Hampshire
New Hampshire · 21079
Office
$1540.21
Facility
$1034.65
$22.53 lower than Fresno for the office setting.
Northern Nj
New Jersey · 21079
Office
$1686.92
Facility
$1123.57
$124.18 higher than Fresno for the office setting.
Rest Of New Jersey
New Jersey · 21079
Office
$1624.39
Facility
$1094.07
$61.65 higher than Fresno for the office setting.
New Mexico
New Mexico · 21079
Office
$1479.93
Facility
$1034.59
$82.81 lower than Fresno for the office setting.
Nevada**
Nevada · 21079
Office
$1508.23
Facility
$1022.10
$54.51 lower than Fresno for the office setting.
Nyc Suburbs/Long Island
New York · 21079
Office
$1775.44
Facility
$1198.00
$212.70 higher than Fresno for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 21079
Office
$1639.78
Facility
$1108.00
$77.04 higher than Fresno for the office setting.
Queens
New York · 21079
Office
$1735.12
Facility
$1161.09
$172.38 higher than Fresno for the office setting.
Rest Of New York
New York · 21079
Office
$1460.94
Facility
$999.58
$101.80 lower than Fresno for the office setting.
Ohio
Ohio · 21079
Office
$1460.65
Facility
$1017.25
$102.09 lower than Fresno for the office setting.
Oklahoma
Oklahoma · 21079
Office
$1426.77
Facility
$993.09
$135.97 lower than Fresno for the office setting.
Portland
Oregon · 21079
Office
$1590.39
Facility
$1050.83
$27.65 higher than Fresno for the office setting.
Rest Of Oregon
Oregon · 21079
Office
$1493.61
Facility
$1009.90
$69.13 lower than Fresno for the office setting.
Metropolitan Philadelphia
Pennsylvania · 21079
Office
$1580.37
Facility
$1074.81
$17.63 higher than Fresno for the office setting.
Rest Of Pennsylvania
Pennsylvania · 21079
Office
$1458.83
Facility
$1013.01
$103.91 lower than Fresno for the office setting.
Puerto Rico
Puerto Rico · 21079
Office
$1528.28
Facility
$1037.29
$34.46 lower than Fresno for the office setting.
Rhode Island
Rhode Island · 21079
Office
$1549.78
Facility
$1048.11
$12.96 lower than Fresno for the office setting.
South Carolina
South Carolina · 21079
Office
$1455.00
Facility
$1006.26
$107.74 lower than Fresno for the office setting.
South Dakota**
South Dakota · 21079
Office
$1465.19
Facility
$979.54
$97.55 lower than Fresno for the office setting.
Tennessee
Tennessee · 21079
Office
$1417.69
Facility
$976.24
$145.05 lower than Fresno for the office setting.
Austin
Texas · 21079
Office
$1554.67
Facility
$1040.86
$8.07 lower than Fresno for the office setting.
Beaumont
Texas · 21079
Office
$1451.79
Facility
$1009.85
$110.95 lower than Fresno for the office setting.
Brazoria
Texas · 21079
Office
$1502.43
Facility
$1021.15
$60.31 lower than Fresno for the office setting.
Dallas
Texas · 21079
Office
$1513.35
Facility
$1029.64
$49.39 lower than Fresno for the office setting.
Fort Worth
Texas · 21079
Office
$1507.35
Facility
$1028.50
$55.39 lower than Fresno for the office setting.
Galveston
Texas · 21079
Office
$1507.94
Facility
$1025.69
$54.80 lower than Fresno for the office setting.
Houston
Texas · 21079
Office
$1554.61
Facility
$1072.36
$8.13 lower than Fresno for the office setting.
Rest Of Texas
Texas · 21079
Office
$1477.27
Facility
$1016.39
$85.47 lower than Fresno for the office setting.
Utah
Utah · 21079
Office
$1470.45
Facility
$1013.94
$92.29 lower than Fresno for the office setting.
Virginia
Virginia · 21079
Office
$1484.63
Facility
$1007.24
$78.11 lower than Fresno for the office setting.
Virgin Islands
United States Virgin Islands · 21079
Office
$1528.28
Facility
$1037.29
$34.46 lower than Fresno for the office setting.
Vermont
Vermont · 21079
Office
$1472.57
Facility
$991.78
$90.17 lower than Fresno for the office setting.
Rest Of Washington
Washington · 21079
Office
$1548.47
Facility
$1037.08
$14.27 lower than Fresno for the office setting.
Seattle (King Cnty)
Washington · 21079
Office
$1703.68
Facility
$1107.78
$140.94 higher than Fresno for the office setting.
Wisconsin
Wisconsin · 21079
Office
$1432.98
Facility
$967.73
$129.76 lower than Fresno for the office setting.
West Virginia
West Virginia · 21079
Office
$1465.43
Facility
$1043.40
$97.31 lower than Fresno for the office setting.
Wyoming**
Wyoming · 21079
Office
$1499.60
Facility
$1013.95
$63.14 lower than Fresno for the office setting.
See how rates vary across the country
21079 · 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.
$1,380.31
$1,892.89
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $1,892.89 | 1 |
| AL | $1,396.02 | 1 |
| AR | $1,380.31 | 1 |
| AZ | $1,487.47 | 1 |
| CA | $1,562.74–$1,876.00 | 29 |
| CO | $1,557.26 | 1 |
| CT | $1,608.84 | 1 |
| DC | $1,697.00 | 1 |
| DE | $1,508.25 | 1 |
| FL | $1,533.34–$1,681.09 | 3 |
| GA | $1,461.41–$1,552.41 | 2 |
| GU | $1,583.17 | 1 |
| HI | $1,583.17 | 1 |
| IA | $1,410.03 | 1 |
| ID | $1,420.05 | 1 |
| IL | $1,507.92–$1,640.68 | 4 |
| IN | $1,426.13 | 1 |
| KS | $1,411.33 | 1 |
| KY | $1,435.68 | 1 |
| LA | $1,436.51–$1,491.43 | 2 |
| MA | $1,553.71–$1,679.92 | 2 |
| MD | $1,530.55–$1,697.00 | 3 |
| ME | $1,432.74–$1,483.93 | 2 |
| MI | $1,470.95–$1,555.32 | 2 |
| MN | $1,482.38 | 1 |
| MO | $1,421.54–$1,487.83 | 3 |
| MS | $1,400.81 | 1 |
| MT | $1,521.57 | 1 |
| NC | $1,443.42 | 1 |
| ND | $1,471.15 | 1 |
| NE | $1,414.09 | 1 |
| NH | $1,540.21 | 1 |
| NJ | $1,624.39–$1,686.92 | 2 |
| NM | $1,479.93 | 1 |
| NV | $1,508.23 | 1 |
| NY | $1,460.94–$1,775.44 | 5 |
| OH | $1,460.65 | 1 |
| OK | $1,426.77 | 1 |
| OR | $1,493.61–$1,590.39 | 2 |
| PA | $1,458.83–$1,580.37 | 2 |
| PR | $1,528.28 | 1 |
| RI | $1,549.78 | 1 |
| SC | $1,455.00 | 1 |
| SD | $1,465.19 | 1 |
| TN | $1,417.69 | 1 |
| TX | $1,451.79–$1,554.67 | 8 |
| UT | $1,470.45 | 1 |
| VA | $1,484.63–$1,697.00 | 2 |
| VI | $1,528.28 | 1 |
| VT | $1,472.57 | 1 |
| WA | $1,548.47–$1,703.68 | 2 |
| WI | $1,432.98 | 1 |
| WV | $1,465.43 | 1 |
| WY | $1,499.60 | 1 |
Where does this rate apply?
Fresno is a Medicare payment area. Our Census mapping connects it to 45 cities and communities in California, 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.
Why are the office and facility amounts different?
For 21079 in Fresno, the physician’s office rate is $1562.74 and the facility-setting rate is $1030.47: a difference of $532.27.
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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21079 in Fresno. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1719.01
$1562.74 × 110% = $1719.01
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
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 21079 in Fresno.
PPRRVU2026_Oct_nonQPP.csv
1,863
- Code
- 21079
- Physician work
- 21.75
- Practice expense
- 21.26
- Malpractice
- 2.55
GPCI2026.csv
11
- Locality
- Fresno
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.75 | × 1.017 | 22.1197 |
| Practice expense | 21.26 | × 1.096 | 23.3010 |
| Malpractice | 2.55 | × 0.536 | 1.3668 |
| Total RVUs | 46.7875 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Fresno$1562.74
Open 21079 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.75 | 1.017 |
| Practice expense | 21.26 | 1.096 |
| Malpractice | 2.55 | 0.536 |
(21.75 × 1.017 + 21.26 × 1.096 + 2.55 × 0.536) × $33.4009 = $1562.74
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.75 | 1.017 |
| Practice expense | 6.72 | 1.096 |
| Malpractice | 2.55 | 0.536 |
(21.75 × 1.017 + 6.72 × 1.096 + 2.55 × 0.536) × $33.4009 = $1030.47
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
21079 · Office / nonfacility
$1562.74
Effective 2026-10-01
The base rate is $76.29 higher than on 2025-10-01, moving from $1486.45 to $1562.74 (5.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$1486.45changed to$1562.74
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 22.31 changed to 21.75
- Practice expense RVU 20.25 changed to 21.26
- Malpractice RVU 2.14 changed to 2.55
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $1486.45
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1562.74 | $1030.47 | RVU26D |
| 2026-07-01 | $1562.74 | $1030.47 | RVU26C |
| 2026-04-01 | $1562.74 | $1030.47 | RVU26B |
| 2026-01-01 | $1562.74 | $1030.47 | RVU26A |
| 2025-10-01 | $1486.45 | $1166.84 | RVU25D |
| 2025-07-01 | $1486.45 | $1166.84 | RVU25C |
| 2025-04-01 | $1486.45 | $1166.84 | RVU25B |
| 2025-01-01 | $1486.45 | $1166.84 | RVU25A |
21079 billing questions
How is an interim obturator different from a surgical obturator?
Use 21079 for an interim prosthesis used during healing. Code 21076 describes impression and preparation for a surgical obturator.
How does an interim obturator differ from a definitive obturator?
Code 21079 is for the transitional appliance used during healing; 21080 is for a definitive obturator.
Can the impression and prosthesis preparation be billed separately?
The code represents the impression and preparation service for the interim obturator. Do not separately report those same included steps as independent services.
Should modifier 50 be appended for a bilateral defect?
No. CMS identifies bilateral adjustment as inappropriate for this code, and modifier 50 should not be used.
Can an assistant surgeon or co-surgeon be paid for this service?
CMS applies a statutory restriction to assistant-at-surgery payment and does not permit co-surgeons or team surgery for this code.
What happens when this service is performed with another procedure in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
1,86021073,,Mnpj of tmj w/anesth,A,,3.36,9.03,,2.85,,0.48,12.87,6.69,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86121076,,Impres&prep surg obt prosth,A,,13.07,12.80,,4.07,,1.67,27.54,18.81,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86221077,,Impres&prep orbital prosth,A,,32.86,29.07,,9.15,,3.75,65.68,45.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86321079,,Impres&prep intrm obt prosth,A,,21.75,21.26,,6.72,,2.55,45.56,31.02,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86421080,,Impres&prep def obt prosth,A,,24.43,24.45,,7.48,,2.91,51.79,34.82,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86521081,,Impres&prep mndbl res prosth,A,,22.28,22.71,,6.95,,2.68,47.67,31.91,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86621082,,Impres&prep paltl aug prosth,A,,20.32,22.14,,7.02,,2.40,44.86,29.74,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536