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CMS RVU26D · Effective 2026-10-01

21080 in Madera

Office / nonfacility

$1777.00

Base rate per service

Facility setting

$1155.78

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 21080: Definitive obturator prosthesis preparation

Impression and preparation of a definitive obturator prosthesis to restore an acquired maxillary defect, commonly after resection and healing.

This service covers taking an impression and preparing a definitive obturator prosthesis for a patient with an acquired maxillary or palatal defect, often following maxillectomy. The custom appliance closes the opening between the oral and nasal cavities and can support speech and swallowing. A maxillofacial prosthodontist or dentist with maxillofacial prosthetic expertise typically performs the work in a dental prosthetics clinic or hospital outpatient setting. The definitive stage is generally selected after the surgical defect has healed or stabilized, rather than for an appliance used immediately after surgery or during interim healing.

Report this code for the definitive obturator service, not the surgical or interim obturator stage. Documentation should identify the defect and clinical stage and describe the impression and preparation performed. CMS assigns a 90-day major-surgery global period, including 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 others at 50%. Bilateral adjustment is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

CMS billing rules for 21080

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 RVU24.43 · 47%
  • Practice expense (office) RVU24.45 · 47%
  • Malpractice RVU2.91 · 6%

521

Medicare services in 2024 · #3524 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.

21080 compared with similar codes

Office rates for Madera, from the same CMS release.

21076

Obturator prosthesis

Surgical obturator

$942.44

Choose 21076 for the surgical obturator stage. Choose 21080 for the definitive obturator service.

21079

Obturator prosthesis

Interim obturator

$1,562.74

21079 describes an interim obturator during healing; 21080 describes the definitive obturator stage.

21081

Mandibular prosthesis

Impression and custom preparation

$1,636.16

21081 concerns a prosthesis for a mandibular resection defect. This code is for a definitive obturator associated with a maxillary or palatal defect.

The same code, a different location

How does Madera compare?

In Bakersfield, the office rate for 21080 is $1785.73—$8.73 higher than the $1777.00 rate in Madera. Both use the same code, release and participation basis.

21080 across payment areas

Same release and payment basis · bars start at $0

  1. Madera · This locality

    $1777.00

  2. Bakersfield

    $1785.73

    $8.73 higher than Madera

  3. Chico

    $1777.00

    The same base rate than Madera

  4. El Centro

    $1777.49

    $0.49 higher than Madera

  5. Fresno

    $1777.00

    The same base rate than Madera

  6. Hanford-Corcoran

    $1777.00

    The same base rate than Madera

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $1880.08

    $103.08 higher than Madera

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, 21080 ranges from $1567.54 in Arkansas to $2147.27 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 · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Modesto

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Napa

    California · 21080

    Office

    $1993.11

    Facility

    $1246.05

    $216.11 higher than Madera for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21080

    Office

    $1864.67

    Facility

    $1194.69

    $87.67 higher than Madera for the office setting.

  • Redding

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Rest Of California

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21080

    Office

    $1808.63

    Facility

    $1187.40

    $31.63 higher than Madera for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21080

    Office

    $1847.22

    Facility

    $1188.02

    $70.22 higher than Madera for the office setting.

  • Salinas

    California · 21080

    Office

    $1839.88

    Facility

    $1182.94

    $62.88 higher than Madera for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21080

    Office

    $1869.86

    Facility

    $1191.95

    $92.86 higher than Madera for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21080

    Office

    $2089.60

    Facility

    $1290.39

    $312.60 higher than Madera for the office setting.

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

    California · 21080

    Office

    $2086.29

    Facility

    $1287.08

    $309.29 higher than Madera for the office setting.

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

    California · 21080

    Office

    $2135.45

    Facility

    $1318.11

    $358.45 higher than Madera for the office setting.

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

    California · 21080

    Office

    $2121.94

    Facility

    $1304.60

    $344.94 higher than Madera for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21080

    Office

    $1812.12

    Facility

    $1166.52

    $35.12 higher than Madera for the office setting.

  • Santa Cruz-Watsonville

    California · 21080

    Office

    $1877.45

    Facility

    $1188.77

    $100.45 higher than Madera for the office setting.

  • Santa Maria-Santa Barbara

    California · 21080

    Office

    $1843.15

    Facility

    $1182.24

    $66.15 higher than Madera for the office setting.

  • Santa Rosa-Petaluma

    California · 21080

    Office

    $1895.41

    Facility

    $1199.36

    $118.41 higher than Madera for the office setting.

  • Stockton

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Vallejo

    California · 21080

    Office

    $1988.35

    Facility

    $1241.29

    $211.35 higher than Madera for the office setting.

  • Visalia

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Yuba City

    California · 21080

    Office

    $1777.00

    Facility

    $1155.78

    The same base rate than Madera for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 21080

    Office

    $1930.24

    Facility

    $1262.54

    $153.24 higher than Madera for the office setting.

  • Miami

    Florida · 21080

    Office

    $1911.93

    Facility

    $1321.88

    $134.93 higher than Madera for the office setting.

  • Chicago

    Illinois · 21080

    Office

    $1865.50

    Facility

    $1295.85

    $88.50 higher than Madera for the office setting.

  • Manhattan

    New York · 21080

    Office

    $1971.31

    Facility

    $1312.67

    $194.31 higher than Madera for the office setting.

  • Alaska*

    Alaska · 21080

    Office

    $2147.27

    Facility

    $1543.61

    $370.27 higher than Madera for the office setting.

  • Alabama

    Alabama · 21080

    Office

    $1585.57

    Facility

    $1089.61

    $191.43 lower than Madera for the office setting.

  • Arkansas

    Arkansas · 21080

    Office

    $1567.54

    Facility

    $1080.65

    $209.46 lower than Madera for the office setting.

  • Arizona

    Arizona · 21080

    Office

    $1690.52

    Facility

    $1141.28

    $86.48 lower than Madera for the office setting.

  • Colorado

    Colorado · 21080

    Office

    $1770.60

    Facility

    $1167.51

    $6.40 lower than Madera for the office setting.

  • Connecticut

    Connecticut · 21080

    Office

    $1829.45

    Facility

    $1218.99

    $52.45 higher than Madera for the office setting.

  • Delaware

    Delaware · 21080

    Office

    $1714.30

    Facility

    $1154.28

    $62.70 lower than Madera for the office setting.

  • Fort Lauderdale

    Florida · 21080

    Office

    $1818.98

    Facility

    $1244.80

    $41.98 higher than Madera for the office setting.

  • Rest Of Florida

    Florida · 21080

    Office

    $1742.79

    Facility

    $1200.92

    $34.21 lower than Madera for the office setting.

  • Atlanta

    Georgia · 21080

    Office

    $1764.88

    Facility

    $1189.00

    $12.12 lower than Madera for the office setting.

  • Rest Of Georgia

    Georgia · 21080

    Office

    $1660.30

    Facility

    $1154.70

    $116.70 lower than Madera for the office setting.

  • Hawaii, Guam

    Hawaii · 21080

    Office

    $1800.79

    Facility

    $1156.33

    $23.79 higher than Madera for the office setting.

  • Iowa

    Iowa · 21080

    Office

    $1601.81

    Facility

    $1083.17

    $175.19 lower than Madera for the office setting.

  • Idaho

    Idaho · 21080

    Office

    $1613.28

    Facility

    $1091.81

    $163.72 lower than Madera for the office setting.

  • East St. Louis

    Illinois · 21080

    Office

    $1763.06

    Facility

    $1241.59

    $13.94 lower than Madera for the office setting.

  • Rest Of Illinois

    Illinois · 21080

    Office

    $1713.51

    Facility

    $1196.01

    $63.49 lower than Madera for the office setting.

  • Suburban Chicago

    Illinois · 21080

    Office

    $1832.63

    Facility

    $1250.51

    $55.63 higher than Madera for the office setting.

  • Indiana

    Indiana · 21080

    Office

    $1620.26

    Facility

    $1094.82

    $156.74 lower than Madera for the office setting.

  • Kansas

    Kansas · 21080

    Office

    $1603.22

    Facility

    $1090.83

    $173.78 lower than Madera for the office setting.

  • Kentucky

    Kentucky · 21080

    Office

    $1630.92

    Facility

    $1127.03

    $146.08 lower than Madera for the office setting.

  • New Orleans

    Louisiana · 21080

    Office

    $1694.87

    Facility

    $1161.50

    $82.13 lower than Madera for the office setting.

  • Rest Of Louisiana

    Louisiana · 21080

    Office

    $1631.84

    Facility

    $1130.21

    $145.16 lower than Madera for the office setting.

  • Metropolitan Boston

    Massachusetts · 21080

    Office

    $1911.03

    Facility

    $1234.25

    $134.03 higher than Madera for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21080

    Office

    $1766.44

    Facility

    $1169.59

    $10.56 lower than Madera for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21080

    Office

    $1825.54

    Facility

    $1217.35

    $48.54 higher than Madera for the office setting.

  • Rest Of Maryland

    Maryland · 21080

    Office

    $1739.82

    Facility

    $1166.21

    $37.18 lower than Madera for the office setting.

  • Rest Of Maine

    Maine · 21080

    Office

    $1627.76

    Facility

    $1106.29

    $149.24 lower than Madera for the office setting.

  • Southern Maine

    Maine · 21080

    Office

    $1686.62

    Facility

    $1124.91

    $90.38 lower than Madera for the office setting.

  • Detroit

    Michigan · 21080

    Office

    $1767.93

    Facility

    $1220.95

    $9.07 lower than Madera for the office setting.

  • Rest Of Michigan

    Michigan · 21080

    Office

    $1671.32

    Facility

    $1153.82

    $105.68 lower than Madera for the office setting.

  • Minnesota

    Minnesota · 21080

    Office

    $1685.09

    Facility

    $1101.84

    $91.91 lower than Madera for the office setting.

  • Metropolitan Kansas City

    Missouri · 21080

    Office

    $1677.78

    Facility

    $1145.54

    $99.22 lower than Madera for the office setting.

  • Metropolitan St. Louis

    Missouri · 21080

    Office

    $1690.83

    Facility

    $1151.22

    $86.17 lower than Madera for the office setting.

  • Rest Of Missouri

    Missouri · 21080

    Office

    $1614.61

    Facility

    $1126.01

    $162.39 lower than Madera for the office setting.

  • Mississippi

    Mississippi · 21080

    Office

    $1590.95

    Facility

    $1102.92

    $186.05 lower than Madera for the office setting.

  • Montana**

    Montana · 21080

    Office

    $1729.64

    Facility

    $1162.82

    $47.36 lower than Madera for the office setting.

  • North Carolina

    North Carolina · 21080

    Office

    $1640.03

    Facility

    $1111.19

    $136.97 lower than Madera for the office setting.

  • North Dakota**

    North Dakota · 21080

    Office

    $1672.10

    Facility

    $1105.28

    $104.90 lower than Madera for the office setting.

  • Nebraska

    Nebraska · 21080

    Office

    $1606.49

    Facility

    $1083.33

    $170.51 lower than Madera for the office setting.

  • New Hampshire

    New Hampshire · 21080

    Office

    $1751.17

    Facility

    $1161.11

    $25.83 lower than Madera for the office setting.

  • Northern Nj

    New Jersey · 21080

    Office

    $1918.51

    Facility

    $1261.01

    $141.51 higher than Madera for the office setting.

  • Rest Of New Jersey

    New Jersey · 21080

    Office

    $1847.03

    Facility

    $1228.07

    $70.03 higher than Madera for the office setting.

  • New Mexico

    New Mexico · 21080

    Office

    $1681.59

    Facility

    $1161.82

    $95.41 lower than Madera for the office setting.

  • Nevada**

    Nevada · 21080

    Office

    $1714.42

    Facility

    $1147.04

    $62.58 lower than Madera for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21080

    Office

    $2019.70

    Facility

    $1345.76

    $242.70 higher than Madera for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21080

    Office

    $1864.55

    Facility

    $1243.88

    $87.55 higher than Madera for the office setting.

  • Queens

    New York · 21080

    Office

    $1973.65

    Facility

    $1303.67

    $196.65 higher than Madera for the office setting.

  • Rest Of New York

    New York · 21080

    Office

    $1660.13

    Facility

    $1121.66

    $116.87 lower than Madera for the office setting.

  • Ohio

    Ohio · 21080

    Office

    $1659.56

    Facility

    $1142.06

    $117.44 lower than Madera for the office setting.

  • Oklahoma

    Oklahoma · 21080

    Office

    $1620.78

    Facility

    $1114.61

    $156.22 lower than Madera for the office setting.

  • Portland

    Oregon · 21080

    Office

    $1808.65

    Facility

    $1178.92

    $31.65 higher than Madera for the office setting.

  • Rest Of Oregon

    Oregon · 21080

    Office

    $1697.70

    Facility

    $1133.15

    $79.30 lower than Madera for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21080

    Office

    $1796.76

    Facility

    $1206.71

    $19.76 higher than Madera for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21080

    Office

    $1657.52

    Facility

    $1137.19

    $119.48 lower than Madera for the office setting.

  • Puerto Rico

    Puerto Rico · 21080

    Office

    $1737.36

    Facility

    $1164.31

    $39.64 lower than Madera for the office setting.

  • Rhode Island

    Rhode Island · 21080

    Office

    $1761.79

    Facility

    $1176.27

    $15.21 lower than Madera for the office setting.

  • South Carolina

    South Carolina · 21080

    Office

    $1653.19

    Facility

    $1129.45

    $123.81 lower than Madera for the office setting.

  • South Dakota**

    South Dakota · 21080

    Office

    $1665.29

    Facility

    $1098.48

    $111.71 lower than Madera for the office setting.

  • Tennessee

    Tennessee · 21080

    Office

    $1610.52

    Facility

    $1095.28

    $166.48 lower than Madera for the office setting.

  • Austin

    Texas · 21080

    Office

    $1767.75

    Facility

    $1168.06

    $9.25 lower than Madera for the office setting.

  • Beaumont

    Texas · 21080

    Office

    $1649.43

    Facility

    $1133.63

    $127.57 lower than Madera for the office setting.

  • Brazoria

    Texas · 21080

    Office

    $1707.63

    Facility

    $1145.92

    $69.37 lower than Madera for the office setting.

  • Dallas

    Texas · 21080

    Office

    $1720.11

    Facility

    $1155.56

    $56.89 lower than Madera for the office setting.

  • Fort Worth

    Texas · 21080

    Office

    $1713.20

    Facility

    $1154.33

    $63.80 lower than Madera for the office setting.

  • Galveston

    Texas · 21080

    Office

    $1713.93

    Facility

    $1151.08

    $63.07 lower than Madera for the office setting.

  • Houston

    Texas · 21080

    Office

    $1767.19

    Facility

    $1204.34

    $9.81 lower than Madera for the office setting.

  • Rest Of Texas

    Texas · 21080

    Office

    $1678.76

    Facility

    $1140.85

    $98.24 lower than Madera for the office setting.

  • Utah

    Utah · 21080

    Office

    $1670.92

    Facility

    $1138.11

    $106.08 lower than Madera for the office setting.

  • Virginia

    Virginia · 21080

    Office

    $1687.37

    Facility

    $1130.20

    $89.63 lower than Madera for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21080

    Office

    $1737.36

    Facility

    $1164.31

    $39.64 lower than Madera for the office setting.

  • Vermont

    Vermont · 21080

    Office

    $1673.65

    Facility

    $1112.51

    $103.35 lower than Madera for the office setting.

  • Rest Of Washington

    Washington · 21080

    Office

    $1760.49

    Facility

    $1163.64

    $16.51 lower than Madera for the office setting.

  • Seattle (King Cnty)

    Washington · 21080

    Office

    $1938.22

    Facility

    $1242.74

    $161.22 higher than Madera for the office setting.

  • Wisconsin

    Wisconsin · 21080

    Office

    $1628.27

    Facility

    $1085.27

    $148.73 lower than Madera for the office setting.

  • West Virginia

    West Virginia · 21080

    Office

    $1664.74

    Facility

    $1172.18

    $112.26 lower than Madera for the office setting.

  • Wyoming**

    Wyoming · 21080

    Office

    $1704.56

    Facility

    $1137.75

    $72.44 lower than Madera for the office setting.

See how rates vary across the country

21080 · 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.

$1,567.54

$2,147.27

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$2,147.271
AL$1,585.571
AR$1,567.541
AZ$1,690.521
CA$1,777.00–$2,135.4529
CO$1,770.601
CT$1,829.451
DC$1,930.241
DE$1,714.301
FL$1,742.79–$1,911.933
GA$1,660.30–$1,764.882
GU$1,800.791
HI$1,800.791
IA$1,601.811
ID$1,613.281
IL$1,713.51–$1,865.504
IN$1,620.261
KS$1,603.221
KY$1,630.921
LA$1,631.84–$1,694.872
MA$1,766.44–$1,911.032
MD$1,739.82–$1,930.243
ME$1,627.76–$1,686.622
MI$1,671.32–$1,767.932
MN$1,685.091
MO$1,614.61–$1,690.833
MS$1,590.951
MT$1,729.641
NC$1,640.031
ND$1,672.101
NE$1,606.491
NH$1,751.171
NJ$1,847.03–$1,918.512
NM$1,681.591
NV$1,714.421
NY$1,660.13–$2,019.705
OH$1,659.561
OK$1,620.781
OR$1,697.70–$1,808.652
PA$1,657.52–$1,796.762
PR$1,737.361
RI$1,761.791
SC$1,653.191
SD$1,665.291
TN$1,610.521
TX$1,649.43–$1,767.758
UT$1,670.921
VA$1,687.37–$1,930.242
VI$1,737.361
VT$1,673.651
WA$1,760.49–$1,938.222
WI$1,628.271
WV$1,664.741
WY$1,704.561

Explore 21080 on the national rate map →

Where does this rate apply?

Madera is a Medicare payment area. Our Census mapping connects it to 17 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 21080 in Madera, the physician’s office rate is $1777.00 and the facility-setting rate is $1155.78: a difference of $621.22.

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 21080 in Madera. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$1954.70

$1777.00 × 110% = $1954.70

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.

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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 21080 in Madera.

PPRRVU2026_Oct_nonQPP.csv

1,864

Code
21080
Physician work
24.43
Practice expense
24.45
Malpractice
2.91

GPCI2026.csv

14

Locality
Madera
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 21080 in Madera
ComponentRVULocality factorAdjusted
Physician work24.43× 1.01724.8453
Practice expense24.45× 1.09626.7972
Malpractice2.91× 0.5361.5598
Total RVUs53.2023
Conversion factor× 33.4009

Office / nonfacility rate, Madera$1777.00

Open 21080 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work24.431.017
Practice expense24.451.096
Malpractice2.910.536

(24.43 × 1.017 + 24.45 × 1.096 + 2.91 × 0.536) × $33.4009 = $1777.00

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work24.431.017
Practice expense7.481.096
Malpractice2.910.536

(24.43 × 1.017 + 7.48 × 1.096 + 2.91 × 0.536) × $33.4009 = $1155.78

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

21080 · Office / nonfacility

$1777.00

Effective 2026-10-01

The base rate is $85.51 higher than on 2025-10-01, moving from $1691.49 to $1777.00 (5.1%).

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

    $1691.49changed to$1777.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 25.06 changed to 24.43
    • Practice expense RVU 23.36 changed to 24.45
    • Malpractice RVU 2.41 changed to 2.91
    • 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.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $1691.49

    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$1777.00$1155.78RVU26D
2026-07-01$1777.00$1155.78RVU26C
2026-04-01$1777.00$1155.78RVU26B
2026-01-01$1777.00$1155.78RVU26A
2025-10-01$1691.49$1312.14RVU25D
2025-07-01$1691.49$1312.14RVU25C
2025-04-01$1691.49$1312.14RVU25B
2025-01-01$1691.49$1312.14RVU25A

21080 billing questions

When should this code be chosen over 21079?

Use 21080 for the definitive obturator stage. Code 21079 describes an interim obturator used during the healing period.

How does 21080 differ from 21076?

21080 is for a definitive obturator; 21076 is for a surgical obturator used in the surgical stage.

What documentation supports reporting 21080?

Document the acquired maxillary or palatal defect, its clinical stage, and the impression and preparation work for the definitive appliance.

Can modifier 50 be used for bilateral obturator work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the global period affect related care?

The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care through day 90.

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

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure is 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.

RVUs for 21080PPRRVU2026_Oct_nonQPP.csv, line 1,864 (RVU26D)
Geographic factors for MaderaGPCI2026.csv, line 14 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet