$1,601.32–$1,664.89
Choose 21083 for a device that raises a poorly mobile soft palate. Code 21082 describes a palatal augmentation prosthesis that changes palatal contour.
On this page
CMS RVU26D · Effective 2026-10-01
21083 Palatal lift prosthesis Medicare reimbursement rates in New Jersey
Reports impression and custom preparation of a palatal lift prosthesis to elevate a weak or poorly mobile soft palate and improve velopharyngeal closure. Compare 21083 office and facility rates across CMS payment localities in New Jersey.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 21083 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$1509.10–$1569.91
2 of 2 localities have a supported rate.
Facility setting
$967.83–$994.94
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Maxillofacial prosthetics
About 21083: Custom palatal lift prosthesis preparation
Reports impression and custom preparation of a palatal lift prosthesis to elevate a weak or poorly mobile soft palate and improve velopharyngeal closure.
A palatal lift prosthesis raises the soft palate when it cannot move adequately, helping close the passage between the nose and mouth during speech. It is used for velopharyngeal dysfunction, including weakness or paralysis of the palate, and is typically prepared by a dental or maxillofacial prosthetic provider. The service involves taking an impression and custom-preparing the device for the patient; it is distinct from a prosthesis that adds bulk to the palate.
Report this code when the service is for a custom palatal lift, not a palatal augmentation or another oral prosthesis. Documentation should identify the functional problem and support the need for the lift, along with 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 are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21083
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.79 · 44%
- Practice expense (office) RVU21.33 · 50%
- Malpractice RVU2.14 · 5%
23
Medicare services in 2024 · #5828 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.
21083 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$1,721.11–$1,789.59
Code 21084 is for a speech aid prosthesis. Select the code that matches the prosthesis actually prepared, rather than choosing by the shared speech-related goal.
$1,847.03–$1,918.51
Code 21080 describes a definitive obturator prosthesis, not a palatal lift. The device type and oral defect being managed distinguish the services.
Compare 21083 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$1569.91
Facility
$994.94
Rest Of New Jersey →
Office / nonfacility
$1509.10
Facility
$967.83
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21083 billing questions
How is a palatal lift different from palatal augmentation?
A lift raises a poorly mobile soft palate to help close the velopharyngeal passage. Palatal augmentation changes the palate’s contour to improve contact with the tongue.
What documentation supports reporting this code?
Document the palatal functional deficit and why a lift is needed, plus the impression and custom preparation performed for the patient.
Should modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
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 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.
1,86421080,,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
1,86721083,,Impres&prep paltl lft prosth,A,,18.79,21.33,,6.49,,2.14,42.26,27.42,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86821084,,Impres&prep sp aid prosth,A,,21.92,23.80,,7.22,,2.50,48.22,31.64,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86921085,,Impres&prep oral surg splint,A,,8.77,11.42,,3.03,,1.07,21.26,12.87,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87021086,,Impres&prep auricular prosth,A,,24.26,21.70,,6.71,,2.76,48.72,33.73,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00