Billing code 21082: Palatal prosthesisMedicare rate & RVUs in Rhode Island
Reports custom preparation of a palatal augmentation prosthesis that reshapes the palate to improve tongue contact for speech or swallowing.
Medicare pays $1,527.01 for 21082 in the office in Rhode Island (Rhode Island). Which amount applies depends on the service address.
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 9 sections
What 21082 covers
A palatal augmentation prosthesis changes the contour of the hard palate so the tongue can make more effective contact during speech or swallowing. It is commonly considered for patients with reduced tongue mobility or tissue loss, such as after glossectomy. A maxillofacial prosthodontist or another clinician experienced in oral prosthetic rehabilitation evaluates the oral anatomy, obtains an impression, and customizes the appliance to the patient’s functional needs. The service may involve fitting and adjustments to establish the intended palatal contour.
Report this code when the service is for a palatal augmentation prosthesis, rather than a device that lifts the soft palate or closes a surgical defect. Documentation should identify the functional problem, relevant oral anatomy, impression and customization work, and the prosthesis’s fit and purpose. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral adjustment is inappropriate. 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.
21082 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $1,527.01 | $1,005.32 |
How the 21082 rate is calculated
Each of 21082’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 · 21082
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.32Practice expense 22.14Malpractice 2.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21082
21082 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21082
Palatal 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 · 21082
Palatal 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
21082 without 51 · national office
$1,498.36
Palatal prosthesis
21082-51 · Second procedure: 50%
$749.18
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%).
21082 compared with similar codes
Compare codes
21082 vs 21083 vs 21084 vs 21080 vs 21081: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21083Palatal lift prosthesis
- 21082 reshapes the palate to improve tongue-to-palate contact. 21083 describes a palatal lift intended to elevate the soft palate.
- 21084Speech aid prosthesis
- 21084 is for a speech-aid prosthesis serving a different functional purpose; select 21082 when the custom appliance augments the palate for tongue contact.
- 21080Obturator prosthesis
- 21080 concerns a definitive obturator for a palatal defect. 21082 is for a palatal contour designed to improve tongue contact, not to obturate the defect.
- 21081Mandibular prosthesis
- 21081 concerns a prosthesis associated with mandibular resection. 21082 is selected for an appliance that augments the palate.
21082 billing questions
How is this different from a palatal lift prosthesis?
Use 21082 for a prosthesis that reshapes the palate to improve tongue contact. A palatal lift, reported with 21083, elevates the soft palate to address inadequate closure between the oral and nasal cavities.
What should the record show?
Document the patient’s tongue-related functional limitation, relevant oral anatomy, the impression and custom contouring performed, and how the prosthesis fits and is intended to help.
Is adjustment of the prosthesis included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Related postoperative adjustments during that period are included in the global service.
Can this code be reported with another procedure on the same date?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The code’s bilateral adjustment is inappropriate.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is limited to cases with documented medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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