Billing code 21083: Palatal lift prosthesisMedicare rate & RVUs in Utah
Reports impression and custom preparation of a palatal lift prosthesis to elevate a weak or poorly mobile soft palate and improve velopharyngeal closure.
Medicare pays $1,361.48 for 21083 in the office in Utah (Utah). 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 21083 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $1,361.48 | $895.56 |
How the 21083 rate is calculated
Each of 21083’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 · 21083
RVUs × geographic indexes × conversion factor
Work18.79
18.79 RVUs× 1.000 GPCI
Practice expense21.33
21.33 RVUs× 1.000 GPCI
Malpractice2.14
2.14 RVUs× 1.000 GPCI
Adjusted RVUs
42.2600
Conversion factor
$33.4009
Medicare rate
$1,411.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21083
21083 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21083
Palatal lift 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 · 21083
Palatal lift 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
21083 without 51 · national office
$1,411.52
Palatal lift prosthesis
21083-51 · Second procedure: 50%
$705.76
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%).
21083 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21082Palatal prosthesis
- Choose 21083 for a device that raises a poorly mobile soft palate. Code 21082 describes a palatal augmentation prosthesis that changes palatal contour.
- 21084Speech aid prosthesis
- 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.
- 21080Obturator prosthesis
- Code 21080 describes a definitive obturator prosthesis, not a palatal lift. The device type and oral defect being managed distinguish the services.
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 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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