Billing code 21084: Speech aid prosthesisMedicare rate & RVUs in Utah
Reported for an impression and custom preparation of a speech aid prosthesis that helps address velopharyngeal insufficiency affecting speech.
Medicare pays $1,554.38 for 21084 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 21084 covers
A maxillofacial prosthodontist or other qualified dental or medical professional takes an impression and custom-prepares an intraoral speech aid prosthesis. A common design uses a speech bulb extending toward the nasopharynx to help improve closure when the soft palate cannot adequately separate the oral and nasal passages. The service may be provided in an outpatient clinic or hospital setting for congenital or acquired velopharyngeal dysfunction.
Select this code when the documented service is custom preparation of a speech aid prosthesis, rather than a palatal lift, palatal augmentation prosthesis, or obturator. The record should identify the speech-related functional problem, relevant anatomy and findings, and 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. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. 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.
21084 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $1,554.38 | $1,033.82 |
How the 21084 rate is calculated
Each of 21084’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 · 21084
RVUs × geographic indexes × conversion factor
Work21.92
21.92 RVUs× 1.000 GPCI
Practice expense23.80
23.80 RVUs× 1.000 GPCI
Malpractice2.50
2.50 RVUs× 1.000 GPCI
Adjusted RVUs
48.2200
Conversion factor
$33.4009
Medicare rate
$1,610.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21084
21084 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21084
Speech aid 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 · 21084
Speech aid 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
21084 without 51 · national office
$1,610.59
Speech aid prosthesis
21084-51 · Second procedure: 50%
$805.30
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%).
21084 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21083Palatal lift prosthesis
- Choose 21084 for custom preparation of a speech aid prosthesis, commonly using a speech bulb. Choose 21083 when the appliance is a palatal lift that raises the soft palate.
- 21082Palatal prosthesis
- Code 21082 is for a palatal augmentation prosthesis. It is selected for its palatal contour and oral-function purpose, not for a speech aid prosthesis.
- 21080Obturator prosthesis
- Code 21080 describes definitive obturator preparation for a maxillary defect. Use 21084 when the prepared appliance is a speech aid prosthesis rather than an obturator.
- 21079Obturator prosthesis
- Code 21079 is for interim obturator preparation. It is not the speech aid prosthesis service represented by 21084.
21084 billing questions
How is this different from a palatal lift prosthesis?
A speech aid prosthesis commonly uses a bulb to help close the velopharyngeal gap. A palatal lift raises a mobile but weak soft palate; select based on the prosthesis designed and the patient's functional problem.
When would an obturator code be more appropriate?
Use an obturator code when the prosthesis is designed to close an oral or palatal defect, such as a defect after maxillary surgery. Code 21084 describes custom preparation of a speech aid prosthesis for a speech-related functional problem.
What should the documentation establish?
Document the speech-related dysfunction, pertinent palate and velopharyngeal findings, the impression taken, and the custom prosthesis preparation performed.
How does the 90-day global period affect related care?
The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. Assistant-at-surgery payment requires documentation of medical necessity.
Can modifier 50 or co-surgeon billing be used?
The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. Co-surgeons and team surgery are not permitted.
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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