$1,349.00
21082 reshapes the palate to improve tongue-to-palate contact. 21083 describes a palatal lift intended to elevate the soft palate.
On this page
CMS RVU26D · Effective 2026-10-01
21082 Palatal prosthesis Medicare reimbursement rates in West Virginia
Reports custom preparation of a palatal augmentation prosthesis that reshapes the palate to improve tongue contact for speech or swallowing. Compare 21082 office and facility rates across CMS payment localities in West Virginia.
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 21082 in West Virginia?
West Virginia has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$1436.04
1 of 1 localities have a supported rate.
Payment area: West Virginia
One mapped payment locality.
Facility setting
$997.18
1 of 1 localities have a supported rate.
Payment area: West Virginia
One mapped payment locality.
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 21082: Palatal augmentation prosthesis preparation
Reports custom preparation of a palatal augmentation prosthesis that reshapes the palate to improve tongue contact for speech or swallowing.
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.
CMS billing rules for 21082
- 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 RVU20.32 · 45%
- Practice expense (office) RVU22.14 · 49%
- Malpractice RVU2.40 · 5%
206
Medicare services in 2024 · #4297 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.
21082 compared with similar codes
Office rates for West Virginia, from the same CMS release.
$1,542.44
21084 is for a speech-aid prosthesis serving a different functional purpose; select 21082 when the custom appliance augments the palate for tongue contact.
$1,664.74
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.
$1,531.43
21081 concerns a prosthesis associated with mandibular resection. 21082 is selected for an appliance that augments the palate.
Compare 21082 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.
1 of 1 payment localities
West Virginia →
Office / nonfacility
$1436.04
Facility
$997.18
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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 21082 in West Virginia.
PPRRVU2026_Oct_nonQPP.csv
1,866
- Code
- 21082
- Physician work
- 20.32
- Practice expense
- 22.14
- Malpractice
- 2.40
GPCI2026.csv
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.32 | × 1.000 | 20.3200 |
| Practice expense | 22.14 | × 0.869 | 19.2397 |
| Malpractice | 2.40 | × 1.431 | 3.4344 |
| Total RVUs | 42.9941 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, West Virginia$1436.04
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.32 | 1 |
| Practice expense | 22.14 | 0.869 |
| Malpractice | 2.4 | 1.431 |
(20.32 × 1 + 22.14 × 0.869 + 2.4 × 1.431) × $33.4009 = $1436.04
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.32 | 1 |
| Practice expense | 7.02 | 0.869 |
| Malpractice | 2.4 | 1.431 |
(20.32 × 1 + 7.02 × 0.869 + 2.4 × 1.431) × $33.4009 = $997.18
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.
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 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.
1,86321079,,Impres&prep intrm obt prosth,A,,21.75,21.26,,6.72,,2.55,45.56,31.02,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,86421080,,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
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,