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See a sample rate comparisonCPT 21079 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Impression And Custom Preparat, Impression And Custom Preparation Interim Obturatorprosthesis Impression And Custom Preparation Interim Obturator
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 58 - Staged or related procedure during postoperative period None 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21079 |
| Medicaid Fee Schedule | View Medicaid rates for 21079 |
National average reimbursement for CPT 21079 by major payers:
$1,831.91
$2,130.95
$2,088.58
$2,119.37
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CPT 21079
5 of 25 sample ratesHigher to lower in this preview
Ambulatory Surgery Center Of Cool Springs LLC, Vanderbilt Surgery Center Cool Springs
Ambulatory Surgery Center Of Cool Springs LLC
$9,039.00Published rateSurgcenter At Paradise Valley, LLC, Surgcenter At Pima Crossing
Surgcenter At Paradise Valley
$5,020.00Published rateCenter For Special Surgery LLC
$3,398.00Published rateIntegrated Surgical Institute, LLC
Integrated Surgical Institute
$1,957.00Published rateBay Area Endoscopy Center Limited Partnership
$360.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21079 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21079 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 21079 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 21076-CPT | High | Custom Artificial Palate, A Prosthesis Made For The Roof Of The Mouth (Palate) From A Cast Model Of Impressions. It Is Used To Restore Oral Functions Such As Chewing Swallowing And Speech. |
| 21079-CPT | High | Impression And Custom Preparat, Impression And Custom Preparation Interim Obturatorprosthesis Impression And Custom Preparation Interim Obturator |
| 21080-CPT | High | Custom Artificial Palate, A Prosthesis Made For The Roof Of The Mouth (Palate) From A Cast Model Of Impressions. It Is Used To Restore Oral Functions Such As Chewing Swallowing And Speech. |
| 21081-CPT | High | Impression And Custom Preparat, Impression And Custom Preparation Mandibular Resectionprosthesis Impression And Custom Preparation Mandibular Resection |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21079. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21079 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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