CPT code 91030: Acid challenge, provocative esophageal acid test2026 Medicare rate & RVUs in Pennsylvania
Reports a provocative esophageal acid challenge used to assess whether acid exposure reproduces a patient’s characteristic esophageal or chest symptoms.
Medicare pays $151.81–$168.90 for 91030 in the office in Pennsylvania, from Rest of Pennsylvania to Metropolitan Philadelphia, PA. 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.
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On this page 9 sections
What 91030 covers
This test introduces acid into the esophagus through a catheter while the clinician observes whether the patient’s characteristic symptoms are reproduced. It may be used in evaluating noncardiac chest pain or suspected acid-related esophageal symptoms. A gastroenterologist or another clinician experienced in esophageal testing typically performs the procedure; trained staff may assist with the test, and a physician interprets the findings.
Report 91030 when the service is an esophageal acid perfusion challenge, rather than pressure measurement or monitoring of naturally occurring reflux. Documentation should support the clinical indication, the acid challenge performed, the patient’s symptom response, and the interpretation. The code has a 0-day global period, so same-day preoperative and postoperative care is included. Bill the global service without a component modifier, or report modifier 26 for interpretation or TC for equipment and staff. Modifier 50 is inappropriate for this single-organ test. 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.
Where 91030 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | $168.90 | Unavailable |
| Rest of Pennsylvania | $151.81 | Unavailable |
How the 91030 rate is calculated
Each of 91030’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 · 91030
RVUs × geographic indexes × conversion factor
Work0.89
0.89 RVUs× 1.000 GPCI
Practice expense3.93
3.93 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
4.8700
Conversion factor
$33.4009
Medicare rate
$162.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 91030
The CMS indicators that decide how 91030 is paid alongside other services.
CMS payment indicators · 91030
Acid challenge, provocative esophageal acid test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
91030 without 26 · national office
$162.66
Acid challenge, provocative esophageal acid test
91030-26 · Professional component
$48.10
Pays only the interpretation and report.
91030 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 91010Esophageal manometryStandard pressure study
- Choose 91030 for an acid perfusion challenge intended to reproduce symptoms. Choose 91010 when the service measures esophageal motility.
- 91034Reflux monitoringNasal catheter pH test
- 91030 provokes a response by introducing acid. 91034 monitors esophageal pH over time to assess naturally occurring acid exposure.
- 91035Reflux testingMucosa-attached telemetry electrode
- 91030 is an acid challenge; 91035 uses a wireless capsule to monitor esophageal pH over time.
91030 billing questions
How is 91030 different from esophageal motility testing?
91030 evaluates whether acid perfusion reproduces symptoms. Motility testing, such as 91010, evaluates esophageal pressure and movement.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the interpretation or TC for the technical service; billing without either modifier represents the global service.
Is modifier 50 appropriate?
No. The esophagus is tested as one organ, so bilateral reporting is inappropriate.
What documentation supports reporting 91030?
Document the reason for testing, the acid perfusion challenge performed, the patient’s response, and the interpretation.
What is included in the global service?
The 0-day global period includes same-day preoperative and postoperative care.
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.
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
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