CPT code 91030: Acid challenge, provocative esophageal acid test2026 Medicare rate & RVUs in Puerto Rico

Reports a provocative esophageal acid challenge used to assess whether acid exposure reproduces a patient’s characteristic esophageal or chest symptoms.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Puerto Rico, Medicare pays $164.08 for 91030 in the office.

$164.08Office (non-facility)
Not available in this settingHospital or facility
+0.9%vs the national office rate ($162.66)

Check a contract rate as a % of Medicare · 91030 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 91030 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 91030 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Puerto Rico compares for 91030

Across 109 of 109 payment localities, the office rate for 91030 runs from $143.34 in Arkansas to $223.18 in San Benito County, CA. Puerto Rico pays $164.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

91030 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$164.08
  2. Los Angeles, CA · California$187.34+$23.26
  3. Washington, DC area · District of Columbia$187.82+$23.74
  4. Miami, FL · Florida$170.60+$6.52
  5. Chicago, IL · Illinois$165.69+$1.61
  6. Manhattan, NY · New York$186.81+$22.73
  7. Alaska · Alaska$185.31+$21.23

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

91030 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$145.53—
ArkansasArkansas$143.34—
ArizonaArizona$158.35—
Bakersfield, CACalifornia$175.18—
Chico, CACalifornia$174.99—
El Centro, CACalifornia$175.00—
Fresno, CACalifornia$174.99—
Hanford, CACalifornia$174.99—

91030 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$143.34

$199.09

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
91030 office rate range by state
State / territoryOffice rate rangeLocalities
AK$185.311
AL$145.531
AR$143.341
AZ$158.351
CA$174.99–$223.1829
CO$171.051
CT$173.721
DC$187.821
DE$161.071
FL$157.73–$170.603
GA$148.81–$165.192
GU$179.941
HI$179.941
IA$150.501
ID$151.281
IL$152.18–$167.704
IN$152.221
KS$149.231
KY$147.951
LA$147.50–$155.142
MA$169.76–$189.162
MD$164.40–$187.823
ME$151.53–$160.862
MI$151.46–$159.212
MN$165.291
MO$144.50–$156.363
MS$143.981
MT$162.661
NC$153.261
ND$161.671
NE$151.521
NH$167.841
NJ$176.09–$185.652
NM$152.101
NV$162.511
NY$155.60–$190.815
OH$151.261
OK$148.241
OR$161.64–$177.282
PA$151.81–$168.902
PR$164.081
RI$167.381
SC$152.441
SD$161.551
TN$149.941
TX$150.73–$170.148
UT$154.621
VA$159.94–$187.822
VI$164.081
VT$160.521
WA$169.61–$193.642
WI$155.991
WV$146.191
WY$162.231

See 91030 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,600

Code
91030
Physician work
0.89
Practice expense
3.93
Malpractice
0.05

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 91030 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.89× 1.0000.8900
Practice expense3.93× 1.0113.9732
Malpractice0.05× 0.9850.0493
Total RVUs4.9125
Conversion factor× 33.4009

Office rate, Puerto Rico$164.08

Office: (0.89 × 1 + 3.93 × 1.011 + 0.05 × 0.985) × $33.4009 = $164.08

Open 91030 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

How 91030 has changed in Puerto Rico

91030 · Office / nonfacility

$164.08

Effective 2026-10-01

The base rate is $24.26 higher than on 2025-10-01, moving from $139.82 to $164.08 (17.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $139.82changed to$164.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.91 changed to 0.89
    • Practice expense RVU 3.34 changed to 3.93
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $145.90changed to$139.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.40 changed to 3.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $143.51changed to$145.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $147.27changed to$143.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.35 changed to 3.40
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $146.39changed to$147.27

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $152.14changed to$146.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.40 changed to 3.35
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $152.35changed to$152.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.37 changed to 3.40

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $143.03changed to$152.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.98 changed to 3.37
    • Malpractice RVU 0.05 changed to 0.06
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $141.64changed to$143.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.95 changed to 2.98
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $141.12changed to$141.64

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.94 changed to 2.95

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $120.75changed to$141.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.83 changed to 2.94
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $105.80changed to$120.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.88 changed to 2.83
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $107.75changed to$105.80

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.95 changed to 2.88
    • Malpractice RVU 0.03 changed to 0.05

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $107.21changed to$107.75

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $105.47changed to$107.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.92 changed to 2.95
    • Malpractice RVU 0.05 changed to 0.03
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $110.05changed to$105.47

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.41 changed to 2.92
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $110.05

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$164.08Not available in this settingRVU26D
2026-07-01$164.08Not available in this settingRVU26C
2026-04-01$164.08Not available in this settingRVU26B
2026-01-01$164.08Not available in this settingRVU26A
2025-10-01$139.82Not available in this settingRVU25D
2025-07-01$139.82Not available in this settingRVU25C
2025-04-01$139.82Not available in this settingRVU25B
2025-01-01$139.82Not available in this settingRVU25A
2024-10-01$145.90Not available in this settingRVU24D
2024-07-01$145.90Not available in this settingRVU24C
2024-04-01$145.90Not available in this settingRVU24B
2024-03-09$145.90Not available in this settingRVU24AR
2024-01-01$143.51Not available in this settingRVU24A
2023-10-01$147.27Not available in this settingRVU23D
2023-07-01$146.39Not available in this settingRVU23C
2023-04-01$146.39Not available in this settingRVU23B
2023-01-01$146.39Not available in this settingRVU23A
2022-10-01$152.14Not available in this settingRVU22D
2022-07-01$152.14Not available in this settingRVU22C
2022-04-01$152.14Not available in this settingRVU22B
2022-01-01$152.14Not available in this settingRVU22A
2021-10-01$152.35Not available in this settingRVU21D
2021-07-01$152.35Not available in this settingRVU21C
2021-04-01$152.35Not available in this settingRVU21B
2021-01-01$152.35Not available in this settingRVU21A
2020-10-01$143.03Not available in this settingRVU20D
2020-07-01$143.03Not available in this settingRVU20C
2020-04-01$143.03Not available in this settingRVU20B
2020-01-01$143.03Not available in this settingRVU20A
2019-10-01$141.64Not available in this settingRVU19D
2019-07-01$141.64Not available in this settingRVU19C
2019-04-01$141.64Not available in this settingRVU19B
2019-01-01$141.64Not available in this settingRVU19A
2018-10-01$141.12Not available in this settingRVU18D
2018-07-01$141.12Not available in this settingRVU18C
2018-04-01$141.12Not available in this settingRVU18B
2018-01-01$141.12Not available in this settingRVU18AR1
2017-10-01$120.75Not available in this settingRVU17D
2017-07-01$120.75Not available in this settingRVU17C
2017-04-01$120.75Not available in this settingRVU17B
2017-01-01$120.75Not available in this settingRVU17A
2016-10-01$105.80Not available in this settingRVU16D
2016-07-01$105.80Not available in this settingRVU16C
2016-04-01$105.80Not available in this settingRVU16B
2016-01-01$105.80Not available in this settingRVU16A
2015-10-01$107.75Not available in this settingRVU15D
2015-07-01$107.75Not available in this settingRVU15C
2015-04-01$107.21Not available in this settingRVU15B
2015-01-01$107.21Not available in this settingRVU15A
2014-10-01$105.47Not available in this settingRVU14D
2014-07-01$105.47Not available in this settingRVU14C
2014-04-01$105.47Not available in this settingRVU14B
2014-01-01$105.47Not available in this settingRVU14A
2013-10-01$110.05Not available in this settingRVU13D
2013-07-01$110.05Not available in this settingRVU13C
2013-04-01$110.05Not available in this settingRVU13B
2013-01-01$110.05Not available in this settingRVU13AR

Price 91030 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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

Show the CMS file lines behind this rate
RVUs for 91030PPRRVU2026_Oct_nonQPP.csv, line 11,600 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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