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CPT code 91034: Reflux monitoring, nasal catheter pH test2026 Medicare rate & RVUs in North Carolina

Reports ambulatory esophageal acid monitoring with a transnasal catheter to evaluate reflux and correlate recorded acid events with symptoms.

CMS RVU26DEffective Oct 1, 2026One payment locality2.9K Medicare services in 2024

In North Carolina, Medicare pays $190.19 for 91034 in the office.

$190.19Office (non-facility)
Not available in this settingHospital or facility
−6.0%vs the national office rate ($202.41)

Check a contract rate as a % of Medicare · 91034 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 91034 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 91034 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 91034 covers

This service evaluates gastroesophageal reflux by placing a pH-sensing catheter through the nose into the esophagus and recording acid exposure during ambulatory monitoring, commonly over 24 hours. A gastroenterologist or other qualified clinician places the catheter; the study data are analyzed and interpreted to assess acid reflux and its relationship to reported symptoms. It may be used when reflux symptoms persist or when objective acid-exposure data are needed in a reflux evaluation.

Report 91034 for catheter-based pH monitoring, not a wireless capsule study or an impedance-based test. The record should support catheter placement, monitoring, analysis, and interpretation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Bill the global service without a modifier, or use modifier 26 for interpretation or TC for the technical service. Modifier 50 is inappropriate. 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 North Carolina compares for 91034

Across 109 of 109 payment localities, the office rate for 91034 runs from $177.42 in Arkansas to $278.92 in San Benito County, CA. North Carolina pays $190.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

91034 in North Carolina vs other payment areas
  1. North Carolina · this page$190.19
  2. Los Angeles, CA · California$233.56+$43.37
  3. Washington, DC area · District of Columbia$234.33+$44.14
  4. Miami, FL · Florida$213.38+$23.19
  5. Chicago, IL · Illinois$206.93+$16.74
  6. Manhattan, NY · New York$233.22+$43.03
  7. Alaska · Alaska$228.00+$37.81

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

91034 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$180.25—
ArkansasArkansas$177.42—
ArizonaArizona$196.82—
Bakersfield, CACalifornia$218.10—
Chico, CACalifornia$217.84—
El Centro, CACalifornia$217.85—
Fresno, CACalifornia$217.84—
Hanford, CACalifornia$217.84—

91034 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$177.42

$248.38

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

View every state and territory as a table
91034 office rate range by state
State / territoryOffice rate rangeLocalities
AK$228.001
AL$180.251
AR$177.421
AZ$196.821
CA$217.84–$278.9229
CO$212.961
CT$216.541
DC$234.331
DE$200.281
FL$196.36–$213.383
GA$184.78–$205.732
GU$224.301
HI$224.301
IA$186.521
ID$187.561
IL$189.30–$209.234
IN$188.771
KS$184.961
KY$183.531
LA$182.98–$192.862
MA$211.28–$236.012
MD$204.52–$234.333
ME$187.96–$199.912
MI$188.14–$198.362
MN$205.401
MO$179.16–$194.353
MS$178.361
MT$202.401
NC$190.191
ND$200.821
NE$187.811
NH$208.961
NJ$219.39–$231.472
NM$189.001
NV$202.131
NY$193.22–$238.485
OH$187.811
OK$183.841
OR$200.94–$220.882
PA$188.49–$210.382
PR$204.221
RI$208.271
SC$189.241
SD$200.641
TN$185.881
TX$187.10–$211.918
UT$192.061
VA$198.77–$234.332
VI$204.221
VT$199.411
WA$211.09–$241.642
WI$193.501
WV$181.551
WY$201.711

See 91034 in every payment locality

How the 91034 rate is calculated

Each of 91034’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 · 91034

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.95

0.95 RVUs× 1.000 GPCI

Practice expense5.03

5.03 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

6.0600

Conversion factor

$33.4009

Medicare rate

$202.41

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,603

Code
91034
Physician work
0.95
Practice expense
5.03
Malpractice
0.08

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 91034 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.95× 1.0000.9500
Practice expense5.03× 0.9334.6930
Malpractice0.08× 0.6390.0511
Total RVUs5.6941
Conversion factor× 33.4009

Office rate, North Carolina$190.19

Office: (0.95 × 1 + 5.03 × 0.933 + 0.08 × 0.639) × $33.4009 = $190.19

Open 91034 in the RVU calculator

Payment rules and modifiers for 91034

The CMS indicators that decide how 91034 is paid alongside other services.

CMS payment indicators · 91034

Reflux monitoring, nasal catheter pH 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

91034 without 26 · national office

$202.41

Reflux monitoring, nasal catheter pH test

91034-26 · Professional component

$50.44

Pays only the interpretation and report.

When to use modifier 26

Codes related to 91034

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 91034
CodeHow it relatesOffice range, North Carolina
Used instead
91035Reflux testing, mucosa-attached telemetry electrodeWireless pH monitoring is an alternative method for esophageal reflux assessment.$470.69
91037Esophageal impedance, one hour or lessUse for impedance-based reflux testing rather than catheter pH-only monitoring.$176.26
91038Esophageal impedance, more than one hourAn impedance-based reflux test; distinguish it from catheter pH-only monitoring.$417.70

How 91034 has changed in North Carolina

91034 · Office / nonfacility

$190.19

Effective 2026-10-01

The base rate is $20.72 higher than on 2025-10-01, moving from $169.47 to $190.19 (12.2%).

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

    $169.47changed to$190.19

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.97 changed to 0.95
    • Practice expense RVU 4.56 changed to 5.03
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $178.63changed to$169.47

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.69 changed to 4.56
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $175.71changed to$178.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $183.15changed to$175.71

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.72 changed to 4.69
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $189.02changed to$183.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.77 changed to 4.72
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $191.64changed to$189.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.82 changed to 4.77
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $183.59changed to$191.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.37 changed to 4.82
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $182.58changed to$183.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.34 changed to 4.37
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $181.04changed to$182.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.30 changed to 4.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $179.25changed to$181.04

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.26 changed to 4.30
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $180.11changed to$179.25

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.30 changed to 4.26
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $179.93changed to$180.11

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.05 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $179.04changed to$179.93

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $179.83changed to$179.04

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.32 changed to 4.30
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $189.04changed to$179.83

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.91 changed to 4.32
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $189.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$190.19Not available in this settingRVU26D
2026-07-01$190.19Not available in this settingRVU26C
2026-04-01$190.19Not available in this settingRVU26B
2026-01-01$190.19Not available in this settingRVU26A
2025-10-01$169.47Not available in this settingRVU25D
2025-07-01$169.47Not available in this settingRVU25C
2025-04-01$169.47Not available in this settingRVU25B
2025-01-01$169.47Not available in this settingRVU25A
2024-10-01$178.63Not available in this settingRVU24D
2024-07-01$178.63Not available in this settingRVU24C
2024-04-01$178.63Not available in this settingRVU24B
2024-03-09$178.63Not available in this settingRVU24AR
2024-01-01$175.71Not available in this settingRVU24A
2023-10-01$183.15Not available in this settingRVU23D
2023-07-01$183.15Not available in this settingRVU23C
2023-04-01$183.15Not available in this settingRVU23B
2023-01-01$183.15Not available in this settingRVU23A
2022-10-01$189.02Not available in this settingRVU22D
2022-07-01$189.02Not available in this settingRVU22C
2022-04-01$189.02Not available in this settingRVU22B
2022-01-01$189.02Not available in this settingRVU22A
2021-10-01$191.64Not available in this settingRVU21D
2021-07-01$191.64Not available in this settingRVU21C
2021-04-01$191.64Not available in this settingRVU21B
2021-01-01$191.64Not available in this settingRVU21A
2020-10-01$183.59Not available in this settingRVU20D
2020-07-01$183.59Not available in this settingRVU20C
2020-04-01$183.59Not available in this settingRVU20B
2020-01-01$183.59Not available in this settingRVU20A
2019-10-01$182.58Not available in this settingRVU19D
2019-07-01$182.58Not available in this settingRVU19C
2019-04-01$182.58Not available in this settingRVU19B
2019-01-01$182.58Not available in this settingRVU19A
2018-10-01$181.04Not available in this settingRVU18D
2018-07-01$181.04Not available in this settingRVU18C
2018-04-01$181.04Not available in this settingRVU18B
2018-01-01$181.04Not available in this settingRVU18AR1
2017-10-01$179.25Not available in this settingRVU17D
2017-07-01$179.25Not available in this settingRVU17C
2017-04-01$179.25Not available in this settingRVU17B
2017-01-01$179.25Not available in this settingRVU17A
2016-10-01$180.11Not available in this settingRVU16D
2016-07-01$180.11Not available in this settingRVU16C
2016-04-01$180.11Not available in this settingRVU16B
2016-01-01$180.11Not available in this settingRVU16A
2015-10-01$179.93Not available in this settingRVU15D
2015-07-01$179.93Not available in this settingRVU15C
2015-04-01$179.04Not available in this settingRVU15B
2015-01-01$179.04Not available in this settingRVU15A
2014-10-01$179.83Not available in this settingRVU14D
2014-07-01$179.83Not available in this settingRVU14C
2014-04-01$179.83Not available in this settingRVU14B
2014-01-01$179.83Not available in this settingRVU14A
2013-10-01$189.04Not available in this settingRVU13D
2013-07-01$189.04Not available in this settingRVU13C
2013-04-01$189.04Not available in this settingRVU13B
2013-01-01$189.04Not available in this settingRVU13AR

Price 91034 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

91034 billing questions

How does 91034 differ from 91035?

91034 is for pH monitoring with a transnasal catheter. 91035 is the wireless pH-monitoring method.

Can the interpretation be billed separately?

Yes. Modifier 26 identifies the professional interpretation; TC identifies the technical service. Without either modifier, the claim represents the global service.

What should the record support?

Document the catheter-based monitoring, recorded study data, analysis, and interpretation. The report should identify the findings relevant to esophageal acid exposure and reflux symptoms.

Should modifier 50 be appended?

No. CMS identifies modifier 50 as inappropriate for this service.

How does 91034 differ from impedance reflux testing?

91034 reports catheter-based pH monitoring. Codes 91037 and 91038 describe impedance-based reflux testing, so code selection follows the test actually performed.

Are same-day care and surgical-team services separately payable?

Same-day preoperative and postoperative care is included in the 0-day global period. Assistant-at-surgery payment requires documented medical necessity, while 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 91034PPRRVU2026_Oct_nonQPP.csv, line 11,603 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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