CPT code 91035: Reflux testing, mucosa-attached telemetry electrode2026 Medicare rate & RVUs in Delaware

Reports ambulatory esophageal acid monitoring with a mucosa-attached wireless electrode to evaluate suspected gastroesophageal reflux and measure acid exposure.

CMS RVU26DEffective Oct 1, 2026One payment locality11.9K Medicare services in 2024

In Delaware, Medicare pays $496.76 for 91035 in the office.

$496.76Office (non-facility)
Not available in this settingHospital or facility
−1.1%vs the national office rate ($502.35)

Check a contract rate as a % of Medicare · 91035 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 91035 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 91035 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 91035 covers

This service uses a wireless pH electrode attached to the esophageal lining to collect acid readings during ambulatory monitoring. A gastroenterologist or other qualified clinician commonly places the electrode during an upper endoscopy; the patient then leaves with the recorder and follows instructions for documenting symptoms and activities. The completed study is analyzed to assess esophageal acid exposure and its relationship to reported symptoms, such as persistent heartburn or regurgitation.

Report 91035 for the wireless, mucosa-attached monitoring method, including electrode placement, recording, analysis, and interpretation. Documentation should identify the clinical reason for testing and support the recorded study and interpretation. The global service includes the professional interpretation and technical recording; modifier 26 identifies the professional component, while TC identifies the technical component. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing 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 Delaware compares for 91035

Across 109 of 109 payment localities, the office rate for 91035 runs from $437.09 in Arkansas to $702.66 in San Benito County, CA. Delaware pays $496.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

91035 in Delaware vs other payment areas
  1. Delaware · this page$496.76
  2. Los Angeles, CA · California$584.33+$87.57
  3. Washington, DC area · District of Columbia$585.02+$88.26
  4. Miami, FL · Florida$528.28+$31.52
  5. Chicago, IL · Illinois$511.43+$14.67
  6. Manhattan, NY · New York$580.78+$84.02
  7. Alaska · Alaska$554.95+$58.19

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

Every other payment area

91035 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$444.48—
ArkansasArkansas$437.09—
ArizonaArizona$487.82—
Bakersfield, CACalifornia$544.15—
Chico, CACalifornia$543.68—
El Centro, CACalifornia$543.70—
Fresno, CACalifornia$543.68—
Hanford, CACalifornia$543.68—

91035 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.

$437.09

$623.17

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

View every state and territory as a table
91035 office rate range by state
State / territoryOffice rate rangeLocalities
AK$554.951
AL$444.481
AR$437.091
AZ$487.821
CA$543.68–$702.6629
CO$530.391
CT$538.751
DC$585.021
DE$496.761
FL$485.26–$528.283
GA$455.19–$510.642
GU$561.281
HI$561.281
IA$461.461
ID$464.061
IL$466.41–$518.614
IN$467.251
KS$457.091
KY$452.471
LA$450.90–$476.742
MA$525.78–$590.362
MD$507.80–$585.023
ME$464.81–$496.492
MI$464.23–$490.192
MN$511.741
MO$440.73–$480.973
MS$439.111
MT$502.341
NC$470.691
ND$499.371
NE$464.921
NH$519.991
NJ$545.90–$577.242
NM$466.371
NV$501.961
NY$478.58–$594.175
OH$463.631
OK$453.561
OR$499.08–$551.352
PA$465.54–$522.522
PR$507.181
RI$517.501
SC$467.731
SD$499.021
TN$459.481
TX$461.89–$527.728
UT$475.101
VA$493.30–$585.022
VI$507.181
VT$495.421
WA$525.44–$605.172
WI$480.171
WV$446.141
WY$501.051

See 91035 in every payment locality

How the 91035 rate is calculated

Each of 91035’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 · 91035

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.55

1.55 RVUs× 1.000 GPCI

Practice expense13.34

13.34 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

15.0400

Conversion factor

$33.4009

Medicare rate

$502.35

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,606

Code
91035
Physician work
1.55
Practice expense
13.34
Malpractice
0.15

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 91035 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.55× 1.0051.5577
Practice expense13.34× 0.98813.1799
Malpractice0.15× 0.8990.1348
Total RVUs14.8725
Conversion factor× 33.4009

Office rate, Delaware$496.76

Office: (1.55 × 1.005 + 13.34 × 0.988 + 0.15 × 0.899) × $33.4009 = $496.76

Open 91035 in the RVU calculator

Payment rules and modifiers for 91035

The CMS indicators that decide how 91035 is paid alongside other services.

CMS payment indicators · 91035

Reflux testing, mucosa-attached telemetry electrode

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

91035 without 26 · national office

$502.35

Reflux testing, mucosa-attached telemetry electrode

91035-26 · Professional component

$85.17

Pays only the interpretation and report.

When to use modifier 26

How 91035 has changed in Delaware

91035 · Office / nonfacility

$496.76

Effective 2026-10-01

The base rate is $75.42 higher than on 2025-10-01, moving from $421.34 to $496.76 (17.9%).

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

    $421.34changed to$496.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.59 changed to 1.55
    • Practice expense RVU 11.37 changed to 13.34
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $451.11changed to$421.34

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.91 changed to 11.37
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $443.75changed to$451.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $472.66changed to$443.75

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.14 changed to 11.91
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949
  5. January 1, 2023

    RVU23A

    $506.55changed to$472.66

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.65 changed to 12.14
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $526.79changed to$506.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.10 changed to 12.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $504.33changed to$526.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.00 changed to 13.10
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $502.16changed to$504.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.96 changed to 12.00
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $502.71changed to$502.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.99 changed to 11.96

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $497.95changed to$502.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.83 changed to 11.99
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $498.98changed to$497.95

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.82 changed to 11.83
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $506.65changed to$498.98

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.01 changed to 11.82
    • Malpractice RVU 0.10 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $504.13changed to$506.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $503.02changed to$504.13

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.91 changed to 12.01
    • Malpractice RVU 0.08 changed to 0.10
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $546.04changed to$503.02

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.78 changed to 11.91
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $546.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$496.76Not available in this settingRVU26D
2026-07-01$496.76Not available in this settingRVU26C
2026-04-01$496.76Not available in this settingRVU26B
2026-01-01$496.76Not available in this settingRVU26A
2025-10-01$421.34Not available in this settingRVU25D
2025-07-01$421.34Not available in this settingRVU25C
2025-04-01$421.34Not available in this settingRVU25B
2025-01-01$421.34Not available in this settingRVU25A
2024-10-01$451.11Not available in this settingRVU24D
2024-07-01$451.11Not available in this settingRVU24C
2024-04-01$451.11Not available in this settingRVU24B
2024-03-09$451.11Not available in this settingRVU24AR
2024-01-01$443.75Not available in this settingRVU24A
2023-10-01$472.66Not available in this settingRVU23D
2023-07-01$472.66Not available in this settingRVU23C
2023-04-01$472.66Not available in this settingRVU23B
2023-01-01$472.66Not available in this settingRVU23A
2022-10-01$506.55Not available in this settingRVU22D
2022-07-01$506.55Not available in this settingRVU22C
2022-04-01$506.55Not available in this settingRVU22B
2022-01-01$506.55Not available in this settingRVU22A
2021-10-01$526.79Not available in this settingRVU21D
2021-07-01$526.79Not available in this settingRVU21C
2021-04-01$526.79Not available in this settingRVU21B
2021-01-01$526.79Not available in this settingRVU21A
2020-10-01$504.33Not available in this settingRVU20D
2020-07-01$504.33Not available in this settingRVU20C
2020-04-01$504.33Not available in this settingRVU20B
2020-01-01$504.33Not available in this settingRVU20A
2019-10-01$502.16Not available in this settingRVU19D
2019-07-01$502.16Not available in this settingRVU19C
2019-04-01$502.16Not available in this settingRVU19B
2019-01-01$502.16Not available in this settingRVU19A
2018-10-01$502.71Not available in this settingRVU18D
2018-07-01$502.71Not available in this settingRVU18C
2018-04-01$502.71Not available in this settingRVU18B
2018-01-01$502.71Not available in this settingRVU18AR1
2017-10-01$497.95Not available in this settingRVU17D
2017-07-01$497.95Not available in this settingRVU17C
2017-04-01$497.95Not available in this settingRVU17B
2017-01-01$497.95Not available in this settingRVU17A
2016-10-01$498.98Not available in this settingRVU16D
2016-07-01$498.98Not available in this settingRVU16C
2016-04-01$498.98Not available in this settingRVU16B
2016-01-01$498.98Not available in this settingRVU16A
2015-10-01$506.65Not available in this settingRVU15D
2015-07-01$506.65Not available in this settingRVU15C
2015-04-01$504.13Not available in this settingRVU15B
2015-01-01$504.13Not available in this settingRVU15A
2014-10-01$503.02Not available in this settingRVU14D
2014-07-01$503.02Not available in this settingRVU14C
2014-04-01$503.02Not available in this settingRVU14B
2014-01-01$503.02Not available in this settingRVU14A
2013-10-01$546.04Not available in this settingRVU13D
2013-07-01$546.04Not available in this settingRVU13C
2013-04-01$546.04Not available in this settingRVU13B
2013-01-01$546.04Not available in this settingRVU13AR

Price 91035 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

91035 billing questions

How does 91035 differ from 91034?

91035 is for pH monitoring with a mucosa-attached wireless electrode. 91034 describes catheter-based esophageal pH monitoring.

Does 91035 include electrode placement and study interpretation?

Yes. The service includes placement of the mucosa-attached electrode, recording, analysis, and interpretation.

Can the professional and technical portions be billed separately?

Yes. Use modifier 26 for the professional interpretation and modifier TC for the technical service; billing without either modifier represents the global service.

Can modifier 50 be reported?

No. Modifier 50 is inappropriate for this service because its descriptor and anatomy do not support bilateral adjustment.

What documentation supports reporting 91035?

Document the reason for reflux testing, the wireless mucosa-attached method, the recorded study, and the interpretation of the results.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing 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 91035PPRRVU2026_Oct_nonQPP.csv, line 11,606 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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