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

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

CMS RVU26DEffective Oct 1, 20262 payment localities11.9K Medicare services in 2024

Medicare pays $450.90–$476.74 for 91035 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. Which amount applies depends on the service address.

$450.90–$476.74Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Louisiana
  2. What 91035 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

Where 91035 pays more and less in Louisiana

91035 office and facility rates by payment locality
Payment localityOfficeFacility
New Orleans, LA$476.74Unavailable
Rest of Louisiana$450.90Unavailable

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.

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

91035 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 91035

    Reflux testing, mucosa-attached telemetry electrode1.55 wRVU

    $502.35

  • 91034

    Reflux monitoring, nasal catheter pH test0.95 wRVU

    $202.41−$299.94

  • 91037

    Esophageal impedance, one hour or less0.95 wRVU

    $187.38−$314.97

  • 91038

    Esophageal impedance, more than one hour1.1 wRVU

    $445.90−$56.45

How to choose

91034Reflux monitoringNasal catheter pH test
Choose 91035 for wireless pH monitoring using an electrode attached to the esophageal lining. Choose 91034 for catheter-based pH monitoring.
91037Esophageal impedanceOne hour or less
91037 reports esophageal impedance testing, rather than the mucosa-attached wireless pH study reported with 91035.
91038Esophageal impedanceMore than one hour
91038 reports esophageal impedance testing for more than one hour. 91035 is the wireless mucosa-attached pH monitoring service.

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)

Open CMS sourceHow we calculate rates

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