CPT code 91035: Reflux testing, mucosa-attached telemetry electrode2026 Medicare rate & RVUs in North Dakota
Reports ambulatory esophageal acid monitoring with a mucosa-attached wireless electrode to evaluate suspected gastroesophageal reflux and measure acid exposure.
In North Dakota, Medicare pays $499.37 for 91035 in the office.
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.
On this page 11 sections
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 North Dakota 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. North Dakota pays $499.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$499.37
- Los Angeles, CA · California$584.33+$84.96
- Washington, DC area · District of Columbia$585.02+$85.65
- Miami, FL · Florida$528.28+$28.91
- Chicago, IL · Illinois$511.43+$12.06
- Manhattan, NY · New York$580.78+$81.41
- Alaska · Alaska$554.95+$55.58
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $543.68 | — |
| Merced, CACalifornia | $543.68 | — |
| Modesto, CACalifornia | $543.68 | — |
| Napa, CACalifornia | $644.84 | — |
| Oxnard, CACalifornia | $583.00 | — |
| Redding, CACalifornia | $543.68 | — |
| Rest of CaliforniaCalifornia | $543.68 | — |
| Riverside, CACalifornia | $545.32 | — |
| Sacramento, CACalifornia | $574.52 | — |
| Salinas, CACalifornia | $572.48 | — |
| San Diego, CACalifornia | $588.94 | — |
| Marin County, CACalifornia | $687.24 | — |
| San Francisco, CACalifornia | $687.07 | — |
| San Benito County, CACalifornia | $702.66 | — |
| Santa Clara County, CACalifornia | $701.96 | — |
| San Luis Obispo, CACalifornia | $562.84 | — |
| Santa Cruz, CACalifornia | $596.91 | — |
| Santa Maria, CACalifornia | $575.44 | — |
| Santa Rosa, CACalifornia | $603.17 | — |
| Stockton, CACalifornia | $543.68 | — |
| Vallejo, CACalifornia | $644.59 | — |
| Visalia, CACalifornia | $543.68 | — |
| Yuba City, CACalifornia | $543.68 | — |
| ColoradoColorado | $530.39 | — |
| ConnecticutConnecticut | $538.75 | — |
| DelawareDelaware | $496.76 | — |
| Fort Lauderdale, FLFlorida | $512.19 | — |
| Rest of FloridaFlorida | $485.26 | — |
| Atlanta, GAGeorgia | $510.64 | — |
| Rest of GeorgiaGeorgia | $455.19 | — |
| Hawaii, Guam, HIHawaii | $561.28 | — |
| IowaIowa | $461.46 | — |
| IdahoIdaho | $464.06 | — |
| East St. Louis, ILIllinois | $471.78 | — |
| Rest of IllinoisIllinois | $466.41 | — |
| Suburban Chicago, ILIllinois | $518.61 | — |
| IndianaIndiana | $467.25 | — |
| KansasKansas | $457.09 | — |
| KentuckyKentucky | $452.47 | — |
| New Orleans, LALouisiana | $476.74 | — |
| Rest of LouisianaLouisiana | $450.90 | — |
| Metropolitan Boston, MAMassachusetts | $590.36 | — |
| Rest of MassachusettsMassachusetts | $525.78 | — |
| Baltimore area, MDMaryland | $536.89 | — |
| Rest of MarylandMaryland | $507.80 | — |
| Rest of MaineMaine | $464.81 | — |
| Southern Maine, MEMaine | $496.49 | — |
| Detroit, MIMichigan | $490.19 | — |
| Rest of MichiganMichigan | $464.23 | — |
| MinnesotaMinnesota | $511.74 | — |
| Metropolitan Kansas City, MOMissouri | $475.05 | — |
| Metropolitan St. Louis, MOMissouri | $480.97 | — |
| Rest of MissouriMissouri | $440.73 | — |
| MississippiMississippi | $439.11 | — |
| MontanaMontana | $502.34 | — |
| North CarolinaNorth Carolina | $470.69 | — |
| NebraskaNebraska | $464.92 | — |
| New HampshireNew Hampshire | $519.99 | — |
| Northern New JerseyNew Jersey | $577.24 | — |
| Rest of New JerseyNew Jersey | $545.90 | — |
| New MexicoNew Mexico | $466.37 | — |
| NevadaNevada | $501.96 | — |
| NYC suburbs and Long Island, NYNew York | $594.17 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $548.06 | — |
| Queens, NYNew York | $588.97 | — |
| Rest of New YorkNew York | $478.58 | — |
| OhioOhio | $463.63 | — |
| OklahomaOklahoma | $453.56 | — |
| Portland, OROregon | $551.35 | — |
| Rest of OregonOregon | $499.08 | — |
| Metropolitan Philadelphia, PAPennsylvania | $522.52 | — |
| Rest of PennsylvaniaPennsylvania | $465.54 | — |
| Puerto RicoPuerto Rico | $507.18 | — |
| Rhode IslandRhode Island | $517.50 | — |
| South CarolinaSouth Carolina | $467.73 | — |
| South DakotaSouth Dakota | $499.02 | — |
| TennesseeTennessee | $459.48 | — |
| Austin, TXTexas | $527.72 | — |
| Beaumont, TXTexas | $461.89 | — |
| Brazoria, TXTexas | $497.65 | — |
| Dallas, TXTexas | $500.32 | — |
| Fort Worth, TXTexas | $495.93 | — |
| Galveston, TXTexas | $498.78 | — |
| Houston, TXTexas | $501.53 | — |
| Rest of TexasTexas | $479.14 | — |
| UtahUtah | $475.10 | — |
| VirginiaVirginia | $493.30 | — |
| Virgin Islands, VIUnited States Virgin Islands | $507.18 | — |
| VermontVermont | $495.42 | — |
| Rest of WashingtonWashington | $525.44 | — |
| King County, WAWashington | $605.17 | — |
| WisconsinWisconsin | $480.17 | — |
| West VirginiaWest Virginia | $446.14 | — |
| WyomingWyoming | $501.05 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $554.95 | 1 |
| AL | $444.48 | 1 |
| AR | $437.09 | 1 |
| AZ | $487.82 | 1 |
| CA | $543.68–$702.66 | 29 |
| CO | $530.39 | 1 |
| CT | $538.75 | 1 |
| DC | $585.02 | 1 |
| DE | $496.76 | 1 |
| FL | $485.26–$528.28 | 3 |
| GA | $455.19–$510.64 | 2 |
| GU | $561.28 | 1 |
| HI | $561.28 | 1 |
| IA | $461.46 | 1 |
| ID | $464.06 | 1 |
| IL | $466.41–$518.61 | 4 |
| IN | $467.25 | 1 |
| KS | $457.09 | 1 |
| KY | $452.47 | 1 |
| LA | $450.90–$476.74 | 2 |
| MA | $525.78–$590.36 | 2 |
| MD | $507.80–$585.02 | 3 |
| ME | $464.81–$496.49 | 2 |
| MI | $464.23–$490.19 | 2 |
| MN | $511.74 | 1 |
| MO | $440.73–$480.97 | 3 |
| MS | $439.11 | 1 |
| MT | $502.34 | 1 |
| NC | $470.69 | 1 |
| ND | $499.37 | 1 |
| NE | $464.92 | 1 |
| NH | $519.99 | 1 |
| NJ | $545.90–$577.24 | 2 |
| NM | $466.37 | 1 |
| NV | $501.96 | 1 |
| NY | $478.58–$594.17 | 5 |
| OH | $463.63 | 1 |
| OK | $453.56 | 1 |
| OR | $499.08–$551.35 | 2 |
| PA | $465.54–$522.52 | 2 |
| PR | $507.18 | 1 |
| RI | $517.50 | 1 |
| SC | $467.73 | 1 |
| SD | $499.02 | 1 |
| TN | $459.48 | 1 |
| TX | $461.89–$527.72 | 8 |
| UT | $475.10 | 1 |
| VA | $493.30–$585.02 | 2 |
| VI | $507.18 | 1 |
| VT | $495.42 | 1 |
| WA | $525.44–$605.17 | 2 |
| WI | $480.17 | 1 |
| WV | $446.14 | 1 |
| WY | $501.05 | 1 |
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
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 North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.55 | × 1.000 | 1.5500 |
| Practice expense | 13.34 | × 1.000 | 13.3400 |
| Malpractice | 0.15 | × 0.406 | 0.0609 |
| Total RVUs | 14.9509 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$499.37
Office: (1.55 × 1 + 13.34 × 1 + 0.15 × 0.406) × $33.4009 = $499.37
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
| 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
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.
How 91035 has changed in North Dakota
91035 · Office / nonfacility
$499.37
Effective 2026-10-01
The base rate is $77.65 higher than on 2025-10-01, moving from $421.72 to $499.37 (18.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$421.72changed to$499.37
- 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
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$451.79changed to$421.72
- 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.
March 9, 2024
RVU24AR
$444.42changed to$451.79
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$467.36changed to$444.42
- 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
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$494.58changed to$467.36
- 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
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$514.38changed to$494.58
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 13.10 changed to 12.65
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$492.56changed to$514.38
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 12.00 changed to 13.10
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$490.86changed to$492.56
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$491.40changed to$490.86
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.99 changed to 11.96
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$484.18changed to$491.40
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.83 changed to 11.99
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$482.71changed to$484.18
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 11.82 changed to 11.83
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$490.69changed to$482.71
- 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.
July 1, 2015
RVU15C
$488.24changed to$490.69
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$485.14changed to$488.24
- 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
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$524.34changed to$485.14
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 13.78 changed to 11.91
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $524.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $499.37 | Not available in this setting | RVU26D |
| 2026-07-01 | $499.37 | Not available in this setting | RVU26C |
| 2026-04-01 | $499.37 | Not available in this setting | RVU26B |
| 2026-01-01 | $499.37 | Not available in this setting | RVU26A |
| 2025-10-01 | $421.72 | Not available in this setting | RVU25D |
| 2025-07-01 | $421.72 | Not available in this setting | RVU25C |
| 2025-04-01 | $421.72 | Not available in this setting | RVU25B |
| 2025-01-01 | $421.72 | Not available in this setting | RVU25A |
| 2024-10-01 | $451.79 | Not available in this setting | RVU24D |
| 2024-07-01 | $451.79 | Not available in this setting | RVU24C |
| 2024-04-01 | $451.79 | Not available in this setting | RVU24B |
| 2024-03-09 | $451.79 | Not available in this setting | RVU24AR |
| 2024-01-01 | $444.42 | Not available in this setting | RVU24A |
| 2023-10-01 | $467.36 | Not available in this setting | RVU23D |
| 2023-07-01 | $467.36 | Not available in this setting | RVU23C |
| 2023-04-01 | $467.36 | Not available in this setting | RVU23B |
| 2023-01-01 | $467.36 | Not available in this setting | RVU23A |
| 2022-10-01 | $494.58 | Not available in this setting | RVU22D |
| 2022-07-01 | $494.58 | Not available in this setting | RVU22C |
| 2022-04-01 | $494.58 | Not available in this setting | RVU22B |
| 2022-01-01 | $494.58 | Not available in this setting | RVU22A |
| 2021-10-01 | $514.38 | Not available in this setting | RVU21D |
| 2021-07-01 | $514.38 | Not available in this setting | RVU21C |
| 2021-04-01 | $514.38 | Not available in this setting | RVU21B |
| 2021-01-01 | $514.38 | Not available in this setting | RVU21A |
| 2020-10-01 | $492.56 | Not available in this setting | RVU20D |
| 2020-07-01 | $492.56 | Not available in this setting | RVU20C |
| 2020-04-01 | $492.56 | Not available in this setting | RVU20B |
| 2020-01-01 | $492.56 | Not available in this setting | RVU20A |
| 2019-10-01 | $490.86 | Not available in this setting | RVU19D |
| 2019-07-01 | $490.86 | Not available in this setting | RVU19C |
| 2019-04-01 | $490.86 | Not available in this setting | RVU19B |
| 2019-01-01 | $490.86 | Not available in this setting | RVU19A |
| 2018-10-01 | $491.40 | Not available in this setting | RVU18D |
| 2018-07-01 | $491.40 | Not available in this setting | RVU18C |
| 2018-04-01 | $491.40 | Not available in this setting | RVU18B |
| 2018-01-01 | $491.40 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $484.18 | Not available in this setting | RVU17D |
| 2017-07-01 | $484.18 | Not available in this setting | RVU17C |
| 2017-04-01 | $484.18 | Not available in this setting | RVU17B |
| 2017-01-01 | $484.18 | Not available in this setting | RVU17A |
| 2016-10-01 | $482.71 | Not available in this setting | RVU16D |
| 2016-07-01 | $482.71 | Not available in this setting | RVU16C |
| 2016-04-01 | $482.71 | Not available in this setting | RVU16B |
| 2016-01-01 | $482.71 | Not available in this setting | RVU16A |
| 2015-10-01 | $490.69 | Not available in this setting | RVU15D |
| 2015-07-01 | $490.69 | Not available in this setting | RVU15C |
| 2015-04-01 | $488.24 | Not available in this setting | RVU15B |
| 2015-01-01 | $488.24 | Not available in this setting | RVU15A |
| 2014-10-01 | $485.14 | Not available in this setting | RVU14D |
| 2014-07-01 | $485.14 | Not available in this setting | RVU14C |
| 2014-04-01 | $485.14 | Not available in this setting | RVU14B |
| 2014-01-01 | $485.14 | Not available in this setting | RVU14A |
| 2013-10-01 | $524.34 | Not available in this setting | RVU13D |
| 2013-07-01 | $524.34 | Not available in this setting | RVU13C |
| 2013-04-01 | $524.34 | Not available in this setting | RVU13B |
| 2013-01-01 | $524.34 | Not available in this setting | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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
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