FeeBase
Log inGet started
Menu

CPT code 91037: Esophageal impedance, one hour or less2026 Medicare rate & RVUs in Puerto Rico

Reports a short-duration esophageal impedance study used to assess bolus movement and reflux, including nonacid reflux, with interpretation and a report.

CMS RVU26DEffective Oct 1, 2026One payment locality10K Medicare services in 2024

In Puerto Rico, Medicare pays $189.03 for 91037 in the office.

$189.03Office (non-facility)
Not available in this settingHospital or facility
+0.9%vs the national office rate ($187.38)

Check a contract rate as a % of Medicare · 91037 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 91037 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 91037 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 91037 covers

This diagnostic study uses an esophageal catheter with impedance sensors to assess movement of liquid or gas through the esophagus and identify reflux events. It can help evaluate persistent reflux symptoms, including suspected nonacid reflux, or swallowing complaints when objective information about esophageal transit is needed. Gastroenterology or esophageal motility practices commonly perform the study, with trained staff placing the catheter and a qualified clinician interpreting the findings. This code is for the recording of one hour or less; the longer-duration service is reported separately under 91038.

Report the service when the documented study includes impedance measurements, analysis, interpretation, and a report. The claim may represent the global service or the professional interpretation with modifier 26 or technical portion with modifier TC. 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-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 91037

Across 109 of 109 payment localities, the office rate for 91037 runs from $164.63 in Arkansas to $257.55 in San Benito County, CA. Puerto Rico pays $189.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

91037 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$189.03
  2. Los Angeles, CA · California$215.95+$26.92
  3. Washington, DC area · District of Columbia$216.65+$27.62
  4. Miami, FL · Florida$197.24+$8.21
  5. Chicago, IL · Illinois$191.40+$2.37
  6. Manhattan, NY · New York$215.62+$26.59
  7. Alaska · Alaska$212.16+$23.13

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

Every other payment area

91037 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$167.20—
ArkansasArkansas$164.63—
ArizonaArizona$182.29—
Bakersfield, CACalifornia$201.79—
Chico, CACalifornia$201.55—
El Centro, CACalifornia$201.56—
Fresno, CACalifornia$201.55—
Hanford, CACalifornia$201.55—

91037 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.

$164.63

$229.55

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

View every state and territory as a table
91037 office rate range by state
State / territoryOffice rate rangeLocalities
AK$212.161
AL$167.201
AR$164.631
AZ$182.291
CA$201.55–$257.5529
CO$197.061
CT$200.311
DC$216.651
DE$185.461
FL$181.81–$197.243
GA$171.27–$190.402
GU$207.401
HI$207.401
IA$172.941
ID$173.881
IL$175.36–$193.554
IN$174.991
KS$171.501
KY$170.161
LA$169.65–$178.652
MA$195.54–$218.162
MD$189.34–$216.653
ME$174.23–$185.142
MI$174.34–$183.622
MN$190.181
MO$166.16–$180.023
MS$165.461
MT$187.371
NC$176.261
ND$185.991
NE$174.121
NH$193.371
NJ$202.98–$214.072
NM$175.121
NV$187.141
NY$179.02–$220.395
OH$174.061
OK$170.451
OR$186.07–$204.312
PA$174.68–$194.692
PR$189.031
RI$192.791
SC$175.381
SD$185.831
TN$172.351
TX$173.42–$196.078
UT$177.941
VA$184.09–$216.652
VI$189.031
VT$184.691
WA$195.36–$223.342
WI$179.321
WV$168.301
WY$186.771

See 91037 in every payment locality

How the 91037 rate is calculated

Each of 91037’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 · 91037

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.95

0.95 RVUs× 1.000 GPCI

Practice expense4.59

4.59 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

5.6100

Conversion factor

$33.4009

Medicare rate

$187.38

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

11,609

Code
91037
Physician work
0.95
Practice expense
4.59
Malpractice
0.07

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 91037 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.95× 1.0000.9500
Practice expense4.59× 1.0114.6405
Malpractice0.07× 0.9850.0690
Total RVUs5.6594
Conversion factor× 33.4009

Office rate, Puerto Rico$189.03

Office: (0.95 × 1 + 4.59 × 1.011 + 0.07 × 0.985) × $33.4009 = $189.03

Open 91037 in the RVU calculator

Payment rules and modifiers for 91037

The CMS indicators that decide how 91037 is paid alongside other services.

CMS payment indicators · 91037

Esophageal impedance, one hour or less

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

91037 without 26 · national office

$187.38

Esophageal impedance, one hour or less

91037-26 · Professional component

$51.44

Pays only the interpretation and report.

When to use modifier 26

Codes related to 91037

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

Codes related to 91037
CodeHow it relatesOffice range, Puerto Rico
Same family
91038Esophageal impedance, more than one hourImpedance study for a recording longer than one hour.$450.33
Used instead
91010Esophageal manometry, standard pressure studyEsophageal motility testing uses a different study method.$248.00
91034Reflux monitoring, nasal catheter pH testCatheter-based gastroesophageal reflux monitoring is a different diagnostic approach.$204.22
91035Reflux testing, mucosa-attached telemetry electrodeWireless reflux monitoring uses an esophageal electrode rather than impedance testing.$507.18

How 91037 has changed in Puerto Rico

91037 · Office / nonfacility

$189.03

Effective 2026-10-01

The base rate is $28.06 higher than on 2025-10-01, moving from $160.97 to $189.03 (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

    $160.97changed to$189.03

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.97 changed to 0.95
    • Practice expense RVU 3.92 changed to 4.59
    • Malpractice RVU 0.06 changed to 0.07
    • 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

    $169.34changed to$160.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.03 changed to 3.92

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $166.57changed to$169.34

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $172.19changed to$166.57

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.02 changed to 4.03
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $171.13changed to$172.19

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $178.99changed to$171.13

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.12 changed to 4.02
    • Malpractice RVU 0.05 changed to 0.06
    • 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

    $179.77changed to$178.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.10 changed to 4.12

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $171.02changed to$179.77

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.68 changed to 4.10
    • Malpractice RVU 0.06 changed to 0.05
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $168.83changed to$171.02

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.62 changed to 3.68
    • Malpractice RVU 0.07 changed to 0.06
    • 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

    $166.11changed to$168.83

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.56 changed to 3.62
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $143.41changed to$166.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.49 changed to 3.56
    • 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

    $123.45changed to$143.41

    • Conversion factor 35.8043 changed to 35.8887
    • 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

    $125.27changed to$123.45

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.54 changed to 3.49
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $124.65changed to$125.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $122.54changed to$124.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.51 changed to 3.54
    • Malpractice RVU 0.08 changed to 0.07
    • 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

    $126.41changed to$122.54

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.02 changed to 3.51
    • 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: $126.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$189.03Not available in this settingRVU26D
2026-07-01$189.03Not available in this settingRVU26C
2026-04-01$189.03Not available in this settingRVU26B
2026-01-01$189.03Not available in this settingRVU26A
2025-10-01$160.97Not available in this settingRVU25D
2025-07-01$160.97Not available in this settingRVU25C
2025-04-01$160.97Not available in this settingRVU25B
2025-01-01$160.97Not available in this settingRVU25A
2024-10-01$169.34Not available in this settingRVU24D
2024-07-01$169.34Not available in this settingRVU24C
2024-04-01$169.34Not available in this settingRVU24B
2024-03-09$169.34Not available in this settingRVU24AR
2024-01-01$166.57Not available in this settingRVU24A
2023-10-01$172.19Not available in this settingRVU23D
2023-07-01$171.13Not available in this settingRVU23C
2023-04-01$171.13Not available in this settingRVU23B
2023-01-01$171.13Not available in this settingRVU23A
2022-10-01$178.99Not available in this settingRVU22D
2022-07-01$178.99Not available in this settingRVU22C
2022-04-01$178.99Not available in this settingRVU22B
2022-01-01$178.99Not available in this settingRVU22A
2021-10-01$179.77Not available in this settingRVU21D
2021-07-01$179.77Not available in this settingRVU21C
2021-04-01$179.77Not available in this settingRVU21B
2021-01-01$179.77Not available in this settingRVU21A
2020-10-01$171.02Not available in this settingRVU20D
2020-07-01$171.02Not available in this settingRVU20C
2020-04-01$171.02Not available in this settingRVU20B
2020-01-01$171.02Not available in this settingRVU20A
2019-10-01$168.83Not available in this settingRVU19D
2019-07-01$168.83Not available in this settingRVU19C
2019-04-01$168.83Not available in this settingRVU19B
2019-01-01$168.83Not available in this settingRVU19A
2018-10-01$166.11Not available in this settingRVU18D
2018-07-01$166.11Not available in this settingRVU18C
2018-04-01$166.11Not available in this settingRVU18B
2018-01-01$166.11Not available in this settingRVU18AR1
2017-10-01$143.41Not available in this settingRVU17D
2017-07-01$143.41Not available in this settingRVU17C
2017-04-01$143.41Not available in this settingRVU17B
2017-01-01$143.41Not available in this settingRVU17A
2016-10-01$123.45Not available in this settingRVU16D
2016-07-01$123.45Not available in this settingRVU16C
2016-04-01$123.45Not available in this settingRVU16B
2016-01-01$123.45Not available in this settingRVU16A
2015-10-01$125.27Not available in this settingRVU15D
2015-07-01$125.27Not available in this settingRVU15C
2015-04-01$124.65Not available in this settingRVU15B
2015-01-01$124.65Not available in this settingRVU15A
2014-10-01$122.54Not available in this settingRVU14D
2014-07-01$122.54Not available in this settingRVU14C
2014-04-01$122.54Not available in this settingRVU14B
2014-01-01$122.54Not available in this settingRVU14A
2013-10-01$126.41Not available in this settingRVU13D
2013-07-01$126.41Not available in this settingRVU13C
2013-04-01$126.41Not available in this settingRVU13B
2013-01-01$126.41Not available in this settingRVU13AR

Price 91037 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

91037 billing questions

How is 91037 distinguished from 91038?

Use 91037 for an impedance recording of one hour or less. Use 91038 when the recording exceeds one hour.

Can the interpretation and equipment portions be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.

Is this the same test as esophageal manometry?

No. Impedance evaluates movement of liquid or gas and reflux events, while 91010 reports an esophageal motility study. Select the code that matches the study actually performed and documented.

Can modifier 50 be used?

No. Bilateral adjustment is inappropriate for this service.

What documentation supports reporting 91037?

Document the impedance study, its recording duration, measurements, analysis, interpretation, and report. The record should support a duration of one hour or less.

Are surgical team modifiers payable with this code?

Co-surgeon and team-surgery billing are not permitted. Assistant-at-surgery payment requires documentation of medical necessity.

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 91037PPRRVU2026_Oct_nonQPP.csv, line 11,609 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 91037 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 91037 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist