CPT code 91038: Esophageal impedance, more than one hour2026 Medicare rate & RVUs in Minnesota
Reports prolonged catheter-based esophageal impedance monitoring to evaluate reflux episodes and their relationship to symptoms during a recording lasting more than one hour.
In Minnesota, Medicare pays $455.81 for 91038 in the office.
Check a contract rate as a % of Medicare · 91038 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 91038 covers
A thin catheter with impedance sensors is passed through the nose into the esophagus to record movement of swallowed material and reflux over a prolonged period. The test can help evaluate persistent heartburn, regurgitation, or other suspected reflux symptoms, including symptoms that continue during acid-suppressing treatment. It is typically performed in a gastroenterology or motility laboratory, with a physician interpreting the recording and reporting the findings.
Select this service for impedance monitoring lasting more than one hour, rather than the shorter-duration service. Documentation should support catheter placement, the recording period, analysis, and interpretation. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. The 0-day global period includes same-day preoperative and postoperative care. 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 Minnesota compares for 91038
Across 109 of 109 payment localities, the office rate for 91038 runs from $387.29 in Arkansas to $628.37 in San Benito County, CA. Minnesota pays $455.81. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Minnesota · this page$455.81
- Los Angeles, CA · California$520.90+$65.09
- Washington, DC area · District of Columbia$520.54+$64.73
- Miami, FL · Florida$466.65+$10.84
- Chicago, IL · Illinois$451.65−$4.16
- Manhattan, NY · New York$515.67+$59.86
- Alaska · Alaska$489.49+$33.68
Other areas in Minnesota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $393.93 | — |
| ArkansasArkansas | $387.29 | — |
| ArizonaArizona | $432.92 | — |
| Bakersfield, CACalifornia | $484.58 | — |
| Chico, CACalifornia | $484.31 | — |
| El Centro, CACalifornia | $484.32 | — |
| Fresno, CACalifornia | $484.31 | — |
| Hanford, CACalifornia | $484.31 | — |
| Madera, CACalifornia | $484.31 | — |
| Merced, CACalifornia | $484.31 | — |
| Modesto, CACalifornia | $484.31 | — |
| Napa, CACalifornia | $576.17 | — |
| Oxnard, CACalifornia | $519.90 | — |
| Redding, CACalifornia | $484.31 | — |
| Rest of CaliforniaCalifornia | $484.31 | — |
| Riverside, CACalifornia | $485.19 | — |
| Sacramento, CACalifornia | $512.24 | — |
| Salinas, CACalifornia | $510.43 | — |
| San Diego, CACalifornia | $525.45 | — |
| Marin County, CACalifornia | $614.61 | — |
| San Francisco, CACalifornia | $614.52 | — |
| San Benito County, CACalifornia | $628.37 | — |
| Santa Clara County, CACalifornia | $628.00 | — |
| San Luis Obispo, CACalifornia | $501.79 | — |
| Santa Cruz, CACalifornia | $532.83 | — |
| Santa Maria, CACalifornia | $513.17 | — |
| Santa Rosa, CACalifornia | $538.44 | — |
| Stockton, CACalifornia | $484.31 | — |
| Vallejo, CACalifornia | $576.03 | — |
| Visalia, CACalifornia | $484.31 | — |
| Yuba City, CACalifornia | $484.31 | — |
| ColoradoColorado | $471.77 | — |
| ConnecticutConnecticut | $478.50 | — |
| DelawareDelaware | $440.94 | — |
| Fort Lauderdale, FLFlorida | $453.35 | — |
| Rest of FloridaFlorida | $429.36 | — |
| Atlanta, GAGeorgia | $453.05 | — |
| Rest of GeorgiaGeorgia | $402.51 | — |
| Hawaii, Guam, HIHawaii | $500.47 | — |
| IowaIowa | $409.74 | — |
| IdahoIdaho | $411.97 | — |
| East St. Louis, ILIllinois | $416.09 | — |
| Rest of IllinoisIllinois | $412.04 | — |
| Suburban Chicago, ILIllinois | $459.20 | — |
| IndianaIndiana | $414.85 | — |
| KansasKansas | $405.55 | — |
| KentuckyKentucky | $400.55 | — |
| New Orleans, LALouisiana | $422.28 | — |
| Rest of LouisianaLouisiana | $399.04 | — |
| Metropolitan Boston, MAMassachusetts | $525.97 | — |
| Rest of MassachusettsMassachusetts | $467.49 | — |
| Baltimore area, MDMaryland | $476.80 | — |
| Rest of MarylandMaryland | $450.93 | — |
| Rest of MaineMaine | $412.37 | — |
| Southern Maine, MEMaine | $441.26 | — |
| Detroit, MIMichigan | $433.51 | — |
| Rest of MichiganMichigan | $410.88 | — |
| Metropolitan Kansas City, MOMissouri | $421.04 | — |
| Metropolitan St. Louis, MOMissouri | $426.40 | — |
| Rest of MissouriMissouri | $389.74 | — |
| MississippiMississippi | $388.70 | — |
| MontanaMontana | $445.90 | — |
| North CarolinaNorth Carolina | $417.70 | — |
| North DakotaNorth Dakota | $444.31 | — |
| NebraskaNebraska | $412.94 | — |
| New HampshireNew Hampshire | $462.23 | — |
| Northern New JerseyNew Jersey | $513.44 | — |
| Rest of New JerseyNew Jersey | $485.03 | — |
| New MexicoNew Mexico | $412.70 | — |
| NevadaNevada | $445.86 | — |
| NYC suburbs and Long Island, NYNew York | $527.37 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $486.73 | — |
| Queens, NYNew York | $523.42 | — |
| Rest of New YorkNew York | $424.78 | — |
| OhioOhio | $410.56 | — |
| OklahomaOklahoma | $401.81 | — |
| Portland, OROregon | $490.93 | — |
| Rest of OregonOregon | $443.48 | — |
| Metropolitan Philadelphia, PAPennsylvania | $463.75 | — |
| Rest of PennsylvaniaPennsylvania | $412.42 | — |
| Puerto RicoPuerto Rico | $450.33 | — |
| Rhode IslandRhode Island | $459.73 | — |
| South CarolinaSouth Carolina | $414.61 | — |
| South DakotaSouth Dakota | $444.13 | — |
| TennesseeTennessee | $407.67 | — |
| Austin, TXTexas | $469.25 | — |
| Beaumont, TXTexas | $409.13 | — |
| Brazoria, TXTexas | $441.95 | — |
| Dallas, TXTexas | $444.23 | — |
| Fort Worth, TXTexas | $440.20 | — |
| Galveston, TXTexas | $442.89 | — |
| Houston, TXTexas | $444.36 | — |
| Rest of TexasTexas | $424.91 | — |
| UtahUtah | $421.24 | — |
| VirginiaVirginia | $438.21 | — |
| Virgin Islands, VIUnited States Virgin Islands | $450.33 | — |
| VermontVermont | $440.52 | — |
| Rest of WashingtonWashington | $467.28 | — |
| King County, WAWashington | $539.52 | — |
| WisconsinWisconsin | $426.98 | — |
| West VirginiaWest Virginia | $393.80 | — |
| WyomingWyoming | $445.21 | — |
91038 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.
$387.29
$556.34
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 | $489.49 | 1 |
| AL | $393.93 | 1 |
| AR | $387.29 | 1 |
| AZ | $432.92 | 1 |
| CA | $484.31–$628.37 | 29 |
| CO | $471.77 | 1 |
| CT | $478.50 | 1 |
| DC | $520.54 | 1 |
| DE | $440.94 | 1 |
| FL | $429.36–$466.65 | 3 |
| GA | $402.51–$453.05 | 2 |
| GU | $500.47 | 1 |
| HI | $500.47 | 1 |
| IA | $409.74 | 1 |
| ID | $411.97 | 1 |
| IL | $412.04–$459.20 | 4 |
| IN | $414.85 | 1 |
| KS | $405.55 | 1 |
| KY | $400.55 | 1 |
| LA | $399.04–$422.28 | 2 |
| MA | $467.49–$525.97 | 2 |
| MD | $450.93–$520.54 | 3 |
| ME | $412.37–$441.26 | 2 |
| MI | $410.88–$433.51 | 2 |
| MN | $455.81 | 1 |
| MO | $389.74–$426.40 | 3 |
| MS | $388.70 | 1 |
| MT | $445.90 | 1 |
| NC | $417.70 | 1 |
| ND | $444.31 | 1 |
| NE | $412.94 | 1 |
| NH | $462.23 | 1 |
| NJ | $485.03–$513.44 | 2 |
| NM | $412.70 | 1 |
| NV | $445.86 | 1 |
| NY | $424.78–$527.37 | 5 |
| OH | $410.56 | 1 |
| OK | $401.81 | 1 |
| OR | $443.48–$490.93 | 2 |
| PA | $412.42–$463.75 | 2 |
| PR | $450.33 | 1 |
| RI | $459.73 | 1 |
| SC | $414.61 | 1 |
| SD | $444.13 | 1 |
| TN | $407.67 | 1 |
| TX | $409.13–$469.25 | 8 |
| UT | $421.24 | 1 |
| VA | $438.21–$520.54 | 2 |
| VI | $450.33 | 1 |
| VT | $440.52 | 1 |
| WA | $467.28–$539.52 | 2 |
| WI | $426.98 | 1 |
| WV | $393.80 | 1 |
| WY | $445.21 | 1 |
How the 91038 rate is calculated
Each of 91038’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 · 91038
RVUs × geographic indexes × conversion factor
Work1.10
1.10 RVUs× 1.000 GPCI
Practice expense12.17
12.17 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
13.3500
Conversion factor
$33.4009
Medicare rate
$445.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Minnesota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,612
- Code
- 91038
- Physician work
- 1.10
- Practice expense
- 12.17
- Malpractice
- 0.08
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.10 | × 1.000 | 1.1000 |
| Practice expense | 12.17 | × 1.029 | 12.5229 |
| Malpractice | 0.08 | × 0.296 | 0.0237 |
| Total RVUs | 13.6466 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Minnesota$455.81
Office: (1.1 × 1 + 12.17 × 1.029 + 0.08 × 0.296) × $33.4009 = $455.81
Payment rules and modifiers for 91038
The CMS indicators that decide how 91038 is paid alongside other services.
CMS payment indicators · 91038
Esophageal impedance, more than one hour
| 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
91038 without 26 · national office
$445.90
Esophageal impedance, more than one hour
91038-26 · Professional component
$59.79
Pays only the interpretation and report.
How 91038 has changed in Minnesota
91038 · Office / nonfacility
$455.81
Effective 2026-10-01
The base rate is $73.84 higher than on 2025-10-01, moving from $381.97 to $455.81 (19.3%).
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
$381.97changed to$455.81
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 10.43 changed to 12.17
- Malpractice RVU 0.06 changed to 0.08
- Practice expense GPCI 1.025 changed to 1.029
- Malpractice GPCI 0.300 changed to 0.296
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$409.56changed to$381.97
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 10.91 changed to 10.43
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$402.88changed to$409.56
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$421.23changed to$402.88
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 11.10 changed to 10.91
- Malpractice RVU 0.06 changed to 0.07
- Practice expense GPCI 1.019 changed to 1.025
- Malpractice GPCI 0.326 changed to 0.300
January 1, 2023
RVU23A
$443.70changed to$421.23
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 11.55 changed to 11.10
- Practice expense GPCI 1.013 changed to 1.019
- Malpractice GPCI 0.353 changed to 0.326
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$465.99changed to$443.70
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.08 changed to 11.55
- Malpractice RVU 0.05 changed to 0.06
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$452.81changed to$465.99
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 11.29 changed to 12.08
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 1.012 changed to 1.013
- Malpractice GPCI 0.357 changed to 0.353
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$455.79changed to$452.81
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 11.40 changed to 11.29
- Practice expense GPCI 1.011 changed to 1.012
- Malpractice GPCI 0.362 changed to 0.357
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$462.34changed to$455.79
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.59 changed to 11.40
- Malpractice RVU 0.07 changed to 0.06
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$458.93changed to$462.34
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.48 changed to 11.59
- Practice expense GPCI 1.016 changed to 1.011
- Malpractice GPCI 0.341 changed to 0.362
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$459.80changed to$458.93
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 11.49 changed to 11.48
- Practice expense GPCI 1.020 changed to 1.016
- Malpractice GPCI 0.319 changed to 0.341
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$469.14changed to$459.80
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 11.69 changed to 11.49
- Malpractice RVU 0.10 changed to 0.07
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$466.80changed to$469.14
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$461.15changed to$466.80
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 11.57 changed to 11.69
- Malpractice RVU 0.06 changed to 0.10
- Practice expense GPCI 1.016 changed to 1.020
- Malpractice GPCI 0.301 changed to 0.319
Held through RVU15B.
January 1, 2014
RVU14A
$497.31changed to$461.15
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 13.34 changed to 11.57
- Practice expense GPCI 1.012 changed to 1.016
- Malpractice GPCI 0.282 changed to 0.301
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$497.31
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $455.81 | Not available in this setting | RVU26D |
| 2026-07-01 | $455.81 | Not available in this setting | RVU26C |
| 2026-04-01 | $455.81 | Not available in this setting | RVU26B |
| 2026-01-01 | $455.81 | Not available in this setting | RVU26A |
| 2025-10-01 | $381.97 | Not available in this setting | RVU25D |
| 2025-07-01 | $381.97 | Not available in this setting | RVU25C |
| 2025-04-01 | $381.97 | Not available in this setting | RVU25B |
| 2025-01-01 | $381.97 | Not available in this setting | RVU25A |
| 2024-10-01 | $409.56 | Not available in this setting | RVU24D |
| 2024-07-01 | $409.56 | Not available in this setting | RVU24C |
| 2024-04-01 | $409.56 | Not available in this setting | RVU24B |
| 2024-03-09 | $409.56 | Not available in this setting | RVU24AR |
| 2024-01-01 | $402.88 | Not available in this setting | RVU24A |
| 2023-10-01 | $421.23 | Not available in this setting | RVU23D |
| 2023-07-01 | $421.23 | Not available in this setting | RVU23C |
| 2023-04-01 | $421.23 | Not available in this setting | RVU23B |
| 2023-01-01 | $421.23 | Not available in this setting | RVU23A |
| 2022-10-01 | $443.70 | Not available in this setting | RVU22D |
| 2022-07-01 | $443.70 | Not available in this setting | RVU22C |
| 2022-04-01 | $443.70 | Not available in this setting | RVU22B |
| 2022-01-01 | $443.70 | Not available in this setting | RVU22A |
| 2021-10-01 | $465.99 | Not available in this setting | RVU21D |
| 2021-07-01 | $465.99 | Not available in this setting | RVU21C |
| 2021-04-01 | $465.99 | Not available in this setting | RVU21B |
| 2021-01-01 | $465.99 | Not available in this setting | RVU21A |
| 2020-10-01 | $452.81 | Not available in this setting | RVU20D |
| 2020-07-01 | $452.81 | Not available in this setting | RVU20C |
| 2020-04-01 | $452.81 | Not available in this setting | RVU20B |
| 2020-01-01 | $452.81 | Not available in this setting | RVU20A |
| 2019-10-01 | $455.79 | Not available in this setting | RVU19D |
| 2019-07-01 | $455.79 | Not available in this setting | RVU19C |
| 2019-04-01 | $455.79 | Not available in this setting | RVU19B |
| 2019-01-01 | $455.79 | Not available in this setting | RVU19A |
| 2018-10-01 | $462.34 | Not available in this setting | RVU18D |
| 2018-07-01 | $462.34 | Not available in this setting | RVU18C |
| 2018-04-01 | $462.34 | Not available in this setting | RVU18B |
| 2018-01-01 | $462.34 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $458.93 | Not available in this setting | RVU17D |
| 2017-07-01 | $458.93 | Not available in this setting | RVU17C |
| 2017-04-01 | $458.93 | Not available in this setting | RVU17B |
| 2017-01-01 | $458.93 | Not available in this setting | RVU17A |
| 2016-10-01 | $459.80 | Not available in this setting | RVU16D |
| 2016-07-01 | $459.80 | Not available in this setting | RVU16C |
| 2016-04-01 | $459.80 | Not available in this setting | RVU16B |
| 2016-01-01 | $459.80 | Not available in this setting | RVU16A |
| 2015-10-01 | $469.14 | Not available in this setting | RVU15D |
| 2015-07-01 | $469.14 | Not available in this setting | RVU15C |
| 2015-04-01 | $466.80 | Not available in this setting | RVU15B |
| 2015-01-01 | $466.80 | Not available in this setting | RVU15A |
| 2014-10-01 | $461.15 | Not available in this setting | RVU14D |
| 2014-07-01 | $461.15 | Not available in this setting | RVU14C |
| 2014-04-01 | $461.15 | Not available in this setting | RVU14B |
| 2014-01-01 | $461.15 | Not available in this setting | RVU14A |
| 2013-10-01 | $497.31 | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Minnesota rate applies
Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.
- Ada
- Adams
- Adrian
- Afton
- Aitkin
- Akeley
- Albany
- Albert Lea
91038 billing questions
When should this code be selected instead of 91037?
Use this code when the impedance recording lasts more than one hour. Code 91037 is for the shorter-duration impedance test.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports the service?
Document catheter placement, the duration of the impedance recording, and the analysis and interpretation. The record should also support the clinical reason for evaluating reflux or related symptoms.
Is modifier 50 appropriate for this test?
No. CMS identifies bilateral adjustment as inappropriate for this service.
How does this differ from catheter-based pH monitoring?
Impedance monitoring evaluates movement of material through the esophagus, including reflux episodes. Code 91034 describes catheter-based pH monitoring, which measures esophageal acidity.
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
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