CPT code 91038: Esophageal impedance, more than one hour2026 Medicare rate & RVUs in New Hampshire
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 New Hampshire, Medicare pays $462.23 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 New Hampshire 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. New Hampshire pays $462.23. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Hampshire · this page$462.23
- Los Angeles, CA · California$520.90+$58.67
- Washington, DC area · District of Columbia$520.54+$58.31
- Miami, FL · Florida$466.65+$4.42
- Chicago, IL · Illinois$451.65−$10.58
- Manhattan, NY · New York$515.67+$53.44
- Alaska · Alaska$489.49+$27.26
Other areas in New Hampshire 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 | — |
| MinnesotaMinnesota | $455.81 | — |
| 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 | — |
| 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 New Hampshire 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
74
- Locality
- New Hampshire
- Physician work
- 1.000
- Practice expense
- 1.041
- Malpractice
- 0.875
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.10 | × 1.000 | 1.1000 |
| Practice expense | 12.17 | × 1.041 | 12.6690 |
| Malpractice | 0.08 | × 0.875 | 0.0700 |
| Total RVUs | 13.8390 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Hampshire$462.23
Office: (1.1 × 1 + 12.17 × 1.041 + 0.08 × 0.875) × $33.4009 = $462.23
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 New Hampshire
91038 · Office / nonfacility
$462.23
Effective 2026-10-01
The base rate is $76.06 higher than on 2025-10-01, moving from $386.17 to $462.23 (19.7%).
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
$386.17changed to$462.23
- 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 1.034 changed to 1.041
- Malpractice GPCI 0.898 changed to 0.875
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$414.22changed to$386.17
- 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
$407.46changed to$414.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$428.81changed to$407.46
- 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 1.036 changed to 1.034
- Malpractice GPCI 0.907 changed to 0.898
January 1, 2023
RVU23A
$454.86changed to$428.81
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 11.55 changed to 11.10
- Practice expense GPCI 1.038 changed to 1.036
- Malpractice GPCI 0.917 changed to 0.907
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$477.51changed to$454.86
- 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
$466.39changed to$477.51
- 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 1.042 changed to 1.038
- Malpractice GPCI 0.984 changed to 0.917
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$471.25changed to$466.39
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 11.40 changed to 11.29
- Practice expense GPCI 1.045 changed to 1.042
- Malpractice GPCI 1.050 changed to 0.984
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$478.26changed to$471.25
- 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
$475.32changed to$478.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.48 changed to 11.59
- Practice expense GPCI 1.052 changed to 1.045
- Malpractice GPCI 0.962 changed to 1.050
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$476.82changed to$475.32
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 11.49 changed to 11.48
- Practice expense GPCI 1.058 changed to 1.052
- Malpractice GPCI 0.873 changed to 0.962
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$487.09changed to$476.82
- 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
$484.67changed to$487.09
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$476.88changed to$484.67
- 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 1.051 changed to 1.058
- Malpractice GPCI 0.867 changed to 0.873
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$476.88
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $462.23 | Not available in this setting | RVU26D |
| 2026-07-01 | $462.23 | Not available in this setting | RVU26C |
| 2026-04-01 | $462.23 | Not available in this setting | RVU26B |
| 2026-01-01 | $462.23 | Not available in this setting | RVU26A |
| 2025-10-01 | $386.17 | Not available in this setting | RVU25D |
| 2025-07-01 | $386.17 | Not available in this setting | RVU25C |
| 2025-04-01 | $386.17 | Not available in this setting | RVU25B |
| 2025-01-01 | $386.17 | Not available in this setting | RVU25A |
| 2024-10-01 | $414.22 | Not available in this setting | RVU24D |
| 2024-07-01 | $414.22 | Not available in this setting | RVU24C |
| 2024-04-01 | $414.22 | Not available in this setting | RVU24B |
| 2024-03-09 | $414.22 | Not available in this setting | RVU24AR |
| 2024-01-01 | $407.46 | Not available in this setting | RVU24A |
| 2023-10-01 | $428.81 | Not available in this setting | RVU23D |
| 2023-07-01 | $428.81 | Not available in this setting | RVU23C |
| 2023-04-01 | $428.81 | Not available in this setting | RVU23B |
| 2023-01-01 | $428.81 | Not available in this setting | RVU23A |
| 2022-10-01 | $454.86 | Not available in this setting | RVU22D |
| 2022-07-01 | $454.86 | Not available in this setting | RVU22C |
| 2022-04-01 | $454.86 | Not available in this setting | RVU22B |
| 2022-01-01 | $454.86 | Not available in this setting | RVU22A |
| 2021-10-01 | $477.51 | Not available in this setting | RVU21D |
| 2021-07-01 | $477.51 | Not available in this setting | RVU21C |
| 2021-04-01 | $477.51 | Not available in this setting | RVU21B |
| 2021-01-01 | $477.51 | Not available in this setting | RVU21A |
| 2020-10-01 | $466.39 | Not available in this setting | RVU20D |
| 2020-07-01 | $466.39 | Not available in this setting | RVU20C |
| 2020-04-01 | $466.39 | Not available in this setting | RVU20B |
| 2020-01-01 | $466.39 | Not available in this setting | RVU20A |
| 2019-10-01 | $471.25 | Not available in this setting | RVU19D |
| 2019-07-01 | $471.25 | Not available in this setting | RVU19C |
| 2019-04-01 | $471.25 | Not available in this setting | RVU19B |
| 2019-01-01 | $471.25 | Not available in this setting | RVU19A |
| 2018-10-01 | $478.26 | Not available in this setting | RVU18D |
| 2018-07-01 | $478.26 | Not available in this setting | RVU18C |
| 2018-04-01 | $478.26 | Not available in this setting | RVU18B |
| 2018-01-01 | $478.26 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $475.32 | Not available in this setting | RVU17D |
| 2017-07-01 | $475.32 | Not available in this setting | RVU17C |
| 2017-04-01 | $475.32 | Not available in this setting | RVU17B |
| 2017-01-01 | $475.32 | Not available in this setting | RVU17A |
| 2016-10-01 | $476.82 | Not available in this setting | RVU16D |
| 2016-07-01 | $476.82 | Not available in this setting | RVU16C |
| 2016-04-01 | $476.82 | Not available in this setting | RVU16B |
| 2016-01-01 | $476.82 | Not available in this setting | RVU16A |
| 2015-10-01 | $487.09 | Not available in this setting | RVU15D |
| 2015-07-01 | $487.09 | Not available in this setting | RVU15C |
| 2015-04-01 | $484.67 | Not available in this setting | RVU15B |
| 2015-01-01 | $484.67 | Not available in this setting | RVU15A |
| 2014-10-01 | $476.88 | Not available in this setting | RVU14D |
| 2014-07-01 | $476.88 | Not available in this setting | RVU14C |
| 2014-04-01 | $476.88 | Not available in this setting | RVU14B |
| 2014-01-01 | $476.88 | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | 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 New Hampshire rate applies
New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.
- Alton
- Amherst
- Antrim
- Ashland
- Bartlett
- Belmont
- Bennington
- Berlin
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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