CPT code 91124: Rectal physiology, sensation, tone, compliance2026 Medicare rate & RVUs

A rectal physiology study assesses sensation, tone, and compliance, typically when evaluating altered rectal function such as constipation or fecal incontinence.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $768.55 for 91124 nationally in the office. Local office rates run $672.02–$1,067.78.

Medicare rate · 91124

Rectal physiology, sensation, tone, compliance

Office or facility?

Work RVUs
3.05
Total RVUs
23.01
Global days
XXX

National rate · 2026

$768.55

Office setting, before claim adjustments.

See every locality for 91124 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 91124 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 91124 covers

This study evaluates how the rectum senses distention and responds to it, including rectal tone and compliance. Testing commonly uses controlled balloon distention to assess sensory responses and pressure changes. Gastroenterologists, colorectal specialists, or clinicians in a gastrointestinal motility service may perform it in an outpatient testing setting for patients with symptoms such as impaired evacuation or fecal incontinence.

Select 91124 when the documented service is the rectal sensation, tone, and compliance study, rather than a more comprehensive anorectal manometry service. The report should identify the testing performed and include the physiologic findings and interpretation. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and reporting without either modifier represents the global service.

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 91124 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$672.02 to $1067.78

$672.02$869.90$1067.78
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

91124 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$682.95Unavailable
Alaska$859.05Unavailable
Arizona$747.06Unavailable
Arkansas$672.02Unavailable
Atlanta, GA$780.89Unavailable
Austin, TX$806.16Unavailable
Bakersfield, CA$830.91Unavailable
Baltimore area, MD$820.06Unavailable
Beaumont, TX$708.69Unavailable
Brazoria, TX$761.82Unavailable

91124 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.

$672.02

$948.97

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

View every state and territory as a table
91124 office rate range by state
State / territoryOffice rate rangeLocalities
AK$859.051
AL$682.951
AR$672.021
AZ$747.061
CA$830.17–$1,067.7829
CO$810.371
CT$822.901
DC$892.251
DE$760.411
FL$743.24–$806.823
GA$698.76–$780.892
GU$855.791
HI$855.791
IA$708.081
ID$711.941
IL$715.33–$792.744
IN$716.651
KS$701.611
KY$694.741
LA$692.42–$730.652
MA$803.64–$899.832
MD$776.88–$892.253
ME$713.03–$759.912
MI$712.14–$750.522
MN$782.501
MO$677.38–$736.923
MS$674.991
MT$768.541
NC$721.731
ND$764.191
NE$713.221
NH$794.671
NJ$834.00–$880.972
NM$715.311
NV$767.991
NY$733.41–$905.995
OH$711.251
OK$696.371
OR$763.73–$841.492
PA$714.09–$798.842
PR$775.701
RI$791.451
SC$717.341
SD$763.681
TN$705.151
TX$708.69–$806.168
UT$728.251
VA$755.19–$892.252
VI$775.701
VT$758.331
WA$803.07–$921.972
WI$735.781
WV$685.351
WY$766.641

How the 91124 rate is calculated

Each of 91124’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 · 91124

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.05

3.05 RVUs× 1.000 GPCI

Practice expense19.74

19.74 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

23.0100

Conversion factor

$33.4009

Medicare rate

$768.55

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 91124

The CMS indicators that decide how 91124 is paid alongside other services.

CMS payment indicators · 91124

Rectal physiology, sensation, tone, compliance

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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

91124 without 26 · national office

$768.55

Rectal physiology, sensation, tone, compliance

91124-26 · Professional component

$163.66

Pays only the interpretation and report.

When to use modifier 26

91124 compared with similar codes

Compare codes · National

91124 vs 91125: Medicare rates

Office or facility?

  • 91124

    Rectal physiology, sensation, tone, compliance3.05 wRVU

    $768.55

  • 91125

    Anorectal testing, manometry with sensory testing2.7 wRVU

    $347.37−$421.18

How to choose

91125Anorectal testingManometry with sensory testing
91125 describes a broader anorectal manometry service that includes rectal sensation and balloon expulsion testing; 91124 is for the rectal sensation, tone, and compliance study.

91124 billing questions

How is 91124 distinguished from 91125?

91124 represents the rectal sensation, tone, and compliance study. Choose 91125 when the documented service is the broader anorectal manometry service that includes rectal sensation and balloon expulsion testing.

Can the professional and technical portions be billed separately?

Yes. Use modifier 26 for the professional interpretation or modifier TC for the technical equipment and staff portion. Without either modifier, the claim represents the global service.

What documentation supports reporting 91124?

Document the rectal physiologic testing performed, the recorded sensory or pressure findings, and the interpretation. The record should support that the service was a rectal sensation, tone, and compliance study.

Is this the same as anorectal manometry?

The services are related but not interchangeable by name alone. Select the code that matches the actual testing performed and documented, particularly whether the service includes the broader manometry and balloon expulsion assessment.

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 91124PPRRVU2026_Oct_nonQPP.csv, line 11,634 (RVU26D)

Open CMS sourceHow we calculate rates

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