CPT code 91125: Anorectal testing, manometry with sensory testing2026 Medicare rate & RVUs in Montana
Reports anorectal pressure testing combined with rectal sensory assessment and balloon expulsion, commonly used to evaluate constipation, defecatory difficulty, or fecal incontinence.
In Montana, Medicare pays $347.36 for 91125 in the office.
Check a contract rate as a % of Medicare · 91125 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 91125 covers
This study assesses anorectal function using a pressure-sensing catheter and rectal balloon testing. It evaluates anal sphincter pressures and coordination along with rectal sensory responses and the ability to expel a balloon. Gastroenterologists, colorectal specialists, and motility teams commonly perform it in an outpatient motility laboratory for patients with persistent constipation, suspected outlet dysfunction, or fecal incontinence.
Report 91125 when the service includes the combined anorectal manometry, sensory assessment, and balloon expulsion evaluation; document the test elements performed and relevant findings. The global service includes the professional interpretation and the technical work, equipment, and staff. When those portions are billed separately, modifier 26 identifies the interpretation and modifier TC identifies the technical 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.
How Montana compares for 91125
Across 109 of 109 payment localities, the office rate for 91125 runs from $309.15 in Arkansas to $465.82 in San Benito County, CA. Montana pays $347.36. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$347.36
- Los Angeles, CA · California$395.19+$47.83
- Washington, DC area · District of Columbia$397.65+$50.29
- Miami, FL · Florida$366.36+$19.00
- Chicago, IL · Illinois$356.61+$9.25
- Manhattan, NY · New York$397.21+$49.85
- Alaska · Alaska$406.26+$58.90
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $313.47 | — |
| ArkansasArkansas | $309.15 | — |
| ArizonaArizona | $338.75 | — |
| Bakersfield, CACalifornia | $371.01 | — |
| Chico, CACalifornia | $370.41 | — |
| El Centro, CACalifornia | $370.44 | — |
| Fresno, CACalifornia | $370.41 | — |
| Hanford, CACalifornia | $370.41 | — |
| Madera, CACalifornia | $370.41 | — |
| Merced, CACalifornia | $370.41 | — |
| Modesto, CACalifornia | $370.41 | — |
| Napa, CACalifornia | $430.24 | — |
| Oxnard, CACalifornia | $393.53 | — |
| Redding, CACalifornia | $370.41 | — |
| Rest of CaliforniaCalifornia | $370.41 | — |
| Riverside, CACalifornia | $372.30 | — |
| Sacramento, CACalifornia | $388.98 | — |
| Salinas, CACalifornia | $387.52 | — |
| San Diego, CACalifornia | $396.77 | — |
| Marin County, CACalifornia | $455.98 | — |
| San Francisco, CACalifornia | $455.79 | — |
| San Benito County, CACalifornia | $465.82 | — |
| Santa Clara County, CACalifornia | $465.03 | — |
| San Luis Obispo, CACalifornia | $381.23 | — |
| Santa Cruz, CACalifornia | $400.70 | — |
| Santa Maria, CACalifornia | $389.01 | — |
| Santa Rosa, CACalifornia | $404.78 | — |
| Stockton, CACalifornia | $370.41 | — |
| Vallejo, CACalifornia | $429.96 | — |
| Visalia, CACalifornia | $370.41 | — |
| Yuba City, CACalifornia | $370.41 | — |
| ColoradoColorado | $363.30 | — |
| ConnecticutConnecticut | $369.73 | — |
| DelawareDelaware | $344.23 | — |
| Fort Lauderdale, FLFlorida | $355.23 | — |
| Rest of FloridaFlorida | $339.16 | — |
| Atlanta, GAGeorgia | $352.81 | — |
| Rest of GeorgiaGeorgia | $321.30 | — |
| Hawaii, Guam, HIHawaii | $379.44 | — |
| IowaIowa | $322.57 | — |
| IdahoIdaho | $324.26 | — |
| East St. Louis, ILIllinois | $333.01 | — |
| Rest of IllinoisIllinois | $328.68 | — |
| Suburban Chicago, ILIllinois | $359.17 | — |
| IndianaIndiana | $326.09 | — |
| KansasKansas | $320.41 | — |
| KentuckyKentucky | $318.97 | — |
| New Orleans, LALouisiana | $333.30 | — |
| Rest of LouisianaLouisiana | $318.21 | — |
| Metropolitan Boston, MAMassachusetts | $399.23 | — |
| Rest of MassachusettsMassachusetts | $360.99 | — |
| Baltimore area, MDMaryland | $368.52 | — |
| Rest of MarylandMaryland | $350.82 | — |
| Rest of MaineMaine | $325.10 | — |
| Southern Maine, MEMaine | $343.01 | — |
| Detroit, MIMichigan | $342.46 | — |
| Rest of MichiganMichigan | $326.22 | — |
| MinnesotaMinnesota | $350.67 | — |
| Metropolitan Kansas City, MOMissouri | $331.90 | — |
| Metropolitan St. Louis, MOMissouri | $335.31 | — |
| Rest of MissouriMissouri | $312.51 | — |
| MississippiMississippi | $310.93 | — |
| North CarolinaNorth Carolina | $328.47 | — |
| North DakotaNorth Dakota | $344.00 | — |
| NebraskaNebraska | $324.47 | — |
| New HampshireNew Hampshire | $356.97 | — |
| Northern New JerseyNew Jersey | $393.68 | — |
| Rest of New JerseyNew Jersey | $374.67 | — |
| New MexicoNew Mexico | $327.64 | — |
| NevadaNevada | $346.67 | — |
| NYC suburbs and Long Island, NYNew York | $405.54 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $376.51 | — |
| Queens, NYNew York | $401.43 | — |
| Rest of New YorkNew York | $333.11 | — |
| OhioOhio | $325.53 | — |
| OklahomaOklahoma | $319.19 | — |
| Portland, OROregon | $375.28 | — |
| Rest of OregonOregon | $344.68 | — |
| Metropolitan Philadelphia, PAPennsylvania | $360.40 | — |
| Rest of PennsylvaniaPennsylvania | $326.43 | — |
| Puerto RicoPuerto Rico | $350.05 | — |
| Rhode IslandRhode Island | $356.77 | — |
| South CarolinaSouth Carolina | $327.40 | — |
| South DakotaSouth Dakota | $343.60 | — |
| TennesseeTennessee | $321.85 | — |
| Austin, TXTexas | $361.49 | — |
| Beaumont, TXTexas | $324.33 | — |
| Brazoria, TXTexas | $344.58 | — |
| Dallas, TXTexas | $346.37 | — |
| Fort Worth, TXTexas | $343.93 | — |
| Galveston, TXTexas | $345.35 | — |
| Houston, TXTexas | $348.47 | — |
| Rest of TexasTexas | $333.99 | — |
| UtahUtah | $331.70 | — |
| VirginiaVirginia | $341.42 | — |
| Virgin Islands, VIUnited States Virgin Islands | $350.05 | — |
| VermontVermont | $342.05 | — |
| Rest of WashingtonWashington | $360.51 | — |
| King County, WAWashington | $407.93 | — |
| WisconsinWisconsin | $332.88 | — |
| West VirginiaWest Virginia | $316.87 | — |
| WyomingWyoming | $345.89 | — |
91125 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.
$309.15
$418.12
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 | $406.26 | 1 |
| AL | $313.47 | 1 |
| AR | $309.15 | 1 |
| AZ | $338.75 | 1 |
| CA | $370.41–$465.82 | 29 |
| CO | $363.30 | 1 |
| CT | $369.73 | 1 |
| DC | $397.65 | 1 |
| DE | $344.23 | 1 |
| FL | $339.16–$366.36 | 3 |
| GA | $321.30–$352.81 | 2 |
| GU | $379.44 | 1 |
| HI | $379.44 | 1 |
| IA | $322.57 | 1 |
| ID | $324.26 | 1 |
| IL | $328.68–$359.17 | 4 |
| IN | $326.09 | 1 |
| KS | $320.41 | 1 |
| KY | $318.97 | 1 |
| LA | $318.21–$333.30 | 2 |
| MA | $360.99–$399.23 | 2 |
| MD | $350.82–$397.65 | 3 |
| ME | $325.10–$343.01 | 2 |
| MI | $326.22–$342.46 | 2 |
| MN | $350.67 | 1 |
| MO | $312.51–$335.31 | 3 |
| MS | $310.93 | 1 |
| MT | $347.36 | 1 |
| NC | $328.47 | 1 |
| ND | $344.00 | 1 |
| NE | $324.47 | 1 |
| NH | $356.97 | 1 |
| NJ | $374.67–$393.68 | 2 |
| NM | $327.64 | 1 |
| NV | $346.67 | 1 |
| NY | $333.11–$405.54 | 5 |
| OH | $325.53 | 1 |
| OK | $319.19 | 1 |
| OR | $344.68–$375.28 | 2 |
| PA | $326.43–$360.40 | 2 |
| PR | $350.05 | 1 |
| RI | $356.77 | 1 |
| SC | $327.40 | 1 |
| SD | $343.60 | 1 |
| TN | $321.85 | 1 |
| TX | $324.33–$361.49 | 8 |
| UT | $331.70 | 1 |
| VA | $341.42–$397.65 | 2 |
| VI | $350.05 | 1 |
| VT | $342.05 | 1 |
| WA | $360.51–$407.93 | 2 |
| WI | $332.88 | 1 |
| WV | $316.87 | 1 |
| WY | $345.89 | 1 |
How the 91125 rate is calculated
Each of 91125’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 · 91125
RVUs × geographic indexes × conversion factor
Work2.70
2.70 RVUs× 1.000 GPCI
Practice expense7.53
7.53 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
10.4000
Conversion factor
$33.4009
Medicare rate
$347.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,637
- Code
- 91125
- Physician work
- 2.70
- Practice expense
- 7.53
- Malpractice
- 0.17
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.70 | × 1.000 | 2.7000 |
| Practice expense | 7.53 | × 1.000 | 7.5300 |
| Malpractice | 0.17 | × 0.998 | 0.1697 |
| Total RVUs | 10.3997 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$347.36
Office: (2.7 × 1 + 7.53 × 1 + 0.17 × 0.998) × $33.4009 = $347.36
Payment rules and modifiers for 91125
The CMS indicators that decide how 91125 is paid alongside other services.
CMS payment indicators · 91125
Anorectal testing, manometry with sensory testing
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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
91125 without 26 · national office
$347.37
Anorectal testing, manometry with sensory testing
91125-26 · Professional component
$142.29
Pays only the interpretation and report.
How 91125 has changed in Montana
91125 · Office / nonfacility
$347.36
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
No ratechanged to$347.36
Held through RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $347.36 | Not available in this setting | RVU26D |
| 2026-07-01 | $347.36 | Not available in this setting | RVU26C |
| 2026-04-01 | $347.36 | Not available in this setting | RVU26B |
| 2026-01-01 | $347.36 | Not available in this setting | RVU26A |
| 2025-10-01 | Not in this release | Not in this release | RVU25D |
| 2025-07-01 | Not in this release | Not in this release | RVU25C |
| 2025-04-01 | Not in this release | Not in this release | RVU25B |
| 2025-01-01 | Not in this release | Not in this release | RVU25A |
| 2024-10-01 | Not in this release | Not in this release | RVU24D |
| 2024-07-01 | Not in this release | Not in this release | RVU24C |
| 2024-04-01 | Not in this release | Not in this release | RVU24B |
| 2024-03-09 | Not in this release | Not in this release | RVU24AR |
| 2024-01-01 | Not in this release | Not in this release | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
91125 billing questions
When should 91125 be selected instead of 91122?
Use 91125 for the combined anorectal pressure, sensory, and balloon expulsion assessment. Use 91122 when the documented service is anorectal manometry without that combined testing.
Are sensory testing and balloon expulsion included?
They are part of the combined service represented by 91125. Document the elements performed and avoid reporting those elements again as separate services from the same test.
How are the professional and technical portions reported?
Report the global service without a component modifier. Use modifier 26 for the professional interpretation or modifier TC for the technical work, equipment, and staff when the portions are billed separately.
What documentation supports 91125?
Record the reason for testing, the anorectal measurements and sensory assessment performed, balloon expulsion results, and the interpreting clinician's findings.
Is 91125 appropriate for constipation alone?
The symptom alone does not establish the service. The record should show that the combined anorectal manometry, sensory assessment, and balloon expulsion evaluation was performed.
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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