83013
No office rateH pylori (c-13) breath
83013 is for H. pylori breath-test analysis. Use 91065 for hydrogen and/or methane testing directed at conditions such as carbohydrate malabsorption or bacterial overgrowth.
On this page
CMS RVU26D · Effective 2026-10-01
91065 Breath test Medicare reimbursement rates
Measures exhaled hydrogen and/or methane after a test substrate to evaluate suspected carbohydrate malabsorption or intestinal bacterial overgrowth. Compare 91065 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 91065?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$56.09–$90.13
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $34.04 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 91065 pays more and less
109 payment localities
$56.09 to $90.13
Gastrointestinal testing
About 91065: Hydrogen or methane breath test
Measures exhaled hydrogen and/or methane after a test substrate to evaluate suspected carbohydrate malabsorption or intestinal bacterial overgrowth.
The test measures hydrogen and/or methane in a patient’s breath after administration of a test substrate. Gastroenterology practices and diagnostic laboratories commonly use it to investigate suspected lactose or fructose malabsorption and intestinal bacterial overgrowth. Serial breath measurements are interpreted in relation to the administered substrate and the clinical question; this is not an esophageal pressure or reflux study.
Report the service when the hydrogen/methane breath test is performed, with documentation identifying the indication, substrate or protocol, test results, and interpretation. The global service includes both the professional interpretation and technical work; modifier 26 identifies interpretation, while modifier TC identifies equipment and staff. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this test. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 91065
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.20 · 10%
- Practice expense (office) RVU1.71 · 89%
- Malpractice RVU0.02 · 1%
51.4K
Medicare services in 2024 · #771 by national volume
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.
91065 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$216.02–$337.90
91010 evaluates esophageal motility using pressure measurements. Code 91065 measures exhaled gases after a test substrate.
See how rates vary across the country
91065 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$56.09
$79.94
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $71.22 | 1 |
| AL | $57.03 | 1 |
| AR | $56.09 | 1 |
| AZ | $62.60 | 1 |
| CA | $69.75–$90.13 | 29 |
| CO | $68.05 | 1 |
| CT | $69.14 | 1 |
| DC | $75.07 | 1 |
| DE | $63.74 | 1 |
| FL | $62.29–$67.83 | 3 |
| GA | $58.42–$65.53 | 2 |
| GU | $72.01 | 1 |
| HI | $72.01 | 1 |
| IA | $59.21 | 1 |
| ID | $59.54 | 1 |
| IL | $59.87–$66.57 | 4 |
| IN | $59.95 | 1 |
| KS | $58.65 | 1 |
| KY | $58.07 | 1 |
| LA | $57.87–$61.18 | 2 |
| MA | $67.46–$75.74 | 2 |
| MD | $65.16–$75.07 | 3 |
| ME | $59.64–$63.70 | 2 |
| MI | $59.58–$62.92 | 2 |
| MN | $65.65 | 1 |
| MO | $56.56–$61.72 | 3 |
| MS | $56.35 | 1 |
| MT | $64.46 | 1 |
| NC | $60.40 | 1 |
| ND | $64.07 | 1 |
| NE | $59.65 | 1 |
| NH | $66.72 | 1 |
| NJ | $70.05–$74.07 | 2 |
| NM | $59.86 | 1 |
| NV | $64.41 | 1 |
| NY | $61.41–$76.26 | 5 |
| OH | $59.50 | 1 |
| OK | $58.20 | 1 |
| OR | $64.04–$70.74 | 2 |
| PA | $59.74–$67.05 | 2 |
| PR | $65.08 | 1 |
| RI | $66.40 | 1 |
| SC | $60.02 | 1 |
| SD | $64.02 | 1 |
| TN | $58.96 | 1 |
| TX | $59.28–$67.71 | 8 |
| UT | $60.97 | 1 |
| VA | $63.30–$75.07 | 2 |
| VI | $65.08 | 1 |
| VT | $63.56 | 1 |
| WA | $67.42–$77.64 | 2 |
| WI | $61.60 | 1 |
| WV | $57.27 | 1 |
| WY | $64.29 | 1 |
Compare 91065 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $57.03 | Facility Unavailable |
| Alaska* | Office $71.22 | Facility Unavailable |
| Arizona | Office $62.60 | Facility Unavailable |
| Arkansas | Office $56.09 | Facility Unavailable |
| Atlanta | Office $65.53 | Facility Unavailable |
| Austin | Office $67.71 | Facility Unavailable |
| Bakersfield | Office $69.81 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $68.90 | Facility Unavailable |
| Beaumont | Office $59.28 | Facility Unavailable |
| Brazoria | Office $63.86 | Facility Unavailable |
| Chicago | Office $65.66 | Facility Unavailable |
| Chico | Office $69.75 | Facility Unavailable |
| Colorado | Office $68.05 | Facility Unavailable |
| Connecticut | Office $69.14 | Facility Unavailable |
| Dallas | Office $64.20 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $75.07 | Facility Unavailable |
| Delaware | Office $63.74 | Facility Unavailable |
| Detroit | Office $62.92 | Facility Unavailable |
| East St. Louis | Office $60.57 | Facility Unavailable |
| El Centro | Office $69.75 | Facility Unavailable |
| Fort Lauderdale | Office $65.75 | Facility Unavailable |
| Fort Worth | Office $63.64 | Facility Unavailable |
| Fresno | Office $69.75 | Facility Unavailable |
| Galveston | Office $64.00 | Facility Unavailable |
| Hanford-Corcoran | Office $69.75 | Facility Unavailable |
| Hawaii, Guam | Office $72.01 | Facility Unavailable |
| Houston | Office $64.37 | Facility Unavailable |
| Idaho | Office $59.54 | Facility Unavailable |
| Indiana | Office $59.95 | Facility Unavailable |
| Iowa | Office $59.21 | Facility Unavailable |
| Kansas | Office $58.65 | Facility Unavailable |
| Kentucky | Office $58.07 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $74.97 | Facility Unavailable |
| Madera | Office $69.75 | Facility Unavailable |
| Manhattan | Office $74.54 | Facility Unavailable |
| Merced | Office $69.75 | Facility Unavailable |
| Metropolitan Boston | Office $75.74 | Facility Unavailable |
| Metropolitan Kansas City | Office $60.96 | Facility Unavailable |
| Metropolitan Philadelphia | Office $67.05 | Facility Unavailable |
| Metropolitan St. Louis | Office $61.72 | Facility Unavailable |
| Miami | Office $67.83 | Facility Unavailable |
| Minnesota | Office $65.65 | Facility Unavailable |
| Mississippi | Office $56.35 | Facility Unavailable |
| Modesto | Office $69.75 | Facility Unavailable |
| Montana** | Office $64.46 | Facility Unavailable |
| Napa | Office $82.72 | Facility Unavailable |
| Nebraska | Office $59.65 | Facility Unavailable |
| Nevada** | Office $64.41 | Facility Unavailable |
| New Hampshire | Office $66.72 | Facility Unavailable |
| New Mexico | Office $59.86 | Facility Unavailable |
| New Orleans | Office $61.18 | Facility Unavailable |
| North Carolina | Office $60.40 | Facility Unavailable |
| North Dakota** | Office $64.07 | Facility Unavailable |
| Northern Nj | Office $74.07 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $76.26 | Facility Unavailable |
| Ohio | Office $59.50 | Facility Unavailable |
| Oklahoma | Office $58.20 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $74.79 | Facility Unavailable |
| Portland | Office $70.74 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $70.33 | Facility Unavailable |
| Puerto Rico | Office $65.08 | Facility Unavailable |
| Queens | Office $75.58 | Facility Unavailable |
| Redding | Office $69.75 | Facility Unavailable |
| Rest Of California | Office $69.75 | Facility Unavailable |
| Rest Of Florida | Office $62.29 | Facility Unavailable |
| Rest Of Georgia | Office $58.42 | Facility Unavailable |
| Rest Of Illinois | Office $59.87 | Facility Unavailable |
| Rest Of Louisiana | Office $57.87 | Facility Unavailable |
| Rest Of Maine | Office $59.64 | Facility Unavailable |
| Rest Of Maryland | Office $65.16 | Facility Unavailable |
| Rest Of Massachusetts | Office $67.46 | Facility Unavailable |
| Rest Of Michigan | Office $59.58 | Facility Unavailable |
| Rest Of Missouri | Office $56.56 | Facility Unavailable |
| Rest Of New Jersey | Office $70.05 | Facility Unavailable |
| Rest Of New York | Office $61.41 | Facility Unavailable |
| Rest Of Oregon | Office $64.04 | Facility Unavailable |
| Rest Of Pennsylvania | Office $59.74 | Facility Unavailable |
| Rest Of Texas | Office $61.49 | Facility Unavailable |
| Rest Of Washington | Office $67.42 | Facility Unavailable |
| Rhode Island | Office $66.40 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $69.97 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $73.70 | Facility Unavailable |
| Salinas | Office $73.44 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $75.55 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $88.15 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $88.13 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $90.13 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $90.04 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $72.21 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $76.57 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $73.82 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $77.38 | Facility Unavailable |
| Seattle (King Cnty) | Office $77.64 | Facility Unavailable |
| South Carolina | Office $60.02 | Facility Unavailable |
| South Dakota** | Office $64.02 | Facility Unavailable |
| Southern Maine | Office $63.70 | Facility Unavailable |
| Stockton | Office $69.75 | Facility Unavailable |
| Suburban Chicago | Office $66.57 | Facility Unavailable |
| Tennessee | Office $58.96 | Facility Unavailable |
| Utah | Office $60.97 | Facility Unavailable |
| Vallejo | Office $82.69 | Facility Unavailable |
| Vermont | Office $63.56 | Facility Unavailable |
| Virgin Islands | Office $65.08 | Facility Unavailable |
| Virginia | Office $63.30 | Facility Unavailable |
| Visalia | Office $69.75 | Facility Unavailable |
| West Virginia | Office $57.27 | Facility Unavailable |
| Wisconsin | Office $61.60 | Facility Unavailable |
| Wyoming** | Office $64.29 | Facility Unavailable |
| Yuba City | Office $69.75 | Facility Unavailable |
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91065 billing questions
When is 91065 appropriate instead of an H. pylori breath-test code?
Use 91065 for hydrogen and/or methane testing directed at issues such as carbohydrate malabsorption or bacterial overgrowth. H. pylori breath testing uses codes for that specific diagnostic target, such as 83013.
Can the professional and technical 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.
Should modifier 50 be appended for this test?
No. The CMS facts identify bilateral adjustment as inappropriate for this service.
What documentation supports reporting 91065?
Document the clinical indication, the test protocol or substrate, the breath measurements, and the interpretation. These details support that the service was a hydrogen/methane breath test rather than another gastrointestinal diagnostic study.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included in the service.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,61591040,,Esoph balloon distension tst,A,,0.95,16.24,,16.24,NA,0.08,17.27,17.27,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,61691040,26,Esoph balloon distension tst,A,,0.95,0.52,,0.52,,0.07,1.54,1.54,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,61791040,TC,Esoph balloon distension tst,A,,0.00,15.72,,15.72,NA,0.01,15.73,15.73,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,61891065,,Breath hydrogen/methane test,A,,0.20,1.71,,1.71,NA,0.02,1.93,1.93,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,61991065,26,Breath hydrogen/methane test,A,,0.20,0.08,,0.08,,0.01,0.29,0.29,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,62091065,TC,Breath hydrogen/methane test,A,,0.00,1.63,,1.63,NA,0.01,1.64,1.64,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,62191110,,Gi trc img intral esoph-ile,A,,2.18,21.75,,21.75,NA,0.09,24.02,24.02,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,29.00,29.00,0.09