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CMS RVU26D · Effective 2026-10-01

91040 in Manhattan

Office / nonfacility

$668.30

Base rate per service

Facility setting

Not available in this setting

Base rate per service

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.

Esophageal function testing

About 91040: Esophageal balloon distension study

Reports an esophageal balloon distension study that measures luminal opening and distensibility, often during endoscopy, to evaluate suspected outflow or motility disorders.

During this diagnostic study, a compliant balloon catheter is positioned in the esophagus and inflated in a controlled manner while the device records changes in luminal dimensions and distension response. Impedance planimetry systems such as EndoFLIP are commonly used to characterize opening in the esophageal body or at the esophagogastric junction. Gastroenterologists typically perform the test in an endoscopy unit to evaluate suspected achalasia or other esophageal outflow disorders, or to assess physiologic response after treatment.

Report 91040 for the balloon-based distension assessment and its interpretation, not for conventional pressure-channel manometry, reflux monitoring, or the endoscopic examination itself. Documentation should identify the clinical question, balloon-based measurements and findings, and the physician’s interpretation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. The service may be billed globally or split into professional interpretation with modifier 26 and technical equipment and staff with modifier TC. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 91040

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 RVU0.95 · 6%
  • Practice expense (office) RVU16.24 · 94%
  • Malpractice RVU0.08 · 0%

5.4K

Medicare services in 2024 · #1816 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.

91040 compared with similar codes

Office rates for Manhattan, from the same CMS release.

91010

Esophageal manometry

Standard pressure study

$282.84

Choose 91010 for an esophageal motility study based on pressure patterns. Choose 91040 when the study measures luminal opening and distension response with a balloon.

91013

Esophageal motility

With stimulation or perfusion

$32.54

91013 is esophageal motility testing with stimulation or perfusion. It does not describe the balloon-based assessment of esophageal distensibility reported with 91040.

91035

Reflux testing

Mucosa-attached telemetry electrode

$580.78

91035 is an electrode-based esophageal reflux test. It addresses reflux rather than the opening and distension response measured by 91040.

The same code, a different location

How does Manhattan compare?

In Nyc Suburbs/Long Island, the office rate for 91040 is $683.67—$15.37 higher than the $668.30 rate in Manhattan. Both use the same code, release and participation basis.

91040 across payment areas

Same release and payment basis · bars start at $0

  1. Manhattan · This locality

    $668.30

  2. Nyc Suburbs/Long Island

    $683.67

    $15.37 higher than Manhattan

  3. Poughkpsie/N Nyc Suburbs

    $630.35

    $37.95 lower than Manhattan

  4. Queens

    $678.77

    $10.47 higher than Manhattan

  5. Rest Of New York

    $548.92

    $119.38 lower than Manhattan

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $676.50

    $8.20 higher than Manhattan

  7. Dc + Md/Va Suburbs

    $675.40

    $7.10 higher than Manhattan

Other payment areas listed in New York appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 91040 ranges from $499.05 in Arkansas to $818.84 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Miami

    Florida · 91040

    Office

    $603.16

    Facility

    Unavailable

    $65.14 lower than Manhattan for the office setting.

  • Chicago

    Illinois · 91040

    Office

    $583.23

    Facility

    Unavailable

    $85.07 lower than Manhattan for the office setting.

  • Alaska*

    Alaska · 91040

    Office

    $626.76

    Facility

    Unavailable

    $41.54 lower than Manhattan for the office setting.

  • Alabama

    Alabama · 91040

    Office

    $507.87

    Facility

    Unavailable

    $160.43 lower than Manhattan for the office setting.

  • Arkansas

    Arkansas · 91040

    Office

    $499.05

    Facility

    Unavailable

    $169.25 lower than Manhattan for the office setting.

  • Arizona

    Arizona · 91040

    Office

    $559.63

    Facility

    Unavailable

    $108.67 lower than Manhattan for the office setting.

  • Bakersfield

    California · 91040

    Office

    $628.46

    Facility

    Unavailable

    $39.84 lower than Manhattan for the office setting.

  • Chico

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • El Centro

    California · 91040

    Office

    $628.22

    Facility

    Unavailable

    $40.08 lower than Manhattan for the office setting.

  • Fresno

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Hanford-Corcoran

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Madera

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Merced

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Modesto

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Napa

    California · 91040

    Office

    $750.01

    Facility

    Unavailable

    $81.71 higher than Manhattan for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 91040

    Office

    $675.44

    Facility

    Unavailable

    $7.14 higher than Manhattan for the office setting.

  • Redding

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Rest Of California

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 91040

    Office

    $629.09

    Facility

    Unavailable

    $39.21 lower than Manhattan for the office setting.

  • Sacramento-Roseville-Folsom

    California · 91040

    Office

    $665.15

    Facility

    Unavailable

    $3.15 lower than Manhattan for the office setting.

  • Salinas

    California · 91040

    Office

    $662.82

    Facility

    Unavailable

    $5.48 lower than Manhattan for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 91040

    Office

    $682.88

    Facility

    Unavailable

    $14.58 higher than Manhattan for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 91040

    Office

    $800.80

    Facility

    Unavailable

    $132.50 higher than Manhattan for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 91040

    Office

    $800.71

    Facility

    Unavailable

    $132.41 higher than Manhattan for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 91040

    Office

    $818.84

    Facility

    Unavailable

    $150.54 higher than Manhattan for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 91040

    Office

    $818.47

    Facility

    Unavailable

    $150.17 higher than Manhattan for the office setting.

  • San Luis Obispo-Paso Robles

    California · 91040

    Office

    $651.53

    Facility

    Unavailable

    $16.77 lower than Manhattan for the office setting.

  • Santa Cruz-Watsonville

    California · 91040

    Office

    $692.88

    Facility

    Unavailable

    $24.58 higher than Manhattan for the office setting.

  • Santa Maria-Santa Barbara

    California · 91040

    Office

    $666.53

    Facility

    Unavailable

    $1.77 lower than Manhattan for the office setting.

  • Santa Rosa-Petaluma

    California · 91040

    Office

    $700.22

    Facility

    Unavailable

    $31.92 higher than Manhattan for the office setting.

  • Stockton

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Vallejo

    California · 91040

    Office

    $749.88

    Facility

    Unavailable

    $81.58 higher than Manhattan for the office setting.

  • Visalia

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Yuba City

    California · 91040

    Office

    $628.21

    Facility

    Unavailable

    $40.09 lower than Manhattan for the office setting.

  • Colorado

    Colorado · 91040

    Office

    $611.34

    Facility

    Unavailable

    $56.96 lower than Manhattan for the office setting.

  • Connecticut

    Connecticut · 91040

    Office

    $619.80

    Facility

    Unavailable

    $48.50 lower than Manhattan for the office setting.

  • Delaware

    Delaware · 91040

    Office

    $570.21

    Facility

    Unavailable

    $98.09 lower than Manhattan for the office setting.

  • Fort Lauderdale

    Florida · 91040

    Office

    $586.04

    Facility

    Unavailable

    $82.26 lower than Manhattan for the office setting.

  • Rest Of Florida

    Florida · 91040

    Office

    $554.31

    Facility

    Unavailable

    $113.99 lower than Manhattan for the office setting.

  • Atlanta

    Georgia · 91040

    Office

    $586.14

    Facility

    Unavailable

    $82.16 lower than Manhattan for the office setting.

  • Rest Of Georgia

    Georgia · 91040

    Office

    $518.76

    Facility

    Unavailable

    $149.54 lower than Manhattan for the office setting.

  • Hawaii, Guam

    Hawaii · 91040

    Office

    $650.02

    Facility

    Unavailable

    $18.28 lower than Manhattan for the office setting.

  • Iowa

    Iowa · 91040

    Office

    $529.12

    Facility

    Unavailable

    $139.18 lower than Manhattan for the office setting.

  • Idaho

    Idaho · 91040

    Office

    $532.03

    Facility

    Unavailable

    $136.27 lower than Manhattan for the office setting.

  • East St. Louis

    Illinois · 91040

    Office

    $536.15

    Facility

    Unavailable

    $132.15 lower than Manhattan for the office setting.

  • Rest Of Illinois

    Illinois · 91040

    Office

    $531.15

    Facility

    Unavailable

    $137.15 lower than Manhattan for the office setting.

  • Suburban Chicago

    Illinois · 91040

    Office

    $593.76

    Facility

    Unavailable

    $74.54 lower than Manhattan for the office setting.

  • Indiana

    Indiana · 91040

    Office

    $535.86

    Facility

    Unavailable

    $132.44 lower than Manhattan for the office setting.

  • Kansas

    Kansas · 91040

    Office

    $523.43

    Facility

    Unavailable

    $144.87 lower than Manhattan for the office setting.

  • Kentucky

    Kentucky · 91040

    Office

    $516.40

    Facility

    Unavailable

    $151.90 lower than Manhattan for the office setting.

  • New Orleans

    Louisiana · 91040

    Office

    $545.19

    Facility

    Unavailable

    $123.11 lower than Manhattan for the office setting.

  • Rest Of Louisiana

    Louisiana · 91040

    Office

    $514.34

    Facility

    Unavailable

    $153.96 lower than Manhattan for the office setting.

  • Metropolitan Boston

    Massachusetts · 91040

    Office

    $683.07

    Facility

    Unavailable

    $14.77 higher than Manhattan for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 91040

    Office

    $605.55

    Facility

    Unavailable

    $62.75 lower than Manhattan for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 91040

    Office

    $617.57

    Facility

    Unavailable

    $50.73 lower than Manhattan for the office setting.

  • Rest Of Maryland

    Maryland · 91040

    Office

    $583.44

    Facility

    Unavailable

    $84.86 lower than Manhattan for the office setting.

  • Rest Of Maine

    Maine · 91040

    Office

    $532.43

    Facility

    Unavailable

    $135.87 lower than Manhattan for the office setting.

  • Southern Maine

    Maine · 91040

    Office

    $570.97

    Facility

    Unavailable

    $97.33 lower than Manhattan for the office setting.

  • Detroit

    Michigan · 91040

    Office

    $559.68

    Facility

    Unavailable

    $108.62 lower than Manhattan for the office setting.

  • Rest Of Michigan

    Michigan · 91040

    Office

    $529.99

    Facility

    Unavailable

    $138.31 lower than Manhattan for the office setting.

  • Minnesota

    Minnesota · 91040

    Office

    $590.68

    Facility

    Unavailable

    $77.62 lower than Manhattan for the office setting.

  • Metropolitan Kansas City

    Missouri · 91040

    Office

    $543.68

    Facility

    Unavailable

    $124.62 lower than Manhattan for the office setting.

  • Metropolitan St. Louis

    Missouri · 91040

    Office

    $550.80

    Facility

    Unavailable

    $117.50 lower than Manhattan for the office setting.

  • Rest Of Missouri

    Missouri · 91040

    Office

    $501.91

    Facility

    Unavailable

    $166.39 lower than Manhattan for the office setting.

  • Mississippi

    Mississippi · 91040

    Office

    $500.74

    Facility

    Unavailable

    $167.56 lower than Manhattan for the office setting.

  • Montana**

    Montana · 91040

    Office

    $576.83

    Facility

    Unavailable

    $91.47 lower than Manhattan for the office setting.

  • North Carolina

    North Carolina · 91040

    Office

    $539.53

    Facility

    Unavailable

    $128.77 lower than Manhattan for the office setting.

  • North Dakota**

    North Dakota · 91040

    Office

    $575.25

    Facility

    Unavailable

    $93.05 lower than Manhattan for the office setting.

  • Nebraska

    Nebraska · 91040

    Office

    $533.40

    Facility

    Unavailable

    $134.90 lower than Manhattan for the office setting.

  • New Hampshire

    New Hampshire · 91040

    Office

    $598.74

    Facility

    Unavailable

    $69.56 lower than Manhattan for the office setting.

  • Northern Nj

    New Jersey · 91040

    Office

    $665.80

    Facility

    Unavailable

    $2.50 lower than Manhattan for the office setting.

  • Rest Of New Jersey

    New Jersey · 91040

    Office

    $628.27

    Facility

    Unavailable

    $40.03 lower than Manhattan for the office setting.

  • New Mexico

    New Mexico · 91040

    Office

    $532.35

    Facility

    Unavailable

    $135.95 lower than Manhattan for the office setting.

  • Nevada**

    Nevada · 91040

    Office

    $576.93

    Facility

    Unavailable

    $91.37 lower than Manhattan for the office setting.

  • Ohio

    Ohio · 91040

    Office

    $529.66

    Facility

    Unavailable

    $138.64 lower than Manhattan for the office setting.

  • Oklahoma

    Oklahoma · 91040

    Office

    $518.20

    Facility

    Unavailable

    $150.10 lower than Manhattan for the office setting.

  • Portland

    Oregon · 91040

    Office

    $636.87

    Facility

    Unavailable

    $31.43 lower than Manhattan for the office setting.

  • Rest Of Oregon

    Oregon · 91040

    Office

    $573.87

    Facility

    Unavailable

    $94.43 lower than Manhattan for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 91040

    Office

    $600.16

    Facility

    Unavailable

    $68.14 lower than Manhattan for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 91040

    Office

    $532.21

    Facility

    Unavailable

    $136.09 lower than Manhattan for the office setting.

  • Puerto Rico

    Puerto Rico · 91040

    Office

    $582.76

    Facility

    Unavailable

    $85.54 lower than Manhattan for the office setting.

  • Rhode Island

    Rhode Island · 91040

    Office

    $595.05

    Facility

    Unavailable

    $73.25 lower than Manhattan for the office setting.

  • South Carolina

    South Carolina · 91040

    Office

    $535.21

    Facility

    Unavailable

    $133.09 lower than Manhattan for the office setting.

  • South Dakota**

    South Dakota · 91040

    Office

    $575.06

    Facility

    Unavailable

    $93.24 lower than Manhattan for the office setting.

  • Tennessee

    Tennessee · 91040

    Office

    $526.24

    Facility

    Unavailable

    $142.06 lower than Manhattan for the office setting.

  • Austin

    Texas · 91040

    Office

    $608.05

    Facility

    Unavailable

    $60.25 lower than Manhattan for the office setting.

  • Beaumont

    Texas · 91040

    Office

    $527.83

    Facility

    Unavailable

    $140.47 lower than Manhattan for the office setting.

  • Brazoria

    Texas · 91040

    Office

    $571.62

    Facility

    Unavailable

    $96.68 lower than Manhattan for the office setting.

  • Dallas

    Texas · 91040

    Office

    $574.57

    Facility

    Unavailable

    $93.73 lower than Manhattan for the office setting.

  • Fort Worth

    Texas · 91040

    Office

    $569.18

    Facility

    Unavailable

    $99.12 lower than Manhattan for the office setting.

  • Galveston

    Texas · 91040

    Office

    $572.83

    Facility

    Unavailable

    $95.47 lower than Manhattan for the office setting.

  • Houston

    Texas · 91040

    Office

    $574.30

    Facility

    Unavailable

    $94.00 lower than Manhattan for the office setting.

  • Rest Of Texas

    Texas · 91040

    Office

    $548.91

    Facility

    Unavailable

    $119.39 lower than Manhattan for the office setting.

  • Utah

    Utah · 91040

    Office

    $544.02

    Facility

    Unavailable

    $124.28 lower than Manhattan for the office setting.

  • Virginia

    Virginia · 91040

    Office

    $566.83

    Facility

    Unavailable

    $101.47 lower than Manhattan for the office setting.

  • Virgin Islands

    United States Virgin Islands · 91040

    Office

    $582.76

    Facility

    Unavailable

    $85.54 lower than Manhattan for the office setting.

  • Vermont

    Vermont · 91040

    Office

    $570.09

    Facility

    Unavailable

    $98.21 lower than Manhattan for the office setting.

  • Rest Of Washington

    Washington · 91040

    Office

    $605.36

    Facility

    Unavailable

    $62.94 lower than Manhattan for the office setting.

  • Seattle (King Cnty)

    Washington · 91040

    Office

    $701.06

    Facility

    Unavailable

    $32.76 higher than Manhattan for the office setting.

  • Wisconsin

    Wisconsin · 91040

    Office

    $552.20

    Facility

    Unavailable

    $116.10 lower than Manhattan for the office setting.

  • West Virginia

    West Virginia · 91040

    Office

    $506.93

    Facility

    Unavailable

    $161.37 lower than Manhattan for the office setting.

  • Wyoming**

    Wyoming · 91040

    Office

    $576.14

    Facility

    Unavailable

    $92.16 lower than Manhattan for the office setting.

See how rates vary across the country

91040 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$499.05

$723.53

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$626.761
AL$507.871
AR$499.051
AZ$559.631
CA$628.21–$818.8429
CO$611.341
CT$619.801
DC$675.401
DE$570.211
FL$554.31–$603.163
GA$518.76–$586.142
GU$650.021
HI$650.021
IA$529.121
ID$532.031
IL$531.15–$593.764
IN$535.861
KS$523.431
KY$516.401
LA$514.34–$545.192
MA$605.55–$683.072
MD$583.44–$675.403
ME$532.43–$570.972
MI$529.99–$559.682
MN$590.681
MO$501.91–$550.803
MS$500.741
MT$576.831
NC$539.531
ND$575.251
NE$533.401
NH$598.741
NJ$628.27–$665.802
NM$532.351
NV$576.931
NY$548.92–$683.675
OH$529.661
OK$518.201
OR$573.87–$636.872
PA$532.21–$600.162
PR$582.761
RI$595.051
SC$535.211
SD$575.061
TN$526.241
TX$527.83–$608.058
UT$544.021
VA$566.83–$675.402
VI$582.761
VT$570.091
WA$605.36–$701.062
WI$552.201
WV$506.931
WY$576.141

Explore 91040 on the national rate map →

Where does this rate apply?

Manhattan is a Medicare payment area. Our Census mapping connects it to 1 cities and communities in New York, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in New York →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 91040 in Manhattan. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$735.13

$668.30 × 110% = $735.13

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 91040 in Manhattan.

PPRRVU2026_Oct_nonQPP.csv

11,615

Code
91040
Physician work
0.95
Practice expense
16.24
Malpractice
0.08

GPCI2026.csv

78

Locality
Manhattan
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office / nonfacility calculation for 91040 in Manhattan
ComponentRVULocality factorAdjusted
Physician work0.95× 1.0641.0108
Practice expense16.24× 1.16218.8709
Malpractice0.08× 1.5860.1269
Total RVUs20.0086
Conversion factor× 33.4009

Office / nonfacility rate, Manhattan$668.30

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 91040 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.951.064
Practice expense16.241.162
Malpractice0.081.586

(0.95 × 1.064 + 16.24 × 1.162 + 0.08 × 1.586) × $33.4009 = $668.30

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

91040 · Office / nonfacility

$668.30

Effective 2026-10-01

The base rate is $112.16 higher than on 2025-10-01, moving from $556.14 to $668.30 (20.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $556.14changed to$668.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.97 changed to 0.95
    • Practice expense RVU 13.76 changed to 16.24
    • Malpractice RVU 0.07 changed to 0.08
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $556.14

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$668.30Not available in this settingRVU26D
2026-07-01$668.30Not available in this settingRVU26C
2026-04-01$668.30Not available in this settingRVU26B
2026-01-01$668.30Not available in this settingRVU26A
2025-10-01$556.14Not available in this settingRVU25D
2025-07-01$556.14Not available in this settingRVU25C
2025-04-01$556.14Not available in this settingRVU25B
2025-01-01$556.14Not available in this settingRVU25A

91040 billing questions

How does 91040 differ from esophageal manometry?

91040 evaluates how the esophageal lumen opens during balloon distension. Esophageal manometry measures pressure patterns and contractions through pressure sensors.

Does 91040 include the endoscopic examination?

No. 91040 represents the balloon distension assessment and its interpretation, not the endoscopic examination. Report an endoscopy only when it is separately performed and its documentation supports that service.

Can the professional and technical portions 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.

Can modifier 50 be used when the test evaluates both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

What documentation supports reporting 91040?

Document the clinical question, the balloon-based measurements and findings, and the physician’s interpretation. The record should make clear that the service assessed distension and luminal opening rather than only pressure patterns or reflux.

What surgical-assistance rules apply?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing are not permitted for this code.

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.

RVUs for 91040PPRRVU2026_Oct_nonQPP.csv, line 11,615 (RVU26D)
Geographic factors for ManhattanGPCI2026.csv, line 78 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet