Choose 91034 for pH monitoring with a transnasal catheter; choose 91035 when the study uses wireless pH monitoring.
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CMS RVU26D · Effective 2026-10-01
91034 Reflux monitoring Medicare reimbursement rates in Delaware
Reports ambulatory esophageal acid monitoring with a transnasal catheter to evaluate reflux and correlate recorded acid events with symptoms. Compare 91034 office and facility rates across CMS payment localities in Delaware.
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 91034 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$200.28
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Gastroenterology
About 91034: Transnasal esophageal pH monitoring
Reports ambulatory esophageal acid monitoring with a transnasal catheter to evaluate reflux and correlate recorded acid events with symptoms.
This service evaluates gastroesophageal reflux by placing a pH-sensing catheter through the nose into the esophagus and recording acid exposure during ambulatory monitoring, commonly over 24 hours. A gastroenterologist or other qualified clinician places the catheter; the study data are analyzed and interpreted to assess acid reflux and its relationship to reported symptoms. It may be used when reflux symptoms persist or when objective acid-exposure data are needed in a reflux evaluation.
Report 91034 for catheter-based pH monitoring, not a wireless capsule study or an impedance-based test. The record should support catheter placement, monitoring, analysis, and interpretation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Bill the global service without a modifier, or use modifier 26 for interpretation or TC for the technical service. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 91034
- 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 · 16%
- Practice expense (office) RVU5.03 · 83%
- Malpractice RVU0.08 · 1%
2.9K
Medicare services in 2024 · #2195 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.
91034 compared with similar codes
Office rates for Delaware, from the same CMS release.
91037 describes impedance-based reflux testing. Use 91034 when the performed study is catheter-based pH monitoring without impedance.
91038 is an impedance-based reflux test. The presence of impedance in the performed study distinguishes it from 91034.
91030 is an acid-perfusion test that provokes an esophageal response; 91034 records esophageal acid exposure during pH monitoring.
Compare 91034 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
$200.28
Facility
Unavailable
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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 91034 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
11,603
- Code
- 91034
- Physician work
- 0.95
- Practice expense
- 5.03
- Malpractice
- 0.08
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.95 | × 1.005 | 0.9547 |
| Practice expense | 5.03 | × 0.988 | 4.9696 |
| Malpractice | 0.08 | × 0.899 | 0.0719 |
| Total RVUs | 5.9963 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$200.28
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.95 | 1.005 |
| Practice expense | 5.03 | 0.988 |
| Malpractice | 0.08 | 0.899 |
(0.95 × 1.005 + 5.03 × 0.988 + 0.08 × 0.899) × $33.4009 = $200.28
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.
91034 billing questions
How does 91034 differ from 91035?
91034 is for pH monitoring with a transnasal catheter. 91035 is the wireless pH-monitoring method.
Can the interpretation be billed separately?
Yes. Modifier 26 identifies the professional interpretation; TC identifies the technical service. Without either modifier, the claim represents the global service.
What should the record support?
Document the catheter-based monitoring, recorded study data, analysis, and interpretation. The report should identify the findings relevant to esophageal acid exposure and reflux symptoms.
Should modifier 50 be appended?
No. CMS identifies modifier 50 as inappropriate for this service.
How does 91034 differ from impedance reflux testing?
91034 reports catheter-based pH monitoring. Codes 91037 and 91038 describe impedance-based reflux testing, so code selection follows the test actually performed.
Are same-day care and surgical-team services separately payable?
Same-day preoperative and postoperative care is included in the 0-day global period. Assistant-at-surgery payment requires documented medical necessity, while co-surgeons and team surgery are not permitted.
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.
