CPT code 91010: Esophageal manometry2026 Medicare rate & RVUs in Kentucky
Esophageal manometry records pressure patterns during swallowing to evaluate dysphagia, suspected motility disorders, and esophageal function before selected procedures.
Medicare pays $223.26 for 91010 in the office in Kentucky (Kentucky). Which amount applies depends on the service address.
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 9 sections
What 91010 covers
Esophageal manometry uses a pressure-sensing catheter passed through the nose into the esophagus to record pressure changes during swallowing. The study evaluates coordinated esophageal contractions and lower esophageal sphincter function, often for dysphagia, suspected achalasia, or other motility disorders. Gastroenterology practices typically perform it in an outpatient motility lab or endoscopy setting, with a clinician interpreting the recorded study and producing a report.
Report the study when standard pressure measurements are performed; document the indication, procedure details, findings, and interpretation. The global service includes both the technical work and interpretation; modifier 26 identifies the professional interpretation, while modifier TC identifies equipment and staff. Same-day preoperative and postoperative care is included in the 0-day global period. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing are not permitted.
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.
91010 in Kentucky
| Payment locality | Office | Facility |
|---|---|---|
| Kentucky | $223.26 | Unavailable |
How the 91010 rate is calculated
Each of 91010’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 · 91010
RVUs × geographic indexes × conversion factor
Work1.25
1.25 RVUs× 1.000 GPCI
Practice expense6.02
6.02 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
7.3600
Conversion factor
$33.4009
Medicare rate
$245.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 91010
The CMS indicators that decide how 91010 is paid alongside other services.
CMS payment indicators · 91010
Esophageal manometry
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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
91010 without 26 · national office
$245.83
Esophageal manometry
91010-26 · Professional component
$67.80
Pays only the interpretation and report.
91010 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 91013Esophageal motility
- 91010 represents standard pressure motility testing. 91013 is added when stimulation or perfusion is performed with the motility study.
- 91037Esophageal impedance
- 91010 records esophageal pressure patterns during swallowing; 91037 evaluates esophageal function using impedance to assess bolus movement or reflux.
- 91034Reflux monitoring
- 91010 evaluates esophageal motility with pressure measurements. 91034 monitors esophageal acid exposure to investigate reflux.
91010 billing questions
When should 91010 be reported instead of 91013?
Report 91010 for a standard esophageal pressure motility study. Use 91013 as an add-on when the study includes stimulation or perfusion.
Can the interpretation and technical service 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.
What documentation supports 91010?
Document the clinical reason for testing, the study performed, the pressure findings, and the interpreting clinician's report. The record should support that standard esophageal motility measurements were obtained.
Is modifier 50 appropriate for this code?
No. The descriptor and anatomy do not support bilateral reporting, so modifier 50 is inappropriate.
How are same-day services around the test treated?
The code has a 0-day global period, which includes same-day preoperative and postoperative care.
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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