Billing code 91035: Reflux testingMedicare rate & RVUs in Oklahoma
Reports ambulatory esophageal acid monitoring with a mucosa-attached wireless electrode to evaluate suspected gastroesophageal reflux and measure acid exposure.
Medicare pays $453.56 for 91035 in the office in Oklahoma (Oklahoma). 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 91035 covers
This service uses a wireless pH electrode attached to the esophageal lining to collect acid readings during ambulatory monitoring. A gastroenterologist or other qualified clinician commonly places the electrode during an upper endoscopy; the patient then leaves with the recorder and follows instructions for documenting symptoms and activities. The completed study is analyzed to assess esophageal acid exposure and its relationship to reported symptoms, such as persistent heartburn or regurgitation.
Report 91035 for the wireless, mucosa-attached monitoring method, including electrode placement, recording, analysis, and interpretation. Documentation should identify the clinical reason for testing and support the recorded study and interpretation. The global service includes the professional interpretation and technical recording; modifier 26 identifies the professional component, while TC identifies the technical component. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this service. 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.
91035 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $453.56 | Unavailable |
How the 91035 rate is calculated
Each of 91035’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 · 91035
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.55Practice expense 13.34Malpractice 0.15
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 91035
The CMS indicators that decide how 91035 is paid alongside other services.
CMS payment indicators · 91035
Reflux testing
| 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
91035 without 26 · national office
$502.35
Reflux testing
91035-26 · Professional component
$85.17
Pays only the interpretation and report.
91035 compared with similar codes
Compare codes
91035 vs 91034 vs 91037 vs 91038: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 91034Reflux monitoring
- Choose 91035 for wireless pH monitoring using an electrode attached to the esophageal lining. Choose 91034 for catheter-based pH monitoring.
- 91037Esophageal impedance
- 91037 reports esophageal impedance testing, rather than the mucosa-attached wireless pH study reported with 91035.
- 91038Esophageal impedance
- 91038 reports esophageal impedance testing for more than one hour. 91035 is the wireless mucosa-attached pH monitoring service.
91035 billing questions
How does 91035 differ from 91034?
91035 is for pH monitoring with a mucosa-attached wireless electrode. 91034 describes catheter-based esophageal pH monitoring.
Does 91035 include electrode placement and study interpretation?
Yes. The service includes placement of the mucosa-attached electrode, recording, analysis, and interpretation.
Can the professional and technical portions be billed separately?
Yes. Use modifier 26 for the professional interpretation and modifier TC for the technical service; billing without either modifier represents the global service.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this service because its descriptor and anatomy do not support bilateral adjustment.
What documentation supports reporting 91035?
Document the reason for reflux testing, the wireless mucosa-attached method, the recorded study, and the interpretation of the results.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing 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 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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