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 in Oregon
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 in Oregon.
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 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$64.04–$70.74
2 of 2 localities have a supported rate.
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.
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 rates for Oregon, from the same CMS release.
$244.13–$268.05
91010 evaluates esophageal motility using pressure measurements. Code 91065 measures exhaled gases after a test substrate.
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.
2 of 2 payment localities
Portland →
Office / nonfacility
$70.74
Facility
Unavailable
Rest Of Oregon →
Office / nonfacility
$64.04
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