Billing code 91124: Rectal physiologyMedicare rate & RVUs in Texas
A rectal physiology study assesses sensation, tone, and compliance, typically when evaluating altered rectal function such as constipation or fecal incontinence.
Medicare pays $708.69–$806.16 for 91124 in the office in Texas, from Beaumont to Austin. 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 91124 covers
This study evaluates how the rectum senses distention and responds to it, including rectal tone and compliance. Testing commonly uses controlled balloon distention to assess sensory responses and pressure changes. Gastroenterologists, colorectal specialists, or clinicians in a gastrointestinal motility service may perform it in an outpatient testing setting for patients with symptoms such as impaired evacuation or fecal incontinence.
Select 91124 when the documented service is the rectal sensation, tone, and compliance study, rather than a more comprehensive anorectal manometry service. The report should identify the testing performed and include the physiologic findings and interpretation. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and reporting without either modifier represents the global service.
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.
Where 91124 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$708.69 to $806.16
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $806.16 | Unavailable |
| Beaumont | $708.69 | Unavailable |
| Brazoria | $761.82 | Unavailable |
| Dallas | $765.79 | Unavailable |
| Fort Worth | $759.29 | Unavailable |
| Galveston | $763.49 | Unavailable |
| Houston | $767.52 | Unavailable |
| Rest Of Texas | $734.22 | Unavailable |
How the 91124 rate is calculated
Each of 91124’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 · 91124
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.05Practice expense 19.74Malpractice 0.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 91124
The CMS indicators that decide how 91124 is paid alongside other services.
CMS payment indicators · 91124
Rectal physiology
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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
91124 without 26 · national office
$768.55
Rectal physiology
91124-26 · Professional component
$163.66
Pays only the interpretation and report.
91124 compared with similar codes
Compare codes
91124 vs 91125: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 91125Anorectal testing
- 91125 describes a broader anorectal manometry service that includes rectal sensation and balloon expulsion testing; 91124 is for the rectal sensation, tone, and compliance study.
91124 billing questions
How is 91124 distinguished from 91125?
91124 represents the rectal sensation, tone, and compliance study. Choose 91125 when the documented service is the broader anorectal manometry service that includes rectal sensation and balloon expulsion testing.
Can the professional and technical portions be billed separately?
Yes. Use modifier 26 for the professional interpretation or modifier TC for the technical equipment and staff portion. Without either modifier, the claim represents the global service.
What documentation supports reporting 91124?
Document the rectal physiologic testing performed, the recorded sensory or pressure findings, and the interpretation. The record should support that the service was a rectal sensation, tone, and compliance study.
Is this the same as anorectal manometry?
The services are related but not interchangeable by name alone. Select the code that matches the actual testing performed and documented, particularly whether the service includes the broader manometry and balloon expulsion assessment.
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
Fee sheets
Put 91124 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →