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See a sample rate comparisonCPT 91030 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Test For Acid Reflux, Test To Detect Esophageal Reflux (Condition Where The Stomach Acid From Digestion Is Regurgitated Back Up Into The Esophagus).
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Gastroenterology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $162.66 national non-facility rate (2026) · View Medicare rates for 91030 |
| Medicaid Fee Schedule | $130.265 median of the 8 states in the free preview · View Medicaid rates for 91030 |
National average reimbursement for CPT 91030 by major payers:
$171.20
$175.81
$172.76
$223.40
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CPT 91030
5 of 25 sample ratesHigher to lower in this preview
Joseph Pepitone
Northshore University Healthsystem Faculty Practice Associates
$266.04Published rateAngela Green
$180.94Published rateChristopher Raio
St Joseph Hospital
$142.82Published rateDavid Banayan
Loyola University Medical Center
$89.11Published rateNiranjan Karnik
The Board Of Trustees Of The University Of Illinois
$60.22Published rate
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See a sample payer proposalCPT 91030 vs. Other Gastroenterology Procedures Codes
The CPT 91030 code is part of the Medicine Services and Procedures services used for Gastroenterology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 91030 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 91010-CPT | Moderate | Study Of Esophagus Function, The Esophagus Function Study (Esophageal Motility) Examines How The Muscle Moves Food From Swallowing To The Stomach. It Can Evaluate The Valves That Stop Acid Reflux As Well As Identify A Problem With Swallowing. |
| 91013-CPT | Low | Diagnostic Test, Esophageal Motility (Manometric Study Of The Esophagus And/Or Gastroesophageal Junction) Study With Interpretation And Report; With Stimulation Or Perfusion During 2-Dimensional Data Study (Eg Stimulant Acid Or Alkali Perfusion) (List Separately In Addition To Code For Primary Procedure) |
| 91020-CPT | Moderate | Esophagogastric Manometric Studies |
| 91030-CPT | Low | Test For Acid Reflux, Test To Detect Esophageal Reflux (Condition Where The Stomach Acid From Digestion Is Regurgitated Back Up Into The Esophagus). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91030 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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