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See a sample rate comparisonCPT 91035 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.
G Esoph Reflx Tst W Electrod, Esophagus Gastroesophageal Reflux Test With Mucosal Attached Telemetry Ph Electrode Placement Recording Analysis And Interpretation
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Gastroenterology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $502.35 national non-facility rate (2026) · View Medicare rates for 91035 |
| Medicaid Fee Schedule | $398.09 median of the 8 states in the free preview · View Medicaid rates for 91035 |
National average reimbursement for CPT 91035 by major payers:
$517.42
$614.79
$654.65
$761.69
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CPT 91035
5 of 25 sample ratesHigher to lower in this preview
Laura Sahyoun
$1,635.92Published rateChristopher Tomaino
Chs Physician Partners PC
$618.75Published rateJonathan Rieber
Manhattan Gastroenterology Associates PC
$488.05Published rateGary Sinensky
Allegiance Health
$400.36Published rateBarry Obadiah
Metropolitan Gastroenterology, P.C.
$78.81Published rate
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See a sample payer proposalCPT 91035 vs. Other Gastroenterology Procedures Codes
The CPT 91035 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 91035 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 |
|---|---|---|
| 91034-CPT | Moderate | Gastroesophageal Reflux Test, Esophagus Gastroesophageal Reflux Test With Nasal Catheter Ph Electrode S Placement Recording Analysis And Interpretation |
| 91035-CPT | Moderate | G Esoph Reflx Tst W Electrod, Esophagus Gastroesophageal Reflux Test With Mucosal Attached Telemetry Ph Electrode Placement Recording Analysis And Interpretation |
| 91037-CPT | Low | Esophageal Function Test Gast, Esophageal Function Test Gastroesophageal Reflux Test With Nasal Catheter Intraluminal Impedance Electrode(S) Placement Recording Analysis And Interpretation |
| 91038-CPT | Moderate | Esoph Imped Funct Test 1hr, Esophageal Function Test Gastroesophageal Reflux Test With Nasal Catheter Intraluminal Impedance Electrode S Placement Recording Analysis And Interpretation Prolonged Greater Than 1 Hour Up To 24 Hours |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91035 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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