CPT 91010
Global 000 ActiveEsophagus motility study
CPT 91010 Billing & Documentation Guide
CPT code 91010 (Esophagus motility study) is classified under Gastro Diagnostics with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.25, a non-facility practice expense RVU of 6.02, and a malpractice RVU of 0.09, a total non-facility RVU of 7.36 and facility RVU of 7.36. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $255.03, though rates vary from $216.02 to $337.9 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 91010, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 91010 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 91010 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 91010
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.25 | 1.25 |
| Practice Expense RVU | 6.02 | 6.02 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 7.36 | 7.36 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 91010
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $282.8 | $282.8 | $264.45 - $337.9 | 29 |
| Florida | $249.35 | $249.35 | $238.5 - $258.67 | 3 |
| Georgia | $237.24 | $237.24 | $224.69 - $249.78 | 2 |
| Illinois | $241.93 | $241.93 | $230.03 - $253.87 | 4 |
| Michigan | $234.8 | $234.8 | $228.73 - $240.86 | 2 |
| North Carolina | $231.27 | $231.27 | $231.27 - $231.27 | 1 |
| New York | $272.13 | $272.13 | $234.88 - $289.08 | 5 |
| Ohio | $228.36 | $228.36 | $228.36 - $228.36 | 1 |
| Pennsylvania | $242.3 | $242.3 | $229.18 - $255.41 | 2 |
| Texas | $242.73 | $242.73 | $227.52 - $257.23 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 91010
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 91010 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0240T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0241T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 91010
What does CPT code 91010 mean? +
CPT code 91010 represents: Esophagus motility study. It's in the Gastro Diagnostics category with a global period of 000.
What is the Medicare reimbursement for CPT 91010? +
The 2026 Medicare national average non-facility payment for CPT 91010 is $255.03. Rates range from $216.02 to $337.9 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 91010? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 91010? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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