CPT 91013
Global ZZZ ActiveEsophgl motil w/stim/perfus
CPT 91013 Billing & Documentation Guide
CPT code 91013 (Esophgl motil w/stim/perfus) is classified under Gastro Diagnostics with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.18, a non-facility practice expense RVU of 0.66, and a malpractice RVU of 0.01, a total non-facility RVU of 0.85 and facility RVU of 0.85. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $29.43, though rates vary from $25.12 to $38.64 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 91013, 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 91013 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 91013 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 91013
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.18 | 0.18 |
| Practice Expense RVU | 0.66 | 0.66 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 0.85 | 0.85 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 91013
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 | $32.49 | $32.49 | $30.45 - $38.64 | 29 |
| Florida | $28.78 | $28.78 | $27.59 - $29.81 | 3 |
| Georgia | $27.45 | $27.45 | $26.07 - $28.83 | 2 |
| Illinois | $27.98 | $27.98 | $26.66 - $29.29 | 4 |
| Michigan | $27.19 | $27.19 | $26.52 - $27.85 | 2 |
| North Carolina | $26.79 | $26.79 | $26.79 - $26.79 | 1 |
| New York | $31.35 | $31.35 | $27.19 - $33.23 | 5 |
| Ohio | $26.48 | $26.48 | $26.48 - $26.48 | 1 |
| Pennsylvania | $28.02 | $28.02 | $26.56 - $29.47 | 2 |
| Texas | $28.06 | $28.06 | $26.38 - $29.64 | 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 91013
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 91013 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0241T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99446 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99447 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99448 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99449 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99451 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99452 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 91013
What does CPT code 91013 mean? +
CPT code 91013 represents: Esophgl motil w/stim/perfus. It's in the Gastro Diagnostics category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 91013? +
The 2026 Medicare national average non-facility payment for CPT 91013 is $29.43. Rates range from $25.12 to $38.64 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 91013? +
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 91013? +
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 1, 2026.
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