CPT 91035 Gastroenterology

How Much Does G-esoph Reflx Tst with Electrod Cost?

Also known as: G-esoph reflx tst w/electrod (CPT 91035)

G-esoph Reflx Tst with Electrod (CPT 91035) costs $502 at Medicare rates. Hospital outpatient rate: $877.

Cost Comparison by Payer

How much G-esoph reflx tst w/electrod costs across different settings and payers

Medicare
Facility rate
$502
Hospital Outpatient
OPPS rate
$877
Surgery Center
ASC rate
$419
Medicare (Facility)
$502
CMS PFS 2026 national rate
Hospital Outpatient
$877
OPPS rate
Surgery Center (ASC)
$419
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside G-esoph reflx tst w/electrod

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How to Reduce Your Cost for G-esoph reflx tst w/electrod

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $419, compared to $877 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

1.55
Work RVU
13.34
Practice Expense RVU
0.15
Malpractice RVU
15.04
Total RVU

Payment = Total RVU (15.04) x CF ($33.40) = $502

Frequently Asked Questions

How much does G-esoph reflx tst w/electrod cost?

The Medicare facility rate for G-esoph reflx tst w/electrod is $502. In a hospital outpatient setting, the rate is $877. At an ambulatory surgery center, the rate is $419. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does G-esoph reflx tst w/electrod cost without insurance?

Without insurance, the cost of G-esoph reflx tst w/electrod can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover G-esoph reflx tst w/electrod?

Most commercial health insurance plans and Medicare cover G-esoph reflx tst w/electrod when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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