How much does Medicare pay for CPT 91034?

Medicare allowed an average of $120.21 per service and paid $91.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $427.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 91034?

Monitoring and recording of esophageal function through nasal tube. It was billed 1,561 times to 1,547 Medicare beneficiaries by 74 providers in 2024.

Does 91034 pay differently in an office than a hospital?

Yes. The allowed amount averaged $182.95 in an office setting and $48.78 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 91034 most?

Otolaryngology, with 610 services from 24 clinicians. Next are Gastroenterology, General Surgery, Internal Medicine.

CPT 91034

Monitoring and recording of esophageal function through nasal tube

$120.21Medicare-allowed amount per service, averaged across 1,561 services

Providers submitted

$427.84

Asking price, not received

Medicare allowed

$120.21

The fee schedule figure

Medicare paid

$91.78

Balance is patient coinsurance

Providers submitted an average of $427.84 for this code and Medicare allowed $120.21 — 3.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $91.78 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $182.95
Hospital / facility: $48.78

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 831 services were billed in an office setting and 730 in a facility.

Services: 1,561
Beneficiaries: 1,547
Providers billing it: 74
Total allowed: $187,648

What Medicare pays for CPT 91034

Across 1,561 services billed by 74 providers to 1,547 beneficiaries, Medicare allowed an average of $120.21 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 91034

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	610	609	$190.60	24
Gastroenterology	587	579	$59.73	35
General Surgery	100	98	$50.79	3
Internal Medicine	90	90	$152.19	2
Nurse Practitioner	81	80	$115.99	4
Physician Assistant	37	37	$95.66	2
Cardiac Surgery	21	19	$47.45	1
Allergy/ Immunology	12	12	$207.45	1
Thoracic Surgery	12	12	$47.43	1
Pediatric Medicine	11	11	$50.16	1

91034 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Illinois	220	$190.05	$142.82	4
Florida	178	$155.90	$116.72	9
Arizona	126	$47.34	$37.38	7
Minnesota	121	$124.59	$97.68	4
Washington	112	$52.58	$35.16	3
Pennsylvania	109	$86.01	$62.68	6
California	109	$113.16	$83.18	7
Maryland	107	$210.76	$144.06	4
Kansas	85	$169.05	$146.03	5
Missouri	62	$44.08	$35.63	4
Massachusetts	55	$49.62	$34.14	4
Ohio	46	$92.73	$77.99	3
Virginia	33	$47.31	$36.62	1
Oklahoma	25	$170.45	$149.51	1
North Carolina	24	$115.76	$88.64	2
Mississippi	22	$46.28	$35.27	1
Connecticut	18	$51.85	$38.03	1
New Jersey	17	$48.13	$35.84	1
Colorado	16	$48.09	$37.79	1
Nevada	14	$50.46	$37.97	1
New York	14	$235.98	$149.62	1
Idaho	13	$172.79	$129.30	1
Indiana	12	$45.52	$34.94	1
Arkansas	12	$164.84	$149.38	1
New Hampshire	11	$170.38	$142.17	1

Related codes

91065Measurement of hydrogen in breath to test for stomach and bowel sympto$62.96
91010Study of esophagus to assess movement$95.29
91037Monitoring and recording of esophageal function through nasal tube$90.74
91035Monitoring and recording of esophageal function through a capsule atta$147.52
91040Study of esophageal sensation by balloon distension$51.11
91038Prolonged monitoring and recording of esophageal function through nasa$144.18

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.