How much does Medicare pay for CPT 91037?

Medicare allowed an average of $90.74 per service and paid $71.19 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $439.26, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 91037?

Monitoring and recording of esophageal function through nasal tube with electrode. It was billed 7,832 times to 7,779 Medicare beneficiaries by 276 providers in 2024.

Does 91037 pay differently in an office than a hospital?

Yes. The allowed amount averaged $141.09 in an office setting and $48.09 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 91037 most?

Gastroenterology, with 6,492 services from 228 clinicians. Next are Internal Medicine, General Surgery, Nurse Practitioner.

CPT 91037

Monitoring and recording of esophageal function through nasal tube with electrode

$90.74Medicare-allowed amount per service, averaged across 7,832 services

Providers submitted

$439.26

Asking price, not received

Medicare allowed

$90.74

The fee schedule figure

Medicare paid

$71.19

Balance is patient coinsurance

Providers submitted an average of $439.26 for this code and Medicare allowed $90.74 — 4.8× 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 $71.19 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $141.09
Hospital / facility: $48.09

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. 3,592 services were billed in an office setting and 4,240 in a facility.

Services: 7,832
Beneficiaries: 7,779
Providers billing it: 276
Total allowed: $710,676

What Medicare pays for CPT 91037

Across 7,832 services billed by 276 providers to 7,779 beneficiaries, Medicare allowed an average of $90.74 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 91037

Specialty	Services	Beneficiaries	Avg allowed	Providers
Gastroenterology	6,492	6,449	$85.21	228
Internal Medicine	567	561	$128.66	13
General Surgery	526	524	$118.39	22
Nurse Practitioner	86	86	$94.61	4
Physician Assistant	62	62	$99.64	4
Radiation Oncology	35	35	$51.84	1
Otolaryngology	29	27	$152.99	1
Pediatric Medicine	24	24	$50.40	2
Emergency Medicine	11	11	$44.91	1

91037 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
California	1,196	$79.86	$54.96	33
Florida	858	$101.28	$81.90	28
New York	731	$125.87	$86.13	23
Minnesota	378	$115.48	$93.78	7
Ohio	368	$99.26	$82.51	11
Texas	350	$89.20	$71.36	15
Colorado	299	$130.18	$100.36	10
Pennsylvania	284	$117.56	$94.23	13
Maryland	273	$86.46	$64.76	9
Washington	267	$123.40	$91.38	8
New Hampshire	213	$69.91	$57.87	3
Indiana	197	$58.59	$46.16	10
Arizona	186	$45.81	$37.42	4
South Carolina	174	$96.33	$81.58	6
North Carolina	169	$56.22	$47.37	7
Nebraska	162	$94.01	$77.44	7
Massachusetts	149	$50.79	$35.49	8
Virginia	136	$78.65	$61.54	6
Illinois	134	$76.82	$57.32	6
Wisconsin	121	$70.55	$57.02	8
Georgia	116	$63.00	$48.81	5
Michigan	94	$46.80	$36.43	2
Oregon	83	$156.57	$108.02	4
New Mexico	80	$48.43	$36.26	2
Missouri	79	$44.52	$36.50	3
Oklahoma	77	$120.85	$105.08	2
Arkansas	75	$102.63	$89.76	5
District of Columbia	67	$54.56	$35.88	2
Louisiana	66	$87.03	$77.22	5
New Jersey	63	$50.26	$36.74	2
South Dakota	50	$45.86	$35.73	2
Utah	45	$45.34	$32.55	2
Delaware	37	$46.08	$36.26	2
Kentucky	37	$46.10	$37.47	2
Montana	34	$46.86	$34.91	1
Tennessee	34	$83.04	$66.81	3
Mississippi	33	$44.52	$36.26	2
Iowa	30	$44.90	$30.19	2
Connecticut	29	$48.38	$36.31	2
Nevada	20	$132.89	$113.10	1
Hawaii	15	$46.22	$37.94	1
Alabama	12	$44.55	$37.17	1
Kansas	11	$47.90	$37.32	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
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
91034Monitoring and recording of esophageal function through nasal tube$120.21

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.