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CPT 91040

Esophageal Balloon Dist Test Endoscopy

Reported by 24 hospitals in the network under the other methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$309

Average

$3.9k

Median

$587

High

$17.1k

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$153$671$886$2.3k$517
2St. Joseph Health System, LLCIN 46802, IN$153$711$1.1k$2.3k$647
3Wesley Health System LLCHattiesburg, MS$188$437$667$1.7k$422
4Northwest Sahurita Hospital LLCAZ 85748, AZ$240$398$616$8.0k$456
5Northwest Sahurita Hospital LLCAZ 85629, AZ$240$398$616$8.0k$456
6Oro Valley Hospital LLCTucson, AZ$274$398$593$8.0k$436
7Northwest Hospital LLCAZ 85741, AZ$268$396$582$8.0k$427
8Affinity Hospital LLCBirmingham, AL$137$419$534$3.9k$289
9Sanford USD Medical CenterSioux Falls, SD$238$917$917$1.9k—
10Mercy Health Fairfield Hospital LlcFairfield, OH$370$370$371$377$2
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