When should I use 91065?

Office breath test, typically for H. pylori urea breath test or SIBO eval.

What documentation does 91065 require?

- Indication. - Substrate used (urea, lactulose, glucose). - Baseline and timed measurements. - Interpretation.

What are common 91065 billing pitfalls?

- Patient prep is critical (no antibiotics, PPIs, bismuth for required interval) — invalid prep = invalid result.

How much does 91065 pay in 2026?

2026 work RVU for 91065 is 0.00. National Medicare non-facility allowable is approximately $44.42 at the 2026 conversion factor. Adjust for locality GPCI and your payer's contracted conversion factor for actual payment.

GI · CMS status A

91065

Breath test H pylori

Breath hydrogen or methane test for small bowel bacterial overgrowth, lactose intolerance, or H. pylori.

Model in calculator →Audit a note

Work RVU

0.00

2026 Medicare pays

$44.42

National GPCI · non-facility · CF $33.4009

RVU anatomyWork 0.00 + Practice 1.31 + Malpractice 0.02 = 1.33 total

Work (your effort)Practice expenseMalpractice

When to use it

Office breath test, typically for H.

Full guidance

pylori urea breath test or SIBO eval.

Documentation checklist

✓Indication.
✓Substrate used (urea, lactulose, glucose).
✓Baseline and timed measurements.
✓Interpretation.

Common pitfalls

!Patient prep is critical (no antibiotics, PPIs, bismuth for required interval) — invalid prep = invalid result.

Common ICD-10 pairings

B96.81K90.41

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.