Medicare Reimbursement for G9157 – Transesophageal Doppler Cardiac Monitoring

G9157 is a HCPCS Level II code describing transesophageal Doppler cardiac monitoring. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and by locality, and compares non-facility and facility payment settings.

Medicare allowed amount (2026)

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare payment for G9157 is based on three Relative Value Units (RVUs) — work, practice expense (PE), and malpractice (MP) — that reflect the physician effort, overhead costs, and liability risk associated with the service. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is furnished, since costs vary by region. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings can have different PE RVUs because overhead costs differ when a service is performed in a physician office versus a hospital or facility setting; for this code, the PE RVU is the same in both settings.

RVUs — work 2.15, practice expense 0.32 (non-facility) / 0.32 (facility), malpractice 0.18 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This is an estimate only, not a guarantee of payment.
• Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
• Actual payment varies by locality-specific GPCI values, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
• Always verify the current fee with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.