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See a sample rate comparisonCPT 91020 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Esophagogastric Manometric Studies
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Gastroenterology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $308.62 national non-facility rate (2026) · View Medicare rates for 91020 |
| Medicaid Fee Schedule | $249.19 median of the 8 states in the free preview · View Medicaid rates for 91020 |
National average reimbursement for CPT 91020 by major payers:
$318.06
$314.57
$324.60
$409.82
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CPT 91020
5 of 25 sample ratesHigher to lower in this preview
Srishti Nangia
$643.95Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$445.60Published rateShannon Jennings
Ottawa Regional Hospital & Healthcare Center
$348.60Published rateChristopher Raio
St Francis Hospital
$286.21Published rateMatteo Respino
Indiana University Health Care Associates Inc
$86.05Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 91020 vs. Other Gastroenterology Procedures Codes
The CPT 91020 code is part of the Medicine Services and Procedures services used for Gastroenterology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 91020 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 91010-CPT | Moderate | Study Of Esophagus Function, The Esophagus Function Study (Esophageal Motility) Examines How The Muscle Moves Food From Swallowing To The Stomach. It Can Evaluate The Valves That Stop Acid Reflux As Well As Identify A Problem With Swallowing. |
| 91013-CPT | Low | Diagnostic Test, Esophageal Motility (Manometric Study Of The Esophagus And/Or Gastroesophageal Junction) Study With Interpretation And Report; With Stimulation Or Perfusion During 2-Dimensional Data Study (Eg Stimulant Acid Or Alkali Perfusion) (List Separately In Addition To Code For Primary Procedure) |
| 91020-CPT | Moderate | Esophagogastric Manometric Studies |
| 91022-CPT | Moderate | Duodenal Motility Study |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91020 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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