CPT 91110 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Gastroenterology Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 52 - Reduced Services |
| Complexity Level | Moderate |
National average reimbursement for CPT 91110 by major payers:
$910.96
$1,127.97
$1,152.79
$1,335.72
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 91110 | ||||||
United | 91110 | $179.82 | 1639176993 - JAIME BAQUERO | 203713889 - (FL) ARCADIA MEDICAL ASSOCIATES, PA | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $128.25 | 1841272549 - BRIAN FEIOCK | 650302093 - (FL) GASTROENTEROLOGY ASSOCIATES OF SOUT | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $2159.18 | 1285657544 - PRITI JOSHI-GUSKE | 591680273 - FLORIDA CLINICAL PRACTICE ASSOCIATION INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $199.85 | 1407110414 - EDUARDO RODRIGUEZ ZARATE | 274749421 - TAMPA GENERAL MEDICAL GROUP INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $817.97 | 1619954393 - SANJAY REDDY | 592894914 - (FL) DIGESTIVE DISEASE CONSULTANTS, P.A. | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1427.68 | 1023110814 - ANDRIA MUSHAHWAR | 205733575 | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1074.91 | 1750320099 - GASTROENTEROLOGY ASSOC OF CENTRAL FL | 592358293 - (FL) GASTROENTEROLOGY ASSOCIATES OF CENTRAL FLORIDA, P.A. | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $692.02 | 1356381370 - SETH STEINBERG | 824746934 - (FL) GASTROENTEROLOGY ASSOCIATES OF FLORIDA, LLC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1161.98 | 1689968463 - DUSTIN ALBERT | 650512900 - SMH PHYSICIAN SERVICES INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1421.59 | 1306259817 - KHALID ARSHAD | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 91110 | $1056.50 | 1518925205 - CARLOS MONTERO | 270709861 - (FL) FLORIDA DIGESTIVE HEALTH SPECIALISTS, LLP | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $222.38 | 1699839514 - VICTOR LEVY | 590714812 - LEE MEMORIAL HEALTH SYSTEM | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1229.28 | 1558332874 - ALEXANDER RESTREPO | 800400884 - (FL) NORTHWEST FLORIDA MULTISPECIALTY PHYSICIANS LLC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1542.28 | 1922082130 - NED PANARA | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91110 | $1260.31 | 1568814333 - NEETHI PARANJI | 593149293 - SOUTHWEST VOLUSIA HEALTHCARE CORPORATION | FL | Gastroenterology Physician (207RG0100X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 91110 vs. Other Gastroenterology Procedures Codes
The CPT 91110 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 91110 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 | Esophageal Motility (Manometric Study Of The Esophagus And/Or Gastroesophageal Junction) Study With Interpretation And Report; 2-Dimensional Data |
| 91013-CPT | Low | Esophageal Motility (Manometric Sturdy 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) |
| 91110-CPT | Moderate | Gastrointestinal Tract Imaging Intraluminal (Eg Capsule Endoscopy) Esophagus Through Ileum With Interpretation And Report (Revised 1/1/2013) |
| 91111-CPT | Moderate | Gastrointestinal Tract Imaging Intraluminal (Eg Capsule Endoscopy) Esophagus With Interpretation And Report (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91110 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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