CPT 91122 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 |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 91122 by major payers:

$316.03

$313.97

$345.77

$418.46
| 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 91122 | ||||||
United | 91122 | $78.29 | 1609248772 - GASTROENTEROLOGY AND NUTRITION OF CENTRAL FLORIDA | 204622819 - (FL) GASTROENTEROLOGY AND NUTRITION | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $102.94 | 1194945097 - RIZWANA THANAWALA MD PA | 593445857 - (FL) RIZWANA THANAWALA, M.D., P.A. | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $325.70 | 1932184991 - ALFREDO RABASSA | 203400983 - (FL) GASTRO HEALTH, LLC | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $325.70 | 1245213453 - LEWIS FELDER | 203400983 - (FL) GASTRO HEALTH, LLC | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $138.07 | 1790112191 - FADI DIAB | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $258.07 | 1821296013 - R P GUPTA & ASSOCIATES MD PC | 592110610 - (FL) R P GUPTA ASSOCIATES MD PC | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $285.35 | 1649214040 - BRUCE MCCUNE | 461243081 | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $136.86 | 1548463003 - MOIN KOLA | 161727596 - DIGESTIVE & LIVER CENTER OF FL, PA | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $169.46 | 1679872808 - CAREN TAYLOR | 270709861 - (FL) FLORIDA DIGESTIVE HEALTH SPECIALISTS, LLP | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $460.25 | 1699773564 - HUEY NGUYEN | 272413974 | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $249.00 | 1699839514 - VICTOR LEVY | 590725553 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $107.68 | 1982694030 - CARLOS LEON | 141977089 | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $97.41 | 1861459166 - YAWER NENSEY | 593284825 - (FL) FLORIDA GASTROENTEROLOGY ASSOCIATES, P.A. | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $686.91 | 1194985168 - SOUVIK SARKAR | 680334324 | FL | Gastroenterology Physician (207RG0100X) |
United | 91122 | $174.21 | 1326048034 - SALMAN RASHID | 221894941 - UNIVERSITY RADIOLOGY GROUP, P.C. | 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 91122 vs. Other Gastroenterology Procedures Codes
The CPT 91122 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 91122 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 |
|---|---|---|
| 91117-CPT | Low | Colon Motility (Manometric) Study, Minimum 6 Hours Continuous Recording (Including Provocation Tests, Eg, Meal, Intracolonic Balloon Distension, Pharmacologic Agents, If Performed), With Interpretation And Report |
| 91120-CPT | Moderate | Rectal Sensation, Tone, And Compliance Test (Ie, Response To Graded Balloon Distention) |
| 91122-CPT | Moderate | Anorectal Manometry |
| 91132-CPT | Moderate | Electrogastrography, Diagnostic, Transcutaneous |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91122 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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