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See a sample rate comparisonCPT 91200 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.
Liver Imaging, Elastography Is An Imaging Technique That Can Show The Difference Between Normal And Abnormal Tissues. In This Procedure It Is Used To Assess Liver Fibrosis.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Gastroenterology Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $33.74 national non-facility rate (2026) · View Medicare rates for 91200 |
| Medicaid Fee Schedule | $27.35 median of the 8 states in the free preview · View Medicaid rates for 91200 |
National average reimbursement for CPT 91200 by major payers:
$40.18
$46.95
$45.22
$60.90
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CPT 91200
5 of 25 sample ratesHigher to lower in this preview
Bay Area Healthcare Group, Ltd., Corpus Christi Medical Center
$313.98Published rateEmerus Bhs Sa Thousand Oaks, LLC, Baptist Neighborhood Hospital Overlook
Emerus Bhs Sa Thousand Oaks LLC
$139.55Published rateEastland Memorial Hospital District, Eastland Memorial Hospital
$39.77Published rateBellville Hospital District, Bellville General Hospital
Bellville Medical Center
$20.92Published rateApex Cardiology, PC
$15.78Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 91200 vs. Other Gastroenterology Procedures Codes
The CPT 91200 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 91200 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 | Study Of Intestinal Movement, The Study Lasts At Least Six Hours And Is Designed To Provide Information For Constipation Treatment. A Tube Is Inserted Into The Intestines To Record Muscle Movement And Pressure. A Meal Or Drugs May Be Given To Stimulate The Intestines For The Study. |
| 91132-CPT | Moderate | Electrogastrography, Diagnostic, Transcutaneous |
| 91133-CPT | Moderate | Electrogastrography Diagnos Transcutaneous; W/ Provocative Test, Electrogastrography Diagnostic Transcutaneous; With Provocative Test |
| 91200-CPT | Low | Liver Imaging, Elastography Is An Imaging Technique That Can Show The Difference Between Normal And Abnormal Tissues. In This Procedure It Is Used To Assess Liver Fibrosis. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91200 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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Frequently Asked Questions
To get an estimate for a specific medical procedure or service, you can contact your healthcare provider's billing department directly. For general pricing information based on CPT codes and your specific location, you can also utilize specialized tools like Payerprice's fee schedule lookup tool.
CPT stands for Current Procedural Terminology. CPT codes are numerical codes used by medical professionals to describe the medical, surgical, and diagnostic services provided to patients. They are crucial for accurate medical billing, insurance claims processing, and ensuring consistent communication about healthcare services.
The best way to understand your health insurance coverage is to review your plan documents or contact your insurance provider directly. You can usually find a customer service number on your insurance card or by logging into their online member portal. They can provide details on benefits, deductibles, copayments, and any pre-authorization requirements.
For specific medical service prices based on a CPT code and your location, it is recommended to use a dedicated fee schedule lookup tool. Payerprice offers such a tool, allowing users to search with a CPT code and specific geographical area to find relevant pricing information.
A deductible is the amount you must pay out-of-pocket for covered healthcare services before your insurance plan begins to pay. A copay (or copayment) is a fixed amount you pay for a covered healthcare service after you've met your deductible, or for certain services where the deductible doesn't apply (e.g., doctor's visits). Coinsurance is your share of the cost of a healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service after you've met your deductible.