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See a sample rate comparisonCPT 91299 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.
Unlisted Diagnos Gastroenterology Proc, Unlisted Diagnostic Gastroenterology Procedure
| 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 PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 91299 |
| Medicaid Fee Schedule | $190.85 median of the 2 states in the free preview · View Medicaid rates for 91299 |
National average reimbursement for CPT 91299 by major payers:
$945.73
$39.86
$49.82
$607.25
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CPT 91299
5 of 25 sample ratesHigher to lower in this preview
Kettering Medical Center, Kettering Health Troy
Kettering College
$4,595.00Published rateOrange Coast Memorial Medical Center
Memorial Health Services
$1,925.00Published rateSmsj Tucson Holdings LLC, St. Josephs Hospital
$1,095.00Published ratePortercare Adventist Health System, Adventhealth Parker
Portercare Adventist Health System
$633.00Published rateJohnston Memorial Hospital, Inc, Johnston Memorial Hospital Rehabilitation
Johnston Memorial Hospital Inc
$181.00Published rate
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See a sample payer proposalCPT 91299 vs. Other Gastroenterology Procedures Codes
The CPT 91299 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 91299 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 |
| 91299-CPT | Moderate | Unlisted Diagnos Gastroenterology Proc, Unlisted Diagnostic Gastroenterology Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91299. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91299 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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