Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 91319 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.
Sarscv2 Vac 10mcg Trs Suc Im, Severe Acute Respiratory Syndrome Coronavirus 2 Sarscov 2 Coronavirus Disease Covid 19 Vaccine Mrnalnp Spike Protein 10 Mcg 0 3 Ml Dosage Tris Sucrose Formulation For Intramuscular Use
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Gastroenterology Procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $103.33 per 1 dose (October 2026 ASP) · View Medicare rates for 91319 |
| Medicaid Fee Schedule | $88.92 median of the 8 states in the free preview · View Medicaid rates for 91319 |
National average reimbursement for CPT 91319 by major payers:
$N/A
$N/A
$N/A
$N/A
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 91319.
CPT 91319
5 of 25 sample ratesHigher to lower in this preview
Santosh Shrestha
Siu Physicians & Surgeons Inc
$184.80Published rateChristopher Raio
St Francis Hospital
$103.18Published rateNimisha Patel
$92.40Published rateMary Fahrmeier
$87.77Published rateDavid Kim
Town Center Orthopaedic Associates, P.C.
$77.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 91319 vs. Other Gastroenterology Procedures Codes
The CPT 91319 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 91319 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 |
|---|---|---|
| 91319-CPT | Moderate | Sarscv2 Vac 10mcg Trs Suc Im, Severe Acute Respiratory Syndrome Coronavirus 2 Sarscov 2 Coronavirus Disease Covid 19 Vaccine Mrnalnp Spike Protein 10 Mcg 0 3 Ml Dosage Tris Sucrose Formulation For Intramuscular Use |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 91319. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 91319 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 91319) and we'll show you how you compare in 15 minutes or less.