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91113 Gi trc img intral colon i&r

What 91113 is

CMS fee schedule short descriptor: Gi trc img intral colon i&r.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 91113 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)2.3527.050.1029.50$985.33
Facility (hospital, ASC)2.3527.050.1029.50$985.33

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

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Medically Unlikely Edit (MUE)

Medicare caps 91113 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 91113? These codes are bundled into it

91113 is a Column 1 code in 3 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

91113 is bundled into these codes

91113 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 91113 is the code that denies.

Column 1 codeShort descriptionModifier indicator
91111Gi trc img intral esophagus0Check pair
91112Gi wireless capsule measure0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.