Average reimbursements for the 15 most common GI procedures

In wake of CMS’ recently finalized physician fee schedule, which reduces overall physician pay 1.25% in 2024, reimbursement changes have remained a persistent issue for gastroenterologists.

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Below are the average costs of 15 common gastroenterology procedures at hospital outpatient departments and ASCs — as determined by analytics company Definitive Healthcare — using data from CMS’ physician fee schedule search tool.

Note: Procedure costs listed are the non-facility price, which is the price for procedures performed in office.

Code

Procedure

 Payment amount 

91200

Liver elastography

$30.13

91065

Breath hydrogen/methane test

$72.69

91110

 GI tract imaging, capsule endoscopy 

$717.10

91010

Esophagus motility study

$217.09

91122

Anorectal manometry

$271.12

91035

 Gastroesophageal reflux test with electrode 

$446.63

91120

Rectal sensation test

$491.16

91037

Esophageal function test with electrode

$165.69

91038

Esophageal function test, >1 hour

$395.55

91040

Esophageal balloon distention test

$507.21

 91034 

Gastroesophageal reflux test

$187.95

91299

Gastroenterology procedure (other)

 Contractor priced 

91112

GI wireless capsule measurement

$1,580.56

91133

Electrogastrography w/ test

$451.54

91111

GI tract imaging, esophageal endoscopy

$859.21

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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