CPT code 91111: Capsule imaging, esophagus only2026 Medicare rate & RVUs in Nevada
Reports capsule-based imaging limited to the esophagus, including the technical study and interpretation when performed as a complete service.
In Nevada, Medicare pays $957.58 for 91111 in the office.
Check a contract rate as a % of Medicare · 91111 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 91111 covers
A patient swallows a miniature camera capsule that captures images as it passes through the esophagus. Gastroenterologists typically use this approach to assess the esophageal lining, including when capsule-based evaluation of suspected mucosal abnormalities or varices is selected. The study may be performed in an outpatient setting, with the patient wearing equipment that records the images for later review.
Report 91111 when the capsule imaging study is limited to the esophagus; use the documented study extent to distinguish it from imaging that covers additional gastrointestinal regions. The record should support the reason for the study, the esophageal imaging performed, and the resulting interpretation. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Nevada compares for 91111
Across 109 of 109 payment localities, the office rate for 91111 runs from $825.58 in Arkansas to $1,368.63 in San Benito County, CA. Nevada pays $957.58. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$957.58
- Los Angeles, CA · California$1,127.01+$169.43
- Washington, DC area · District of Columbia$1,123.52+$165.94
- Miami, FL · Florida$997.45+$39.87
- Chicago, IL · Illinois$963.93+$6.35
- Manhattan, NY · New York$1,109.79+$152.21
- Alaska · Alaska$1,031.06+$73.48
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $840.48 | — |
| ArkansasArkansas | $825.58 | — |
| ArizonaArizona | $927.99 | — |
| Bakersfield, CACalifornia | $1,045.73 | — |
| Chico, CACalifornia | $1,045.54 | — |
| El Centro, CACalifornia | $1,045.55 | — |
| Fresno, CACalifornia | $1,045.54 | — |
| Hanford, CACalifornia | $1,045.54 | — |
| Madera, CACalifornia | $1,045.54 | — |
| Merced, CACalifornia | $1,045.54 | — |
| Modesto, CACalifornia | $1,045.54 | — |
| Napa, CACalifornia | $1,252.39 | — |
| Oxnard, CACalifornia | $1,125.64 | — |
| Redding, CACalifornia | $1,045.54 | — |
| Rest of CaliforniaCalifornia | $1,045.54 | — |
| Riverside, CACalifornia | $1,046.10 | — |
| Sacramento, CACalifornia | $1,108.14 | — |
| Salinas, CACalifornia | $1,104.29 | — |
| San Diego, CACalifornia | $1,138.52 | — |
| Marin County, CACalifornia | $1,338.43 | — |
| San Francisco, CACalifornia | $1,338.38 | — |
| San Benito County, CACalifornia | $1,368.63 | — |
| Santa Clara County, CACalifornia | $1,368.40 | — |
| San Luis Obispo, CACalifornia | $1,085.36 | — |
| Santa Cruz, CACalifornia | $1,155.84 | — |
| Santa Maria, CACalifornia | $1,110.68 | — |
| Santa Rosa, CACalifornia | $1,168.14 | — |
| Stockton, CACalifornia | $1,045.54 | — |
| Vallejo, CACalifornia | $1,252.31 | — |
| Visalia, CACalifornia | $1,045.54 | — |
| Yuba City, CACalifornia | $1,045.54 | — |
| ColoradoColorado | $1,016.18 | — |
| ConnecticutConnecticut | $1,029.17 | — |
| DelawareDelaware | $945.80 | — |
| Fort Lauderdale, FLFlorida | $970.32 | — |
| Rest of FloridaFlorida | $917.04 | — |
| Atlanta, GAGeorgia | $972.17 | — |
| Rest of GeorgiaGeorgia | $857.26 | — |
| Hawaii, Guam, HIHawaii | $1,083.08 | — |
| IowaIowa | $877.23 | — |
| IdahoIdaho | $881.99 | — |
| East St. Louis, ILIllinois | $884.56 | — |
| Rest of IllinoisIllinois | $877.33 | — |
| Suburban Chicago, ILIllinois | $983.43 | — |
| IndianaIndiana | $888.49 | — |
| KansasKansas | $867.22 | — |
| KentuckyKentucky | $854.02 | — |
| New Orleans, LALouisiana | $902.54 | — |
| Rest of LouisianaLouisiana | $850.39 | — |
| Metropolitan Boston, MAMassachusetts | $1,137.58 | — |
| Rest of MassachusettsMassachusetts | $1,006.14 | — |
| Baltimore area, MDMaryland | $1,025.39 | — |
| Rest of MarylandMaryland | $968.20 | — |
| Rest of MaineMaine | $882.23 | — |
| Southern Maine, MEMaine | $947.99 | — |
| Detroit, MIMichigan | $925.68 | — |
| Rest of MichiganMichigan | $876.60 | — |
| MinnesotaMinnesota | $982.61 | — |
| Metropolitan Kansas City, MOMissouri | $900.42 | — |
| Metropolitan St. Louis, MOMissouri | $912.50 | — |
| Rest of MissouriMissouri | $829.12 | — |
| MississippiMississippi | $827.80 | — |
| MontanaMontana | $956.93 | — |
| North CarolinaNorth Carolina | $894.30 | — |
| North DakotaNorth Dakota | $955.94 | — |
| NebraskaNebraska | $884.60 | — |
| New HampshireNew Hampshire | $994.69 | — |
| Northern New JerseyNew Jersey | $1,107.04 | — |
| Rest of New JerseyNew Jersey | $1,043.45 | — |
| New MexicoNew Mexico | $880.42 | — |
| NYC suburbs and Long Island, NYNew York | $1,135.24 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,046.57 | — |
| Queens, NYNew York | $1,128.06 | — |
| Rest of New YorkNew York | $910.15 | — |
| OhioOhio | $876.40 | — |
| OklahomaOklahoma | $857.49 | — |
| Portland, OROregon | $1,059.75 | — |
| Rest of OregonOregon | $952.74 | — |
| Metropolitan Philadelphia, PAPennsylvania | $995.75 | — |
| Rest of PennsylvaniaPennsylvania | $880.92 | — |
| Puerto RicoPuerto Rico | $967.10 | — |
| Rhode IslandRhode Island | $987.87 | — |
| South CarolinaSouth Carolina | $886.32 | — |
| South DakotaSouth Dakota | $955.83 | — |
| TennesseeTennessee | $871.91 | — |
| Austin, TXTexas | $1,010.50 | — |
| Beaumont, TXTexas | $873.49 | — |
| Brazoria, TXTexas | $948.47 | — |
| Dallas, TXTexas | $953.26 | — |
| Fort Worth, TXTexas | $944.02 | — |
| Galveston, TXTexas | $950.40 | — |
| Houston, TXTexas | $951.32 | — |
| Rest of TexasTexas | $909.55 | — |
| UtahUtah | $901.21 | — |
| VirginiaVirginia | $940.70 | — |
| Virgin Islands, VIUnited States Virgin Islands | $967.10 | — |
| VermontVermont | $946.85 | — |
| Rest of WashingtonWashington | $1,005.99 | — |
| King County, WAWashington | $1,168.27 | — |
| WisconsinWisconsin | $916.89 | — |
| West VirginiaWest Virginia | $836.37 | — |
| WyomingWyoming | $956.50 | — |
91111 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$825.58
$1,207.09
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,031.06 | 1 |
| AL | $840.48 | 1 |
| AR | $825.58 | 1 |
| AZ | $927.99 | 1 |
| CA | $1,045.54–$1,368.63 | 29 |
| CO | $1,016.18 | 1 |
| CT | $1,029.17 | 1 |
| DC | $1,123.52 | 1 |
| DE | $945.80 | 1 |
| FL | $917.04–$997.45 | 3 |
| GA | $857.26–$972.17 | 2 |
| GU | $1,083.08 | 1 |
| HI | $1,083.08 | 1 |
| IA | $877.23 | 1 |
| ID | $881.99 | 1 |
| IL | $877.33–$983.43 | 4 |
| IN | $888.49 | 1 |
| KS | $867.22 | 1 |
| KY | $854.02 | 1 |
| LA | $850.39–$902.54 | 2 |
| MA | $1,006.14–$1,137.58 | 2 |
| MD | $968.20–$1,123.52 | 3 |
| ME | $882.23–$947.99 | 2 |
| MI | $876.60–$925.68 | 2 |
| MN | $982.61 | 1 |
| MO | $829.12–$912.50 | 3 |
| MS | $827.80 | 1 |
| MT | $956.93 | 1 |
| NC | $894.30 | 1 |
| ND | $955.94 | 1 |
| NE | $884.60 | 1 |
| NH | $994.69 | 1 |
| NJ | $1,043.45–$1,107.04 | 2 |
| NM | $880.42 | 1 |
| NV | $957.58 | 1 |
| NY | $910.15–$1,135.24 | 5 |
| OH | $876.40 | 1 |
| OK | $857.49 | 1 |
| OR | $952.74–$1,059.75 | 2 |
| PA | $880.92–$995.75 | 2 |
| PR | $967.10 | 1 |
| RI | $987.87 | 1 |
| SC | $886.32 | 1 |
| SD | $955.83 | 1 |
| TN | $871.91 | 1 |
| TX | $873.49–$1,010.50 | 8 |
| UT | $901.21 | 1 |
| VA | $940.70–$1,123.52 | 2 |
| VI | $967.10 | 1 |
| VT | $946.85 | 1 |
| WA | $1,005.99–$1,168.27 | 2 |
| WI | $916.89 | 1 |
| WV | $836.37 | 1 |
| WY | $956.50 | 1 |
How the 91111 rate is calculated
Each of 91111’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 91111
RVUs × geographic indexes × conversion factor
Work0.88
0.88 RVUs× 1.000 GPCI
Practice expense27.72
27.72 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
28.6500
Conversion factor
$33.4009
Medicare rate
$956.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,624
- Code
- 91111
- Physician work
- 0.88
- Practice expense
- 27.72
- Malpractice
- 0.05
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.88 | × 1.000 | 0.8800 |
| Practice expense | 27.72 | × 1.001 | 27.7477 |
| Malpractice | 0.05 | × 0.833 | 0.0416 |
| Total RVUs | 28.6694 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Nevada$957.58
Office: (0.88 × 1 + 27.72 × 1.001 + 0.05 × 0.833) × $33.4009 = $957.58
Payment rules and modifiers for 91111
The CMS indicators that decide how 91111 is paid alongside other services.
CMS payment indicators · 91111
Capsule imaging, esophagus only
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
91111 without 26 · national office
$956.94
Capsule imaging, esophagus only
91111-26 · Professional component
$47.76
Pays only the interpretation and report.
How 91111 has changed in Nevada
91111 · Office / nonfacility
$957.58
Effective 2026-10-01
The base rate is $154.02 higher than on 2025-10-01, moving from $803.56 to $957.58 (19.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$803.56changed to$957.58
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.90 changed to 0.88
- Practice expense RVU 23.90 changed to 27.72
- Practice expense GPCI 1.000 changed to 1.001
- Malpractice GPCI 0.844 changed to 0.833
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$873.26changed to$803.56
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 25.30 changed to 23.90
- Malpractice RVU 0.04 changed to 0.05
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$859.00changed to$873.26
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
No ratechanged to$859.00
January 1, 2019
RVU19A
$775.39changed toNo rate
Held through RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D.
January 1, 2018
RVU18AR1
No ratechanged to$775.39
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$766.24changed toNo rate
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$782.25changed to$766.24
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 19.71 changed to 19.35
- Malpractice RVU 0.05 changed to 0.06
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$778.36changed to$782.25
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$774.81changed to$778.36
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 19.50 changed to 19.71
- Work GPCI 1.001 changed to 1.005
- Practice expense GPCI 1.055 changed to 1.051
- Malpractice GPCI 1.107 changed to 0.982
Held through RVU15B.
January 1, 2014
RVU14A
$856.12changed to$774.81
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 22.78 changed to 19.50
- Work GPCI 1.000 changed to 1.001
- Practice expense GPCI 1.058 changed to 1.055
- Malpractice GPCI 1.232 changed to 1.107
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$856.12
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $957.58 | Not available in this setting | RVU26D |
| 2026-07-01 | $957.58 | Not available in this setting | RVU26C |
| 2026-04-01 | $957.58 | Not available in this setting | RVU26B |
| 2026-01-01 | $957.58 | Not available in this setting | RVU26A |
| 2025-10-01 | $803.56 | Not available in this setting | RVU25D |
| 2025-07-01 | $803.56 | Not available in this setting | RVU25C |
| 2025-04-01 | $803.56 | Not available in this setting | RVU25B |
| 2025-01-01 | $803.56 | Not available in this setting | RVU25A |
| 2024-10-01 | $873.26 | Not available in this setting | RVU24D |
| 2024-07-01 | $873.26 | Not available in this setting | RVU24C |
| 2024-04-01 | $873.26 | Not available in this setting | RVU24B |
| 2024-03-09 | $873.26 | Not available in this setting | RVU24AR |
| 2024-01-01 | $859.00 | Not available in this setting | RVU24A |
| 2023-10-01 | Additional calculation required | Not available in this setting | RVU23D |
| 2023-07-01 | Additional calculation required | Not available in this setting | RVU23C |
| 2023-04-01 | Additional calculation required | Not available in this setting | RVU23B |
| 2023-01-01 | Additional calculation required | Not available in this setting | RVU23A |
| 2022-10-01 | Additional calculation required | Not available in this setting | RVU22D |
| 2022-07-01 | Additional calculation required | Not available in this setting | RVU22C |
| 2022-04-01 | Additional calculation required | Not available in this setting | RVU22B |
| 2022-01-01 | Additional calculation required | Not available in this setting | RVU22A |
| 2021-10-01 | Additional calculation required | Not available in this setting | RVU21D |
| 2021-07-01 | Additional calculation required | Not available in this setting | RVU21C |
| 2021-04-01 | Additional calculation required | Not available in this setting | RVU21B |
| 2021-01-01 | Additional calculation required | Not available in this setting | RVU21A |
| 2020-10-01 | Additional calculation required | Not available in this setting | RVU20D |
| 2020-07-01 | Additional calculation required | Not available in this setting | RVU20C |
| 2020-04-01 | Additional calculation required | Not available in this setting | RVU20B |
| 2020-01-01 | Additional calculation required | Not available in this setting | RVU20A |
| 2019-10-01 | Additional calculation required | Not available in this setting | RVU19D |
| 2019-07-01 | Additional calculation required | Not available in this setting | RVU19C |
| 2019-04-01 | Additional calculation required | Not available in this setting | RVU19B |
| 2019-01-01 | Additional calculation required | Not available in this setting | RVU19A |
| 2018-10-01 | $775.39 | Not available in this setting | RVU18D |
| 2018-07-01 | $775.39 | Not available in this setting | RVU18C |
| 2018-04-01 | $775.39 | Not available in this setting | RVU18B |
| 2018-01-01 | $775.39 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Additional calculation required | Not available in this setting | RVU17D |
| 2017-07-01 | Additional calculation required | Not available in this setting | RVU17C |
| 2017-04-01 | Additional calculation required | Not available in this setting | RVU17B |
| 2017-01-01 | Additional calculation required | Not available in this setting | RVU17A |
| 2016-10-01 | $766.24 | Not available in this setting | RVU16D |
| 2016-07-01 | $766.24 | Not available in this setting | RVU16C |
| 2016-04-01 | $766.24 | Not available in this setting | RVU16B |
| 2016-01-01 | $766.24 | Not available in this setting | RVU16A |
| 2015-10-01 | $782.25 | Not available in this setting | RVU15D |
| 2015-07-01 | $782.25 | Not available in this setting | RVU15C |
| 2015-04-01 | $778.36 | Not available in this setting | RVU15B |
| 2015-01-01 | $778.36 | Not available in this setting | RVU15A |
| 2014-10-01 | $774.81 | Not available in this setting | RVU14D |
| 2014-07-01 | $774.81 | Not available in this setting | RVU14C |
| 2014-04-01 | $774.81 | Not available in this setting | RVU14B |
| 2014-01-01 | $774.81 | Not available in this setting | RVU14A |
| 2013-10-01 | $856.12 | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
91111 billing questions
How does 91111 differ from 91110?
91111 is for capsule imaging limited to the esophagus. 91110 covers a broader examination extending from the esophagus through the ileum.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Report the global service without either modifier when billing both components together.
Does 91111 include the image interpretation?
The professional component represents the interpretation. When billed globally, the service includes both the technical component and professional interpretation.
Should each capsule image be billed as a separate unit?
No. The code represents the esophageal capsule imaging study, not individual captured images.
What documentation supports reporting 91111?
Document the clinical reason, that capsule imaging was limited to the esophagus, and the study findings and interpretation. The documented extent helps distinguish 91111 from broader gastrointestinal capsule imaging.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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