CPT code 91113: Colon capsule imaging, colon segment2026 Medicare rate & RVUs in Utah
Reports capsule-based imaging of the colon when a clinician reviews the recorded images and documents an interpretation and report.
In Utah, Medicare pays $930.78 for 91113 in the office.
Check a contract rate as a % of Medicare · 91113 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 91113 covers
A swallowed imaging capsule records views of the colon as it passes through the gastrointestinal tract. A gastroenterologist or other qualified physician reviews the recorded images and prepares the interpretation; technical staff may support capsule administration and image capture. The study may be selected when a capsule-based examination is used to assess colonic mucosa, including after an incomplete conventional colonoscopy or when that examination cannot be completed.
Report 91113 for the colon portion of capsule imaging, not for an esophageal or small-bowel study. Documentation should identify the colon capsule examination, support that images were acquired, and include the physician’s interpretation and report. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff service, and reporting without a component 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 Utah compares for 91113
Across 109 of 109 payment localities, the office rate for 91113 runs from $856.31 in Arkansas to $1,391.76 in San Benito County, CA. Utah pays $930.78. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$930.78
- Los Angeles, CA · California$1,152.76+$221.98
- Washington, DC area · District of Columbia$1,150.76+$219.98
- Miami, FL · Florida$1,027.48+$96.70
- Chicago, IL · Illinois$994.72+$63.94
- Manhattan, NY · New York$1,138.67+$207.89
- Alaska · Alaska$1,081.80+$151.02
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $870.94 | — |
| ArkansasArkansas | $856.31 | — |
| ArizonaArizona | $956.84 | — |
| Bakersfield, CACalifornia | $1,072.25 | — |
| Chico, CACalifornia | $1,071.85 | — |
| El Centro, CACalifornia | $1,071.86 | — |
| Fresno, CACalifornia | $1,071.85 | — |
| Hanford, CACalifornia | $1,071.85 | — |
| Madera, CACalifornia | $1,071.85 | — |
| Merced, CACalifornia | $1,071.85 | — |
| Modesto, CACalifornia | $1,071.85 | — |
| Napa, CACalifornia | $1,275.94 | — |
| Oxnard, CACalifornia | $1,150.70 | — |
| Redding, CACalifornia | $1,071.85 | — |
| Rest of CaliforniaCalifornia | $1,071.85 | — |
| Riverside, CACalifornia | $1,072.98 | — |
| Sacramento, CACalifornia | $1,133.87 | — |
| Salinas, CACalifornia | $1,129.87 | — |
| San Diego, CACalifornia | $1,163.24 | — |
| Marin County, CACalifornia | $1,361.41 | — |
| San Francisco, CACalifornia | $1,361.30 | — |
| San Benito County, CACalifornia | $1,391.76 | — |
| Santa Clara County, CACalifornia | $1,391.29 | — |
| San Luis Obispo, CACalifornia | $1,110.70 | — |
| Santa Cruz, CACalifornia | $1,179.68 | — |
| Santa Maria, CACalifornia | $1,135.95 | — |
| Santa Rosa, CACalifornia | $1,192.13 | — |
| Stockton, CACalifornia | $1,071.85 | — |
| Vallejo, CACalifornia | $1,275.78 | — |
| Visalia, CACalifornia | $1,071.85 | — |
| Yuba City, CACalifornia | $1,071.85 | — |
| ColoradoColorado | $1,043.36 | — |
| ConnecticutConnecticut | $1,057.17 | — |
| DelawareDelaware | $974.54 | — |
| Fort Lauderdale, FLFlorida | $999.77 | — |
| Rest of FloridaFlorida | $947.25 | — |
| Atlanta, GAGeorgia | $1,000.69 | — |
| Rest of GeorgiaGeorgia | $888.39 | — |
| Hawaii, Guam, HIHawaii | $1,107.70 | — |
| IowaIowa | $906.52 | — |
| IdahoIdaho | $911.29 | — |
| East St. Louis, ILIllinois | $916.43 | — |
| Rest of IllinoisIllinois | $908.60 | — |
| Suburban Chicago, ILIllinois | $1,012.85 | — |
| IndianaIndiana | $917.65 | — |
| KansasKansas | $896.93 | — |
| KentuckyKentucky | $884.75 | — |
| New Orleans, LALouisiana | $932.47 | — |
| Rest of LouisianaLouisiana | $881.28 | — |
| Metropolitan Boston, MAMassachusetts | $1,163.46 | — |
| Rest of MassachusettsMassachusetts | $1,033.79 | — |
| Baltimore area, MDMaryland | $1,053.33 | — |
| Rest of MarylandMaryland | $996.68 | — |
| Rest of MaineMaine | $911.78 | — |
| Southern Maine, MEMaine | $975.96 | — |
| Detroit, MIMichigan | $956.00 | — |
| Rest of MichiganMichigan | $907.15 | — |
| MinnesotaMinnesota | $1,009.18 | — |
| Metropolitan Kansas City, MOMissouri | $930.14 | — |
| Metropolitan St. Louis, MOMissouri | $941.97 | — |
| Rest of MissouriMissouri | $860.56 | — |
| MississippiMississippi | $858.87 | — |
| MontanaMontana | $985.32 | — |
| North CarolinaNorth Carolina | $923.59 | — |
| North DakotaNorth Dakota | $983.34 | — |
| NebraskaNebraska | $913.68 | — |
| New HampshireNew Hampshire | $1,021.95 | — |
| Northern New JerseyNew Jersey | $1,135.06 | — |
| Rest of New JerseyNew Jersey | $1,071.91 | — |
| New MexicoNew Mexico | $911.01 | — |
| NevadaNevada | $985.67 | — |
| NYC suburbs and Long Island, NYNew York | $1,163.97 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,075.39 | — |
| Queens, NYNew York | $1,156.26 | — |
| Rest of New YorkNew York | $939.16 | — |
| OhioOhio | $906.75 | — |
| OklahomaOklahoma | $887.91 | — |
| Portland, OROregon | $1,086.02 | — |
| Rest of OregonOregon | $980.72 | — |
| Metropolitan Philadelphia, PAPennsylvania | $1,024.43 | — |
| Rest of PennsylvaniaPennsylvania | $911.06 | — |
| Puerto RicoPuerto Rico | $995.21 | — |
| Rhode IslandRhode Island | $1,016.27 | — |
| South CarolinaSouth Carolina | $916.16 | — |
| South DakotaSouth Dakota | $983.11 | — |
| TennesseeTennessee | $901.56 | — |
| Austin, TXTexas | $1,037.51 | — |
| Beaumont, TXTexas | $903.77 | — |
| Brazoria, TXTexas | $977.09 | — |
| Dallas, TXTexas | $981.94 | — |
| Fort Worth, TXTexas | $972.95 | — |
| Galveston, TXTexas | $979.06 | — |
| Houston, TXTexas | $980.89 | — |
| Rest of TexasTexas | $938.92 | — |
| VirginiaVirginia | $968.99 | — |
| Virgin Islands, VIUnited States Virgin Islands | $995.21 | — |
| VermontVermont | $974.64 | — |
| Rest of WashingtonWashington | $1,033.43 | — |
| King County, WAWashington | $1,193.73 | — |
| WisconsinWisconsin | $945.07 | — |
| West VirginiaWest Virginia | $868.41 | — |
| WyomingWyoming | $984.46 | — |
91113 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.
$856.31
$1,231.80
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 | $1,081.80 | 1 |
| AL | $870.94 | 1 |
| AR | $856.31 | 1 |
| AZ | $956.84 | 1 |
| CA | $1,071.85–$1,391.76 | 29 |
| CO | $1,043.36 | 1 |
| CT | $1,057.17 | 1 |
| DC | $1,150.76 | 1 |
| DE | $974.54 | 1 |
| FL | $947.25–$1,027.48 | 3 |
| GA | $888.39–$1,000.69 | 2 |
| GU | $1,107.70 | 1 |
| HI | $1,107.70 | 1 |
| IA | $906.52 | 1 |
| ID | $911.29 | 1 |
| IL | $908.60–$1,012.85 | 4 |
| IN | $917.65 | 1 |
| KS | $896.93 | 1 |
| KY | $884.75 | 1 |
| LA | $881.28–$932.47 | 2 |
| MA | $1,033.79–$1,163.46 | 2 |
| MD | $996.68–$1,150.76 | 3 |
| ME | $911.78–$975.96 | 2 |
| MI | $907.15–$956.00 | 2 |
| MN | $1,009.18 | 1 |
| MO | $860.56–$941.97 | 3 |
| MS | $858.87 | 1 |
| MT | $985.32 | 1 |
| NC | $923.59 | 1 |
| ND | $983.34 | 1 |
| NE | $913.68 | 1 |
| NH | $1,021.95 | 1 |
| NJ | $1,071.91–$1,135.06 | 2 |
| NM | $911.01 | 1 |
| NV | $985.67 | 1 |
| NY | $939.16–$1,163.97 | 5 |
| OH | $906.75 | 1 |
| OK | $887.91 | 1 |
| OR | $980.72–$1,086.02 | 2 |
| PA | $911.06–$1,024.43 | 2 |
| PR | $995.21 | 1 |
| RI | $1,016.27 | 1 |
| SC | $916.16 | 1 |
| SD | $983.11 | 1 |
| TN | $901.56 | 1 |
| TX | $903.77–$1,037.51 | 8 |
| UT | $930.78 | 1 |
| VA | $968.99–$1,150.76 | 2 |
| VI | $995.21 | 1 |
| VT | $974.64 | 1 |
| WA | $1,033.43–$1,193.73 | 2 |
| WI | $945.07 | 1 |
| WV | $868.41 | 1 |
| WY | $984.46 | 1 |
How the 91113 rate is calculated
Each of 91113’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 · 91113
RVUs × geographic indexes × conversion factor
Work2.35
2.35 RVUs× 1.000 GPCI
Practice expense27.05
27.05 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
29.5000
Conversion factor
$33.4009
Medicare rate
$985.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Utah inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,630
- Code
- 91113
- Physician work
- 2.35
- Practice expense
- 27.05
- Malpractice
- 0.10
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.35 | × 1.000 | 2.3500 |
| Practice expense | 27.05 | × 0.940 | 25.4270 |
| Malpractice | 0.10 | × 0.898 | 0.0898 |
| Total RVUs | 27.8668 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$930.78
Office: (2.35 × 1 + 27.05 × 0.94 + 0.1 × 0.898) × $33.4009 = $930.78
Payment rules and modifiers for 91113
The CMS indicators that decide how 91113 is paid alongside other services.
CMS payment indicators · 91113
Colon capsule imaging, colon segment
| 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
91113 without 26 · national office
$985.33
Colon capsule imaging, colon segment
91113-26 · Professional component
$127.26
Pays only the interpretation and report.
How 91113 has changed in Utah
91113 · Office / nonfacility
$930.78
Effective 2026-10-01
The base rate is $154.79 higher than on 2025-10-01, moving from $775.99 to $930.78 (19.9%).
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
$775.99changed to$930.78
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.41 changed to 2.35
- Practice expense RVU 23.04 changed to 27.05
- Malpractice RVU 0.09 changed to 0.10
- Practice expense GPCI 0.933 changed to 0.940
- Malpractice GPCI 0.930 changed to 0.898
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$838.01changed to$775.99
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 24.30 changed to 23.04
- Malpractice RVU 0.10 changed to 0.09
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$824.33changed to$838.01
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$864.38changed to$824.33
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 24.85 changed to 24.30
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
No ratechanged to$864.38
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
No ratechanged toNo rate
Held through RVU22B, RVU22C, RVU22D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $930.78 | Not available in this setting | RVU26D |
| 2026-07-01 | $930.78 | Not available in this setting | RVU26C |
| 2026-04-01 | $930.78 | Not available in this setting | RVU26B |
| 2026-01-01 | $930.78 | Not available in this setting | RVU26A |
| 2025-10-01 | $775.99 | Not available in this setting | RVU25D |
| 2025-07-01 | $775.99 | Not available in this setting | RVU25C |
| 2025-04-01 | $775.99 | Not available in this setting | RVU25B |
| 2025-01-01 | $775.99 | Not available in this setting | RVU25A |
| 2024-10-01 | $838.01 | Not available in this setting | RVU24D |
| 2024-07-01 | $838.01 | Not available in this setting | RVU24C |
| 2024-04-01 | $838.01 | Not available in this setting | RVU24B |
| 2024-03-09 | $838.01 | Not available in this setting | RVU24AR |
| 2024-01-01 | $824.33 | Not available in this setting | RVU24A |
| 2023-10-01 | $864.38 | Not available in this setting | RVU23D |
| 2023-07-01 | $864.38 | Not available in this setting | RVU23C |
| 2023-04-01 | $864.38 | Not available in this setting | RVU23B |
| 2023-01-01 | $864.38 | 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 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
91113 billing questions
How is 91113 distinguished from 91110?
91113 reports capsule imaging of the colon. 91110 is for capsule imaging of the small intestine, so select the code for the segment examined.
Does 91113 include the image interpretation?
The global service includes the technical service and professional interpretation with report. When those services are billed separately, modifier 26 identifies the professional component and modifier TC identifies the technical component.
What documentation supports 91113?
Document that colon capsule imaging was performed, that images were acquired, and that the physician reviewed the images and prepared an interpretation and report.
How does 91113 differ from conventional colonoscopy?
91113 describes capsule-based image acquisition and interpretation. A diagnostic colonoscopy such as 45378 uses an endoscope to directly examine the colon.
Is 91113 reported for esophageal capsule imaging?
No. 91113 is for the colon segment; 91111 describes capsule imaging of the esophagus.
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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