CPT code 91200: Liver elastography, transient shear-wave method2026 Medicare rate & RVUs in Madera, CA

Reports mechanically induced liver elastography used to assess liver stiffness as a noninvasive marker of fibrosis in patients with chronic liver disease.

CMS RVU26DEffective Oct 1, 2026One payment locality57.2K Medicare services in 2024

In Madera, CA, Medicare pays $36.07 for 91200 in the office.

$36.07Office (non-facility)
Not available in this settingHospital or facility
+6.9%vs the national office rate ($33.73)

Check a contract rate as a % of Medicare · 91200 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 91200 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Madera, CA
  2. What 91200 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 91200 covers

This test uses mechanically generated shear waves, commonly vibration-controlled transient elastography, to measure liver stiffness without producing diagnostic images. It is used in evaluating conditions such as chronic viral hepatitis and fatty liver disease, where stiffness can help assess the likelihood or degree of hepatic fibrosis. Trained staff typically acquire the measurements in an outpatient setting, with a physician interpreting the results and documenting a report.

Select 91200 for the mechanically induced liver elastography service, rather than ultrasound elastography performed with imaging. The record should support the clinical reason for testing and include the interpreted results. The global service includes both the technical work, such as equipment and staff, and the professional interpretation and report. When those components are billed separately, report modifier 26 for the professional component or modifier TC for the technical component.

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 Madera, CA compares for 91200

Across 109 of 109 payment localities, the office rate for 91200 runs from $29.69 in Arkansas to $45.82 in San Benito County, CA. Madera, CA pays $36.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

91200 in Madera, CA vs other payment areas
  1. Madera, CA · this page$36.07
  2. Bakersfield, CA · California$36.13+$0.06
  3. Chico, CA · California$36.07
  4. El Centro, CA · California$36.07
  5. Fresno, CA · California$36.07
  6. Hanford, CA · California$36.07
  7. Los Angeles, CA · California$38.61+$2.54

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

91200 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$36.07—
Modesto, CACalifornia$36.07—
Napa, CACalifornia$42.22—
Oxnard, CACalifornia$38.47—
Redding, CACalifornia$36.07—
Rest of CaliforniaCalifornia$36.07—
Riverside, CACalifornia$36.29—
Sacramento, CACalifornia$37.97—

91200 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.

$29.69

$40.95

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
91200 office rate range by state
State / territoryOffice rate rangeLocalities
AK$38.491
AL$30.151
AR$29.691
AZ$32.821
CA$36.07–$45.8229
CO$35.361
CT$36.041
DC$38.871
DE$33.381
FL$32.91–$35.843
GA$31.01–$34.312
GU$37.071
HI$37.071
IA$31.091
ID$31.271
IL$31.82–$35.014
IN$31.471
KS$30.871
KY$30.751
LA$30.67–$32.272
MA$35.10–$39.052
MD$34.06–$38.873
ME$31.37–$33.252
MI$31.53–$33.272
MN$34.031
MO$30.08–$32.473
MS$29.891
MT$33.731
NC$31.731
ND$33.341
NE$31.291
NH$34.731
NJ$36.49–$38.422
NM$31.681
NV$33.651
NY$32.22–$39.725
OH$31.441
OK$30.761
OR$33.43–$36.602
PA$31.53–$35.072
PR$34.021
RI$34.661
SC$31.631
SD$33.291
TN$31.021
TX$31.31–$35.208
UT$32.081
VA$33.09–$38.872
VI$34.021
VT$33.141
WA$35.06–$39.942
WI$32.161
WV$30.571
WY$33.561

See 91200 in every payment locality

How the 91200 rate is calculated

Each of 91200’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 · 91200

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.20

0.20 RVUs× 1.000 GPCI

Practice expense0.79

0.79 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.0100

Conversion factor

$33.4009

Medicare rate

$33.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Madera, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,646

Code
91200
Physician work
0.20
Practice expense
0.79
Malpractice
0.02

GPCI2026.csv

14

Locality
Madera, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 91200 in Madera, CA
ComponentRVULocality factorAdjusted
Physician work0.20× 1.0170.2034
Practice expense0.79× 1.0960.8658
Malpractice0.02× 0.5360.0107
Total RVUs1.0800
Conversion factor× 33.4009

Office rate, Madera, CA$36.07

Office: (0.2 × 1.017 + 0.79 × 1.096 + 0.02 × 0.536) × $33.4009 = $36.07

Open 91200 in the RVU calculator

Payment rules and modifiers for 91200

The CMS indicators that decide how 91200 is paid alongside other services.

CMS payment indicators · 91200

Liver elastography, transient shear-wave method

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

91200 without 26 · national office

$33.73

Liver elastography, transient shear-wave method

91200-26 · Professional component

$11.02

Pays only the interpretation and report.

When to use modifier 26

How 91200 has changed in Madera, CA

91200 · Office / nonfacility

$36.07

Effective 2026-10-01

The base rate is $4.78 higher than on 2025-10-01, moving from $31.29 to $36.07 (15.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $31.29changed to$36.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.21 changed to 0.20
    • Practice expense RVU 0.68 changed to 0.79
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.57changed to$31.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.69 changed to 0.68

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $32.03changed to$32.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $32.52changed to$32.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.68 changed to 0.69
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $32.94changed to$32.52

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $34.33changed to$32.94

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.71 changed to 0.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $39.74changed to$34.33

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.27 changed to 0.21
    • Practice expense RVU 0.76 changed to 0.71
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $41.68changed to$39.74

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.81 changed to 0.76
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $43.18changed to$41.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.85 changed to 0.81

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $41.34changed to$43.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.80 changed to 0.85
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$41.34

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2015

    RVU15A

    No ratechanged toNo rate

    Held through RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$36.07Not available in this settingRVU26D
2026-07-01$36.07Not available in this settingRVU26C
2026-04-01$36.07Not available in this settingRVU26B
2026-01-01$36.07Not available in this settingRVU26A
2025-10-01$31.29Not available in this settingRVU25D
2025-07-01$31.29Not available in this settingRVU25C
2025-04-01$31.29Not available in this settingRVU25B
2025-01-01$31.29Not available in this settingRVU25A
2024-10-01$32.57Not available in this settingRVU24D
2024-07-01$32.57Not available in this settingRVU24C
2024-04-01$32.57Not available in this settingRVU24B
2024-03-09$32.57Not available in this settingRVU24AR
2024-01-01$32.03Not available in this settingRVU24A
2023-10-01$32.52Not available in this settingRVU23D
2023-07-01$32.52Not available in this settingRVU23C
2023-04-01$32.52Not available in this settingRVU23B
2023-01-01$32.52Not available in this settingRVU23A
2022-10-01$32.94Not available in this settingRVU22D
2022-07-01$32.94Not available in this settingRVU22C
2022-04-01$32.94Not available in this settingRVU22B
2022-01-01$32.94Not available in this settingRVU22A
2021-10-01$34.33Not available in this settingRVU21D
2021-07-01$34.33Not available in this settingRVU21C
2021-04-01$34.33Not available in this settingRVU21B
2021-01-01$34.33Not available in this settingRVU21A
2020-10-01$39.74Not available in this settingRVU20D
2020-07-01$39.74Not available in this settingRVU20C
2020-04-01$39.74Not available in this settingRVU20B
2020-01-01$39.74Not available in this settingRVU20A
2019-10-01$41.68Not available in this settingRVU19D
2019-07-01$41.68Not available in this settingRVU19C
2019-04-01$41.68Not available in this settingRVU19B
2019-01-01$41.68Not available in this settingRVU19A
2018-10-01$43.18Not available in this settingRVU18D
2018-07-01$43.18Not available in this settingRVU18C
2018-04-01$43.18Not available in this settingRVU18B
2018-01-01$43.18Not available in this settingRVU18AR1
2017-10-01$41.34Not available in this settingRVU17D
2017-07-01$41.34Not available in this settingRVU17C
2017-04-01$41.34Not available in this settingRVU17B
2017-01-01$41.34Not available in this settingRVU17A
2016-10-01Rate data unavailableNot available in this settingRVU16D
2016-07-01Rate data unavailableNot available in this settingRVU16C
2016-04-01Rate data unavailableNot available in this settingRVU16B
2016-01-01Rate data unavailableNot available in this settingRVU16A
2015-10-01Rate data unavailableNot available in this settingRVU15D
2015-07-01Rate data unavailableNot available in this settingRVU15C
2015-04-01Rate data unavailableNot available in this settingRVU15B
2015-01-01Rate data unavailableNot available in this settingRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 91200 for an earlier date of service

Where the Madera, CA rate applies

Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Madera
  • Ahwahnee
  • Bass Lake
  • Bonadelle Ranchos
  • Chowchilla
  • Coarsegold
  • Fairmead
  • La Vina

Browse all communities in California

91200 billing questions

How is 91200 different from ultrasound elastography codes?

91200 describes mechanically induced shear-wave testing of the liver without imaging. Ultrasound elastography codes describe elastography performed with ultrasound imaging.

Can the professional and technical portions be billed separately?

Yes. Use modifier 26 for the interpretation and report, and modifier TC for equipment and staff. Without a modifier, 91200 represents the global service.

What documentation supports reporting 91200?

Document the clinical reason for evaluating liver stiffness, the test results, and the physician’s interpretation and report.

Is the test a liver biopsy?

No. It measures liver stiffness noninvasively and does not obtain tissue for histologic examination.

What clinical situations commonly prompt this test?

It is commonly used when assessing possible fibrosis in chronic liver disease, including chronic viral hepatitis or fatty liver disease.

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
RVUs for 91200PPRRVU2026_Oct_nonQPP.csv, line 11,646 (RVU26D)
Geographic factors for Madera, CAGPCI2026.csv, line 14 (RVU26D)

Open CMS sourceHow we calculate rates

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