CPT code 91200: Liver elastography, transient shear-wave method2026 Medicare rate & RVUs in Iowa
Reports mechanically induced liver elastography used to assess liver stiffness as a noninvasive marker of fibrosis in patients with chronic liver disease.
In Iowa, Medicare pays $31.09 for 91200 in the office.
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.
On this page 11 sections
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 Iowa 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. Iowa pays $31.09. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$31.09
- Los Angeles, CA · California$38.61+$7.52
- Washington, DC area · District of Columbia$38.87+$7.78
- Miami, FL · Florida$35.84+$4.75
- Chicago, IL · Illinois$34.78+$3.69
- Manhattan, NY · New York$38.83+$7.74
- Alaska · Alaska$38.49+$7.40
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $30.15 | — |
| ArkansasArkansas | $29.69 | — |
| ArizonaArizona | $32.82 | — |
| Bakersfield, CACalifornia | $36.13 | — |
| Chico, CACalifornia | $36.07 | — |
| El Centro, CACalifornia | $36.07 | — |
| Fresno, CACalifornia | $36.07 | — |
| Hanford, CACalifornia | $36.07 | — |
| Madera, CACalifornia | $36.07 | — |
| 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 | — |
| Salinas, CACalifornia | $37.83 | — |
| San Diego, CACalifornia | $38.80 | — |
| Marin County, CACalifornia | $44.83 | — |
| San Francisco, CACalifornia | $44.80 | — |
| San Benito County, CACalifornia | $45.82 | — |
| Santa Clara County, CACalifornia | $45.73 | — |
| San Luis Obispo, CACalifornia | $37.21 | — |
| Santa Cruz, CACalifornia | $39.24 | — |
| Santa Maria, CACalifornia | $37.99 | — |
| Santa Rosa, CACalifornia | $39.64 | — |
| Stockton, CACalifornia | $36.07 | — |
| Vallejo, CACalifornia | $42.19 | — |
| Visalia, CACalifornia | $36.07 | — |
| Yuba City, CACalifornia | $36.07 | — |
| ColoradoColorado | $35.36 | — |
| ConnecticutConnecticut | $36.04 | — |
| DelawareDelaware | $33.38 | — |
| Fort Lauderdale, FLFlorida | $34.62 | — |
| Rest of FloridaFlorida | $32.91 | — |
| Atlanta, GAGeorgia | $34.31 | — |
| Rest of GeorgiaGeorgia | $31.01 | — |
| Hawaii, Guam, HIHawaii | $37.07 | — |
| IdahoIdaho | $31.27 | — |
| East St. Louis, ILIllinois | $32.30 | — |
| Rest of IllinoisIllinois | $31.82 | — |
| Suburban Chicago, ILIllinois | $35.01 | — |
| IndianaIndiana | $31.47 | — |
| KansasKansas | $30.87 | — |
| KentuckyKentucky | $30.75 | — |
| New Orleans, LALouisiana | $32.27 | — |
| Rest of LouisianaLouisiana | $30.67 | — |
| Metropolitan Boston, MAMassachusetts | $39.05 | — |
| Rest of MassachusettsMassachusetts | $35.10 | — |
| Baltimore area, MDMaryland | $35.93 | — |
| Rest of MarylandMaryland | $34.06 | — |
| Rest of MaineMaine | $31.37 | — |
| Southern Maine, MEMaine | $33.25 | — |
| Detroit, MIMichigan | $33.27 | — |
| Rest of MichiganMichigan | $31.53 | — |
| MinnesotaMinnesota | $34.03 | — |
| Metropolitan Kansas City, MOMissouri | $32.11 | — |
| Metropolitan St. Louis, MOMissouri | $32.47 | — |
| Rest of MissouriMissouri | $30.08 | — |
| MississippiMississippi | $29.89 | — |
| MontanaMontana | $33.73 | — |
| North CarolinaNorth Carolina | $31.73 | — |
| North DakotaNorth Dakota | $33.34 | — |
| NebraskaNebraska | $31.29 | — |
| New HampshireNew Hampshire | $34.73 | — |
| Northern New JerseyNew Jersey | $38.42 | — |
| Rest of New JerseyNew Jersey | $36.49 | — |
| New MexicoNew Mexico | $31.68 | — |
| NevadaNevada | $33.65 | — |
| NYC suburbs and Long Island, NYNew York | $39.72 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $36.68 | — |
| Queens, NYNew York | $39.26 | — |
| Rest of New YorkNew York | $32.22 | — |
| OhioOhio | $31.44 | — |
| OklahomaOklahoma | $30.76 | — |
| Portland, OROregon | $36.60 | — |
| Rest of OregonOregon | $33.43 | — |
| Metropolitan Philadelphia, PAPennsylvania | $35.07 | — |
| Rest of PennsylvaniaPennsylvania | $31.53 | — |
| Puerto RicoPuerto Rico | $34.02 | — |
| Rhode IslandRhode Island | $34.66 | — |
| South CarolinaSouth Carolina | $31.63 | — |
| South DakotaSouth Dakota | $33.29 | — |
| TennesseeTennessee | $31.02 | — |
| Austin, TXTexas | $35.20 | — |
| Beaumont, TXTexas | $31.31 | — |
| Brazoria, TXTexas | $33.40 | — |
| Dallas, TXTexas | $33.59 | — |
| Fort Worth, TXTexas | $33.34 | — |
| Galveston, TXTexas | $33.49 | — |
| Houston, TXTexas | $33.85 | — |
| Rest of TexasTexas | $32.32 | — |
| UtahUtah | $32.08 | — |
| VirginiaVirginia | $33.09 | — |
| Virgin Islands, VIUnited States Virgin Islands | $34.02 | — |
| VermontVermont | $33.14 | — |
| Rest of WashingtonWashington | $35.06 | — |
| King County, WAWashington | $39.94 | — |
| WisconsinWisconsin | $32.16 | — |
| West VirginiaWest Virginia | $30.57 | — |
| WyomingWyoming | $33.56 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $38.49 | 1 |
| AL | $30.15 | 1 |
| AR | $29.69 | 1 |
| AZ | $32.82 | 1 |
| CA | $36.07–$45.82 | 29 |
| CO | $35.36 | 1 |
| CT | $36.04 | 1 |
| DC | $38.87 | 1 |
| DE | $33.38 | 1 |
| FL | $32.91–$35.84 | 3 |
| GA | $31.01–$34.31 | 2 |
| GU | $37.07 | 1 |
| HI | $37.07 | 1 |
| IA | $31.09 | 1 |
| ID | $31.27 | 1 |
| IL | $31.82–$35.01 | 4 |
| IN | $31.47 | 1 |
| KS | $30.87 | 1 |
| KY | $30.75 | 1 |
| LA | $30.67–$32.27 | 2 |
| MA | $35.10–$39.05 | 2 |
| MD | $34.06–$38.87 | 3 |
| ME | $31.37–$33.25 | 2 |
| MI | $31.53–$33.27 | 2 |
| MN | $34.03 | 1 |
| MO | $30.08–$32.47 | 3 |
| MS | $29.89 | 1 |
| MT | $33.73 | 1 |
| NC | $31.73 | 1 |
| ND | $33.34 | 1 |
| NE | $31.29 | 1 |
| NH | $34.73 | 1 |
| NJ | $36.49–$38.42 | 2 |
| NM | $31.68 | 1 |
| NV | $33.65 | 1 |
| NY | $32.22–$39.72 | 5 |
| OH | $31.44 | 1 |
| OK | $30.76 | 1 |
| OR | $33.43–$36.60 | 2 |
| PA | $31.53–$35.07 | 2 |
| PR | $34.02 | 1 |
| RI | $34.66 | 1 |
| SC | $31.63 | 1 |
| SD | $33.29 | 1 |
| TN | $31.02 | 1 |
| TX | $31.31–$35.20 | 8 |
| UT | $32.08 | 1 |
| VA | $33.09–$38.87 | 2 |
| VI | $34.02 | 1 |
| VT | $33.14 | 1 |
| WA | $35.06–$39.94 | 2 |
| WI | $32.16 | 1 |
| WV | $30.57 | 1 |
| WY | $33.56 | 1 |
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
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 Iowa 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
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.20 | × 1.000 | 0.2000 |
| Practice expense | 0.79 | × 0.915 | 0.7229 |
| Malpractice | 0.02 | × 0.397 | 0.0079 |
| Total RVUs | 0.9308 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$31.09
Office: (0.2 × 1 + 0.79 × 0.915 + 0.02 × 0.397) × $33.4009 = $31.09
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
| 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
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.
How 91200 has changed in Iowa
91200 · Office / nonfacility
$31.09
Effective 2026-10-01
The base rate is $3.92 higher than on 2025-10-01, moving from $27.17 to $31.09 (14.4%).
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
$27.17changed to$31.09
- 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
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$28.26changed to$27.17
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.69 changed to 0.68
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$27.80changed to$28.26
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$28.38changed to$27.80
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.68 changed to 0.69
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$28.91changed to$28.38
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$30.09changed to$28.91
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.71 changed to 0.68
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$34.93changed to$30.09
- 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
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$36.51changed to$34.93
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.81 changed to 0.76
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$37.78changed to$36.51
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.85 changed to 0.81
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$35.92changed to$37.78
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.80 changed to 0.85
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$29.27changed to$35.92
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.60 changed to 0.80
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$33.35changed to$29.27
- Conversion factor 35.9335 changed to 35.8043
- Work RVU 0.30 changed to 0.27
- Practice expense RVU 0.69 changed to 0.60
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$33.18changed to$33.35
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$33.18
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $31.09 | Not available in this setting | RVU26D |
| 2026-07-01 | $31.09 | Not available in this setting | RVU26C |
| 2026-04-01 | $31.09 | Not available in this setting | RVU26B |
| 2026-01-01 | $31.09 | Not available in this setting | RVU26A |
| 2025-10-01 | $27.17 | Not available in this setting | RVU25D |
| 2025-07-01 | $27.17 | Not available in this setting | RVU25C |
| 2025-04-01 | $27.17 | Not available in this setting | RVU25B |
| 2025-01-01 | $27.17 | Not available in this setting | RVU25A |
| 2024-10-01 | $28.26 | Not available in this setting | RVU24D |
| 2024-07-01 | $28.26 | Not available in this setting | RVU24C |
| 2024-04-01 | $28.26 | Not available in this setting | RVU24B |
| 2024-03-09 | $28.26 | Not available in this setting | RVU24AR |
| 2024-01-01 | $27.80 | Not available in this setting | RVU24A |
| 2023-10-01 | $28.38 | Not available in this setting | RVU23D |
| 2023-07-01 | $28.38 | Not available in this setting | RVU23C |
| 2023-04-01 | $28.38 | Not available in this setting | RVU23B |
| 2023-01-01 | $28.38 | Not available in this setting | RVU23A |
| 2022-10-01 | $28.91 | Not available in this setting | RVU22D |
| 2022-07-01 | $28.91 | Not available in this setting | RVU22C |
| 2022-04-01 | $28.91 | Not available in this setting | RVU22B |
| 2022-01-01 | $28.91 | Not available in this setting | RVU22A |
| 2021-10-01 | $30.09 | Not available in this setting | RVU21D |
| 2021-07-01 | $30.09 | Not available in this setting | RVU21C |
| 2021-04-01 | $30.09 | Not available in this setting | RVU21B |
| 2021-01-01 | $30.09 | Not available in this setting | RVU21A |
| 2020-10-01 | $34.93 | Not available in this setting | RVU20D |
| 2020-07-01 | $34.93 | Not available in this setting | RVU20C |
| 2020-04-01 | $34.93 | Not available in this setting | RVU20B |
| 2020-01-01 | $34.93 | Not available in this setting | RVU20A |
| 2019-10-01 | $36.51 | Not available in this setting | RVU19D |
| 2019-07-01 | $36.51 | Not available in this setting | RVU19C |
| 2019-04-01 | $36.51 | Not available in this setting | RVU19B |
| 2019-01-01 | $36.51 | Not available in this setting | RVU19A |
| 2018-10-01 | $37.78 | Not available in this setting | RVU18D |
| 2018-07-01 | $37.78 | Not available in this setting | RVU18C |
| 2018-04-01 | $37.78 | Not available in this setting | RVU18B |
| 2018-01-01 | $37.78 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $35.92 | Not available in this setting | RVU17D |
| 2017-07-01 | $35.92 | Not available in this setting | RVU17C |
| 2017-04-01 | $35.92 | Not available in this setting | RVU17B |
| 2017-01-01 | $35.92 | Not available in this setting | RVU17A |
| 2016-10-01 | $29.27 | Not available in this setting | RVU16D |
| 2016-07-01 | $29.27 | Not available in this setting | RVU16C |
| 2016-04-01 | $29.27 | Not available in this setting | RVU16B |
| 2016-01-01 | $29.27 | Not available in this setting | RVU16A |
| 2015-10-01 | $33.35 | Not available in this setting | RVU15D |
| 2015-07-01 | $33.35 | Not available in this setting | RVU15C |
| 2015-04-01 | $33.18 | Not available in this setting | RVU15B |
| 2015-01-01 | $33.18 | Not available in this setting | 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 Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
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
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