$841.35–$945.88
Use 91113 for colon capsule imaging and 91110 for small-intestine capsule imaging; the examined segment determines the code.
On this page
CMS RVU26D · Effective 2026-10-01
91113 Colon capsule imaging Medicare reimbursement rates in Massachusetts
Reports capsule-based imaging of the colon when a clinician reviews the recorded images and documents an interpretation and report. Compare 91113 office and facility rates across CMS payment localities in Massachusetts.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 91113 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$1033.79–$1163.46
2 of 2 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastrointestinal imaging
About 91113: Colon capsule imaging with interpretation
Reports capsule-based imaging of the colon when a clinician reviews the recorded images and documents an interpretation and report.
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.
CMS billing rules for 91113
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU2.35 · 8%
- Practice expense (office) RVU27.05 · 92%
- Malpractice RVU0.10 · 0%
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.
91113 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$1,006.14–$1,137.58
91111 covers capsule imaging of the esophagus, while 91113 covers the colon.
$390.70–$431.04
45378 is diagnostic colonoscopy using an endoscope for direct examination. 91113 is capsule-based colon imaging with interpretation and report.
Compare 91113 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$1163.46
Facility
Unavailable
Rest Of Massachusetts →
Office / nonfacility
$1033.79
Facility
Unavailable
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,62791112,,Gi wireless capsule measure,A,,2.05,50.76,,50.76,NA,0.10,52.91,52.91,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,62891112,26,Gi wireless capsule measure,A,,2.05,1.19,,1.19,,0.08,3.32,3.32,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,62991112,TC,Gi wireless capsule measure,A,,0.00,49.57,,49.57,NA,0.02,49.59,49.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,63091113,,Gi trc img intral colon i&r,A,,2.35,27.05,,27.05,NA,0.10,29.50,29.50,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,29.80,29.80,0.10
11,63191113,26,Gi trc img intral colon i&r,A,,2.35,1.38,,1.38,,0.08,3.81,3.81,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,63291113,TC,Gi trc img intral colon i&r,A,,0.00,25.67,,25.67,NA,0.02,25.69,25.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,28.42,28.42,0.02
11,63391117,,Colon motility 6 hr study,A,,2.39,1.08,NA,1.08,,0.18,3.65,3.65,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00