CPT 91113
Global XXX ActiveGi trc img intral colon i&r
CPT 91113 Billing & Documentation Guide
CPT code 91113 (Gi trc img intral colon i&r) is classified under Gastro Diagnostics with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.35, a non-facility practice expense RVU of 27.05, and a malpractice RVU of 0.1, a total non-facility RVU of 29.5 and facility RVU of 29.5. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1025.87, though rates vary from $856.31 to $1391.76 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 91113, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 91113 with related codes; this code has 5 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 91113 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 91113
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.35 | 2.35 |
| Practice Expense RVU | 27.05 | 27.05 |
| Malpractice RVU | 0.1 | 0.1 |
| Total RVU | 29.5 | 29.5 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 91113
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1152.2 | $1152.2 | $1071.85 - $1391.76 | 29 |
| Florida | $991.5 | $991.5 | $947.25 - $1027.48 | 3 |
| Georgia | $944.54 | $944.54 | $888.39 - $1000.69 | 2 |
| Illinois | $958.15 | $958.15 | $908.6 - $1012.85 | 4 |
| Michigan | $931.58 | $931.58 | $907.15 - $956 | 2 |
| North Carolina | $923.59 | $923.59 | $923.59 - $923.59 | 1 |
| New York | $1094.69 | $1094.69 | $939.16 - $1163.97 | 5 |
| Ohio | $906.75 | $906.75 | $906.75 - $906.75 | 1 |
| Pennsylvania | $967.75 | $967.75 | $911.06 - $1024.43 | 2 |
| Texas | $971.52 | $971.52 | $903.77 - $1037.51 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 91113
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 91113 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 91111 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 91112 | Column 2 (secondary), bundled into primary | No | Mutually exclusive procedures |
Frequently Asked Questions, CPT 91113
What does CPT code 91113 mean? +
CPT code 91113 represents: Gi trc img intral colon i&r. It's in the Gastro Diagnostics category with a global period of XXX.
What is the Medicare reimbursement for CPT 91113? +
The 2026 Medicare national average non-facility payment for CPT 91113 is $1025.87. Rates range from $856.31 to $1391.76 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 91113? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 91113? +
This code has 5 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team