Healthcare Insights
Top 15 gastroenterology CPT codes of 2021
While most people will weather a bout or acid reflux or food poisoning without seeing a doctor, it’s more likely than not that an individual will find themselves receiving medical care for a gastroenterology condition at some point in their lives. Digestive diseases are listed as the primary diagnosis for an estimated 66.4 million ambulatory care visits each year (including physicians’ offices, hospital emergency rooms and outpatient facilities).
Keep reading to see our list of the top 15 gastroenterology CPT codes with the highest procedure volumes below.
Top 15 gastroenterology procedure codes by volume
| Rank | HCPCS/CPT code | HCPCS/CPT description | # total procedures | % total procedures | Total charges | % Total charges | Avg charge/procedure | Explore dataset |
|---|---|---|---|---|---|---|---|---|
| 1 | 91200 | Liver elastography | 157,094 | 33.50% | $30,717,213 | 8.40% | $196 | Explore |
| 2 | 91010 | Esophagus motility study | 62,409 | 13.30% | $67,870,660 | 18.50% | $1,088 | Explore |
| 3 | 91110 | GI tract imaging, capsule endoscopy | 57,692 | 12.30% | $117,073,026 | 31.90% | $2,029 | Explore |
| 4 | 91065 | Breath hydrogen/methane test | 45,921 | 9.80% | $15,681,437 | 4.30% | $341 | Explore |
| 5 | 91122 | Anorectal manometry | 42,320 | 9.00% | $30,111,553 | 8.20% | $712 | Explore |
| 6 | 91035 | Gastroesophageal reflux test w/ electrode | 31,928 | 6.80% | $39,700,525 | 10.80% | $1,243 | Explore |
| 7 | 91037 | Esophageal function test w/ electrode | 18,885 | 4.00% | $10,090,274 | 2.70% | $534 | Explore |
| 8 | 91120 | Rectal sensation test | 16,373 | 3.50% | $12,819,387 | 3.50% | $783 | Explore |
| 9 | 91038 | Esophageal function test, >1 hour | 11,905 | 2.50% | $13,253,267 | 3.60% | $1,113 | Explore |
| 10 | 91034 | Gastroesophageal reflux test | 10,063 | 2.10% | $9,922,811 | 2.70% | $986 | Explore |
| 11 | 91040 | Esophageal balloon distention test | 7,149 | 1.50% | $10,146,281 | 2.80% | $1,419 | Explore |
| 12 | 91299 | Gastroenterology procedure (other) | 3,020 | 0.60% | $2,402,631 | 0.70% | $796 | Explore |
| 13 | 91112 | GI wireless capsule measurement | 1,866 | 0.40% | $4,646,872 | 1.30% | $2,490 | Explore |
| 14 | 91020 | Gastric motility studies | 516 | 0.10% | $1,073,349 | 0.30% | $2,080 | Explore |
| 15 | 91111 | GI tract imaging, esophageal endoscopy | 433 | 0.10% | $951,367 | 0.30% | $2,197 | Explore |
Fig 1. Data is from the Definitive Healthcare ClaimsMx product. Data is accurate as of April 2022.
Which gastroenterology procedure was performed the most in 2021?
The top 15 gastroenterology CPT codes of 2021 represent a total of 467,574 individual procedures, or about 99.5% of all gastroenterology procedures performed that year.
The liver elastography procedure (CPT code 91200) tops the chart with 157,094 claims filed. That’s just over a third of all gastroenterology procedures performed last year.
At an average of $192 per procedure, it’s far from the priciest procedure on the list—that title belongs to number 13, the gastrointestinal (GI) tract pressure measurement using a wireless capsule—but it was responsible for about 8.4% of total charges in 2021.
Liver elastography identifies the presence of fibrosis, a condition that causes scar tissue to build up in the liver and can lead to cirrhosis, cancer or organ failure. Liver fibrosis is usually caused by long-term, excessive consumption of alcohol, or by metabolic abnormalities associated with obesity, diabetes and poor diet.
While Americans are drinking less these days, the prevalence of obesity continues to rise in the U.S., with 42.4% of adults qualifying as obese in 2018. The relationship between rising obesity and liver fibrosis rates (among many other GI conditions) suggests that gastroenterology will be an increasingly important field in American healthcare for years to come.
What other procedures do gastroenterologists frequently perform?
Second on our list, the esophagus motility study (CPT code 91010) had 62,409 procedures in 2021, making up 13.3% of all gastroenterology procedures.
The esophagus motility study uses a manometer to measure esophageal muscle pressure in patients with gastroesophageal reflux disease (GERD). Most people will experience gastroesophageal reflux—AKA acid reflux—at some point in their lives, but GERD tends to develop when the lower esophageal sphincter has been weakened long-term due to obesity, pregnancy or smoking.
With 57,692 procedures in 2021, the GI tract imaging from esophagus to ileum procedure sits in the third position on our list. This procedure involves swallowing a small, camera-filled capsule that takes pictures throughout the digestive tract. It can be used to identify a wide range of inflammatory bowel diseases, find the source of GI bleeding, diagnose cancer or screen for polyps.
Many GI conditions are quite common and relatively easy to manage, especially when identified early but stigma around digestive issues may keep people from seeking help. For instance, between 10-15% of American adults are believed to have irritable bowel syndrome, but only 5-7% have sought professional diagnosis and treatment.
What is gastroenterology?
Gastroenterology is the study of the human digestive system and the diseases that affect its normal function. Gastroenterologists develop a thorough understanding of the entire gastrointestinal (GI) tract, including the esophagus, stomach, intestines, rectum, pancreas, gallbladder and liver.
GI conditions include a wide range of symptoms from annoying but typically mild—like indigestion or acute diarrhea—to potentially life-threatening but hard to detect—like cancers of the pancreas or gallbladder.
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