2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change Transnasal esophagoscopy 43197 Esophagoscopy flex dx brush $199.22 $203.08 $3.86 2% $86.62 $83.74 -$2.87 -3% 43198 Esophagosc flex trnsn biopy $219.43 $222.97 $3.54 2% $103.22 $99.79 -$3.42 -3% Esophagoscopy 43200 Esophagoscopy flexible brush $248.66 $273.56 $24.90 10% $90.95 $88.98 -$1.97 -2% 43201 Esoph scope w/submucous inj $248.66 $269.72 $21.06 8% $107.55 $104.33 -$3.22 -3% 43202 Esophagoscopy flex biopsy $347.91 $379.64 $31.73 9% $107.19 $104.33 -$2.86 -3% 43204 Esoph scope w/sclerosis inj N/A N/A N/A N/A $140.75 $137.13 -$3.62 -3% 43205 Esophagus endoscopy/ligation N/A N/A N/A N/A $146.89 $143.06 -$3.82 -3% 43206 Esoph optical endomicroscopy $293.77 $316.13 $22.36 8% $138.22 $135.04 -$3.19 -2% 43210 Egd esophagogastrc fndoplsty N/A N/A N/A N/A $451.49 $439.30 -$12.18 -3% 43211 Esophagoscop mucosal resect N/A N/A N/A N/A $244.33 $237.97 -$6.36 -3% 43212 Esophagoscop stent placement N/A N/A N/A N/A $197.77 $192.96 -$4.81 -2% 43213 Esophagoscopy retro balloon $1,262.79 $1,348.97 $86.18 7% $269.95 $263.44 -$6.51 -2% 43214 Esophagosc dilate balloon 30 N/A N/A N/A N/A $200.66 $195.75 -$4.91 -2% 43215 Esophagoscopy flex remove fb $395.19 $421.51 $26.32 7% $147.25 $143.41 -$3.84 -3% 43216 Esophagoscopy lesion removal $403.85 $438.61 $34.76 9% $139.31 $135.73 -$3.57 -3% 43217 Esophagoscopy snare les remv $412.51 $447.33 $34.82 8% $166.74 $162.60 -$4.13 -2% 43220 Esophagoscopy balloon <30mm $1,039.03 $1,054.47 $15.44 1% $122.71 $120.03 -$2.67 -2% 43226 Esoph endoscopy dilation $367.76 $403.02 $35.26 10% $135.34 $132.59 -$2.74 -2% 43227 Esophagoscopy control bleed $638.43 $666.81 $28.38 4% $171.43 $167.49 -$3.94 -2% 43229 Esophagoscopy lesion ablate $715.30 $773.23 $57.93 8% $205.71 $200.29 -$5.43 -3% 43231 Esophagoscop ultrasound exam N/A N/A N/A N/A $165.65 $161.56 -$4.10 -2% 43232 Esophagoscopy w/us needle bx N/A N/A N/A N/A $207.52 $202.03 -$5.49 -3% EGD 43235 Egd diagnostic brush wash $288.00 $311.60 $23.60 8% $127.76 $124.57 -$3.19 -2% 43233 Egd balloon dil esoph30 mm/> N/A N/A N/A N/A $238.92 $233.43 -$5.48 -2% 43236 Uppr gi scope w/submuc inj $384.36 $421.51 $37.15 10% $144.00 $140.27 -$3.73 -3% 43237 Endoscopic us exam esoph N/A N/A N/A N/A $203.55 $198.54 -$5.01 -2% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change 43238 Egd us fine needle bx/aspir N/A N/A N/A N/A $241.80 $235.88 -$5.93 -2% 43239 Egd biopsy single/multiple $383.64 $400.92 $17.29 5% $144.00 $140.27 -$3.73 -3% 43240 Egd w/transmural drain cyst N/A N/A N/A N/A $408.90 $397.43 -$11.47 -3% 43241 Egd tube/cath insertion N/A N/A N/A N/A $147.61 $144.11 -$3.50 -2% 43242 Egd us fine needle bx/aspir N/A N/A N/A N/A $273.56 $266.23 -$7.33 -3% 43243 Egd injection varices N/A N/A N/A N/A $247.22 $240.41 -$6.80 -3% 43244 Egd varices ligation N/A N/A N/A N/A $255.52 $248.44 -$7.08 -3% 43245 Egd dilate stricture $605.95 $646.92 $40.97 7% $183.34 $179.35 -$3.99 -2% 43246 Egd place gastrostomy tube N/A N/A N/A N/A $209.32 $203.43 -$5.90 -3% 43247 Egd remove foreign body $381.47 $404.76 $23.29 6% $184.42 $179.70 -$4.72 -3% 43248 Egd guide wire insertion $399.52 $433.02 $33.51 8% $172.51 $168.53 -$3.98 -2% 43249 Esoph egd dilation <30 mm $1,120.59 $1,202.07 $81.47 7% $159.52 $155.97 -$3.55 -2% 43250 Egd cautery tumor polyp $445.71 $482.92 $37.21 8% $178.28 $173.77 -$4.52 -3% 43251 Egd remove lesion snare $490.10 $528.28 $38.18 8% $204.27 $198.89 -$5.38 -3% 43252 Egd optical endomicroscopy $333.83 $354.51 $20.68 6% $176.12 $170.98 -$5.14 -3% 43253 Egd us transmural injxn/mark N/A N/A N/A N/A $274.28 $266.23 -$8.05 -3% 43254 Egd endo mucosal resection N/A N/A N/A N/A $281.50 $273.91 -$7.59 -3% 43255 Egd control bleeding any $674.52 $700.30 $25.78 4% $208.96 $203.43 -$5.53 -3% 43257 Egd w/thrml txmnt gerd N/A N/A N/A N/A $243.25 $235.53 -$7.72 -3% 43259 Egd us exam duodenum/jejunum N/A N/A N/A N/A $235.67 $229.25 -$6.42 -3% 43266 Egd endoscopic stent place N/A N/A N/A N/A $227.01 $220.87 -$6.13 -3% 43270 Egd lesion ablation $734.43 $790.68 $56.25 8% $233.86 $227.85 -$6.01 -3% ERCP 43260 Ercp w/specimen collection N/A N/A N/A N/A $336.00 $327.30 -$8.70 -3% 43261 Endo cholangiopancreatograph N/A N/A N/A N/A $352.24 $343.35 -$8.89 -3% 43262 Endo cholangiopancreatograph N/A N/A N/A N/A $371.73 $362.54 -$9.19 -2% 43263 Ercp sphincter pressure meas N/A N/A N/A N/A $371.73 $362.54 -$9.19 -2% 43264 Ercp remove duct calculi N/A N/A N/A N/A $378.58 $369.52 -$9.07 -2% 43265 Ercp lithotripsy calculi N/A N/A N/A N/A $451.49 $440.00 -$11.48 -3% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change 43273 Endoscopic pancreatoscopy N/A N/A N/A N/A $125.23 $121.78 -$3.46 -3% 43274 Ercp duct stent placement N/A N/A N/A N/A $482.16 $470.01 -$12.15 -3% 43275 Ercp remove forgn body duct N/A N/A N/A N/A $391.94 $382.08 -$9.86 -3% 43276 Ercp stent exchange w/dilate N/A N/A N/A N/A $501.65 $489.20 -$12.45 -2% 43277 Ercp ea duct/ampulla dilate N/A N/A N/A N/A $394.10 $384.17 -$9.93 -3% 43278 Ercp lesion ablate w/dilate N/A N/A N/A N/A $451.49 $438.96 -$12.53 -3% Small bowel endoscopy 44360 Small bowel endoscopy N/A N/A N/A N/A $149.41 $145.50 -$3.91 -3% 44361 Small bowel endoscopy/biopsy N/A N/A N/A N/A $164.93 $161.21 -$3.73 -2% 44363 S bowel endoscope/foreign body N/A N/A N/A N/A $199.94 $194.35 -$5.58 -3% 44364 Small bowel endoscopy/snare N/A N/A N/A N/A $212.93 $207.27 -$5.67 -3% 44365 S bowel endoscope/hot biopsy N/A N/A N/A N/A $189.11 $184.58 -$4.53 -2% 44366 S bowel endoscope/ctrl bleeding N/A N/A N/A N/A $250.10 $243.20 -$6.90 -3% 44369 Small bowel endoscopy/ablate N/A N/A N/A N/A $256.24 $249.14 -$7.10 -3% 44370 Small bowel endoscopy/stent N/A N/A N/A N/A $277.53 $269.72 -$7.81 -3% 44372 S bowel endoscope/place J-tube N/A N/A N/A N/A $250.10 $242.86 -$7.25 -3% 44373 S bowel endoscope/convert J-tube N/A N/A N/A N/A $200.30 $195.05 -$5.25 -3% 44376 S bowel endoscopy, enteroscopy N/A N/A N/A N/A $295.94 $287.87 -$8.07 -3% 44377 S bowel endoscopy, enteroscopy/bx N/A N/A N/A N/A $311.46 $303.22 -$8.24 -3% 44378 S bowel endoscope/ctrl bleeding N/A N/A N/A N/A $400.60 $390.10 -$10.49 -3% 44379 S bowel endoscope, entero/stent N/A N/A N/A N/A $425.86 $414.53 -$11.33 -3% Ileoscopy through stoma 44380 Ileoscopy thru stoma $187.67 $206.57 $18.90 10% $58.10 $57.22 -$0.88 -2% 44381 Small bowel endoscopy br/wa $1,006.19 $1,082.04 $75.85 8% $86.62 $84.79 -$1.83 -2% 44382 Ileoscopy thru stoma/biopsy $293.77 $320.32 $26.55 9% $75.79 $74.67 -$1.12 -1% 44384 Small bowel endoscopy N/A N/A N/A N/A $160.24 $156.67 -$3.57 -2% Pouchoscopy 44385 Endoscopy of bowel pouch $206.07 $224.71 $18.64 9% $75.07 $72.93 -$2.14 -3% 44386 Endoscopy bowel pouch/biop $308.21 $332.88 $24.67 8% $92.75 $90.02 -$2.73 -3% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change Colonoscopy through stoma 44388 C-stoma $313.62 $331.48 $17.86 6% $163.13 $159.11 -$4.01 -2% 44388 53 C-stoma $183.70 $165.74 -$17.96 -10% $81.20 $79.21 -$2.00 -2% 44389 C-stoma with biopsy $412.87 $437.21 $24.34 6% $179.37 $174.81 -$4.55 -3% 44390 C-stoma for foreign body $404.93 $425.70 $20.77 5% $219.07 $213.55 -$5.52 -3% 44391 C-stoma for bleeding $695.45 $713.91 $18.46 3% $240.00 $233.78 -$6.21 -3% 44392 C-stoma & polypectomy $381.83 $404.76 $22.93 6% $208.60 $201.68 -$6.92 -3% 44394 C-stoma w/snare $437.05 $461.98 $24.93 6% $235.31 $228.55 -$6.76 -3% 44401 C-stoma with ablation $2,895.50 $2,869.26 -$26.24 -1% $252.63 $245.65 -$6.98 -3% 44402 C-stoma w/stent plcmt N/A N/A N/A N/A $272.84 $264.84 -$8.00 -3% 44403 C-stoma w/resection N/A N/A N/A N/A $316.51 $308.46 -$8.05 -3% 44404 C-stoma w/injection $410.70 $440.00 $29.30 7% $179.37 $174.47 -$4.90 -3% 44405 C-stoma w/dilation $574.19 $604.35 $30.16 5% $190.56 $185.63 -$4.92 -3% 44406 C-stoma w/ultrasound N/A N/A N/A N/A $238.92 $232.74 -$6.18 -3% 44407 C-stoma w/ndl aspir/bx N/A N/A N/A N/A $286.92 $279.14 -$7.77 -3% 44408 C-stoma w/decompression N/A N/A N/A N/A $241.08 $235.18 -$5.90 -2% Colonoscopy 45330 Diagnostic sigmoidoscopy $179.73 $195.40 $15.67 9% $58.10 $56.53 -$1.58 -3% 45331 Sigmoidoscopy and biopsy $282.58 $306.36 $23.78 8% $74.35 $72.93 -$1.42 -2% 45332 Sigmoidoscopy w/fb removal $272.12 $292.40 $20.29 7% $109.71 $106.42 -$3.29 -3% 45333 Sigmoidoscopy & polypectomy $321.92 $351.72 $29.80 9% $97.80 $95.26 -$2.55 -3% 45334 Sigmoidoscopy for bleeding $542.43 $560.03 $17.60 3% $121.98 $118.99 -$3.00 -2% 45335 Sigmoidoscopy w/submuc inj $273.56 $306.71 $33.15 12% $68.93 $67.69 -$1.24 -2% 45337 Sigmoidoscopy & decompress N/A N/A N/A N/A $120.54 $116.89 -$3.65 -3% 45338 Sigmoidoscopy w/tumr remove $291.25 $316.48 $25.23 9% $125.23 $122.13 -$3.11 -2% 45340 Sig w/balloon dilation $466.28 $502.11 $35.83 8% $80.84 $78.86 -$1.98 -2% 45341 Sigmoidoscopy w/ultrasound N/A N/A N/A N/A $128.84 $125.62 -$3.23 -3% 45342 Sigmoidoscopy w/us guide bx N/A N/A N/A N/A $176.48 $172.37 -$4.11 -2% 45346 Sigmoidoscopy w/ablation $2,824.40 $2,790.40 -$34.00 -1% $166.74 $162.95 -$3.79 -2% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change 45347 Sigmoidoscopy w/plcmt stent N/A N/A N/A N/A $160.24 $156.67 -$3.57 -2% 45349 Sigmoidoscopy w/resection N/A N/A N/A N/A $206.80 $201.33 -$5.46 -3% 45350 Sgmdsc w/band ligation $642.76 $717.05 $74.29 12% $105.38 $102.24 -$3.15 -3% 45378 Diagnostic colonoscopy $339.97 $356.96 $16.99 5% $193.08 $188.42 -$4.66 -2% 45378 53 Diagnostic colonoscopy $194.16 $178.30 -$15.86 -8% $96.00 $93.86 -$2.14 -2% 45379 Colonoscopy w/fb removal $438.49 $456.75 $18.26 4% $249.38 $242.16 -$7.22 -3% 45380 Colonoscopy and biopsy $437.77 $461.64 $23.86 5% $208.96 $204.12 -$4.84 -2% 45381 Colonoscopy submucous inj $434.52 $465.47 $30.95 7% $208.96 $204.12 -$4.84 -2% 45382 Colonoscopy/control bleeding $722.52 $741.13 $18.61 3% $269.95 $262.75 -$7.21 -3% 45384 Lesion remove colonoscopy $488.30 $518.51 $30.21 6% $238.19 $231.69 -$6.50 -3% 45385 Lesion removal colonoscopy $457.26 $478.04 $20.78 5% $265.26 $257.86 -$7.40 -3% 45386 Colonoscopy dilate stricture $628.33 $662.62 $34.29 5% $220.51 $214.94 -$5.57 -3% 45388 Colonoscopy w/ablation $2,991.86 $2,962.77 -$29.09 -1% $282.58 $274.96 -$7.63 -3% 45389 Colonoscopy w/stent plcmt N/A N/A N/A N/A $302.07 $294.15 -$7.92 -3% 45390 Colonoscopy w/resection N/A N/A N/A N/A $346.10 $337.07 -$9.04 -3% 45391 Colonoscopy w/endoscope us N/A N/A N/A N/A $268.15 $261.00 -$7.15 -3% 45392 Colonoscopy w/endoscopic fnb N/A N/A N/A N/A $316.87 $309.50 -$7.37 -2% 45393 Colonoscopy w/decompression N/A N/A N/A N/A $263.82 $257.16 -$6.66 -3% 45398 Colonoscopy w/band ligation $807.33 $880.35 $73.02 9% $246.49 $239.02 -$7.48 -3% CT Colonography 74261 Ct colonography dx $485.05 $480.83 -$4.22 -1% N/A N/A N/A N/A 74261 TC Ct colonography dx $362.34 $362.89 $0.54 0% N/A N/A N/A N/A 74261 26 Ct colonography dx $122.71 $117.94 -$4.77 -4% $122.71 $117.94 -$4.77 -4% 74262 Ct colonography dx w/dye $545.32 $541.89 -$3.43 -1% N/A N/A N/A N/A 74262 TC Ct colonography dx w/dye $417.56 $419.42 $1.85 0% N/A N/A N/A N/A 74262 26 Ct colonography dx w/dye $127.76 $122.47 -$5.28 -4% $127.76 $122.47 -$5.28 -4% 74263 Ct colonography screening $763.30 $774.63 $11.32 1% N/A N/A N/A N/A 74263 TC Ct colonography screening $646.01 $660.88 $14.86 2% N/A N/A N/A N/A 74263 26 Ct colonography screening $117.29 $113.75 -$3.54 -3% $117.29 $113.75 -$3.54 -3% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change GI pathology specimens 88304 Tissue exam by pathologist $41.86 $42.22 $0.36 1% N/A N/A N/A N/A 88304 TC Tissue exam by pathologist $29.95 $30.71 $0.75 3% N/A N/A N/A N/A 88304 26 Tissue exam by pathologist $11.91 $11.51 -$0.39 -3% $11.91 $11.51 -$0.39 -3% 88305 Tissue exam by pathologist $71.46 $71.53 $0.07 0% N/A N/A N/A N/A 88305 TC Tissue exam by pathologist $32.12 $33.85 $1.73 5% N/A N/A N/A N/A 88305 26 Tissue exam by pathologist $39.34 $37.68 -$1.65 -4% $39.34 $37.68 -$1.65 -4% GI tests 91010 Esophagus motility study $205.71 $227.50 $21.79 11% N/A N/A N/A N/A 91010 TC Esophagus motility study $137.50 $161.56 $24.05 17% N/A N/A N/A N/A 91010 26 Esophagus motility study $68.21 $65.95 -$2.26 -3% $68.21 $65.95 -$2.26 -3% 91013 Esophgl motil w/stim/perfus $26.35 $27.22 $0.87 3% N/A N/A N/A N/A 91013 TC Esophgl motil w/stim/perfus $16.60 $17.80 $1.19 7% N/A N/A N/A N/A 91013 26 Esophgl motil w/stim/perfus $9.74 $9.42 -$0.32 -3% $9.74 $9.42 -$0.32 -3% 91020 Gastric motility studies $265.26 $288.57 $23.30 9% N/A N/A N/A N/A 91020 TC Gastric motility studies $188.75 $214.24 $25.49 14% N/A N/A N/A N/A 91020 26 Gastric motility studies $76.51 $74.32 -$2.19 -3% $76.51 $74.32 -$2.19 -3% 91022 Duodenal motility study $172.15 $179.35 $7.20 4% N/A N/A N/A N/A 91022 TC Duodenal motility study $95.64 $105.38 $9.74 10% N/A N/A N/A N/A 91022 26 Duodenal motility study $76.51 $73.97 -$2.54 -3% $76.51 $73.97 -$2.54 -3% 91030 Acid perfusion of esophagus $142.19 $151.44 $9.24 6% N/A N/A N/A N/A 91030 TC Acid perfusion of esophagus $93.83 $104.33 $10.50 11% N/A N/A N/A N/A 91030 26 Acid perfusion of esophagus $48.36 $47.11 -$1.25 -3% $48.36 $47.11 -$1.25 -3% 91034 Gastroesophageal reflux test $195.25 $204.12 $8.88 5% N/A N/A N/A N/A 91034 TC Gastroesophageal reflux test $143.28 $153.88 $10.60 7% N/A N/A N/A N/A 91034 26 Gastroesophageal reflux test $51.97 $50.25 -$1.72 -3% $51.97 $50.25 -$1.72 -3% 91035 G-esoph reflx tst w/electrod $494.79 $516.77 $21.97 4% N/A N/A N/A N/A 91035 TC G-esoph reflx tst w/electrod $409.26 $433.72 $24.46 6% N/A N/A N/A N/A 91035 26 G-esoph reflx tst w/electrod $85.53 $83.05 -$2.49 -3% $85.53 $83.05 -$2.49 -3% 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change 91037 Esoph imped function test $169.98 $178.65 $8.67 5% N/A N/A N/A N/A 91037 TC Esoph imped function test $118.38 $128.76 $10.38 9% N/A N/A N/A N/A 91037 26 Esoph imped function test $51.61 $49.90 -$1.71 -3% $51.61 $49.90 -$1.71 -3% 91038 Esoph imped funct test > 1hr $449.32 $461.64 $12.32 3% N/A N/A N/A N/A 91038 TC Esoph imped funct test > 1hr $390.85 $405.11 $14.25 4% N/A N/A N/A N/A 91038 26 Esoph imped funct test > 1hr $58.47 $56.53 -$1.94 -3% $58.47 $56.53 -$1.94 -3% 91040 Esoph balloon distension tst $519.70 $562.13 $42.43 8% N/A N/A N/A N/A 91040 TC Esoph balloon distension tst $467.00 $512.23 $45.23 10% N/A N/A N/A N/A 91040 26 Esoph balloon distension tst $52.69 $49.90 -$2.79 -5% $52.69 $49.90 -$2.79 -5% 91065 Breath hydrogen/methane test $81.56 $94.21 $12.65 16% N/A N/A N/A N/A 91065 TC Breath hydrogen/methane test $71.10 $83.74 $12.65 18% N/A N/A N/A N/A 91065 26 Breath hydrogen/methane test $10.47 $10.47 $0.00 0% $10.47 $10.47 $0.00 0% 91110 Gi tract capsule endoscopy $879.51 $885.59 $6.07 1% N/A N/A N/A N/A 91110 TC Gi tract capsule endoscopy $747.42 $757.18 $9.76 1% N/A N/A N/A N/A 91110 26 Gi tract capsule endoscopy $132.09 $128.41 -$3.68 -3% $132.09 $128.41 -$3.68 -3% 91111 Esophageal capsule endoscopy $883.48 $969.68 $86.20 10% N/A N/A N/A N/A 91111 TC Esophageal capsule endoscopy $830.07 $918.04 $87.97 11% N/A N/A N/A N/A 91111 26 Esophageal capsule endoscopy $53.41 $51.64 -$1.77 -3% $53.41 $51.64 -$1.77 -3% 91112 Gi wireless capsule measure $1,479.33 $1,717.09 $237.76 16% N/A N/A N/A N/A 91112 TC Gi wireless capsule measure $1,367.81 $1,609.27 $241.46 18% N/A N/A N/A N/A 91112 26 Gi wireless capsule measure $111.52 $107.82 -$3.70 -3% $111.52 $107.82 -$3.70 -3% 91117 Colon motility 6 hr study N/A N/A N/A N/A $141.47 $138.18 -$3.30 -2% 91120 Rectal sensation test $497.68 $548.17 $50.49 10% N/A N/A N/A N/A 91120 TC Rectal sensation test $446.79 $498.62 $51.83 12% N/A N/A N/A N/A 91120 26 Rectal sensation test $50.89 $49.55 -$1.34 -3% $50.89 $49.55 -$1.34 -3% 91122 Anal pressure record $257.32 $278.80 $21.47 8% N/A N/A N/A N/A 91122 TC Anal pressure record $165.29 $189.47 $24.18 15% N/A N/A N/A N/A 91122 26 Anal pressure record $92.03 $89.33 -$2.70 -3% $92.03 $89.33 -$2.70 -3% 91132 Electrogastrography $330.58 $428.14 $97.55 30% N/A N/A N/A N/A 2021 MPFS Final Rule Payments

2021 Final Non- 2020 Non- Facility Facility National 2020 Facility 2021 Final National Payment National Facility National CPT Mod Short Descriptor Payment Changes $ Change % Change Payment Payment $ Change % Change 91132 TC Electrogastrography $302.80 $401.27 $98.48 33% N/A N/A N/A N/A 91132 26 Electrogastrography $27.79 $26.87 -$0.92 -3% $27.79 $26.87 -$0.92 -3% 91133 Electrogastrography w/test $354.40 $451.52 $97.11 27% N/A N/A N/A N/A 91133 TC Electrogastrography w/test $319.40 $417.67 $98.27 31% N/A N/A N/A N/A 91133 26 Electrogastrography w/test $35.01 $33.85 -$1.16 -3% $35.01 $33.85 -$1.16 -3% 91200 Liver elastography $37.89 $32.80 -$5.09 -13% N/A N/A N/A N/A 91200 TC Liver elastography $23.46 $21.63 -$1.82 -8% N/A N/A N/A N/A 91200 26 Liver elastography $14.44 $11.17 -$3.27 -23% $14.44 $11.17 -$3.27 -23% Infusion 96360 Hydration iv infusion init $34.65 $36.29 $1.64 5% N/A N/A N/A N/A 96361 Hydrate iv infusion add-on $13.71 $13.96 $0.24 2% N/A N/A N/A N/A 96365 Ther/proph/diag iv inf init $72.18 $73.62 $1.44 2% N/A N/A N/A N/A 96366 Ther/proph/diag iv inf addon $22.01 $22.33 $0.32 1% N/A N/A N/A N/A 96367 Tx/proph/dg addl seq iv inf $31.40 $32.10 $0.70 2% N/A N/A N/A N/A 96368 Ther/diag concurrent inf $21.29 $21.28 -$0.01 0% N/A N/A N/A N/A 96369 Sc ther infusion up to 1 hr $162.04 $158.76 -$3.28 -2% N/A N/A N/A N/A 96370 Sc ther infusion addl hr $15.52 $15.35 -$0.17 -1% N/A N/A N/A N/A 96371 Sc ther infusion reset pump $64.60 $65.95 $1.35 2% N/A N/A N/A N/A 96372 Ther/proph/diag inj sc/im $14.44 $14.31 -$0.13 -1% N/A N/A N/A N/A 96413 Chemo iv infusion 1 hr $142.56 $148.30 $5.74 4% N/A N/A N/A N/A 96415 Chemo iv infusion addl hr $30.68 $31.40 $0.73 2% N/A N/A N/A N/A 96570 Photodynmc tx 30 min add-on $58.83 $56.18 -$2.65 -5% $58.83 $56.18 -$2.65 -5% 96571 Photodynamic tx addl 15 min $27.07 $26.17 -$0.90 -3% $27.07 $26.17 -$0.90 -3% Colorectal cancer screening for Medicare G0104 Ca screen;flexi sigmoidscope $179.73 $195.40 $15.67 9% $58.10 $56.53 -$1.58 -3% G0105 Colorectal scrn; hi risk ind $339.61 $356.96 $17.35 5% $192.72 $188.42 -$4.30 -2% G0105 53 Colorectal scrn; hi risk ind $193.80 $178.30 -$15.50 -8% $95.64 $93.86 -$1.78 -2% G0121 Colon ca scrn not hi rsk ind $340.33 $357.31 $16.98 5% $193.44 $188.77 -$4.67 -2% G0121 53 Colon ca scrn not hi rsk ind $310.37 $178.65 -$131.72 -42% $96.00 $94.21 -$1.79 -2%