CPT code 74220: Esophagram, single contrast2026 Medicare rate & RVUs

Medicare pays $94.19 for 74220 nationally in the office. Local office rates run $83.23–$128.07.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 74220 covers

A single-contrast esophagram is a fluoroscopic X-ray examination in which the patient swallows contrast, usually barium, while images document its passage through the esophagus. It is commonly ordered for dysphagia, suspected esophageal narrowing, diverticulum, or other structural symptoms. Radiologists typically interpret the examination, with imaging staff acquiring views in a hospital radiology department or outpatient imaging center. The study focuses on the esophagus rather than the oral and pharyngeal phases of swallowing or a broader upper gastrointestinal examination.

Select this code when the performed esophageal study uses a single-contrast technique; a double-contrast examination belongs to its sibling code. The report should support the technique and anatomy examined and include the radiologist’s interpretation. CMS permits global billing without a component modifier or split billing: modifier 26 represents the professional interpretation, and modifier TC represents the equipment and staff. The global service includes both components.

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.

Where 74220 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

74220 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 74220 rate is calculated

Each of 74220’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.

Payment rules and modifiers for 74220

The CMS indicators that decide how 74220 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

74220 compared with similar codes

How to choose

74221EsophagramDouble contrast

Both codes examine the esophagus, but 74220 is for a single-contrast technique and 74221 is for a double-contrast technique.

74210Contrast X-rayPharynx and cervical esophagus

74210 focuses on the pharynx and/or cervical esophagus; 74220 is for a single-contrast examination of the esophagus.

74230Swallow studyRecorded fluoroscopic evaluation

74230 evaluates swallowing function, including oral and pharyngeal phases. Choose 74220 for a single-contrast esophageal examination.

74240Upper GI seriesSingle contrast

74240 is an upper gastrointestinal examination, while 74220 is focused on the esophagus.

Codes related to 74220

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates