CPT code 74221: Esophagram, double contrast2026 Medicare rate & RVUs in Mississippi
Reports a radiographic esophageal examination using two contrast agents to assess swallowing-related symptoms and structural abnormalities of the esophagus.
In Mississippi, Medicare pays $93.83 for 74221 in the office.
Check a contract rate as a % of Medicare · 74221 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 74221 covers
This esophagram uses barium and a gas-producing contrast agent to show the esophageal lining and outline during fluoroscopic and radiographic imaging. Radiologists interpret the study, with imaging staff typically assisting in hospital radiology departments and outpatient imaging centers. It may be performed for symptoms such as dysphagia or suspected esophageal narrowing, diverticulum, or other structural abnormality.
Select this code when the performed examination uses the double-contrast technique; the technique documented in the imaging report, rather than the symptom alone, distinguishes it from a single-contrast esophagram. The report should identify the esophageal examination and findings, with the contrast technique documented. Bill the complete service without a component modifier when one entity provides both portions. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment and staff portion when those components are billed separately.
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.
How Mississippi compares for 74221
Across 109 of 109 payment localities, the office rate for 74221 runs from $93.29 in Arkansas to $143.14 in San Benito County, CA. Mississippi pays $93.83. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$93.83
- Los Angeles, CA · California$120.77+$26.94
- Washington, DC area · District of Columbia$121.41+$27.58
- Miami, FL · Florida$111.43+$17.60
- Chicago, IL · Illinois$108.27+$14.44
- Manhattan, NY · New York$121.13+$27.30
- Alaska · Alaska$121.43+$27.60
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $94.68 | — |
| ArkansasArkansas | $93.29 | — |
| ArizonaArizona | $102.79 | — |
| Bakersfield, CACalifornia | $113.12 | — |
| Chico, CACalifornia | $112.95 | — |
| El Centro, CACalifornia | $112.96 | — |
| Fresno, CACalifornia | $112.95 | — |
| Hanford, CACalifornia | $112.95 | — |
| Madera, CACalifornia | $112.95 | — |
| Merced, CACalifornia | $112.95 | — |
| Modesto, CACalifornia | $112.95 | — |
| Napa, CACalifornia | $131.97 | — |
| Oxnard, CACalifornia | $120.33 | — |
| Redding, CACalifornia | $112.95 | — |
| Rest of CaliforniaCalifornia | $112.95 | — |
| Riverside, CACalifornia | $113.50 | — |
| Sacramento, CACalifornia | $118.82 | — |
| Salinas, CACalifornia | $118.38 | — |
| San Diego, CACalifornia | $121.37 | — |
| Marin County, CACalifornia | $140.08 | — |
| San Francisco, CACalifornia | $140.02 | — |
| San Benito County, CACalifornia | $143.14 | — |
| Santa Clara County, CACalifornia | $142.91 | — |
| San Luis Obispo, CACalifornia | $116.44 | — |
| Santa Cruz, CACalifornia | $122.70 | — |
| Santa Maria, CACalifornia | $118.88 | — |
| Santa Rosa, CACalifornia | $123.96 | — |
| Stockton, CACalifornia | $112.95 | — |
| Vallejo, CACalifornia | $131.88 | — |
| Visalia, CACalifornia | $112.95 | — |
| Yuba City, CACalifornia | $112.95 | — |
| ColoradoColorado | $110.65 | — |
| ConnecticutConnecticut | $112.60 | — |
| DelawareDelaware | $104.52 | — |
| Fort Lauderdale, FLFlorida | $107.95 | — |
| Rest of FloridaFlorida | $102.82 | — |
| Atlanta, GAGeorgia | $107.25 | — |
| Rest of GeorgiaGeorgia | $97.10 | — |
| Hawaii, Guam, HIHawaii | $115.96 | — |
| IowaIowa | $97.64 | — |
| IdahoIdaho | $98.17 | — |
| East St. Louis, ILIllinois | $100.75 | — |
| Rest of IllinoisIllinois | $99.43 | — |
| Suburban Chicago, ILIllinois | $109.19 | — |
| IndianaIndiana | $98.76 | — |
| KansasKansas | $96.93 | — |
| KentuckyKentucky | $96.40 | — |
| New Orleans, LALouisiana | $100.99 | — |
| Rest of LouisianaLouisiana | $96.14 | — |
| Metropolitan Boston, MAMassachusetts | $122.04 | — |
| Rest of MassachusettsMassachusetts | $109.87 | — |
| Baltimore area, MDMaryland | $112.23 | — |
| Rest of MarylandMaryland | $106.61 | — |
| Rest of MaineMaine | $98.42 | — |
| Southern Maine, MEMaine | $104.20 | — |
| Detroit, MIMichigan | $103.85 | — |
| Rest of MichiganMichigan | $98.70 | — |
| MinnesotaMinnesota | $106.72 | — |
| Metropolitan Kansas City, MOMissouri | $100.56 | — |
| Metropolitan St. Louis, MOMissouri | $101.65 | — |
| Rest of MissouriMissouri | $94.30 | — |
| MontanaMontana | $105.54 | — |
| North CarolinaNorth Carolina | $99.51 | — |
| North DakotaNorth Dakota | $104.55 | — |
| NebraskaNebraska | $98.26 | — |
| New HampshireNew Hampshire | $108.67 | — |
| Northern New JerseyNew Jersey | $120.08 | — |
| Rest of New JerseyNew Jersey | $114.08 | — |
| New MexicoNew Mexico | $99.15 | — |
| NevadaNevada | $105.35 | — |
| NYC suburbs and Long Island, NYNew York | $123.77 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $114.63 | — |
| Queens, NYNew York | $122.51 | — |
| Rest of New YorkNew York | $100.99 | — |
| OhioOhio | $98.50 | — |
| OklahomaOklahoma | $96.49 | — |
| Portland, OROregon | $114.49 | — |
| Rest of OregonOregon | $104.73 | — |
| Metropolitan Philadelphia, PAPennsylvania | $109.61 | — |
| Rest of PennsylvaniaPennsylvania | $98.80 | — |
| Puerto RicoPuerto Rico | $106.41 | — |
| Rhode IslandRhode Island | $108.48 | — |
| South CarolinaSouth Carolina | $99.13 | — |
| South DakotaSouth Dakota | $104.44 | — |
| TennesseeTennessee | $97.39 | — |
| Austin, TXTexas | $110.11 | — |
| Beaumont, TXTexas | $98.12 | — |
| Brazoria, TXTexas | $104.63 | — |
| Dallas, TXTexas | $105.19 | — |
| Fort Worth, TXTexas | $104.40 | — |
| Galveston, TXTexas | $104.87 | — |
| Houston, TXTexas | $105.79 | — |
| Rest of TexasTexas | $101.25 | — |
| UtahUtah | $100.51 | — |
| VirginiaVirginia | $103.68 | — |
| Virgin Islands, VIUnited States Virgin Islands | $106.41 | — |
| VermontVermont | $103.91 | — |
| Rest of WashingtonWashington | $109.74 | — |
| King County, WAWashington | $124.80 | — |
| WisconsinWisconsin | $100.98 | — |
| West VirginiaWest Virginia | $95.63 | — |
| WyomingWyoming | $105.11 | — |
74221 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$93.29
$128.05
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $121.43 | 1 |
| AL | $94.68 | 1 |
| AR | $93.29 | 1 |
| AZ | $102.79 | 1 |
| CA | $112.95–$143.14 | 29 |
| CO | $110.65 | 1 |
| CT | $112.60 | 1 |
| DC | $121.41 | 1 |
| DE | $104.52 | 1 |
| FL | $102.82–$111.43 | 3 |
| GA | $97.10–$107.25 | 2 |
| GU | $115.96 | 1 |
| HI | $115.96 | 1 |
| IA | $97.64 | 1 |
| ID | $98.17 | 1 |
| IL | $99.43–$109.19 | 4 |
| IN | $98.76 | 1 |
| KS | $96.93 | 1 |
| KY | $96.40 | 1 |
| LA | $96.14–$100.99 | 2 |
| MA | $109.87–$122.04 | 2 |
| MD | $106.61–$121.41 | 3 |
| ME | $98.42–$104.20 | 2 |
| MI | $98.70–$103.85 | 2 |
| MN | $106.72 | 1 |
| MO | $94.30–$101.65 | 3 |
| MS | $93.83 | 1 |
| MT | $105.54 | 1 |
| NC | $99.51 | 1 |
| ND | $104.55 | 1 |
| NE | $98.26 | 1 |
| NH | $108.67 | 1 |
| NJ | $114.08–$120.08 | 2 |
| NM | $99.15 | 1 |
| NV | $105.35 | 1 |
| NY | $100.99–$123.77 | 5 |
| OH | $98.50 | 1 |
| OK | $96.49 | 1 |
| OR | $104.73–$114.49 | 2 |
| PA | $98.80–$109.61 | 2 |
| PR | $106.41 | 1 |
| RI | $108.48 | 1 |
| SC | $99.13 | 1 |
| SD | $104.44 | 1 |
| TN | $97.39 | 1 |
| TX | $98.12–$110.11 | 8 |
| UT | $100.51 | 1 |
| VA | $103.68–$121.41 | 2 |
| VI | $106.41 | 1 |
| VT | $103.91 | 1 |
| WA | $109.74–$124.80 | 2 |
| WI | $100.98 | 1 |
| WV | $95.63 | 1 |
| WY | $105.11 | 1 |
How the 74221 rate is calculated
Each of 74221’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.
How the rate is built · 74221
RVUs × geographic indexes × conversion factor
Work0.68
0.68 RVUs× 1.000 GPCI
Practice expense2.43
2.43 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
3.1600
Conversion factor
$33.4009
Medicare rate
$105.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,345
- Code
- 74221
- Physician work
- 0.68
- Practice expense
- 2.43
- Malpractice
- 0.05
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.68 | × 1.000 | 0.6800 |
| Practice expense | 2.43 | × 0.861 | 2.0922 |
| Malpractice | 0.05 | × 0.739 | 0.0370 |
| Total RVUs | 2.8092 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Mississippi$93.83
Office: (0.68 × 1 + 2.43 × 0.861 + 0.05 × 0.739) × $33.4009 = $93.83
Payment rules and modifiers for 74221
The CMS indicators that decide how 74221 is paid alongside other services.
CMS payment indicators · 74221
Esophagram, double contrast
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
74221 without 26 · national office
$105.55
Esophagram, double contrast
74221-26 · Professional component
$32.06
Pays only the interpretation and report.
How 74221 has changed in Mississippi
74221 · Office / nonfacility
$93.83
Effective 2026-10-01
The base rate is $1.32 higher than on 2025-10-01, moving from $92.51 to $93.83 (1.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$92.51changed to$93.83
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.70 changed to 0.68
- Practice expense RVU 2.49 changed to 2.43
- Practice expense GPCI 0.852 changed to 0.861
- Malpractice GPCI 0.768 changed to 0.739
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$96.62changed to$92.51
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.54 changed to 2.49
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$95.04changed to$96.62
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$99.85changed to$95.04
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.61 changed to 2.54
- Practice expense GPCI 0.847 changed to 0.852
- Malpractice GPCI 0.720 changed to 0.768
January 1, 2023
RVU23A
$102.31changed to$99.85
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.64 changed to 2.61
- Practice expense GPCI 0.842 changed to 0.847
- Malpractice GPCI 0.671 changed to 0.720
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$101.10changed to$102.31
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.57 changed to 2.64
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$97.69changed to$101.10
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.32 changed to 2.57
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.856 changed to 0.842
- Malpractice GPCI 0.521 changed to 0.671
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$97.69
Held through RVU20B, RVU20C, RVU20D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $93.83 | Not available in this setting | RVU26D |
| 2026-07-01 | $93.83 | Not available in this setting | RVU26C |
| 2026-04-01 | $93.83 | Not available in this setting | RVU26B |
| 2026-01-01 | $93.83 | Not available in this setting | RVU26A |
| 2025-10-01 | $92.51 | Not available in this setting | RVU25D |
| 2025-07-01 | $92.51 | Not available in this setting | RVU25C |
| 2025-04-01 | $92.51 | Not available in this setting | RVU25B |
| 2025-01-01 | $92.51 | Not available in this setting | RVU25A |
| 2024-10-01 | $96.62 | Not available in this setting | RVU24D |
| 2024-07-01 | $96.62 | Not available in this setting | RVU24C |
| 2024-04-01 | $96.62 | Not available in this setting | RVU24B |
| 2024-03-09 | $96.62 | Not available in this setting | RVU24AR |
| 2024-01-01 | $95.04 | Not available in this setting | RVU24A |
| 2023-10-01 | $99.85 | Not available in this setting | RVU23D |
| 2023-07-01 | $99.85 | Not available in this setting | RVU23C |
| 2023-04-01 | $99.85 | Not available in this setting | RVU23B |
| 2023-01-01 | $99.85 | Not available in this setting | RVU23A |
| 2022-10-01 | $102.31 | Not available in this setting | RVU22D |
| 2022-07-01 | $102.31 | Not available in this setting | RVU22C |
| 2022-04-01 | $102.31 | Not available in this setting | RVU22B |
| 2022-01-01 | $102.31 | Not available in this setting | RVU22A |
| 2021-10-01 | $101.10 | Not available in this setting | RVU21D |
| 2021-07-01 | $101.10 | Not available in this setting | RVU21C |
| 2021-04-01 | $101.10 | Not available in this setting | RVU21B |
| 2021-01-01 | $101.10 | Not available in this setting | RVU21A |
| 2020-10-01 | $97.69 | Not available in this setting | RVU20D |
| 2020-07-01 | $97.69 | Not available in this setting | RVU20C |
| 2020-04-01 | $97.69 | Not available in this setting | RVU20B |
| 2020-01-01 | $97.69 | Not available in this setting | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
74221 billing questions
How is this code distinguished from 74220?
This code represents a double-contrast esophageal examination using barium and a gas-producing agent. Code 74220 is for a single-contrast esophageal examination.
When should modifier 26 or TC be used?
Use modifier 26 for the radiologist's interpretation and modifier TC for the technical service, including equipment and staff, when billing those portions separately. Report the global service without either modifier when both portions are billed together.
Does this code describe a swallowing-function study?
No. It describes an esophageal contrast examination. Code 74230 is used for a radiographic swallowing-function study.
What documentation supports reporting the double-contrast code?
The imaging documentation should establish that an esophageal examination was performed using the double-contrast technique. The report should also identify the examined anatomy and findings.
Should this code be used for an upper GI examination?
Use this code for an examination focused on the esophagus. Code 74246 describes a double-contrast upper GI examination that includes evaluation beyond 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 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
Show the CMS file lines behind this rate
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