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.

CMS RVU26DEffective Oct 1, 2026One payment locality73.6K Medicare services in 2024

In Mississippi, Medicare pays $93.83 for 74221 in the office.

$93.83Office (non-facility)
Not available in this settingHospital or facility
−11.1%vs the national office rate ($105.55)

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.

We’ll open 74221 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Mississippi
  2. What 74221 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

74221 in Mississippi vs other payment areas
  1. Mississippi · this page$93.83
  2. Los Angeles, CA · California$120.77+$26.94
  3. Washington, DC area · District of Columbia$121.41+$27.58
  4. Miami, FL · Florida$111.43+$17.60
  5. Chicago, IL · Illinois$108.27+$14.44
  6. Manhattan, NY · New York$121.13+$27.30
  7. Alaska · Alaska$121.43+$27.60

Other areas in Mississippi first, then benchmark localities. Bars start at $0.

Every other payment area

74221 in every other Medicare payment locality
Payment localityOfficeFacility
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—

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
74221 office rate range by state
State / territoryOffice rate rangeLocalities
AK$121.431
AL$94.681
AR$93.291
AZ$102.791
CA$112.95–$143.1429
CO$110.651
CT$112.601
DC$121.411
DE$104.521
FL$102.82–$111.433
GA$97.10–$107.252
GU$115.961
HI$115.961
IA$97.641
ID$98.171
IL$99.43–$109.194
IN$98.761
KS$96.931
KY$96.401
LA$96.14–$100.992
MA$109.87–$122.042
MD$106.61–$121.413
ME$98.42–$104.202
MI$98.70–$103.852
MN$106.721
MO$94.30–$101.653
MS$93.831
MT$105.541
NC$99.511
ND$104.551
NE$98.261
NH$108.671
NJ$114.08–$120.082
NM$99.151
NV$105.351
NY$100.99–$123.775
OH$98.501
OK$96.491
OR$104.73–$114.492
PA$98.80–$109.612
PR$106.411
RI$108.481
SC$99.131
SD$104.441
TN$97.391
TX$98.12–$110.118
UT$100.511
VA$103.68–$121.412
VI$106.411
VT$103.911
WA$109.74–$124.802
WI$100.981
WV$95.631
WY$105.111

See 74221 in every payment locality

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

Office or facility?

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
Office calculation for 74221 in Mississippi
ComponentRVULocality factorAdjusted
Physician work0.68× 1.0000.6800
Practice expense2.43× 0.8612.0922
Malpractice0.05× 0.7390.0370
Total RVUs2.8092
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

Open 74221 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

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.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. 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.

  2. 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.

  3. March 9, 2024

    RVU24AR

    $95.04changed to$96.62

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. 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
  5. 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.

  6. 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.

  7. 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.

  8. January 1, 2020

    RVU20A

    No ratechanged to$97.69

    Held through RVU20B, RVU20C, RVU20D.

  9. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.83Not available in this settingRVU26D
2026-07-01$93.83Not available in this settingRVU26C
2026-04-01$93.83Not available in this settingRVU26B
2026-01-01$93.83Not available in this settingRVU26A
2025-10-01$92.51Not available in this settingRVU25D
2025-07-01$92.51Not available in this settingRVU25C
2025-04-01$92.51Not available in this settingRVU25B
2025-01-01$92.51Not available in this settingRVU25A
2024-10-01$96.62Not available in this settingRVU24D
2024-07-01$96.62Not available in this settingRVU24C
2024-04-01$96.62Not available in this settingRVU24B
2024-03-09$96.62Not available in this settingRVU24AR
2024-01-01$95.04Not available in this settingRVU24A
2023-10-01$99.85Not available in this settingRVU23D
2023-07-01$99.85Not available in this settingRVU23C
2023-04-01$99.85Not available in this settingRVU23B
2023-01-01$99.85Not available in this settingRVU23A
2022-10-01$102.31Not available in this settingRVU22D
2022-07-01$102.31Not available in this settingRVU22C
2022-04-01$102.31Not available in this settingRVU22B
2022-01-01$102.31Not available in this settingRVU22A
2021-10-01$101.10Not available in this settingRVU21D
2021-07-01$101.10Not available in this settingRVU21C
2021-04-01$101.10Not available in this settingRVU21B
2021-01-01$101.10Not available in this settingRVU21A
2020-10-01$97.69Not available in this settingRVU20D
2020-07-01$97.69Not available in this settingRVU20C
2020-04-01$97.69Not available in this settingRVU20B
2020-01-01$97.69Not available in this settingRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 74221 for an earlier date of service

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

Browse all communities in Mississippi

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
RVUs for 74221PPRRVU2026_Oct_nonQPP.csv, line 8,345 (RVU26D)
Geographic factors for MississippiGPCI2026.csv, line 67 (RVU26D)

Open CMS sourceHow we calculate rates

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