CPT code 74230: Swallow study, recorded fluoroscopic evaluation2026 Medicare rate & RVUs

Medicare pays $120.24 for 74230 nationally in the office. Local office rates run $105.28–$166.41.

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

What 74230 covers

This study uses fluoroscopy and recorded images to observe swallowing as the patient takes oral contrast material of selected consistencies. It can show how a bolus moves through the oral and pharyngeal phases and whether material enters the airway. Radiologists commonly provide the imaging interpretation, while speech-language pathologists may assess swallowing mechanics during the examination. Studies are performed in radiology departments and other settings equipped for fluoroscopy, often for patients with dysphagia, coughing during meals, or suspected aspiration.

Report 74230 for the recorded fluoroscopic assessment of swallowing function, rather than an examination focused primarily on esophageal structure or transit. The record should support the swallowing concern, the imaging performed, and the findings interpreted. CMS recognizes professional and technical components: report modifier 26 for the professional interpretation, modifier TC for the equipment and staff, or no modifier for the global service. A speech-language pathologist's separately furnished swallowing evaluation may be reported with 92611 when its work is documented.

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 74230 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

74230 rates by state

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

How the 74230 rate is calculated

Each of 74230’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 74230

The CMS indicators that decide how 74230 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

74230 compared with similar codes

How to choose

74220EsophagramSingle contrast

Choose 74230 for recorded assessment of swallowing mechanics and airway protection. Choose 74220 when the examination is directed primarily at the esophagus and its transit.

74210Contrast X-rayPharynx and cervical esophagus

74210 focuses on radiographic examination of the pharynx or cervical esophagus. 74230 captures swallowing function dynamically with recorded imaging.

92611Swallow studyFluoroscopic evaluation

74230 represents the radiologic service and interpretation. 92611 represents the speech-language pathologist's functional swallowing evaluation when separately furnished and documented.

Codes related to 74230

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