CPT code 74230: Swallow study, recorded fluoroscopic evaluation2026 Medicare rate & RVUs in Montana
A fluoroscopic swallowing study with recorded imaging evaluates bolus transit and airway protection when dysphagia or suspected aspiration requires dynamic assessment.
In Montana, Medicare pays $120.24 for 74230 in the office.
Check a contract rate as a % of Medicare · 74230 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 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.
How Montana compares for 74230
Across 109 of 109 payment localities, the office rate for 74230 runs from $105.28 in Arkansas to $166.41 in San Benito County, CA. Montana pays $120.24. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$120.24
- Los Angeles, CA · California$139.09+$18.85
- Washington, DC area · District of Columbia$139.41+$19.17
- Miami, FL · Florida$126.45+$6.21
- Chicago, IL · Illinois$122.60+$2.36
- Manhattan, NY · New York$138.59+$18.35
- Alaska · Alaska$134.93+$14.69
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $106.97 | — |
| ArkansasArkansas | $105.28 | — |
| ArizonaArizona | $116.90 | — |
| Bakersfield, CACalifornia | $129.80 | — |
| Chico, CACalifornia | $129.67 | — |
| El Centro, CACalifornia | $129.67 | — |
| Fresno, CACalifornia | $129.67 | — |
| Hanford, CACalifornia | $129.67 | — |
| Madera, CACalifornia | $129.67 | — |
| Merced, CACalifornia | $129.67 | — |
| Modesto, CACalifornia | $129.67 | — |
| Napa, CACalifornia | $152.97 | — |
| Oxnard, CACalifornia | $138.71 | — |
| Redding, CACalifornia | $129.67 | — |
| Rest of CaliforniaCalifornia | $129.67 | — |
| Riverside, CACalifornia | $130.11 | — |
| Sacramento, CACalifornia | $136.80 | — |
| Salinas, CACalifornia | $136.31 | — |
| San Diego, CACalifornia | $140.05 | — |
| Marin County, CACalifornia | $162.80 | — |
| San Francisco, CACalifornia | $162.76 | — |
| San Benito County, CACalifornia | $166.41 | — |
| Santa Clara County, CACalifornia | $166.23 | — |
| San Luis Obispo, CACalifornia | $134.03 | — |
| Santa Cruz, CACalifornia | $141.82 | — |
| Santa Maria, CACalifornia | $136.97 | — |
| Santa Rosa, CACalifornia | $143.30 | — |
| Stockton, CACalifornia | $129.67 | — |
| Vallejo, CACalifornia | $152.90 | — |
| Visalia, CACalifornia | $129.67 | — |
| Yuba City, CACalifornia | $129.67 | — |
| ColoradoColorado | $126.66 | — |
| ConnecticutConnecticut | $128.69 | — |
| DelawareDelaware | $118.98 | — |
| Fort Lauderdale, FLFlorida | $122.64 | — |
| Rest of FloridaFlorida | $116.45 | — |
| Atlanta, GAGeorgia | $122.19 | — |
| Rest of GeorgiaGeorgia | $109.53 | — |
| Hawaii, Guam, HIHawaii | $133.59 | — |
| IowaIowa | $110.81 | — |
| IdahoIdaho | $111.42 | — |
| East St. Louis, ILIllinois | $113.47 | — |
| Rest of IllinoisIllinois | $112.16 | — |
| Suburban Chicago, ILIllinois | $124.14 | — |
| IndianaIndiana | $112.14 | — |
| KansasKansas | $109.83 | — |
| KentuckyKentucky | $108.86 | — |
| New Orleans, LALouisiana | $114.43 | — |
| Rest of LouisianaLouisiana | $108.51 | — |
| Metropolitan Boston, MAMassachusetts | $140.51 | — |
| Rest of MassachusettsMassachusetts | $125.63 | — |
| Baltimore area, MDMaryland | $128.25 | — |
| Rest of MarylandMaryland | $121.53 | — |
| Rest of MaineMaine | $111.62 | — |
| Southern Maine, MEMaine | $118.84 | — |
| Detroit, MIMichigan | $117.61 | — |
| Rest of MichiganMichigan | $111.58 | — |
| MinnesotaMinnesota | $122.25 | — |
| Metropolitan Kansas City, MOMissouri | $114.02 | — |
| Metropolitan St. Louis, MOMissouri | $115.37 | — |
| Rest of MissouriMissouri | $106.20 | — |
| MississippiMississippi | $105.78 | — |
| North CarolinaNorth Carolina | $112.96 | — |
| North DakotaNorth Dakota | $119.45 | — |
| NebraskaNebraska | $111.59 | — |
| New HampshireNew Hampshire | $124.24 | — |
| Northern New JerseyNew Jersey | $137.67 | — |
| Rest of New JerseyNew Jersey | $130.41 | — |
| New MexicoNew Mexico | $112.08 | — |
| NevadaNevada | $120.12 | — |
| NYC suburbs and Long Island, NYNew York | $141.69 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $130.95 | — |
| Queens, NYNew York | $140.43 | — |
| Rest of New YorkNew York | $114.77 | — |
| OhioOhio | $111.42 | — |
| OklahomaOklahoma | $109.08 | — |
| Portland, OROregon | $131.45 | — |
| Rest of OregonOregon | $119.44 | — |
| Metropolitan Philadelphia, PAPennsylvania | $124.98 | — |
| Rest of PennsylvaniaPennsylvania | $111.84 | — |
| Puerto RicoPuerto Rico | $121.34 | — |
| Rhode IslandRhode Island | $123.78 | — |
| South CarolinaSouth Carolina | $112.33 | — |
| South DakotaSouth Dakota | $119.36 | — |
| TennesseeTennessee | $110.38 | — |
| Austin, TXTexas | $126.01 | — |
| Beaumont, TXTexas | $111.01 | — |
| Brazoria, TXTexas | $119.17 | — |
| Dallas, TXTexas | $119.80 | — |
| Fort Worth, TXTexas | $118.81 | — |
| Galveston, TXTexas | $119.44 | — |
| Houston, TXTexas | $120.17 | — |
| Rest of TexasTexas | $114.94 | — |
| UtahUtah | $114.01 | — |
| VirginiaVirginia | $118.12 | — |
| Virgin Islands, VIUnited States Virgin Islands | $121.34 | — |
| VermontVermont | $118.57 | — |
| Rest of WashingtonWashington | $125.53 | — |
| King County, WAWashington | $143.92 | — |
| WisconsinWisconsin | $115.05 | — |
| West VirginiaWest Virginia | $107.52 | — |
| WyomingWyoming | $119.90 | — |
74230 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.
$105.28
$148.04
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 | $134.93 | 1 |
| AL | $106.97 | 1 |
| AR | $105.28 | 1 |
| AZ | $116.90 | 1 |
| CA | $129.67–$166.41 | 29 |
| CO | $126.66 | 1 |
| CT | $128.69 | 1 |
| DC | $139.41 | 1 |
| DE | $118.98 | 1 |
| FL | $116.45–$126.45 | 3 |
| GA | $109.53–$122.19 | 2 |
| GU | $133.59 | 1 |
| HI | $133.59 | 1 |
| IA | $110.81 | 1 |
| ID | $111.42 | 1 |
| IL | $112.16–$124.14 | 4 |
| IN | $112.14 | 1 |
| KS | $109.83 | 1 |
| KY | $108.86 | 1 |
| LA | $108.51–$114.43 | 2 |
| MA | $125.63–$140.51 | 2 |
| MD | $121.53–$139.41 | 3 |
| ME | $111.62–$118.84 | 2 |
| MI | $111.58–$117.61 | 2 |
| MN | $122.25 | 1 |
| MO | $106.20–$115.37 | 3 |
| MS | $105.78 | 1 |
| MT | $120.24 | 1 |
| NC | $112.96 | 1 |
| ND | $119.45 | 1 |
| NE | $111.59 | 1 |
| NH | $124.24 | 1 |
| NJ | $130.41–$137.67 | 2 |
| NM | $112.08 | 1 |
| NV | $120.12 | 1 |
| NY | $114.77–$141.69 | 5 |
| OH | $111.42 | 1 |
| OK | $109.08 | 1 |
| OR | $119.44–$131.45 | 2 |
| PA | $111.84–$124.98 | 2 |
| PR | $121.34 | 1 |
| RI | $123.78 | 1 |
| SC | $112.33 | 1 |
| SD | $119.36 | 1 |
| TN | $110.38 | 1 |
| TX | $111.01–$126.01 | 8 |
| UT | $114.01 | 1 |
| VA | $118.12–$139.41 | 2 |
| VI | $121.34 | 1 |
| VT | $118.57 | 1 |
| WA | $125.53–$143.92 | 2 |
| WI | $115.05 | 1 |
| WV | $107.52 | 1 |
| WY | $119.90 | 1 |
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.
How the rate is built · 74230
RVUs × geographic indexes × conversion factor
Work0.52
0.52 RVUs× 1.000 GPCI
Practice expense3.04
3.04 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
3.6000
Conversion factor
$33.4009
Medicare rate
$120.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,348
- Code
- 74230
- Physician work
- 0.52
- Practice expense
- 3.04
- Malpractice
- 0.04
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.52 | × 1.000 | 0.5200 |
| Practice expense | 3.04 | × 1.000 | 3.0400 |
| Malpractice | 0.04 | × 0.998 | 0.0399 |
| Total RVUs | 3.5999 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$120.24
Office: (0.52 × 1 + 3.04 × 1 + 0.04 × 0.998) × $33.4009 = $120.24
Payment rules and modifiers for 74230
The CMS indicators that decide how 74230 is paid alongside other services.
CMS payment indicators · 74230
Swallow study, recorded fluoroscopic evaluation
| 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
74230 without 26 · national office
$120.24
Swallow study, recorded fluoroscopic evaluation
74230-26 · Professional component
$24.72
Pays only the interpretation and report.
How 74230 has changed in Montana
74230 · Office / nonfacility
$120.24
Effective 2026-10-01
The base rate is $2.20 higher than on 2025-10-01, moving from $118.04 to $120.24 (1.9%).
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
$118.04changed to$120.24
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.53 changed to 0.52
- Practice expense RVU 3.08 changed to 3.04
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$124.47changed to$118.04
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.17 changed to 3.08
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$122.43changed to$124.47
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$129.41changed to$122.43
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.24 changed to 3.17
- Malpractice RVU 0.05 changed to 0.04
January 1, 2023
RVU23A
$134.92changed to$129.41
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.32 changed to 3.24
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$136.39changed to$134.92
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.33 changed to 3.32
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$131.70changed to$136.39
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.08 changed to 3.33
- Malpractice RVU 0.03 changed to 0.05
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$130.29changed to$131.70
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.02 changed to 3.08
- Malpractice RVU 0.04 changed to 0.03
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$132.31changed to$130.29
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.08 changed to 3.02
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$130.17changed to$132.31
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.04 changed to 3.08
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$130.17
Held through RVU17B, RVU17C, RVU17D.
January 1, 2015
RVU15A
$94.09changed toNo rate
Held through RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
January 1, 2014
RVU14A
$93.36changed to$94.09
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.17 changed to 2.05
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $93.36
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $120.24 | Not available in this setting | RVU26D |
| 2026-07-01 | $120.24 | Not available in this setting | RVU26C |
| 2026-04-01 | $120.24 | Not available in this setting | RVU26B |
| 2026-01-01 | $120.24 | Not available in this setting | RVU26A |
| 2025-10-01 | $118.04 | Not available in this setting | RVU25D |
| 2025-07-01 | $118.04 | Not available in this setting | RVU25C |
| 2025-04-01 | $118.04 | Not available in this setting | RVU25B |
| 2025-01-01 | $118.04 | Not available in this setting | RVU25A |
| 2024-10-01 | $124.47 | Not available in this setting | RVU24D |
| 2024-07-01 | $124.47 | Not available in this setting | RVU24C |
| 2024-04-01 | $124.47 | Not available in this setting | RVU24B |
| 2024-03-09 | $124.47 | Not available in this setting | RVU24AR |
| 2024-01-01 | $122.43 | Not available in this setting | RVU24A |
| 2023-10-01 | $129.41 | Not available in this setting | RVU23D |
| 2023-07-01 | $129.41 | Not available in this setting | RVU23C |
| 2023-04-01 | $129.41 | Not available in this setting | RVU23B |
| 2023-01-01 | $129.41 | Not available in this setting | RVU23A |
| 2022-10-01 | $134.92 | Not available in this setting | RVU22D |
| 2022-07-01 | $134.92 | Not available in this setting | RVU22C |
| 2022-04-01 | $134.92 | Not available in this setting | RVU22B |
| 2022-01-01 | $134.92 | Not available in this setting | RVU22A |
| 2021-10-01 | $136.39 | Not available in this setting | RVU21D |
| 2021-07-01 | $136.39 | Not available in this setting | RVU21C |
| 2021-04-01 | $136.39 | Not available in this setting | RVU21B |
| 2021-01-01 | $136.39 | Not available in this setting | RVU21A |
| 2020-10-01 | $131.70 | Not available in this setting | RVU20D |
| 2020-07-01 | $131.70 | Not available in this setting | RVU20C |
| 2020-04-01 | $131.70 | Not available in this setting | RVU20B |
| 2020-01-01 | $131.70 | Not available in this setting | RVU20A |
| 2019-10-01 | $130.29 | Not available in this setting | RVU19D |
| 2019-07-01 | $130.29 | Not available in this setting | RVU19C |
| 2019-04-01 | $130.29 | Not available in this setting | RVU19B |
| 2019-01-01 | $130.29 | Not available in this setting | RVU19A |
| 2018-10-01 | $132.31 | Not available in this setting | RVU18D |
| 2018-07-01 | $132.31 | Not available in this setting | RVU18C |
| 2018-04-01 | $132.31 | Not available in this setting | RVU18B |
| 2018-01-01 | $132.31 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $130.17 | Not available in this setting | RVU17D |
| 2017-07-01 | $130.17 | Not available in this setting | RVU17C |
| 2017-04-01 | $130.17 | Not available in this setting | RVU17B |
| 2017-01-01 | $130.17 | Not available in this setting | RVU17A |
| 2016-10-01 | Additional calculation required | Not available in this setting | RVU16D |
| 2016-07-01 | Additional calculation required | Not available in this setting | RVU16C |
| 2016-04-01 | Additional calculation required | Not available in this setting | RVU16B |
| 2016-01-01 | Additional calculation required | Not available in this setting | RVU16A |
| 2015-10-01 | Additional calculation required | Not available in this setting | RVU15D |
| 2015-07-01 | Additional calculation required | Not available in this setting | RVU15C |
| 2015-04-01 | Additional calculation required | Not available in this setting | RVU15B |
| 2015-01-01 | Additional calculation required | Not available in this setting | RVU15A |
| 2014-10-01 | $94.09 | Not available in this setting | RVU14D |
| 2014-07-01 | $94.09 | Not available in this setting | RVU14C |
| 2014-04-01 | $94.09 | Not available in this setting | RVU14B |
| 2014-01-01 | $94.09 | Not available in this setting | RVU14A |
| 2013-10-01 | $93.36 | Not available in this setting | RVU13D |
| 2013-07-01 | $93.36 | Not available in this setting | RVU13C |
| 2013-04-01 | $93.36 | Not available in this setting | RVU13B |
| 2013-01-01 | $93.36 | Not available in this setting | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
74230 billing questions
How does 74230 differ from an esophagram?
74230 evaluates swallowing function dynamically, including bolus movement and airway protection. An esophagram such as 74220 focuses on the esophagus and its transit.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Submit without a component modifier when billing the global service.
Can 92611 be reported for the same examination?
A speech-language pathologist may report 92611 for a separately furnished functional swallowing evaluation. Documentation should distinguish that evaluation from the radiologic interpretation reported with 74230.
What documentation supports 74230?
Document the swallowing symptoms or concern, the fluoroscopic assessment and recorded images, and the interpreted findings, including relevant observations of bolus movement or airway entry.
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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