CPT code 74246: Upper GI imaging, air-contrast study2026 Medicare rate & RVUs

Medicare pays $134.61 for 74246 nationally in the office. Local office rates run $119.08–$182.53.

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

What 74246 covers

This examination uses fluoroscopy and radiographs to assess the esophagus, stomach, and duodenum, sometimes extending to the proximal jejunum. The patient swallows contrast, typically high-density barium with an effervescent agent that distends the upper GI tract with gas. A radiologist guides the study and interprets the images, with a technologist assisting with imaging. It is commonly performed in a hospital radiology department or outpatient imaging center to evaluate symptoms or suspected structural abnormalities such as a hiatal hernia or ulcer.

Select this code when the documented examination uses an air-contrast protocol to image the upper GI tract; a single-contrast study is reported differently. The record should support the anatomic coverage, contrast technique, and final interpretation. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies equipment and staff. Reporting without either modifier represents the global service.

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 74246 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

74246 rates by state

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

How the 74246 rate is calculated

Each of 74246’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 74246

The CMS indicators that decide how 74246 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

74246 compared with similar codes

How to choose

74240Upper GI seriesSingle contrast

Both cover an upper GI examination, but 74246 describes an air-contrast technique; 74240 describes a single-contrast study.

74220EsophagramSingle contrast

74220 is limited to an esophageal examination with single contrast. Use 74246 when the air-contrast study evaluates the broader upper GI tract.

74221EsophagramDouble contrast

74221 is a double-contrast esophagus-only examination. Choose 74246 when the study also examines the stomach and duodenum or proximal jejunum.

74250Small-bowel X-raySingle contrast

74250 describes a small-intestine examination, not an air-contrast upper GI series. Select based on the documented anatomy and imaging performed.

Codes related to 74246

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