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CPT code 74248: Small bowel follow-through, add-on to upper GI2026 Medicare rate & RVUs

Add-on fluoroscopic imaging tracks oral contrast through the small bowel during an upper gastrointestinal examination to assess transit and small-intestinal abnormalities.

CMS RVU26DEffective Oct 1, 2026109 payment localities11K Medicare services in 2024

Medicare pays $79.49 for 74248 nationally in the office. Local office rates run $70.91–$105.58.

Medicare rate · 74248

Small bowel follow-through, add-on to upper GI

Office or facility?

Work RVUs
0.68
Total RVUs
2.38
Global days
ZZZ

National rate · 2026

$79.49

Office setting, before claim adjustments.

See every locality for 74248 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 74248 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 74248 covers

This add-on covers serial radiographic imaging as orally administered contrast passes through the small bowel during an upper gastrointestinal examination. A radiologic technologist obtains the images, and a radiologist interprets them. The added small-bowel evaluation can help assess transit and identify abnormalities in the small intestine, such as suspected narrowing or obstruction.

Report 74248 only with the primary upper GI examination, such as 74240 or 74246; it is not a stand-alone small-bowel study. The report should support that the examination included follow-through imaging into the small bowel, not just imaging of the esophagus or stomach. CMS treats it as an add-on paid within the primary procedure’s global period. For the diagnostic test, the global service is billed without a component modifier; modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion.

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 74248 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$70.91 to $105.58

$70.91$88.25$105.58
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

74248 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$71.88Unavailable
Alaska$93.68Unavailable
Arizona$77.55Unavailable
Arkansas$70.91Unavailable
Atlanta, GA$80.78Unavailable
Austin, TX$82.55Unavailable
Bakersfield, CA$84.56Unavailable
Baltimore area, MD$84.28Unavailable
Beaumont, TX$74.42Unavailable
Brazoria, TX$78.81Unavailable

74248 rates by state

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

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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.

$70.91

$94.99

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
74248 office rate range by state
State / territoryOffice rate rangeLocalities
AK$93.681
AL$71.881
AR$70.911
AZ$77.551
CA$84.40–$105.5829
CO$82.931
CT$84.541
DC$90.721
DE$78.781
FL$77.91–$84.313
GA$73.86–$80.782
GU$86.341
HI$86.341
IA$73.801
ID$74.211
IL$75.64–$82.434
IN$74.611
KS$73.381
KY$73.231
LA$73.09–$76.472
MA$82.44–$90.932
MD$80.25–$90.723
ME$74.45–$78.382
MI$74.91–$78.712
MN$79.921
MO$71.85–$76.853
MS$71.401
MT$79.491
NC$75.201
ND$78.501
NE$74.211
NH$81.541
NJ$85.63–$89.862
NM$75.261
NV$79.271
NY$76.24–$92.805
OH$74.711
OK$73.221
OR$78.78–$85.552
PA$74.88–$82.482
PR$80.081
RI$81.561
SC$75.061
SD$78.391
TN$73.711
TX$74.42–$82.558
UT$76.021
VA$78.07–$90.722
VI$80.081
VT$78.121
WA$82.31–$92.832
WI$76.021
WV$72.991
WY$79.061

How the 74248 rate is calculated

Each of 74248’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 · 74248

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.68

0.68 RVUs× 1.000 GPCI

Practice expense1.65

1.65 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.3800

Conversion factor

$33.4009

Medicare rate

$79.49

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 74248

The CMS indicators that decide how 74248 is paid alongside other services.

CMS payment indicators · 74248

Small bowel follow-through, add-on to upper GI

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
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

74248 without 26 · national office

$79.49

Small bowel follow-through, add-on to upper GI

74248-26 · Professional component

$32.06

Pays only the interpretation and report.

When to use modifier 26

74248 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 74248

    Small bowel follow-through, add-on to upper GI0.68 wRVU

    $79.49

  • 74240

    Upper GI series, single contrast0.78 wRVU

    $121.91+$42.42

  • 74246

    Upper GI imaging, air-contrast study0.88 wRVU

    $134.61+$55.12

  • 74250

    Small-bowel X-ray, single contrast0.79 wRVU

    $118.24+$38.75

  • 74251

    Small bowel X-ray, double contrast1.14 wRVU

    $343.70+$264.21

How to choose

74240Upper GI seriesSingle contrast
74240 describes a single-contrast upper GI examination. Add 74248 when the examination also includes small-bowel follow-through.
74246Upper GI imagingAir-contrast study
74246 describes a double-contrast upper GI examination. Add 74248 when serial imaging extends the examination through the small bowel.
74250Small-bowel X-raySingle contrast
74250 is a standalone single-contrast small-intestine examination; 74248 is an add-on to an upper GI examination.
74251Small bowel X-rayDouble contrast
74251 is a standalone double-contrast small-intestine examination; 74248 is used for follow-through performed with a primary upper GI examination.

Codes related to 74248

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 74248
CodeHow it relatesNational office range
Add-on codes
74240Upper GI series, single contrastSingle-contrast upper GI examination that may be reported with this add-on.$107.82–$165.64
74246Upper GI imaging, air-contrast studyDouble-contrast upper GI examination that may be reported with this add-on.$119.08–$182.53
Used instead
74250Small-bowel X-ray, single contrastStandalone small-intestine examination using single contrast.$104.60–$159.92
74251Small bowel X-ray, double contrastStandalone small-intestine examination using double contrast.No office rate

74248 billing questions

Can 74248 be reported by itself?

No. It is an add-on and must be reported with a primary upper GI examination, such as 74240 or 74246.

How is 74248 different from 74250?

74248 is for small-bowel follow-through performed with a primary upper GI examination. 74250 describes a standalone small-intestine examination using single contrast.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the radiologist’s interpretation, and modifier TC identifies the technical portion. Without either modifier, the claim represents the global service.

What documentation supports reporting 74248?

The record should show the primary upper GI examination and that serial imaging followed contrast through the small bowel. Imaging limited to the upper GI tract does not support this add-on.

Does the add-on have its own global period?

CMS specifies that 74248 is paid within the primary procedure’s global period. Submit it only with the primary procedure.

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 74248PPRRVU2026_Oct_nonQPP.csv, line 8,360 (RVU26D)

Open CMS sourceHow we calculate rates

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