CPT code 74248: Small bowel follow-through, add-on to upper GI2026 Medicare rate & RVUs in California
Add-on fluoroscopic imaging tracks oral contrast through the small bowel during an upper gastrointestinal examination to assess transit and small-intestinal abnormalities.
Medicare pays $84.40–$105.58 for 74248 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$84.40 to $105.58
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $84.56 | Unavailable |
| Chico, CA | $84.40 | Unavailable |
| El Centro, CA | $84.40 | Unavailable |
| Fresno, CA | $84.40 | Unavailable |
| Hanford, CA | $84.40 | Unavailable |
| Los Angeles, CA | $89.95 | Unavailable |
| Madera, CA | $84.40 | Unavailable |
| Marin County, CA | $103.34 | Unavailable |
| Merced, CA | $84.40 | Unavailable |
| Modesto, CA | $84.40 | Unavailable |
| Napa, CA | $97.63 | Unavailable |
| Oxnard, CA | $89.53 | Unavailable |
| Redding, CA | $84.40 | Unavailable |
| Rest of California | $84.40 | Unavailable |
| Riverside, CA | $84.95 | Unavailable |
| Sacramento, CA | $88.52 | Unavailable |
| Salinas, CA | $88.19 | Unavailable |
| San Benito County, CA | $105.58 | Unavailable |
| San Diego, CA | $90.21 | Unavailable |
| San Francisco, CA | $103.29 | Unavailable |
| San Luis Obispo, CA | $86.77 | Unavailable |
| Santa Clara County, CA | $105.34 | Unavailable |
| Santa Cruz, CA | $91.05 | Unavailable |
| Santa Maria, CA | $88.50 | Unavailable |
| Santa Rosa, CA | $91.97 | Unavailable |
| Stockton, CA | $84.40 | Unavailable |
| Vallejo, CA | $97.55 | Unavailable |
| Visalia, CA | $84.40 | Unavailable |
| Yuba City, CA | $84.40 | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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
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.
74248 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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