CPT code 74263: CT colonography, screening examination2026 Medicare rate & RVUs in Illinois
Reports CT-based colorectal cancer screening in which reconstructed images are evaluated for colonic polyps or masses in a screening setting.
CMS doesn’t publish an office rate for 74263 in Illinois.
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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What 74263 covers
CT colonography screening uses computed tomography to produce images of the colon for evaluation for polyps or masses. The patient typically completes bowel preparation, and the colon is distended with gas to improve visualization. A radiologist interprets the reconstructed images. The service is performed in diagnostic imaging settings, such as a hospital or imaging center, for a colorectal cancer screening examination.
Report 74263 for the screening study; diagnostic CT colonography is represented by separate codes. Documentation should support the screening purpose and include the imaging study and interpretation. The global service is reported without a component modifier. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. When the study is billed in components, the diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
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 74263 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
How the 74263 rate is calculated
Each of 74263’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 · 74263
RVUs × geographic indexes × conversion factor
Work2.22
2.22 RVUs× 1.000 GPCI
Practice expense22.67
22.67 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
25.0000
Conversion factor
$33.4009
Medicare rate
$835.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 74263
The CMS indicators that decide how 74263 is paid alongside other services.
CMS payment indicators · 74263
CT colonography, screening examination
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
74263 without 26 · national office
$835.02
CT colonography, screening examination
74263-26 · Professional component
$120.24
Pays only the interpretation and report.
74263 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 74261CT colonographyDiagnostic, without contrast
- Choose 74263 when the CT colonography is performed for screening. Choose 74261 for diagnostic CT colonography without contrast.
- 74262CT colonographyDiagnostic with contrast
- 74262 describes diagnostic CT colonography with contrast; 74263 identifies the screening service.
- G0121Screening colonoscopyNot high risk
- G0121 is an average-risk screening colonoscopy performed endoscopically. 74263 reports CT colonography screening.
74263 billing questions
How does 74263 differ from 74261?
74263 is for screening CT colonography. Use 74261 for a diagnostic CT colonography study without contrast.
When is 74262 used instead?
74262 represents diagnostic CT colonography with contrast. The screening purpose, rather than the imaging method alone, distinguishes 74263.
Which modifiers identify the components?
Append modifier 26 for the professional interpretation or modifier TC for the technical service. Report the global service without either modifier.
Does the multiple procedure reduction affect the components?
Yes. The diagnostic imaging multiple procedure reduction applies to the technical and professional components of this service.
What documentation supports reporting 74263?
Document the screening indication and the CT colonography performed, along with the interpreting radiologist’s findings. The record should make clear that the examination was for screening rather than diagnostic evaluation.
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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