Billing code 74021: Abdominal X-rayMedicare rate & RVUs
Reports abdominal radiography using at least three views, often to assess abdominal pain, bowel gas patterns, suspected obstruction, or a radiopaque foreign body.
Medicare pays $42.09 for 74021 nationally in the office. Local office rates run $37.15–$57.20.
Medicare rate · 74021
Abdominal X-ray
Swap in your local Medicare rate.
- Work RVUs
- 0.26
- Total RVUs
- 1.26
- Global days
- XXX
National rate · 2026
$42.09
Office setting, before claim adjustments.
See every locality for 74021 → · 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.
On this page 10 sections
What 74021 covers
This service is an abdominal X-ray examination using three or more views to show the distribution of bowel gas and other radiopaque findings. It may be ordered for abdominal pain or suspected ileus or bowel obstruction, and can help evaluate a radiopaque foreign body. Radiologic technologists acquire the images; a physician, commonly a radiologist, interprets the study. It is performed in settings such as hospital imaging departments and outpatient radiology centers.
Select this code when the documented abdominal study includes at least three views; the number and types of views should support that selection. Report the study once rather than billing separately for each image. Documentation should identify the views obtained and support the clinical reason for imaging. CMS recognizes professional and technical components: modifier 26 represents the interpretation, modifier TC represents equipment and staff, and billing 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 74021 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
$37.15 to $57.20
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $37.70 | Unavailable |
| Alaska* | $48.25 | Unavailable |
| Arizona | $40.97 | Unavailable |
| Arkansas | $37.15 | Unavailable |
| Atlanta | $42.77 | Unavailable |
| Austin | $43.92 | Unavailable |
| Bakersfield | $45.13 | Unavailable |
| Baltimore/Surr. Cntys | $44.77 | Unavailable |
| Beaumont | $39.09 | Unavailable |
| Brazoria | $41.71 | Unavailable |
| Chicago | $43.17 | Unavailable |
| Chico | $45.07 | Unavailable |
| Colorado | $44.14 | Unavailable |
| Connecticut | $44.92 | Unavailable |
| Dallas | $41.94 | Unavailable |
| Dc + Md/Va Suburbs | $48.46 | Unavailable |
| Delaware | $41.67 | Unavailable |
| Detroit | $41.40 | Unavailable |
| East St. Louis | $40.14 | Unavailable |
| El Centro | $45.07 | Unavailable |
| Fort Lauderdale | $43.05 | Unavailable |
| Fort Worth | $41.62 | Unavailable |
| Fresno | $45.07 | Unavailable |
| Galveston | $41.81 | Unavailable |
| Hanford-Corcoran | $45.07 | Unavailable |
| Hawaii, Guam | $46.29 | Unavailable |
| Houston | $42.18 | Unavailable |
| Idaho | $39.11 | Unavailable |
| Indiana | $39.35 | Unavailable |
| Iowa | $38.90 | Unavailable |
| Kansas | $38.61 | Unavailable |
| Kentucky | $38.40 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $48.21 | Unavailable |
| Madera | $45.07 | Unavailable |
| Manhattan | $48.34 | Unavailable |
| Merced | $45.07 | Unavailable |
| Metropolitan Boston | $48.72 | Unavailable |
| Metropolitan Kansas City | $40.07 | Unavailable |
| Metropolitan Philadelphia | $43.71 | Unavailable |
| Metropolitan St. Louis | $40.52 | Unavailable |
| Miami | $44.45 | Unavailable |
| Minnesota | $42.56 | Unavailable |
| Mississippi | $37.36 | Unavailable |
| Modesto | $45.07 | Unavailable |
| Montana** | $42.08 | Unavailable |
| Napa | $52.71 | Unavailable |
| Nebraska | $39.15 | Unavailable |
| Nevada** | $42.01 | Unavailable |
| New Hampshire | $43.34 | Unavailable |
| New Mexico | $39.50 | Unavailable |
| New Orleans | $40.24 | Unavailable |
| North Carolina | $39.65 | Unavailable |
| North Dakota** | $41.69 | Unavailable |
| Northern Nj | $47.91 | Unavailable |
| Nyc Suburbs/Long Island | $49.40 | Unavailable |
| Ohio | $39.24 | Unavailable |
| Oklahoma | $38.43 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $48.03 | Unavailable |
| Portland | $45.69 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $45.73 | Unavailable |
| Puerto Rico | $42.44 | Unavailable |
| Queens | $48.89 | Unavailable |
| Redding | $45.07 | Unavailable |
| Rest Of California | $45.07 | Unavailable |
| Rest Of Florida | $40.98 | Unavailable |
| Rest Of Georgia | $38.68 | Unavailable |
| Rest Of Illinois | $39.61 | Unavailable |
| Rest Of Louisiana | $38.29 | Unavailable |
| Rest Of Maine | $39.21 | Unavailable |
| Rest Of Maryland | $42.51 | Unavailable |
| Rest Of Massachusetts | $43.82 | Unavailable |
| Rest Of Michigan | $39.32 | Unavailable |
| Rest Of Missouri | $37.55 | Unavailable |
| Rest Of New Jersey | $45.51 | Unavailable |
| Rest Of New York | $40.25 | Unavailable |
| Rest Of Oregon | $41.76 | Unavailable |
| Rest Of Pennsylvania | $39.36 | Unavailable |
| Rest Of Texas | $40.35 | Unavailable |
| Rest Of Washington | $43.77 | Unavailable |
| Rhode Island | $43.26 | Unavailable |
| Riverside-San Bernardino-Ontario | $45.29 | Unavailable |
| Sacramento-Roseville-Folsom | $47.42 | Unavailable |
| Salinas | $47.25 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $48.46 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $55.97 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $55.95 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $57.20 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $57.11 | Unavailable |
| San Luis Obispo-Paso Robles | $46.47 | Unavailable |
| Santa Cruz-Watsonville | $49.00 | Unavailable |
| Santa Maria-Santa Barbara | $47.45 | Unavailable |
| Santa Rosa-Petaluma | $49.50 | Unavailable |
| Seattle (King Cnty) | $49.83 | Unavailable |
| South Carolina | $39.50 | Unavailable |
| South Dakota** | $41.64 | Unavailable |
| Southern Maine | $41.54 | Unavailable |
| Stockton | $45.07 | Unavailable |
| Suburban Chicago | $43.55 | Unavailable |
| Tennessee | $38.80 | Unavailable |
| Utah | $40.05 | Unavailable |
| Vallejo | $52.68 | Unavailable |
| Vermont | $41.43 | Unavailable |
| Virgin Islands | $42.44 | Unavailable |
| Virginia | $41.33 | Unavailable |
| Visalia | $45.07 | Unavailable |
| West Virginia | $38.09 | Unavailable |
| Wisconsin | $40.25 | Unavailable |
| Wyoming** | $41.91 | Unavailable |
| Yuba City | $45.07 | Unavailable |
74021 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.
$37.15
$51.14
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 | $48.25 | 1 |
| AL | $37.70 | 1 |
| AR | $37.15 | 1 |
| AZ | $40.97 | 1 |
| CA | $45.07–$57.20 | 29 |
| CO | $44.14 | 1 |
| CT | $44.92 | 1 |
| DC | $48.46 | 1 |
| DE | $41.67 | 1 |
| FL | $40.98–$44.45 | 3 |
| GA | $38.68–$42.77 | 2 |
| GU | $46.29 | 1 |
| HI | $46.29 | 1 |
| IA | $38.90 | 1 |
| ID | $39.11 | 1 |
| IL | $39.61–$43.55 | 4 |
| IN | $39.35 | 1 |
| KS | $38.61 | 1 |
| KY | $38.40 | 1 |
| LA | $38.29–$40.24 | 2 |
| MA | $43.82–$48.72 | 2 |
| MD | $42.51–$48.46 | 3 |
| ME | $39.21–$41.54 | 2 |
| MI | $39.32–$41.40 | 2 |
| MN | $42.56 | 1 |
| MO | $37.55–$40.52 | 3 |
| MS | $37.36 | 1 |
| MT | $42.08 | 1 |
| NC | $39.65 | 1 |
| ND | $41.69 | 1 |
| NE | $39.15 | 1 |
| NH | $43.34 | 1 |
| NJ | $45.51–$47.91 | 2 |
| NM | $39.50 | 1 |
| NV | $42.01 | 1 |
| NY | $40.25–$49.40 | 5 |
| OH | $39.24 | 1 |
| OK | $38.43 | 1 |
| OR | $41.76–$45.69 | 2 |
| PA | $39.36–$43.71 | 2 |
| PR | $42.44 | 1 |
| RI | $43.26 | 1 |
| SC | $39.50 | 1 |
| SD | $41.64 | 1 |
| TN | $38.80 | 1 |
| TX | $39.09–$43.92 | 8 |
| UT | $40.05 | 1 |
| VA | $41.33–$48.46 | 2 |
| VI | $42.44 | 1 |
| VT | $41.43 | 1 |
| WA | $43.77–$49.83 | 2 |
| WI | $40.25 | 1 |
| WV | $38.09 | 1 |
| WY | $41.91 | 1 |
How the 74021 rate is calculated
Each of 74021’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 · 74021
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.26Practice expense 0.98Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 74021
The CMS indicators that decide how 74021 is paid alongside other services.
CMS payment indicators · 74021
Abdominal X-ray
| 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
74021 without 26 · national office
$42.09
Abdominal X-ray
74021-26 · Professional component
$12.36
Pays only the interpretation and report.
74021 compared with similar codes
Compare codes
74021 vs 74018 vs 74019 vs 74022: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 74018Abdomen X-ray
- 74018 is for an abdominal study with one view; 74021 requires at least three abdominal views.
- 74019Abdominal X-ray
- 74019 applies to a two-view abdominal study. Choose 74021 when three or more abdominal views are documented.
- 74022Abdominal X-ray
- 74022 describes an acute abdomen series that includes chest imaging. Use 74021 for the abdominal study when it does not meet that series description.
74021 billing questions
Does each abdominal view generate a separate unit?
No. Report the radiographic study, not a separate unit for every image; the record should support the number and types of views.
How are the professional and technical portions billed?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
How does 74021 differ from an acute abdomen series?
74021 represents an abdominal study with at least three views. The acute abdomen series code, 74022, includes chest imaging as part of the series.
What documentation supports reporting 74021?
The imaging record should identify at least three abdominal views, and the report should document the findings and interpretation. The order or clinical record should support the reason for the examination.
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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