Billing code 74230: Swallow studyMedicare rate & RVUs in Florida
A fluoroscopic swallowing study with recorded imaging evaluates bolus transit and airway protection when dysphagia or suspected aspiration requires dynamic assessment.
Medicare pays $116.45–$126.45 for 74230 in the office in Florida, from Rest Of Florida to Miami. 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.
On this page 9 sections
What 74230 covers
This study uses fluoroscopy and recorded images to observe swallowing as the patient takes oral contrast material of selected consistencies. It can show how a bolus moves through the oral and pharyngeal phases and whether material enters the airway. Radiologists commonly provide the imaging interpretation, while speech-language pathologists may assess swallowing mechanics during the examination. Studies are performed in radiology departments and other settings equipped for fluoroscopy, often for patients with dysphagia, coughing during meals, or suspected aspiration.
Report 74230 for the recorded fluoroscopic assessment of swallowing function, rather than an examination focused primarily on esophageal structure or transit. The record should support the swallowing concern, the imaging performed, and the findings interpreted. CMS recognizes professional and technical components: report modifier 26 for the professional interpretation, modifier TC for the equipment and staff, or no modifier for the global service. A speech-language pathologist's separately furnished swallowing evaluation may be reported with 92611 when its work is documented.
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 74230 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$116.45 to $126.45
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $122.64 | Unavailable |
| Miami | $126.45 | Unavailable |
| Rest Of Florida | $116.45 | Unavailable |
How the 74230 rate is calculated
Each of 74230’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 · 74230
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.52Practice expense 3.04Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 74230
The CMS indicators that decide how 74230 is paid alongside other services.
CMS payment indicators · 74230
Swallow study
| 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
74230 without 26 · national office
$120.24
Swallow study
74230-26 · Professional component
$24.72
Pays only the interpretation and report.
74230 compared with similar codes
Compare codes
74230 vs 74220 vs 74210 vs 92611: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 74220Esophagram
- Choose 74230 for recorded assessment of swallowing mechanics and airway protection. Choose 74220 when the examination is directed primarily at the esophagus and its transit.
- 74210Contrast X-ray
- 74210 focuses on radiographic examination of the pharynx or cervical esophagus. 74230 captures swallowing function dynamically with recorded imaging.
- 92611Swallow study
- 74230 represents the radiologic service and interpretation. 92611 represents the speech-language pathologist's functional swallowing evaluation when separately furnished and documented.
74230 billing questions
How does 74230 differ from an esophagram?
74230 evaluates swallowing function dynamically, including bolus movement and airway protection. An esophagram such as 74220 focuses on the esophagus and its transit.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Submit without a component modifier when billing the global service.
Can 92611 be reported for the same examination?
A speech-language pathologist may report 92611 for a separately furnished functional swallowing evaluation. Documentation should distinguish that evaluation from the radiologic interpretation reported with 74230.
What documentation supports 74230?
Document the swallowing symptoms or concern, the fluoroscopic assessment and recorded images, and the interpreted findings, including relevant observations of bolus movement or airway entry.
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
Fee sheets
Put 74230 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →