Billing code 74290: Gallbladder x-rayMedicare rate & RVUs in Texas
Reports x-ray imaging of the gallbladder after oral contrast is given to evaluate its appearance and findings such as gallstones.
Medicare pays $74.81–$85.12 for 74290 in the office in Texas, from Beaumont to Austin. 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 74290 covers
This study uses oral contrast to make the gallbladder visible on x-ray images. A radiology technologist acquires the images, and a radiologist interprets the gallbladder’s filling and appearance, including findings such as calculi. It is a targeted gallbladder examination, generally performed in a hospital or imaging department when the ordered service is oral-contrast radiography rather than ultrasound or nuclear medicine imaging.
Report 74290 for the completed oral-contrast gallbladder radiographic service. It is not a general upper-GI or small-bowel contrast study, and it does not describe operative imaging of the bile ducts. Documentation should support the gallbladder indication, oral contrast and image acquisition, and a diagnostic interpretation. CMS recognizes separately billable professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies equipment and staff. Report the service without either modifier when billing 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 74290 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$74.81 to $85.12
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $85.12 | Unavailable |
| Beaumont | $74.81 | Unavailable |
| Brazoria | $80.40 | Unavailable |
| Dallas | $80.84 | Unavailable |
| Fort Worth | $80.15 | Unavailable |
| Galveston | $80.59 | Unavailable |
| Houston | $81.14 | Unavailable |
| Rest Of Texas | $77.51 | Unavailable |
How the 74290 rate is calculated
Each of 74290’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 · 74290
RVUs × geographic indexes × conversion factor
Work0.31
0.31 RVUs× 1.000 GPCI
Practice expense2.09
2.09 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
2.4300
Conversion factor
$33.4009
Medicare rate
$81.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 74290
The CMS indicators that decide how 74290 is paid alongside other services.
CMS payment indicators · 74290
Gallbladder 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
74290 without 26 · national office
$81.16
Gallbladder x-ray
74290-26 · Professional component
$14.70
Pays only the interpretation and report.
74290 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76705Abdominal ultrasound
- Use 74290 for oral-contrast gallbladder x-ray imaging; 76705 is a limited abdominal ultrasound examination.
- 78226Hepatobiliary imaging
- Code 78226 describes hepatobiliary nuclear imaging, not oral-contrast x-ray imaging of the gallbladder.
- 74300X-ray bile ducts/pancreas
- Code 74300 concerns intraoperative cholangiography and/or pancreatography. Code 74290 is an oral-contrast radiographic study of the gallbladder.
74290 billing questions
How is 74290 different from a limited abdominal ultrasound?
74290 is an x-ray examination using oral contrast to show the gallbladder. Code 76705 describes a limited abdominal ultrasound, which can be used to examine the gallbladder by a different imaging method.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and TC for the technical service, including equipment and staff. Without either modifier, 74290 represents the global service.
Does 74290 describe imaging of the bile ducts during surgery?
No. It describes oral-contrast x-ray imaging of the gallbladder. Code 74300 is used for intraoperative cholangiography and/or pancreatography supervision and interpretation.
How does 74290 differ from hepatobiliary nuclear imaging?
74290 is a radiographic study using oral contrast. Codes 78226 and 78227 describe hepatobiliary nuclear imaging; 78227 includes ejection-fraction measurement.
What documentation supports reporting 74290?
The record should identify the gallbladder indication, show that oral contrast and radiographic imaging were performed, and include the diagnostic interpretation.
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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