$105.11
Both codes examine the esophagus, but 74220 is for a single-contrast technique and 74221 is for a double-contrast technique.
On this page
CMS RVU26D · Effective 2026-10-01
74220 Esophagram Medicare reimbursement rates in Wyoming
A single-contrast fluoroscopic esophagram evaluates the esophageal lumen and passage of contrast, commonly for dysphagia, suspected narrowing, or other esophageal symptoms. Compare 74220 office and facility rates across CMS payment localities in Wyoming.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 74220 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$93.84
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiology
About 74220: Single-contrast esophagram
A single-contrast fluoroscopic esophagram evaluates the esophageal lumen and passage of contrast, commonly for dysphagia, suspected narrowing, or other esophageal symptoms.
A single-contrast esophagram is a fluoroscopic X-ray examination in which the patient swallows contrast, usually barium, while images document its passage through the esophagus. It is commonly ordered for dysphagia, suspected esophageal narrowing, diverticulum, or other structural symptoms. Radiologists typically interpret the examination, with imaging staff acquiring views in a hospital radiology department or outpatient imaging center. The study focuses on the esophagus rather than the oral and pharyngeal phases of swallowing or a broader upper gastrointestinal examination.
Select this code when the performed esophageal study uses a single-contrast technique; a double-contrast examination belongs to its sibling code. The report should support the technique and anatomy examined and include the radiologist’s interpretation. CMS permits global billing without a component modifier or split billing: modifier 26 represents the professional interpretation, and modifier TC represents the equipment and staff. The global service includes both components.
CMS billing rules for 74220
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.59 · 21%
- Practice expense (office) RVU2.19 · 78%
- Malpractice RVU0.04 · 1%
87.5K
Medicare services in 2024 · #603 by national volume
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.
74220 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$90.84
74210 focuses on the pharynx and/or cervical esophagus; 74220 is for a single-contrast examination of the esophagus.
$119.90
74230 evaluates swallowing function, including oral and pharyngeal phases. Choose 74220 for a single-contrast esophageal examination.
$121.48
74240 is an upper gastrointestinal examination, while 74220 is focused on the esophagus.
Compare 74220 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
$93.84
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 74220 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
8,342
- Code
- 74220
- Physician work
- 0.59
- Practice expense
- 2.19
- Malpractice
- 0.04
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 2.19 | × 1.000 | 2.1900 |
| Malpractice | 0.04 | × 0.740 | 0.0296 |
| Total RVUs | 2.8096 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$93.84
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1 |
| Practice expense | 2.19 | 1 |
| Malpractice | 0.04 | 0.74 |
(0.59 × 1 + 2.19 × 1 + 0.04 × 0.74) × $33.4009 = $93.84
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
74220 billing questions
How does this differ from the double-contrast esophagram?
Use 74220 for a single-contrast technique. When the examination uses double contrast, report 74221 instead.
When should the swallowing-function study be reported instead?
Use 74230 for a study focused on swallowing function, including the oral and pharyngeal phases. Use 74220 for a single-contrast examination focused on the esophagus.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion, including equipment and staff. Billing without either modifier represents the global service.
What documentation supports reporting 74220?
Document the clinical indication, that the examination used a single-contrast technique, the esophageal anatomy evaluated, and the imaging findings and interpretation.
Does this code include an examination of the stomach?
No. This code represents an esophageal study. A broader upper gastrointestinal examination is a different service when the stomach and related anatomy are evaluated.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,33974210,,X-ray xm phrnx&/crv esoph c+,A,,0.58,2.11,,2.11,NA,0.04,2.73,2.73,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,5.54,5.54,0.06
8,34074210,26,X-ray xm phrnx&/crv esoph c+,A,,0.58,0.20,,0.20,,0.03,0.81,0.81,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,34174210,TC,X-ray xm phrnx&/crv esoph c+,A,,0.00,1.91,,1.91,NA,0.01,1.92,1.92,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,5.34,5.34,0.03
8,34274220,,X-ray xm esophagus 1cntrst,A,,0.59,2.19,,2.19,NA,0.04,2.82,2.82,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,5.55,5.55,0.06
8,34374220,26,X-ray xm esophagus 1cntrst,A,,0.59,0.21,,0.21,,0.03,0.83,0.83,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,34474220,TC,X-ray xm esophagus 1cntrst,A,,0.00,1.98,,1.98,NA,0.01,1.99,1.99,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,5.34,5.34,0.03
8,34574221,,X-ray xm esophagus 2cntrst,A,,0.68,2.43,,2.43,NA,0.05,3.16,3.16,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,5.58,5.58,0.06
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,