CPT 74220
Global XXX ActiveX-ray xm esophagus 1cntrst
CPT 74220 Billing & Documentation Guide
CPT code 74220 (X-ray xm esophagus 1cntrst) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.59, a non-facility practice expense RVU of 2.19, and a malpractice RVU of 0.04, a total non-facility RVU of 2.82 and facility RVU of 2.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $97.59, though rates vary from $83.23 to $128.07 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 74220, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 74220 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 74220 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 74220
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.59 | 0.59 |
| Practice Expense RVU | 2.19 | 2.19 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.82 | 2.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 74220
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $107.69 | $107.69 | $100.93 - $128.07 | 29 |
| Florida | $95.7 | $95.7 | $91.64 - $99.23 | 3 |
| Georgia | $91.12 | $91.12 | $86.55 - $95.69 | 2 |
| Illinois | $93.01 | $93.01 | $88.58 - $97.33 | 4 |
| Michigan | $90.28 | $90.28 | $88 - $92.55 | 2 |
| North Carolina | $88.81 | $88.81 | $88.81 - $88.81 | 1 |
| New York | $104.06 | $104.06 | $90.14 - $110.42 | 5 |
| Ohio | $87.84 | $87.84 | $87.84 - $87.84 | 1 |
| Pennsylvania | $92.96 | $92.96 | $88.12 - $97.8 | 2 |
| Texas | $93.07 | $93.07 | $87.51 - $98.32 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 74220
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 74220 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 74210 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 76000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 76001 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 77001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 77002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 74221 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 74230 | Column 2 (secondary), bundled into primary | No | More extensive procedure |
Frequently Asked Questions, CPT 74220
What does CPT code 74220 mean? +
CPT code 74220 represents: X-ray xm esophagus 1cntrst. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 74220? +
The 2026 Medicare national average non-facility payment for CPT 74220 is $97.59. Rates range from $83.23 to $128.07 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 74220? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 74220? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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