CPT 74240
Global XXX ActiveX-ray xm upr gi trc 1cntrst
CPT 74240 Billing & Documentation Guide
CPT code 74240 (X-ray xm upr gi trc 1cntrst) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.78, a non-facility practice expense RVU of 2.82, and a malpractice RVU of 0.05, a total non-facility RVU of 3.65 and facility RVU of 3.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $126.31, though rates vary from $107.82 to $165.64 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 74240, 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 74240 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 2 units of 74240 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 74240
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.78 | 0.78 |
| Practice Expense RVU | 2.82 | 2.82 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 3.65 | 3.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 74240
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 | $139.34 | $139.34 | $130.62 - $165.64 | 29 |
| Florida | $123.81 | $123.81 | $118.61 - $128.33 | 3 |
| Georgia | $117.95 | $117.95 | $112.06 - $123.83 | 2 |
| Illinois | $120.35 | $120.35 | $114.66 - $125.93 | 4 |
| Michigan | $116.85 | $116.85 | $113.93 - $119.76 | 2 |
| North Carolina | $115 | $115 | $115 - $115 | 1 |
| New York | $134.64 | $134.64 | $116.71 - $142.81 | 5 |
| Ohio | $113.73 | $113.73 | $113.73 - $113.73 | 1 |
| Pennsylvania | $120.34 | $120.34 | $114.1 - $126.57 | 2 |
| Texas | $120.48 | $120.48 | $113.32 - $127.24 | 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 74240
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 74240 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 |
| 74000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 74018 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 74019 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 74021 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 74210 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 74220 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 74221 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 74245 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
Frequently Asked Questions, CPT 74240
What does CPT code 74240 mean? +
CPT code 74240 represents: X-ray xm upr gi trc 1cntrst. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 74240? +
The 2026 Medicare national average non-facility payment for CPT 74240 is $126.31. Rates range from $107.82 to $165.64 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 74240? +
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 74240? +
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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