CPT 74210Radiology

X-ray xm phrnx&/crv esoph c+

CPT code 74210 is an X-ray imaging study of the throat (pharynx) and upper esophagus (cervical portion) performed with contrast material, typically barium, to visualize swallowing function and detect abnormalities.

Showing rates for

National Average

Base Medicare rate

$89.92

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.59

PE RVU (NF)

2.15

MP RVU

0.04

Total RVU

2.78

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Ensure documentation explicitly states both pharynx AND cervical esophagus were examined with contrast; if only pharynx is examined, use 70370 instead
Impact: Prevents downcoding from 74210 ($89.92) to 70370 or denial for incomplete procedure documentation
Document the type and amount of contrast material administered; include any special consistency modifications (thin, nectar, honey, pudding) used during the study
Impact: Supports medical necessity and differentiates from non-contrast studies; required for many commercial payer audits
When performed in conjunction with speech pathology services, coordinate billing to ensure speech therapy evaluation (92610) is billed separately and not confused with the radiologic service
Impact: Allows capture of both professional services; combined billing can yield $200+ when properly coordinated
Bill global code 74210 when facility owns equipment and employs interpreting physician; split with 26/TC modifiers only when components are performed by different entities
Impact: Global billing captures full $89.92; unnecessary splitting may delay payment and create coordination issues
Link appropriate ICD-10 codes for dysphagia (R13.10-R13.19), aspiration risk (J69.0), or stroke sequelae (I69.x) to establish medical necessity
Impact: Reduces denial rate by 30-40% compared to non-specific or inappropriate diagnosis coding
Verify LCD/NCD coverage requirements for your MAC; some require prior authorization or specific diagnosis codes for coverage
Impact: Prevents denials for lack of medical necessity; prior authorization compliance ensures payment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 74210 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 74210 is $89.92 for both facility and non-facility settings, based on 2.78 total RVUs and a conversion factor of 32.3465.

What is the difference between CPT 74210 and 70370?

CPT 74210 includes examination of both the pharynx AND cervical esophagus with contrast, while 70370 is limited to pharyngography only. If the cervical esophagus is not adequately visualized or documented, 70370 is the appropriate code.

Can CPT 74210 be billed with a speech pathology swallow evaluation on the same day?

Yes, CPT 74210 (radiologic component) can be billed separately from speech pathology swallow evaluation codes like 92610 or 92611 when both services are medically necessary and documented. The services represent different professional components of a comprehensive swallowing assessment.

How many RVUs is CPT code 74210 worth in 2025?

CPT 74210 has a total of 2.78 RVUs in 2025, consisting of 0.59 work RVUs, 2.15 practice expense RVUs, and 0.04 malpractice RVUs according to the CMS Physician Fee Schedule.

What diagnosis codes support medical necessity for CPT 74210?

Common supporting diagnosis codes include dysphagia codes (R13.10-R13.19), aspiration pneumonitis (J69.0), stroke sequelae (I69.x91), esophageal motility disorders (K22.4), and head/neck cancer history. Documentation must support the clinical indication for the study.

Do I need modifier 26 or TC when billing CPT 74210?

Use modifier 26 when billing only the professional interpretation component, or modifier TC for only the technical component. Bill the code without modifiers (global) when the same entity provides both the equipment/technologist and the physician interpretation.

Can CPT 74210 be billed with an upper GI series (74246) on the same day?

Billing both codes on the same day often triggers bundling edits and requires modifier 59 or XU with strong documentation of distinct clinical indications. Many payers consider the pharyngeal portion of an upper GI study to include the cervical esophagus, making separate billing challenging without clear medical necessity for both studies.