CPT 74250Radiology

X-ray xm sm int 1cntrst std

CPT code 74250 covers an X-ray examination of the small intestine using a single contrast material, typically barium, to visualize the digestive tract. This is a standard imaging study to evaluate conditions affecting the small bowel.

Showing rates for

National Average

Base Medicare rate

$116.45

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

0.81

PE RVU (NF)

2.74

MP RVU

0.05

Total RVU

3.6

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

NCCI bundling edits

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Billing tips

Verify that documentation supports single contrast technique versus multiple contrast (74260) - using only barium qualifies for 74250, but adding air or gas requires 74260
Impact: Incorrect code selection can result in $30-50 payment difference and potential audit flags
Bill professional and technical components separately when services are split between radiologist and facility - use modifier 26 for interpretation only
Impact: Professional component alone typically pays approximately $30-35 while technical component pays $81-86
Document the number of radiographic views and timing intervals throughout the small bowel transit to support medical necessity and distinguish from limited studies
Impact: Inadequate documentation can trigger downcoding to 74245 (upper GI with small bowel) resulting in payment reduction of approximately $20-30
Do not bill 74250 with 74240 or 74245 on same date of service without modifier 59 and clear documentation of separate medical necessity
Impact: CCI edits will bundle these codes resulting in denial of 74250; proper modifier use preserves $116.45 payment
Ensure contrast administration and any adverse reactions are documented in the medical record, as contrast-related complications can affect medical necessity determination
Impact: Missing contrast documentation can result in claim denial or recoupment during audits of full $116.45 payment
For Medicare patients, verify that the study meets appropriate use criteria if required by LCD/NCD and obtain ABN if coverage is uncertain
Non-covered services without valid ABN result in complete write-off of $116.45 with no patient billing allowed

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 74250 in 2025?

The 2025 Medicare national average reimbursement for CPT 74250 is $116.45 for both facility and non-facility settings. This rate is based on 3.6 total RVUs multiplied by the 2025 conversion factor of $32.3465.

What is the difference between CPT 74250 and 74260?

CPT 74250 is for small bowel X-ray examination using single contrast material (typically barium alone), while 74260 is for the same examination using multiple contrast materials (such as barium plus air or gas for double-contrast technique). The choice depends on the imaging technique documented by the radiologist.

Can CPT 74250 be billed with an upper GI series on the same day?

Generally no, as 74250 is often bundled with upper GI codes (74240, 74245) by CCI edits. However, if there is a distinct, separate clinical indication for a dedicated small bowel study beyond the routine small bowel follow-through included in upper GI series, modifier 59 may be appropriate with comprehensive documentation supporting medical necessity.

How many RVUs is CPT code 74250 worth?

CPT 74250 has 3.6 total RVUs for 2025, consisting of 0.81 work RVUs, 2.74 practice expense RVUs (both facility and non-facility), and 0.05 malpractice RVUs according to the CMS Physician Fee Schedule.

What modifiers are commonly used with CPT 74250?

The most common modifiers for 74250 are modifier 26 (professional component only for interpretation), modifier TC (technical component only for equipment/staff), modifier 52 (reduced services if study is incomplete), and modifier 59 (distinct procedural service when billed with other GI imaging requiring separate medical necessity).

What documentation is required to bill CPT 74250?

Required documentation includes the clinical indication for small bowel imaging, type and amount of contrast administered, number and timing of images during small bowel transit, confirmation of single contrast technique, complete radiologist interpretation report, and documentation of patient tolerance. The record must clearly show the study focused specifically on the small intestine beyond what an upper GI series provides.

Is CPT 74250 a professional or technical code?

CPT 74250 is a global code that includes both professional (interpretation) and technical (equipment, staff, supplies) components. When these components are split between providers, use modifier 26 for professional component only or modifier TC for technical component only. The global code should only be billed when one entity provides both components.