X-ray bile duct endoscopy
CPT 74328 covers X-ray imaging of the bile ducts performed during an endoscopic procedure, typically using contrast material to visualize the biliary system. This is the professional component of radiologic supervision and interpretation during endoscopic bile duct examination.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Always verify that the endoscopic procedure code and 74328 are billed by different providers to avoid bundling
Impact: Prevents automatic denials and ensures the full $22 reimbursement for radiologic component
Document the number of images obtained, views performed, and specific contrast administration details in the interpretation report
Impact: Reduces audit risk and supports medical necessity; critical given the low 0.68 total RVU which may trigger review
Use modifier 26 consistently when the hospital owns the equipment and you are only providing interpretation
Impact: Ensures correct payment allocation between professional and technical components
Link appropriate diagnosis codes indicating biliary pathology or symptoms justifying imaging (e.g., K80.x for cholelithiasis, K83.x for bile duct disease)
Impact: Strengthens medical necessity documentation and reduces denial rate by 30-40%
Do not bill 74328 on the same claim as the global ERCP procedure code when performed by the same provider
Impact: Avoids bundling edits; gastroenterologists performing their own fluoroscopy must use global codes instead
Time-stamp the fluoroscopic interpretation separately from the endoscopic procedure note to demonstrate distinct service
Impact: Provides clear audit trail supporting separate billing of the $22 radiologic component
Common denials
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