CPT 74740Radiology

X-ray female genital tract

CPT code 74740 covers X-ray imaging of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. This diagnostic imaging helps doctors evaluate conditions like blockages, abnormalities, or structural problems in the female genital tract.

Showing rates for

National Average

Base Medicare rate

$87.66

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

0.38

PE RVU (NF)

2.3

MP RVU

0.03

Total RVU

2.71

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

NCCI bundling edits

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Billing tips

Always verify if billing globally or splitting professional and technical components with modifiers 26/TC based on your setting
Impact: Incorrect component billing can result in 100% claim denial or significant overpayment recovery
Document and separately bill for contrast material used (HCPCS codes like Q9967 for low osmolar contrast) as 74740 includes only the imaging service
Impact: Contrast materials can add $15-50 to total reimbursement depending on type and amount used
Ensure medical necessity is clearly documented with appropriate diagnosis codes such as N97.1 (female infertility of tubal origin) or N97.9 (female infertility, unspecified)
Impact: Lack of medical necessity documentation is the leading cause of denial for this elective diagnostic procedure
Verify pre-authorization requirements as many commercial payers require prior approval for fertility-related imaging studies
Impact: Missing pre-authorization can result in 100% denial even with perfect documentation; appeals rarely successful
When performed in facility setting, ensure facility bills the technical component and physician bills professional component to avoid duplicate billing
Impact: Duplicate global billing when components split can trigger audits and recoupment of $87.66 overpayment
Code any E/M service on same day separately with modifier 25 only if significant, separately identifiable evaluation was performed beyond the decision for imaging
Impact: Inappropriately bundled E/M loses $50-150 in legitimate reimbursement; inappropriate unbundling triggers audit risk

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Frequently asked questions

What is CPT code 74740 used for?

CPT 74740 is used for X-ray examination of the female genital tract, most commonly hysterosalpingography (HSG), which evaluates the uterine cavity and fallopian tube patency using fluoroscopic imaging with contrast material. It is primarily used in fertility evaluations to determine if fallopian tubes are open or blocked.

How much does Medicare pay for CPT 74740 in 2025?

Medicare pays $87.66 for CPT 74740 in 2025 based on the national average non-facility rate. This amount represents the global service including both professional and technical components. Actual payment may vary by geographic location based on local wage indices.

What is the RVU value for CPT code 74740?

CPT 74740 has a total RVU of 2.71 for 2025, consisting of 0.38 work RVU, 2.3 practice expense RVU, and 0.03 malpractice RVU. Both facility and non-facility PE RVUs are 2.3 for this code.

Does insurance cover hysterosalpingography CPT 74740?

Coverage for CPT 74740 varies significantly by payer and plan. Medicare covers it when medically necessary for diagnostic purposes. Many commercial insurers cover it for infertility evaluation but may require prior authorization. Some plans exclude fertility-related services entirely, so verification of benefits is essential before scheduling.

Can CPT 74740 be billed with an E/M code on the same day?

Yes, CPT 74740 can be billed with an E/M service on the same day if the evaluation and management service is significant and separately identifiable from the decision to perform the imaging. Modifier 25 must be appended to the E/M code, and documentation must clearly support a distinct service beyond the routine pre-procedure assessment.

What diagnosis codes support medical necessity for CPT 74740?

Common supporting diagnosis codes include N97.1 (female infertility of tubal origin), N97.9 (female infertility unspecified), N97.8 (other female infertility), Q51.2-Q51.9 (congenital uterine anomalies), and N85.2 (uterine adhesions). The diagnosis must support the medical necessity for evaluating the female genital tract structure.

What is the difference between billing 74740 with modifier 26 vs TC?

Modifier 26 indicates only the professional component (physician interpretation) is being billed, typically by the radiologist. Modifier TC indicates only the technical component (equipment, supplies, technologist) is being billed, typically by the facility. Without modifiers, the code represents the global service including both components and should only be billed once by a single entity.