How much does Medicare pay for CPT 74220?

Medicare allowed an average of $35.23 per service and paid $26.50 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $147.64, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74220?

Single contrast x-ray of esophagus. It was billed 49,460 times to 48,110 Medicare beneficiaries by 2,193 providers in 2024.

Does 74220 pay differently in an office than a hospital?

Yes. The allowed amount averaged $72.44 in an office setting and $27.78 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 74220 most?

Diagnostic Radiology, with 45,371 services from 2,031 clinicians. Next are Interventional Radiology, Independent Diagnostic Testing Facility (IDTF), Physician Assistant.

CPT 74220

Single contrast x-ray of esophagus

$35.23Medicare-allowed amount per service, averaged across 49,460 services

Providers submitted

$147.64

Asking price, not received

Medicare allowed

$35.23

The fee schedule figure

Medicare paid

$26.50

Balance is patient coinsurance

Providers submitted an average of $147.64 for this code and Medicare allowed $35.23 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $26.50 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $72.44
Hospital / facility: $27.78

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 8,256 services were billed in an office setting and 41,204 in a facility.

Services: 49,460
Beneficiaries: 48,110
Providers billing it: 2,193
Total allowed: $1,742,476

What Medicare pays for CPT 74220

Across 49,460 services billed by 2,193 providers to 48,110 beneficiaries, Medicare allowed an average of $35.23 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 74220

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	45,371	44,063	$34.75	2,031
Interventional Radiology	1,718	1,709	$29.84	79
Independent Diagnostic Testing Facility (IDTF)	835	829	$78.45	19
Physician Assistant	766	749	$24.74	32
Otolaryngology	246	246	$28.74	2
Nurse Practitioner	159	159	$27.79	11
Internal Medicine	106	105	$52.36	6
General Surgery	62	55	$84.19	4
Family Practice	44	43	$70.56	1
Cardiology	39	38	$28.10	1
Nuclear Medicine	29	29	$28.10	2
Pediatric Medicine	25	25	$31.08	1
Preventive Medicine	20	20	$31.85	1
Emergency Medicine	16	16	$27.78	1
Vascular Surgery	13	13	$26.16	1

74220 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	6,085	$40.84	$27.39	205
California	4,751	$43.16	$28.57	210
Florida	4,472	$40.45	$30.01	167
Texas	2,779	$32.94	$24.58	125
Pennsylvania	2,336	$29.85	$21.55	118
Illinois	1,811	$30.53	$22.03	89
South Carolina	1,562	$33.15	$26.07	54
Ohio	1,454	$28.38	$21.24	68
Maryland	1,429	$43.00	$30.76	68
Massachusetts	1,428	$28.03	$19.98	64
New Jersey	1,368	$47.76	$32.60	77
Missouri	1,338	$29.41	$22.59	63
North Carolina	1,336	$30.89	$22.76	57
Georgia	1,231	$33.41	$25.95	62
Virginia	1,215	$30.15	$22.11	57
Tennessee	1,095	$30.99	$23.82	52
Oklahoma	1,040	$38.62	$31.89	39
Arizona	1,005	$39.21	$29.30	48
Alabama	929	$30.51	$23.39	46
Michigan	914	$26.26	$19.59	51
Washington	793	$32.78	$22.23	35
Connecticut	696	$35.53	$25.00	33
Mississippi	663	$29.39	$23.46	32
Louisiana	632	$27.74	$21.21	34
Colorado	617	$27.89	$20.32	25
Minnesota	549	$38.55	$28.09	31
Arkansas	524	$27.29	$21.06	24
Kansas	494	$26.87	$20.66	20
Iowa	479	$44.17	$34.10	20
Kentucky	459	$29.67	$23.08	24
Indiana	401	$26.35	$20.80	22
Delaware	350	$27.59	$20.50	12
Wisconsin	332	$26.69	$19.72	20
West Virginia	323	$26.67	$19.41	16
New Hampshire	310	$27.93	$19.75	14
Alaska	299	$50.46	$31.26	11
New Mexico	268	$27.85	$19.13	11
Nevada	202	$27.24	$20.00	10
Nebraska	195	$25.82	$20.41	12
District of Columbia	179	$29.52	$20.37	9
Montana	171	$27.09	$20.46	7
Idaho	154	$26.24	$19.02	9
Wyoming	136	$33.04	$24.00	6
Oregon	132	$27.79	$21.00	9
Utah	130	$26.44	$18.78	8
South Dakota	114	$26.48	$19.38	4
Maine	113	$26.67	$20.30	6
Vermont	61	$26.96	$19.61	2
Puerto Rico	52	$95.10	$69.01	3
Rhode Island	17	$23.90	$17.10	1
Hawaii	14	$29.04	$16.69	1
North Dakota	12	$26.89	$21.28	1
ZZ	11	$26.56	$21.30	1

Related codes

74230Imaging for evaluation of swallowing function$30.38
74221Double contrast x-ray of esophagus$49.22
74240Single contrast x-ray of upper digestive tract$66.13
74246Double contrast x-ray of upper digestive tract$63.10
74250Single contrast x-ray of small intestine$38.13
74261Diagnostic ct scan of large intestine without contrast$161.07
74270Single contrast x-ray of large intestine$64.16

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.