How much does Medicare pay for CPT 74230?

Medicare allowed an average of $30.38 per service and paid $23.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $137.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74230?

Imaging for evaluation of swallowing function. It was billed 286,293 times to 276,769 Medicare beneficiaries by 7,330 providers in 2024.

Does 74230 pay differently in an office than a hospital?

Yes. The allowed amount averaged $79.32 in an office setting and $24.66 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 74230 most?

Diagnostic Radiology, with 235,253 services from 6,635 clinicians. Next are Interventional Radiology, Physician Assistant, Family Practice.

CPT 74230

Imaging for evaluation of swallowing function

$30.38Medicare-allowed amount per service, averaged across 286,293 services

Providers submitted

$137.17

Asking price, not received

Medicare allowed

$30.38

The fee schedule figure

Medicare paid

$23.59

Balance is patient coinsurance

Providers submitted an average of $137.17 for this code and Medicare allowed $30.38 — 4.5× 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 $23.59 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $79.32
Hospital / facility: $24.66

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. 29,941 services were billed in an office setting and 256,352 in a facility.

Services: 286,293
Beneficiaries: 276,769
Providers billing it: 7,330
Total allowed: $8,697,581

What Medicare pays for CPT 74230

Across 286,293 services billed by 7,330 providers to 276,769 beneficiaries, Medicare allowed an average of $30.38 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 74230

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	235,253	228,580	$26.82	6,635
Interventional Radiology	10,486	10,181	$25.05	332
Physician Assistant	9,333	9,012	$21.24	147
Family Practice	6,125	5,918	$71.67	18
Internal Medicine	5,289	4,705	$61.64	25
General Practice	3,262	2,677	$57.52	10
Nurse Practitioner	3,214	3,130	$34.44	43
Obstetrics & Gynecology	2,374	2,259	$58.48	7
Physical Medicine and Rehabilitation	2,105	1,912	$42.93	33
Emergency Medicine	1,484	1,386	$73.19	8
Otolaryngology	841	795	$118.73	10
Pediatric Medicine	833	794	$72.02	5
Ophthalmology	719	706	$67.23	1
Addiction Medicine	621	605	$64.85	1
Nuclear Medicine	619	570	$25.30	13

74230 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
Texas	27,917	$40.07	$31.13	535
Florida	23,877	$29.86	$22.45	495
California	23,478	$30.05	$21.16	630
Illinois	18,352	$29.61	$22.09	427
Ohio	14,747	$29.60	$23.02	314
New York	13,865	$34.43	$23.78	351
Pennsylvania	11,934	$24.59	$18.18	364
Massachusetts	11,331	$39.69	$28.63	226
North Carolina	10,600	$24.47	$19.04	282
Missouri	8,524	$25.08	$19.19	216
Indiana	8,400	$34.77	$27.79	166
Maryland	8,092	$27.07	$19.43	177
New Jersey	7,572	$26.73	$18.89	247
Minnesota	7,066	$41.12	$30.33	234
Virginia	6,318	$24.45	$18.46	185
Michigan	5,879	$26.35	$19.68	191
Wisconsin	5,669	$23.84	$18.38	193
Colorado	4,774	$27.34	$19.66	124
Kentucky	4,194	$24.04	$18.36	98
Washington	4,161	$25.71	$18.27	136
Tennessee	4,043	$26.69	$21.28	127
Louisiana	3,820	$41.37	$34.15	82
Arizona	3,745	$44.29	$33.91	100
Oklahoma	3,669	$28.79	$22.42	84
Connecticut	3,565	$28.53	$20.58	113
South Carolina	3,294	$27.36	$21.47	98
Arkansas	3,046	$26.21	$21.37	79
Kansas	2,977	$23.41	$18.29	82
Iowa	2,900	$23.67	$18.43	98
Nebraska	2,791	$28.94	$22.88	73
Mississippi	2,584	$35.30	$28.11	45
Alabama	2,425	$23.57	$18.48	79
Utah	2,170	$28.02	$21.84	45
Georgia	2,139	$24.17	$18.10	78
Oregon	2,092	$24.66	$18.46	80
New Hampshire	1,767	$24.72	$18.14	59
Maine	1,446	$24.39	$17.74	56
Rhode Island	1,320	$24.63	$17.38	38
Nevada	1,246	$26.84	$20.75	46
North Dakota	1,063	$23.88	$17.87	32
South Dakota	1,010	$24.09	$18.27	30
West Virginia	958	$24.18	$18.02	33
Delaware	928	$24.45	$18.37	25
District of Columbia	906	$26.19	$18.56	25
New Mexico	861	$24.60	$17.92	26
Alaska	655	$32.68	$17.81	24
Montana	599	$24.32	$18.15	18
Idaho	400	$23.62	$17.74	19
Vermont	365	$24.16	$17.29	13
Wyoming	311	$23.96	$17.54	14
Hawaii	223	$24.64	$17.33	11
Guam	67	$25.63	$18.31	3
XX	67	$25.45	$18.42	1
AA	57	$24.01	$17.40	1
ZZ	18	$23.73	$19.02	1
AP	16	$25.27	$17.76	1

Related codes

74220Single contrast x-ray of esophagus$35.23
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.