How much does Medicare pay for CPT 74240?

Medicare allowed an average of $66.13 per service and paid $52.32 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $196.14, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74240?

Single contrast x-ray of upper digestive tract. It was billed 29,963 times to 28,627 Medicare beneficiaries by 635 providers in 2024.

Does 74240 pay differently in an office than a hospital?

Yes. The allowed amount averaged $84.33 in an office setting and $37.21 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 74240 most?

Diagnostic Radiology, with 10,615 services from 521 clinicians. Next are Family Practice, Internal Medicine, Obstetrics & Gynecology.

CPT 74240

Single contrast x-ray of upper digestive tract

$66.13Medicare-allowed amount per service, averaged across 29,963 services

Providers submitted

$196.14

Asking price, not received

Medicare allowed

$66.13

The fee schedule figure

Medicare paid

$52.32

Balance is patient coinsurance

Providers submitted an average of $196.14 for this code and Medicare allowed $66.13 — 3.0× 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 $52.32 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $84.33
Hospital / facility: $37.21

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. 18,392 services were billed in an office setting and 11,571 in a facility.

Services: 29,963
Beneficiaries: 28,627
Providers billing it: 635
Total allowed: $1,981,453

What Medicare pays for CPT 74240

Across 29,963 services billed by 635 providers to 28,627 beneficiaries, Medicare allowed an average of $66.13 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 74240

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	10,615	10,198	$45.93	521
Family Practice	5,620	5,440	$76.82	16
Internal Medicine	2,719	2,634	$81.35	12
Obstetrics & Gynecology	2,221	2,129	$65.62	6
General Practice	1,504	1,423	$75.65	4
Emergency Medicine	1,209	1,125	$81.52	3
Ophthalmology	712	699	$73.72	1
Pediatric Medicine	673	638	$84.41	2
Physical Medicine and Rehabilitation	637	598	$84.46	2
General Surgery	624	399	$115.56	13
Addiction Medicine	620	604	$71.82	1
Pathology	423	416	$89.27	1
Physician Assistant	354	337	$35.40	13
Undersea and Hyperbaric Medicine	343	323	$74.91	1
Interventional Radiology	334	326	$39.77	18

74240 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	9,616	$75.92	$59.58	68
Massachusetts	2,728	$80.12	$58.54	23
Indiana	2,710	$65.68	$52.90	16
California	2,282	$60.71	$43.91	70
Ohio	1,953	$66.86	$54.38	25
Louisiana	1,330	$73.75	$63.15	13
Florida	1,109	$52.58	$40.45	53
New York	1,087	$57.97	$38.66	55
Mississippi	650	$76.90	$60.79	7
Pennsylvania	514	$37.08	$26.89	31
Illinois	416	$65.45	$51.48	17
Virginia	382	$36.88	$27.70	18
Oklahoma	370	$79.87	$67.00	10
Arizona	361	$62.35	$49.00	13
Tennessee	347	$43.16	$34.21	20
Kentucky	311	$33.97	$26.90	11
New Jersey	272	$57.43	$40.18	15
Georgia	261	$41.01	$32.01	15
South Carolina	258	$36.40	$27.28	13
Michigan	256	$34.66	$26.11	12
Washington	255	$48.25	$36.00	12
Connecticut	234	$71.88	$53.26	5
Missouri	228	$35.56	$27.32	16
Utah	213	$74.31	$58.07	1
Nebraska	178	$78.28	$58.79	2
North Carolina	176	$36.33	$27.43	9
Alabama	152	$59.01	$58.10	8
Maryland	132	$38.36	$27.81	10
District of Columbia	131	$39.12	$28.22	6
Kansas	128	$34.30	$27.88	7
Arkansas	117	$34.87	$28.11	8
Oregon	94	$37.19	$28.09	7
West Virginia	92	$36.32	$25.38	7
Alaska	75	$77.95	$51.91	2
Nevada	68	$37.01	$28.22	4
Colorado	65	$37.49	$27.74	3
Minnesota	64	$37.79	$26.87	4
Montana	58	$36.17	$25.09	4
South Dakota	53	$36.23	$26.50	2
Vermont	47	$36.27	$26.83	1
Delaware	35	$38.39	$28.62	2
New Mexico	34	$36.40	$25.30	2
New Hampshire	33	$39.79	$28.33	2
Wisconsin	31	$35.86	$28.84	2
Rhode Island	16	$38.61	$27.67	1
North Dakota	15	$35.99	$22.81	1
Iowa	14	$35.39	$26.63	1
Maine	12	$36.07	$26.76	1

Related codes

74230Imaging for evaluation of swallowing function$30.38
74220Single contrast x-ray of esophagus$35.23
74221Double contrast x-ray of esophagus$49.22
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.