How much does Medicare pay for CPT 74261?

Medicare allowed an average of $161.07 per service and paid $120.00 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $965.64, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74261?

Diagnostic ct scan of large intestine without contrast. It was billed 3,378 times to 3,078 Medicare beneficiaries by 139 providers in 2024.

Does 74261 pay differently in an office than a hospital?

Yes. The allowed amount averaged $179.31 in an office setting and $111.23 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 74261 most?

Diagnostic Radiology, with 3,225 services from 132 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Interventional Radiology.

CPT 74261

Diagnostic ct scan of large intestine without contrast

$161.07Medicare-allowed amount per service, averaged across 3,378 services

Providers submitted

$965.64

Asking price, not received

Medicare allowed

$161.07

The fee schedule figure

Medicare paid

$120.00

Balance is patient coinsurance

Providers submitted an average of $965.64 for this code and Medicare allowed $161.07 — 6.0× 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 $120.00 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $179.31
Hospital / facility: $111.23

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. 2,473 services were billed in an office setting and 905 in a facility.

Services: 3,378
Beneficiaries: 3,078
Providers billing it: 139
Total allowed: $544,094

What Medicare pays for CPT 74261

Across 3,378 services billed by 139 providers to 3,078 beneficiaries, Medicare allowed an average of $161.07 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 74261

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	3,225	2,947	$161.46	132
Nuclear Medicine	57	35	$124.30	2
Independent Diagnostic Testing Facility (IDTF)	45	45	$104.21	2
Interventional Radiology	37	37	$231.35	2
Gastroenterology	14	14	$217.84	1

74261 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	515	$150.77	$103.26	17
Maryland	480	$162.95	$110.65	14
Florida	430	$199.32	$150.77	15
California	240	$190.31	$121.80	14
New Jersey	233	$186.26	$127.38	10
Massachusetts	148	$177.17	$125.40	4
Virginia	139	$150.38	$109.16	5
Arizona	129	$208.96	$155.80	4
Pennsylvania	120	$110.11	$78.76	7
Michigan	112	$112.21	$79.14	4
Arkansas	93	$134.33	$105.24	4
North Carolina	71	$124.18	$95.39	5
Texas	66	$107.40	$79.04	4
Indiana	65	$106.69	$77.46	4
Ohio	62	$127.70	$89.67	5
Puerto Rico	58	$184.55	$134.78	3
Minnesota	56	$139.26	$96.10	3
South Carolina	52	$107.09	$83.49	2
Delaware	51	$184.34	$136.18	2
Tennessee	50	$108.89	$80.18	4
Nevada	48	$211.70	$153.98	1
Oregon	46	$105.49	$80.63	1
Iowa	39	$132.29	$98.43	3
Wisconsin	31	$109.68	$85.11	1
New Mexico	16	$203.42	$148.10	1
Georgia	14	$110.25	$79.04	1
Illinois	14	$217.84	$168.46	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
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
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.