How much does Medicare pay for CPT 74328?

Medicare allowed an average of $22.25 per service and paid $17.72 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $171.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74328?

Review by radiologist of image from tube placement into bile duct using an endoscope. It was billed 43,001 times to 35,036 Medicare beneficiaries by 1,282 providers in 2024.

Does 74328 pay differently in an office than a hospital?

Yes. The allowed amount averaged $23.79 in an office setting and $22.25 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 74328 most?

Gastroenterology, with 34,493 services from 922 clinicians. Next are Diagnostic Radiology, Internal Medicine, Interventional Radiology.

CPT 74328

Review by radiologist of image from tube placement into bile duct using an endoscope

$22.25Medicare-allowed amount per service, averaged across 43,001 services

Providers submitted

$171.75

Asking price, not received

Medicare allowed

$22.25

The fee schedule figure

Medicare paid

$17.72

Balance is patient coinsurance

Providers submitted an average of $171.75 for this code and Medicare allowed $22.25 — 7.7× 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 $17.72 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $23.79
Hospital / facility: $22.25

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. 12 services were billed in an office setting and 42,989 in a facility.

Services: 43,001
Beneficiaries: 35,036
Providers billing it: 1,282
Total allowed: $956,772

What Medicare pays for CPT 74328

Across 43,001 services billed by 1,282 providers to 35,036 beneficiaries, Medicare allowed an average of $22.25 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 74328

Specialty	Services	Beneficiaries	Avg allowed	Providers
Gastroenterology	34,493	27,372	$22.77	922
Diagnostic Radiology	6,359	5,922	$19.61	292
Internal Medicine	1,432	1,117	$22.96	41
Interventional Radiology	366	349	$16.61	15
General Surgery	157	123	$21.89	7
Hospitalist	105	85	$22.65	2
Pediatric Medicine	40	28	$21.74	1
Infectious Disease	33	25	$22.92	1
Radiation Oncology	16	15	$16.47	1

74328 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
California	4,631	$24.09	$17.61	119
Texas	3,125	$22.07	$17.69	106
Florida	2,993	$19.99	$17.67	101
New York	2,554	$24.80	$17.65	77
Illinois	2,214	$22.71	$17.66	62
Massachusetts	2,076	$23.77	$17.70	39
Pennsylvania	1,817	$22.23	$17.68	57
Missouri	1,522	$21.98	$17.69	37
Ohio	1,437	$21.02	$17.70	48
North Carolina	1,385	$21.19	$17.72	40
Indiana	1,320	$21.18	$17.74	38
Washington	1,302	$23.29	$17.73	32
Michigan	1,279	$22.38	$17.66	34
Virginia	1,272	$22.17	$17.95	37
Arizona	1,217	$20.80	$17.63	32
Minnesota	1,179	$21.81	$17.69	32
New Jersey	897	$23.98	$17.64	25
Colorado	874	$22.27	$17.68	24
Tennessee	724	$19.93	$17.71	25
Connecticut	659	$23.42	$17.50	23
Oklahoma	609	$20.96	$17.62	23
Maryland	589	$22.99	$17.68	14
South Carolina	557	$21.21	$17.71	15
Georgia	551	$20.48	$17.61	24
Wisconsin	522	$17.54	$17.65	21
Alabama	409	$21.38	$17.72	14
Iowa	389	$21.19	$17.45	14
West Virginia	374	$22.17	$17.54	11
District of Columbia	363	$23.90	$17.71	5
South Dakota	331	$21.79	$17.44	9
North Dakota	320	$21.95	$17.70	7
Louisiana	312	$21.34	$17.71	8
Idaho	305	$21.29	$17.76	13
Mississippi	295	$21.18	$17.69	11
Oregon	280	$22.74	$17.66	14
Kansas	229	$21.58	$17.55	5
Maine	213	$22.22	$17.23	9
Nevada	207	$22.18	$17.76	9
Kentucky	195	$18.35	$17.88	7
Rhode Island	176	$23.01	$17.61	11
Arkansas	165	$20.56	$17.56	8
Delaware	156	$22.16	$17.75	5
Utah	143	$21.77	$17.59	5
Hawaii	139	$22.57	$17.56	4
Nebraska	138	$20.20	$17.59	7
New Hampshire	130	$22.24	$17.73	4
Montana	118	$22.25	$17.70	6
Vermont	114	$21.75	$17.74	4
New Mexico	80	$21.39	$17.75	3
Alaska	60	$28.80	$17.38	3
Guam	55	$22.86	$17.70	1

Related codes

74300Review by radiologist of bile and/or pancreatic duct image during surg$11.91
74330Review by radiologist of image from tube placement into bile and pancr$24.41
74360Review by radiologist of image to guide opening of digestive tract$26.19

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.