74230 X-ray xm swlng funcj c+
What 74230 is
CMS fee schedule short descriptor: X-ray xm swlng funcj c+.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 74230 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.52 | 3.04 | 0.04 | 3.60 | $120.24 |
| Facility (hospital, ASC) | 0.52 | 3.04 | 0.04 | 3.60 | $120.24 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 74230 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 74230? These codes are bundled into it
74230 is a Column 1 code in 15 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
74210 | X-ray xm phrnx&/crv esoph c+ | 0 - no modifier bypass | Check pair |
74220 | X-ray xm esophagus 1cntrst | 0 - no modifier bypass | Check pair |
74221 | X-ray xm esophagus 2cntrst | 0 - no modifier bypass | Check pair |
76000 | Fluoroscopy <1 hr phys/qhp | 1 - modifier may bypass | Check pair |
77001 | Fluoroguide for vein device | 1 - modifier may bypass | Check pair |
77002 | Needle localization by xray | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99446 | Ntrprof ph1/ntrnet/ehr 5-10 | 0 - no modifier bypass | Check pair |
99447 | Ntrprof ph1/ntrnet/ehr 11-20 | 0 - no modifier bypass | Check pair |
99448 | Ntrprof ph1/ntrnet/ehr 21-30 | 0 - no modifier bypass | Check pair |
99449 | Ntrprof ph1/ntrnet/ehr 31/> | 0 - no modifier bypass | Check pair |
99451 | Ntrprof ph1/ntrnet/ehr 5/> | 0 - no modifier bypass | Check pair |
99452 | Ntrprof ph1/ntrnet/ehr rfrl | 0 - no modifier bypass | Check pair |
74230 is bundled into these codes
74230 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 74230 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
70370 | Throat x-ray & fluoroscopy | 1 | Check pair |
70371 | Speech evaluation complex | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.