`74261` Ct colonography dx

What 74261 is

CMS fee schedule short descriptor: Ct colonography dx.

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 74261 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	2.34	9.74	0.17	12.25	$409.16
Facility (hospital, ASC)	2.34	9.74	0.17	12.25	$409.16

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.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 74261 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 74261? These codes are bundled into it

74261 is a Column 1 code in 22 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
`01922`	Anes n-invas img/radj ther	0 - no modifier bypass	Check pair
`0558T`	Ct scan f/biomchn ct alys	1 - modifier may bypass	Check pair
`0694T`	3d vol img&rcnstj brst/ax	1 - modifier may bypass	Check pair
`0868T`	Hi-res gastric ep mapping	1 - modifier may bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`72192`	Ct pelvis w/o dye	0 - no modifier bypass	Check pair
`72193`	Ct pelvis w/dye	0 - no modifier bypass	Check pair
`72194`	Ct pelvis w/o & w/dye	0 - no modifier bypass	Check pair
`74150`	Ct abdomen w/o contrast	0 - no modifier bypass	Check pair
`74160`	Ct abdomen w/contrast	0 - no modifier bypass	Check pair
`74170`	Ct abd wo cntrst flwd cntrst	0 - no modifier bypass	Check pair
`74176`	Ct abd & pelvis w/o contrast	0 - no modifier bypass	Check pair
`74177`	Ct abd & pelvis w/contrast	0 - no modifier bypass	Check pair
`74178`	Ct abd&plv wo cntr flwd cntr	0 - no modifier bypass	Check pair
`74263`	Ct colonography screening	1 - modifier may bypass	Check pair
`76000`	Fluoroscopy <1 hr phys/qhp	1 - modifier may bypass	Check pair
`76376`	3d render w/intrp postproces	1 - modifier may bypass	Check pair
`76377`	3d render w/intrp postproces	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

74261 is bundled into these codes

74261 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 74261 is the code that denies.

Column 1 code	Short description	Modifier indicator
`0691T`	Auto alys xst ct std vrt fx	0	Check pair
`0721T`	Quan ct tiss charac w/o ct	1	Check pair
`74262`	Ct colonography dx w/dye	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.