CPT 74221 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 74221 by major payers:
$134.45
$127.03
$134.70
$172.20
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 74221 | ||||||
United | 74221 | $183.58 | 1477843449 - LU PAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CT | Internal Medicine Physician (207R00000X) |
United | 74221 | $35.72 | 1336623578 - LEILA HARDY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 74221 | $59.40 | 1104995638 - KEVIN CONN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 74221 | $35.72 | 1134126766 - ROBERT RIPLEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgery Physician (208600000X) |
United | 74221 | $183.58 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Neurology Physician (2084N0400X) |
United | 74221 | $35.72 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Neurology Physician (2084N0400X) |
United | 74221 | $183.58 | 1720114846 - TIFFANY STODDARD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | VA | Surgery Physician (208600000X) |
United | 74221 | $35.72 | 1659516169 - JESSICA COURTNEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Certified Registered Nurse Anesthetist (367500000X) |
United | 74221 | $124.18 | 1881361780 - BRIANNE SNIDER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Occupational Therapist (225X00000X) |
United | 74221 | $183.58 | 1700086816 - ROBERTA FUNCK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Medical Physician Assistant (363AM0700X) |
United | 74221 | $124.18 | 1790002350 - KRISTOPHER DAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Surgery Physician (208600000X) |
United | 74221 | $124.18 | 1104875186 - WILLIAM UTZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MN | Urology Physician (208800000X) |
United | 74221 | $59.40 | 1003268749 - ELIZABETH GILMORE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 74221 | $183.58 | 1710210273 - JENNIFER FAIRCLOTH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NC | Certified Registered Nurse Anesthetist (367500000X) |
United | 74221 | $183.58 | 1407456585 - CHELSEA LEITER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 74221 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 74221 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 74221 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 74210-CPT | Low | Radiologic Examination Pharynx And/Or Cervical Esophagus Including Scout Neck Radiograph(S) And Delayed Image(S) When Performed Contrast (Eg Barium) Study (Desc Rvsd 1/1/20) |
| 74220-CPT | Low | Radiologic Examination Esophagus Including Scoutchest Radiograph(S) And Delayed Image(S) When Performed; Single-Contrast (Eg Barium) Study (Desc Rvsd 1/1/20) |
| 74221-CPT | Low | Radiologic Examination Esophagus Including Scout Chest Radiograph(S) And Delayed Image(S) When Performed; Double-Contrast (Eg High-Density Barium And Effervescent Agent) Study |
| 74230-CPT | Low | Radiologic Examination Swallowing Function With Cineradiography/Videoradiography Including Scout Neck Radiograph(S) And Delayed Image(S) When Performed Contrast (Eg Barium) Study (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 74221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 74221 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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