CPT 74251 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 74251 by major payers:
$388.85
$410.91
$256.04
$523.61
| 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 74251 | ||||||
United | 74251 | $408.17 | 1720391279 - MUHAMMAD KHAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 74251 | $89.33 | 1538378815 - PAUL WHEELER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 74251 | $1061.06 | 1609966522 - MATTHEW MURRAY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 74251 | $109.19 | 1396166039 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 74251 | $516.59 | 1346668225 - STEPHANIE RICE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Radiation Oncology Physician (2085R0001X) |
United | 74251 | $1318.09 | 1689095325 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 74251 | $58.81 | 1881653293 - PETER MENKHAUS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | SC | Anesthesiology Physician (207L00000X) |
United | 74251 | $457.77 | 1255449500 - EDWARD CAMPBELL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 74251 | $516.59 | 1346650942 - JACK SHORT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 74251 | $457.77 | 1407356173 - SARA SCHMITZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 74251 | $59.90 | 1386746949 - ELINA PALES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Neurology Physician (2084N0400X) |
United | 74251 | $35.34 | 1891276630 - BRIAN ANDREW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MT | Physician Assistant (363A00000X) |
United | 74251 | $348.26 | 1740426790 - JESSICA KERR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 74251 | $516.59 | 1154435857 - CANDACE SCHUIERER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Surgical Physician Assistant (363AS0400X) |
United | 74251 | $457.77 | 1821252925 - ADAM SCHNEIDER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | SD | Orthopaedic Surgery Physician (207X00000X) |
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 74251 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 74251 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 74251 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 |
|---|---|---|
| 74246-CPT | Low | Radiologic Examination Upper Gastrointestinal Tract Including Scout Abdominal Radiograph(S) And Delayed Image(S) When Performed; Double- Contrast (Eg High-Density Barium And Effervescent Agent) Study Including Glucagon When Administered (Desc Rvsd 1/1/20) |
| 74248-CPT | Low | Radiologic Small Intestine Follow-Through Study Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examination) |
| 74250-CPT | Low | Radiologic Examination Small Intestine Includingmultiple Serial Images And Scout Abdominal Radiograph(S) When Performed; Single-Contrast (Eg Barium) Study (Desc Rvsd 1/1/20) |
| 74251-CPT | Moderate | Radiologic Examination Small Intestine Includingmultiple Serial Images And Scout Abdominal Radiograph(S) When Performed; Double-Contrast (Eg High-Density Barium And Air Via Enteroclysis Tube) Study Including Glucagon When Administered (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 74251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 74251 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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