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CPT code 74420: Retrograde urography, with or without KUB2026 Medicare rate & RVUs

Reports imaging and interpretation of the upper urinary tract after contrast is introduced retrograde, such as during cystoscopic evaluation of the ureters.

CMS RVU26DEffective Oct 1, 2026109 payment localities158.5K Medicare services in 2024

Medicare pays $81.16 for 74420 nationally in the office. Local office rates run $71.78–$110.48.

Medicare rate · 74420

Retrograde urography, with or without KUB

Office or facility?

Work RVUs
0.51
Total RVUs
2.43
Global days
XXX

National rate · 2026

$81.16

Office setting, before claim adjustments.

See every locality for 74420 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 74420 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 74420 covers

Retrograde urography uses radiographic imaging, commonly fluoroscopy, to show the ureters and renal collecting system after contrast is introduced through a ureteral catheter. A urologist may perform the study during cystoscopy, or a radiologist may provide imaging supervision and interpretation. A KUB image may be part of the examination, but is not required for this code.

Report this service for the radiologic study and its interpretation, not for placing the ureteral catheter. The record should support the retrograde contrast study and include the images and an interpretation of the findings. When one billing entity provides the complete service, report the global service without a component modifier. Use modifier 26 for the professional interpretation or modifier TC for the technical service, including equipment and staff, when those portions are billed separately.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 74420 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$71.78 to $110.48

$71.78$91.13$110.48
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

74420 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$72.84Unavailable
Alaska$93.33Unavailable
Arizona$79.06Unavailable
Arkansas$71.78Unavailable
Atlanta, GA$82.43Unavailable
Austin, TX$84.75Unavailable
Bakersfield, CA$87.16Unavailable
Baltimore area, MD$86.28Unavailable
Beaumont, TX$75.41Unavailable
Brazoria, TX$80.51Unavailable

74420 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$71.78

$98.77

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
74420 office rate range by state
State / territoryOffice rate rangeLocalities
AK$93.331
AL$72.841
AR$71.781
AZ$79.061
CA$87.05–$110.4829
CO$85.191
CT$86.581
DC$93.431
DE$80.391
FL$78.89–$85.283
GA$74.54–$82.432
GU$89.391
HI$89.391
IA$75.191
ID$75.591
IL$76.24–$83.764
IN$76.041
KS$74.611
KY$74.071
LA$73.86–$77.582
MA$84.58–$94.002
MD$82.01–$93.433
ME$75.74–$80.232
MI$75.80–$79.642
MN$82.291
MO$72.43–$78.143
MS$72.131
MT$81.161
NC$76.571
ND$80.571
NE$75.681
NH$83.631
NJ$87.75–$92.412
NM$76.131
NV$81.061
NY$77.71–$95.045
OH$75.681
OK$74.191
OR$80.61–$88.192
PA$75.93–$84.252
PR$81.841
RI$83.461
SC$76.221
SD$80.501
TN$74.961
TX$75.41–$84.758
UT$77.271
VA$79.80–$93.432
VI$81.841
VT$80.041
WA$84.49–$96.162
WI$77.821
WV$73.331
WY$80.901

How the 74420 rate is calculated

Each of 74420’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 74420

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.51

0.51 RVUs× 1.000 GPCI

Practice expense1.89

1.89 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

2.4300

Conversion factor

$33.4009

Medicare rate

$81.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 74420

The CMS indicators that decide how 74420 is paid alongside other services.

CMS payment indicators · 74420

Retrograde urography, with or without KUB

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

74420 without 26 · national office

$81.16

Retrograde urography, with or without KUB

74420-26 · Professional component

$24.72

Pays only the interpretation and report.

When to use modifier 26

74420 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 74420

    Retrograde urography, with or without KUB0.51 wRVU

    $81.16

  • 74400

    Urography, intravenous contrast0.48 wRVU

    $131.93+$50.77

  • 74425

    Antegrade urography, nephrostomy-route contrast imaging0.5 wRVU

    $133.94+$52.78

  • 74430

    Bladder imaging, retrograde contrast0.31 wRVU

    $41.75−$39.41

How to choose

74400UrographyIntravenous contrast
Choose 74420 when contrast is introduced retrograde through a ureteral catheter; 74400 describes urography using intravenous contrast.
74425Antegrade urographyNephrostomy-route contrast imaging
74425 is for an antegrade study, such as contrast introduced through percutaneous access. This code is for retrograde contrast introduction through a ureteral catheter.
74430Bladder imagingRetrograde contrast
74430 centers on bladder imaging. Use this code for imaging the ureters and renal collecting system during a retrograde study.

Codes related to 74420

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 74420
CodeHow it relatesNational office range
Often billed with
52005Ureteral catheterization, cystoscopic accessCystoscopic ureteral catheterization commonly accompanies the study; the radiologic service is separately represented.$248.55–$370.19
Used instead
74400Urography, intravenous contrastUse for urography performed with intravenous contrast rather than retrograde contrast.$115.02–$183.41
74425Antegrade urography, nephrostomy-route contrast imagingDescribes urography using an antegrade contrast route rather than ureteral retrograde introduction.$116.95–$186.38
74430Bladder imaging, retrograde contrastFocuses on radiographic imaging of the bladder rather than the upper urinary tract.$36.98–$55.86

74420 billing questions

How is this different from intravenous urography?

This code describes imaging after contrast is introduced retrograde through a ureteral catheter. Intravenous urography uses contrast administered into a vein.

Can it be reported with cystoscopic ureteral catheterization?

Yes. The radiologic imaging and interpretation may be reported with the catheterization service, such as CPT 52005, when both services are performed and documented.

When should modifier 26 or TC be used?

Use modifier 26 for the professional interpretation and modifier TC for the technical service. Report without either modifier when billing the global service.

Does a KUB image have to be obtained?

No. A KUB image may be included, but the retrograde study can be reported without one.

What documentation supports the imaging service?

The record should identify the retrograde contrast study and include the images and an interpretation describing the urinary tract findings.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 74420PPRRVU2026_Oct_nonQPP.csv, line 8,426 (RVU26D)

Open CMS sourceHow we calculate rates

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