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

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, 2026One payment locality158.5K Medicare services in 2024

In Puerto Rico, Medicare pays $81.84 for 74420 in the office.

$81.84Office (non-facility)
Not available in this settingHospital or facility
+0.8%vs the national office rate ($81.16)

Check a contract rate as a % of Medicare · 74420 nationwide

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

We’ll open 74420 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 74420 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Puerto Rico compares for 74420

Across 109 of 109 payment localities, the office rate for 74420 runs from $71.78 in Arkansas to $110.48 in San Benito County, CA. Puerto Rico pays $81.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

74420 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$81.84
  2. Los Angeles, CA · California$93.08+$11.24
  3. Washington, DC area · District of Columbia$93.43+$11.59
  4. Miami, FL · Florida$85.28+$3.44
  5. Chicago, IL · Illinois$82.90+$1.06
  6. Manhattan, NY · New York$93.07+$11.23
  7. Alaska · Alaska$93.33+$11.49

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

74420 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$72.84—
ArkansasArkansas$71.78—
ArizonaArizona$79.06—
Bakersfield, CACalifornia$87.16—
Chico, CACalifornia$87.05—
El Centro, CACalifornia$87.05—
Fresno, CACalifornia$87.05—
Hanford, CACalifornia$87.05—

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

See 74420 in every payment locality

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,426

Code
74420
Physician work
0.51
Practice expense
1.89
Malpractice
0.03

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 74420 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.51× 1.0000.5100
Practice expense1.89× 1.0111.9108
Malpractice0.03× 0.9850.0295
Total RVUs2.4503
Conversion factor× 33.4009

Office rate, Puerto Rico$81.84

Office: (0.51 × 1 + 1.89 × 1.011 + 0.03 × 0.985) × $33.4009 = $81.84

Open 74420 in the RVU calculator

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

Codes related to 74420

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

Codes related to 74420
CodeHow it relatesOffice range, Puerto Rico
Often billed with
52005Ureteral catheterization, cystoscopic accessCystoscopic ureteral catheterization commonly accompanies the study; the radiologic service is separately represented.$282.55
Used instead
74400Urography, intravenous contrastUse for urography performed with intravenous contrast rather than retrograde contrast.$133.17
74425Antegrade urography, nephrostomy-route contrast imagingDescribes urography using an antegrade contrast route rather than ureteral retrograde introduction.$135.19
74430Bladder imaging, retrograde contrastFocuses on radiographic imaging of the bladder rather than the upper urinary tract.$42.07

How 74420 has changed in Puerto Rico

74420 · Office / nonfacility

$81.84

Effective 2026-10-01

The base rate is $5.76 higher than on 2025-10-01, moving from $76.08 to $81.84 (7.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $76.08changed to$81.84

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.52 changed to 0.51
    • Practice expense RVU 1.79 changed to 1.89
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $78.29changed to$76.08

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $77.01changed to$78.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $78.74changed to$77.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.76 changed to 1.79
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $78.28changed to$78.74

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $79.72changed to$78.28

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.74 changed to 1.76
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $78.62changed to$79.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.69 changed to 1.74

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $75.50changed to$78.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.53 changed to 1.69
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $73.16changed to$75.50

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.47 changed to 1.53
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    No ratechanged to$73.16

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$81.84Not available in this settingRVU26D
2026-07-01$81.84Not available in this settingRVU26C
2026-04-01$81.84Not available in this settingRVU26B
2026-01-01$81.84Not available in this settingRVU26A
2025-10-01$76.08Not available in this settingRVU25D
2025-07-01$76.08Not available in this settingRVU25C
2025-04-01$76.08Not available in this settingRVU25B
2025-01-01$76.08Not available in this settingRVU25A
2024-10-01$78.29Not available in this settingRVU24D
2024-07-01$78.29Not available in this settingRVU24C
2024-04-01$78.29Not available in this settingRVU24B
2024-03-09$78.29Not available in this settingRVU24AR
2024-01-01$77.01Not available in this settingRVU24A
2023-10-01$78.74Not available in this settingRVU23D
2023-07-01$78.28Not available in this settingRVU23C
2023-04-01$78.28Not available in this settingRVU23B
2023-01-01$78.28Not available in this settingRVU23A
2022-10-01$79.72Not available in this settingRVU22D
2022-07-01$79.72Not available in this settingRVU22C
2022-04-01$79.72Not available in this settingRVU22B
2022-01-01$79.72Not available in this settingRVU22A
2021-10-01$78.62Not available in this settingRVU21D
2021-07-01$78.62Not available in this settingRVU21C
2021-04-01$78.62Not available in this settingRVU21B
2021-01-01$78.62Not available in this settingRVU21A
2020-10-01$75.50Not available in this settingRVU20D
2020-07-01$75.50Not available in this settingRVU20C
2020-04-01$75.50Not available in this settingRVU20B
2020-01-01$75.50Not available in this settingRVU20A
2019-10-01$73.16Not available in this settingRVU19D
2019-07-01$73.16Not available in this settingRVU19C
2019-04-01$73.16Not available in this settingRVU19B
2019-01-01$73.16Not available in this settingRVU19A
2018-10-01Contractor-pricedContractor-pricedRVU18D
2018-07-01Contractor-pricedContractor-pricedRVU18C
2018-04-01Contractor-pricedContractor-pricedRVU18B
2018-01-01Contractor-pricedContractor-pricedRVU18AR1
2017-10-01Contractor-pricedContractor-pricedRVU17D
2017-07-01Contractor-pricedContractor-pricedRVU17C
2017-04-01Contractor-pricedContractor-pricedRVU17B
2017-01-01Contractor-pricedContractor-pricedRVU17A
2016-10-01Contractor-pricedContractor-pricedRVU16D
2016-07-01Contractor-pricedContractor-pricedRVU16C
2016-04-01Contractor-pricedContractor-pricedRVU16B
2016-01-01Contractor-pricedContractor-pricedRVU16A
2015-10-01Contractor-pricedContractor-pricedRVU15D
2015-07-01Contractor-pricedContractor-pricedRVU15C
2015-04-01Contractor-pricedContractor-pricedRVU15B
2015-01-01Contractor-pricedContractor-pricedRVU15A
2014-10-01Contractor-pricedContractor-pricedRVU14D
2014-07-01Contractor-pricedContractor-pricedRVU14C
2014-04-01Contractor-pricedContractor-pricedRVU14B
2014-01-01Contractor-pricedContractor-pricedRVU14A
2013-10-01Contractor-pricedContractor-pricedRVU13D
2013-07-01Contractor-pricedContractor-pricedRVU13C
2013-04-01Contractor-pricedContractor-pricedRVU13B
2013-01-01Contractor-pricedContractor-pricedRVU13AR

Price 74420 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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