CPT code 74425: Antegrade urography, nephrostomy-route contrast imaging2026 Medicare rate & RVUs

Medicare pays $133.94 for 74425 nationally in the office. Local office rates run $116.95–$186.38.

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

What 74425 covers

Antegrade urography uses radiographic imaging to show the renal collecting system and ureter after contrast is injected through percutaneous urinary access, commonly a nephrostomy catheter. A radiologist or interventional radiologist evaluates how contrast fills and passes through the urinary tract, including in patients being assessed for obstruction, narrowing, or a leak. The service is typically performed in a hospital or imaging department where fluoroscopic equipment and the existing access route are available.

Report 74425 for the antegrade contrast examination and its radiologic supervision and interpretation, rather than for catheter placement or exchange alone. The record should identify the access route, describe contrast flow and the images obtained, and include the interpreting clinician’s findings. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or no component modifier when billing the global service. The components are separately priced by CMS.

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 74425 pays more and less

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

109 of 109 payment localities

74425 rates by state

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

How the 74425 rate is calculated

Each of 74425’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.

Payment rules and modifiers for 74425

The CMS indicators that decide how 74425 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

74425 compared with similar codes

How to choose

74420Retrograde urographyWith or without KUB

74420 describes retrograde urography, in which contrast is introduced from below. Choose 74425 when contrast enters the urinary tract through percutaneous access in an antegrade direction.

74400UrographyIntravenous contrast

74400 is intravenous urography, with contrast administered into the bloodstream for excretory imaging. 74425 involves direct antegrade contrast injection through percutaneous urinary access.

74410Intravenous urographyInfusion and/or bolus

74410 describes infusion urography using a drip or bolus technique. 74425 is distinguished by antegrade contrast introduction through percutaneous access.

Codes related to 74425

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

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

Open CMS sourceHow we calculate rates