CPT code 74440: Vasography, vas deferens imaging2026 Medicare rate & RVUs in California
Vasography documents the radiographic evaluation of the vas deferens after contrast introduction, commonly to investigate suspected obstruction during a male infertility workup.
Medicare pays $109.20–$140.75 for 74440 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 74440 covers
This code represents the radiologic service for imaging the vas deferens after contrast is introduced into the duct. Vasography may be performed during a urologic evaluation of male infertility when obstruction or vasal patency is a clinical question. A urologist may access and cannulate the vas deferens, while radiology staff acquire the images and a qualified practitioner interprets them. The study is distinct from imaging the urethra, bladder, or penis because its target is the vas deferens.
Report the service when the record supports a vasography examination and includes the clinical indication, images or imaging record, and interpretation. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff portion, and an unmodified claim represents the global service. The documentation and claim should reflect which portion the billing entity furnished; do not report the global service when billing only one component.
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 74440 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$109.20 to $140.75
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $109.28 | Unavailable |
| Chico, CA | $109.20 | Unavailable |
| El Centro, CA | $109.21 | Unavailable |
| Fresno, CA | $109.20 | Unavailable |
| Hanford, CA | $109.20 | Unavailable |
| Los Angeles, CA | $117.23 | Unavailable |
| Madera, CA | $109.20 | Unavailable |
| Marin County, CA | $137.70 | Unavailable |
| Merced, CA | $109.20 | Unavailable |
| Modesto, CA | $109.20 | Unavailable |
| Napa, CA | $129.26 | Unavailable |
| Oxnard, CA | $116.95 | Unavailable |
| Redding, CA | $109.20 | Unavailable |
| Rest of California | $109.20 | Unavailable |
| Riverside, CA | $109.43 | Unavailable |
| Sacramento, CA | $115.32 | Unavailable |
| Salinas, CA | $114.91 | Unavailable |
| San Benito County, CA | $140.75 | Unavailable |
| San Diego, CA | $118.15 | Unavailable |
| San Francisco, CA | $137.68 | Unavailable |
| San Luis Obispo, CA | $112.98 | Unavailable |
| Santa Clara County, CA | $140.65 | Unavailable |
| Santa Cruz, CA | $119.71 | Unavailable |
| Santa Maria, CA | $115.49 | Unavailable |
| Santa Rosa, CA | $120.96 | Unavailable |
| Stockton, CA | $109.20 | Unavailable |
| Vallejo, CA | $129.22 | Unavailable |
| Visalia, CA | $109.20 | Unavailable |
| Yuba City, CA | $109.20 | Unavailable |
How the 74440 rate is calculated
Each of 74440’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 · 74440
RVUs × geographic indexes × conversion factor
Work0.37
0.37 RVUs× 1.000 GPCI
Practice expense2.63
2.63 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
3.0200
Conversion factor
$33.4009
Medicare rate
$100.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 74440
The CMS indicators that decide how 74440 is paid alongside other services.
CMS payment indicators · 74440
Vasography, vas deferens imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
74440 without 26 · national office
$100.87
Vasography, vas deferens imaging
74440-26 · Professional component
$18.04
Pays only the interpretation and report.
74440 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 74450UrethrocystographyRetrograde study
- 74440 evaluates the vas deferens; 74450 is used for retrograde imaging of the urethra and bladder.
- 74455Voiding studyUrethra and bladder
- Choose 74455 for voiding imaging of the urethra and bladder, not for a contrast study of the vas deferens.
- 74445Penile X-ray
- 74445 concerns radiographic examination of the penis, including cavernosography; 74440 concerns the vas deferens.
- 74430Bladder imagingRetrograde contrast
- 74430 is a bladder contrast examination. It does not describe imaging of the vas deferens.
74440 billing questions
When should I choose 74440 instead of a urethrography code?
Use 74440 for radiographic imaging of the vas deferens. Urethrography codes apply when the examination targets the urethra or urethra and bladder.
What do modifiers 26 and TC identify?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. An unmodified claim represents the global service.
Does 74440 describe the vas deferens cannulation procedure?
The code represents the radiologic examination, not the urologic access procedure itself. The record should support the imaging service and its interpretation.
What documentation supports reporting 74440?
Document the indication for vasography, the examination performed, the images or imaging record, and the interpretation. The claim should also reflect whether the professional, technical, or global service was furnished.
Can the professional and technical portions be billed separately?
Yes. CMS identifies modifier 26 for the professional portion and modifier TC for the technical portion; an unmodified claim represents both.
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
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