Billing code 74420: Retrograde urographyMedicare rate & RVUs in Guam
Reports imaging and interpretation of the upper urinary tract after contrast is introduced retrograde, such as during cystoscopic evaluation of the ureters.
Medicare pays $89.39 for 74420 in the office in Guam (Hawaii, Guam). 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.
On this page 9 sections
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.
74420 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $89.39 | Unavailable |
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
Swap in your local Medicare rate.
Work 0.51Practice expense 1.89Malpractice 0.03
All indexes start 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
| 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
74420 without 26 · national office
$81.16
Retrograde urography
74420-26 · Professional component
$24.72
Pays only the interpretation and report.
74420 compared with similar codes
Compare codes
74420 vs 74400 vs 74425 vs 74430: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 74400Urography
- Choose 74420 when contrast is introduced retrograde through a ureteral catheter; 74400 describes urography using intravenous contrast.
- 74425Antegrade urography
- 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 imaging
- 74430 centers on bladder imaging. Use this code for imaging the ureters and renal collecting system during a retrograde study.
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 billing code 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
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