How does CPT 74420 compare to other diagnostic radiology codes?

CPT 74420 is part of Radiology Procedures for Diagnostic Radiology (Diagnostic Imaging) Procedures, representing a moderate-complexity encounter. It involves more provider time and moderate medical decision-making compared to lower-level codes, typically including multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

What is a CPT code and why is it important?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for accurate billing, insurance processing, and to communicate consistently about medical procedures and services across the healthcare system.

How can I find out the cost of a medical procedure or service?

To find out the cost of a specific medical procedure or service, it's best to consult with your healthcare provider for an estimate or your insurance company for coverage details. For general research or to look up fee schedules based on a CPT code and your specific location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows you to search for pricing information with CPT codes and specific geographical locations.

Where can I look up fee schedules for healthcare services based on CPT codes?

To look up fee schedules for healthcare services, especially if you have a CPT code and specific location in mind, you can use specialized online tools. Payerprice provides a fee schedule lookup tool where you can input CPT codes and specific locations to get relevant pricing information and understand potential costs.

Why do medical costs vary so significantly between providers or locations?

Medical costs can vary significantly due to numerous factors, including the specific healthcare provider or facility, geographic location, insurance agreements (negotiated rates between payers and providers), the complexity of the procedure, and whether the provider is in-network or out-of-network with your insurance plan. Different insurance companies also have varying reimbursement rates.

Does my health insurance cover all medical procedures and services?

No, health insurance typically does not cover all medical procedures and services. Coverage depends entirely on your specific insurance plan's benefits, deductibles, copayments, coinsurance, and whether the service is deemed medically necessary. Plans often have exclusions, limitations, and prior authorization requirements. It is crucial to review your policy details or contact your insurance provider directly to understand what is covered for your particular situation.

CPT 74420 Fee Schedule

Q: What is CPT code 74420?

CPT code 74420 is used for Imaging Of Urinary Tract Following Injection Of A Contrast Agent. Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Exam For Urine Backflow, An Imaging Study To Evaluate Flow Of Urine Back To The Kidneys From The Bladder.

Key Fact	Detail
Service Type	Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures
Common Place of Service	22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center
Common Modifiers	None 26 - Professional component TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 74420
Medicaid Fee Schedule	View Medicaid rates for 74420

National average reimbursement for CPT 74420 by major payers:

$111.44

$157.48

$137.02

$131.88

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CPT 74420

5 of 25 sample ratesHigher to lower in this preview

Roger Li
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
CAUrology PhysicianNPI 1841515525Tax ID 59-3238640
$97.88Published rate
Leah Crist
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
FLNurse PractitionerNPI 1164724670Tax ID 59-3238640
$83.19Published rate
Hillary Holden
Slocum Dickson Medical Group PLLC
NYPhysician AssistantNPI 1295040616Tax ID 20-0362623
$55.93Published rate
Richard Varlotta
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
FLAnesthesiologist AssistantNPI 1255768537Tax ID 59-3238640
$34.99Published rate
Michelle Palumbo
Slocum Dickson Medical Group PLLC
NYFamily Nurse PractitionerNPI 1497534705Tax ID 20-0362623
$28.71Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 74420 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 74420 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 74420 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
74400-CPT	Low	X-Ray Exam Of Urinary System, An Intravenous Pyelogram (Ivp) Is An X-Ray Of The Kidney Drainage Tubes (Ureters) And Bladder Using A Contrast Agent. Images Are Taken As The Bladder Fills And During Urination To Assess The System.
74415-CPT	Low	X-Ray Of Urinary Tract, An Intravenous Urogram (Ivu) X-Rays The Urinary Tract From The Kidneys Through The Bladder. Contrast Material Is Injected To Highlight The Area.
74420-CPT	Low	Exam For Urine Backflow, An Imaging Study To Evaluate Flow Of Urine Back To The Kidneys From The Bladder.
74425-CPT	Low	Imaging Exam Urine System, Contrast Dye Is Injected Into An Artificial Opening That Provides Access To The Urinary System. X-Rays Are Taken As The Dye Moves From The Kidneys To The Bladder. The Pictures Help Detect Problems In The Urine Drainage System.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 74420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 74420 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 74420 Fee Schedule

Roger Li

Leah Crist

Hillary Holden

Richard Varlotta

Michelle Palumbo