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See a sample rate comparisonCPT 74420 Fee Schedule
Medicare rates as of October 2026
CPT 74420 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
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 | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $81.16 national non-facility rate (2026) · View Medicare rates for 74420 |
| Medicaid Fee Schedule | $65.85 median of the 7 states in the free preview · View Medicaid rates for 74420 |
National average reimbursement for CPT 74420 by major payers:
$111.44
BCBS / Anthem
$157.48
UnitedHealthcare
$137.02
Aetna
$131.88
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 74420.
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
$97.88Published rateLeah Crist
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$83.19Published rateHillary Holden
Slocum Dickson Medical Group PLLC
$55.93Published rateRichard Varlotta
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$34.99Published rateMichelle Palumbo
Slocum Dickson Medical Group PLLC
$28.71Published rate
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See a sample payer proposalCPT 74420 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 74420. Select one to see its fee schedule.
| 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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Frequently Asked Questions
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.
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.
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.
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.
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.