How much does Medicare pay for CPT 74420?

Medicare allowed an average of $39.49 per service and paid $31.35 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $269.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74420?

Imaging of urinary tract following injection of a contrast agent. It was billed 127,987 times to 105,600 Medicare beneficiaries by 3,887 providers in 2024.

Does 74420 pay differently in an office than a hospital?

Yes. The allowed amount averaged $30.45 in an office setting and $39.60 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 74420 most?

Urology, with 99,843 services from 3,008 clinicians. Next are Diagnostic Radiology, Ambulatory Surgical Center, Interventional Radiology.

CPT 74420

Imaging of urinary tract following injection of a contrast agent

$39.49Medicare-allowed amount per service, averaged across 127,987 services

Providers submitted

$269.16

Asking price, not received

Medicare allowed

$39.49

The fee schedule figure

Medicare paid

$31.35

Balance is patient coinsurance

Providers submitted an average of $269.16 for this code and Medicare allowed $39.49 — 6.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $31.35 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $30.45
Hospital / facility: $39.60

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,473 services were billed in an office setting and 126,514 in a facility.

Services: 127,987
Beneficiaries: 105,600
Providers billing it: 3,887
Total allowed: $5,054,207

What Medicare pays for CPT 74420

Across 127,987 services billed by 3,887 providers to 105,600 beneficiaries, Medicare allowed an average of $39.49 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 74420

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	99,843	80,191	$23.88	3,008
Diagnostic Radiology	14,954	14,147	$23.61	608
Ambulatory Surgical Center	11,869	10,083	$192.55	225
Interventional Radiology	819	779	$23.54	31
General Surgery	194	153	$24.39	7
Family Practice	87	66	$22.35	2
Internal Medicine	81	64	$23.78	1
Osteopathic Manipulative Medicine	69	60	$22.38	1
Surgical Oncology	44	35	$25.44	2
Thoracic Surgery	14	11	$24.14	1
Emergency Medicine	13	11	$23.92	1

74420 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	10,632	$44.29	$36.16	321
Illinois	7,643	$33.58	$26.05	222
California	7,401	$46.03	$31.78	254
New Jersey	6,295	$54.05	$40.27	177
New York	6,213	$32.46	$23.62	197
Pennsylvania	5,975	$33.38	$26.69	182
Virginia	5,714	$43.54	$35.21	138
Georgia	4,934	$68.41	$55.41	127
Ohio	4,931	$32.12	$26.29	143
North Carolina	4,472	$30.15	$24.43	156
Texas	4,462	$43.47	$35.41	175
Michigan	4,416	$26.78	$20.94	146
Indiana	4,370	$25.68	$20.79	120
Massachusetts	4,351	$26.50	$19.66	129
Arizona	3,821	$38.49	$30.60	102
South Carolina	3,663	$47.52	$39.37	90
Maryland	2,765	$82.54	$65.68	76
Oklahoma	2,746	$29.67	$24.47	58
Missouri	2,704	$44.63	$36.63	93
Tennessee	2,685	$40.36	$34.39	74
Minnesota	2,335	$32.61	$25.35	81
Washington	2,268	$30.61	$23.32	73
Louisiana	1,932	$32.00	$26.01	59
Colorado	1,658	$37.66	$29.53	62
Kentucky	1,579	$27.23	$21.88	51
Kansas	1,496	$44.18	$36.36	48
Oregon	1,360	$60.39	$45.30	46
Connecticut	1,359	$26.59	$19.75	50
Mississippi	1,274	$53.53	$49.33	35
Wisconsin	1,272	$22.84	$18.31	47
Arkansas	1,255	$27.17	$22.51	26
New Hampshire	1,113	$23.80	$18.44	29
Utah	1,070	$47.59	$39.24	40
Alabama	1,041	$39.17	$34.05	35
Iowa	853	$37.91	$32.10	30
West Virginia	831	$23.35	$17.99	28
Idaho	746	$22.62	$18.31	21
Montana	622	$30.82	$24.57	18
Nebraska	531	$54.50	$44.86	20
Rhode Island	453	$24.04	$18.28	19
North Dakota	426	$23.19	$18.26	7
District of Columbia	353	$25.42	$18.35	11
Nevada	352	$23.17	$18.44	14
Alaska	336	$45.65	$28.88	11
Maine	301	$23.38	$18.14	12
New Mexico	273	$29.77	$23.96	10
Vermont	224	$23.16	$18.49	9
Delaware	218	$102.54	$80.04	5
Hawaii	128	$23.78	$17.59	4
Wyoming	98	$22.54	$18.14	4
AA	19	$21.51	$19.00	1
Guam	18	$21.34	$18.71	1

Related codes

74455Review by radiologist of urinary bladder and urethra images$71.79
74430Review by radiologist of urinary bladder image$27.60
74450Review by radiologist of urinary bladder and urethra images$36.16

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.