How much does Medicare pay for CPT 74430?

Medicare allowed an average of $27.60 per service and paid $21.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $143.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74430?

Review by radiologist of urinary bladder image. It was billed 2,181 times to 2,020 Medicare beneficiaries by 91 providers in 2024.

Does 74430 pay differently in an office than a hospital?

Yes. The allowed amount averaged $37.44 in an office setting and $14.82 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 74430 most?

Urology, with 1,508 services from 55 clinicians. Next are Diagnostic Radiology, Interventional Radiology, Nurse Practitioner.

CPT 74430

Review by radiologist of urinary bladder image

$27.60Medicare-allowed amount per service, averaged across 2,181 services

Providers submitted

$143.22

Asking price, not received

Medicare allowed

$27.60

The fee schedule figure

Medicare paid

$21.81

Balance is patient coinsurance

Providers submitted an average of $143.22 for this code and Medicare allowed $27.60 — 5.2× 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 $21.81 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $37.44
Hospital / facility: $14.82

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,232 services were billed in an office setting and 949 in a facility.

Services: 2,181
Beneficiaries: 2,020
Providers billing it: 91
Total allowed: $60,196

What Medicare pays for CPT 74430

Across 2,181 services billed by 91 providers to 2,020 beneficiaries, Medicare allowed an average of $27.60 per service. 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 74430

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	1,508	1,457	$29.50	55
Diagnostic Radiology	493	419	$19.57	26
Interventional Radiology	94	60	$39.07	4
Nurse Practitioner	40	39	$20.62	3
Physician Assistant	32	31	$31.71	2
Emergency Medicine	14	14	$37.87	1

74430 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	287	$36.04	$29.32	4
California	233	$29.83	$20.85	9
Texas	178	$26.39	$21.13	9
North Carolina	124	$16.57	$14.07	4
New York	117	$27.07	$19.28	6
Pennsylvania	115	$35.53	$26.81	4
Georgia	87	$35.82	$28.51	3
Illinois	83	$20.26	$15.33	4
Arizona	81	$37.33	$28.43	4
Washington	72	$21.37	$16.05	4
Wisconsin	67	$13.99	$11.24	3
Tennessee	63	$36.43	$32.19	3
Ohio	54	$28.37	$23.65	3
Massachusetts	51	$21.99	$15.91	1
Mississippi	51	$35.99	$31.48	2
Michigan	49	$26.36	$20.76	3
Indiana	47	$25.79	$21.18	2
West Virginia	45	$14.76	$11.52	2
Minnesota	45	$35.03	$28.80	3
Nebraska	42	$26.53	$21.88	3
South Carolina	42	$14.65	$11.45	2
Virginia	40	$46.91	$31.17	1
Iowa	29	$25.68	$22.39	2
Colorado	29	$14.98	$11.46	1
Alabama	24	$13.97	$11.46	1
Oregon	21	$15.04	$11.47	1
New Hampshire	20	$14.70	$11.44	1
Arkansas	16	$13.33	$11.45	1
Vermont	15	$14.37	$11.46	1
Missouri	15	$22.32	$20.55	1
Montana	15	$14.51	$11.44	1
Nevada	13	$14.56	$11.45	1
Louisiana	11	$14.59	$11.46	1

Related codes

74420Imaging of urinary tract following injection of a contrast agent$39.49
74455Review by radiologist of urinary bladder and urethra images$71.79
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.