How much does Medicare pay for CPT 74455?

Medicare allowed an average of $71.79 per service and paid $57.13 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $277.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74455?

Review by radiologist of urinary bladder and urethra images with contrast and after passing urine. It was billed 5,612 times to 5,548 Medicare beneficiaries by 164 providers in 2024.

Does 74455 pay differently in an office than a hospital?

Yes. The allowed amount averaged $97.47 in an office setting and $20.77 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 74455 most?

Urology, with 5,094 services from 141 clinicians. Next are Diagnostic Radiology, Physician Assistant, Nurse Practitioner.

CPT 74455

Review by radiologist of urinary bladder and urethra images with contrast and after passing urine

$71.79Medicare-allowed amount per service, averaged across 5,612 services

Providers submitted

$277.22

Asking price, not received

Medicare allowed

$71.79

The fee schedule figure

Medicare paid

$57.13

Balance is patient coinsurance

Providers submitted an average of $277.22 for this code and Medicare allowed $71.79 — 3.9× 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 $57.13 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $97.47
Hospital / facility: $20.77

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. 3,733 services were billed in an office setting and 1,879 in a facility.

Services: 5,612
Beneficiaries: 5,548
Providers billing it: 164
Total allowed: $402,885

What Medicare pays for CPT 74455

Across 5,612 services billed by 164 providers to 5,548 beneficiaries, Medicare allowed an average of $71.79 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 74455

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	5,094	5,048	$76.43	141
Diagnostic Radiology	242	231	$13.74	10
Physician Assistant	149	142	$29.23	6
Nurse Practitioner	84	84	$34.72	4
Surgical Oncology	21	21	$16.45	1
Undefined Physician type	11	11	$119.88	1
Obstetrics & Gynecology	11	11	$114.68	1

74455 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
Texas	1,156	$89.35	$75.10	28
New York	730	$99.12	$66.63	19
California	572	$59.40	$41.49	17
New Jersey	411	$114.24	$77.54	9
Pennsylvania	406	$23.25	$18.78	11
Florida	298	$84.69	$68.83	8
Washington	248	$47.74	$33.75	9
South Carolina	232	$48.81	$41.78	3
Maryland	205	$61.65	$48.44	5
Massachusetts	177	$37.47	$26.10	4
Kansas	149	$93.24	$81.30	7
Iowa	138	$14.42	$11.90	4
Virginia	132	$54.45	$46.29	5
North Carolina	97	$76.66	$64.76	4
Illinois	84	$81.64	$59.65	4
Connecticut	83	$57.26	$40.58	4
District of Columbia	77	$60.21	$40.11	2
Georgia	54	$95.34	$81.13	3
Minnesota	54	$88.65	$72.17	3
Oregon	50	$53.07	$42.32	2
Vermont	48	$14.85	$11.49	1
Louisiana	41	$46.99	$39.06	2
Kentucky	41	$53.25	$46.77	2
New Hampshire	30	$15.18	$10.60	1
Michigan	28	$15.23	$11.53	2
Arizona	27	$49.66	$39.36	2
Alaska	16	$20.63	$12.00	1
Missouri	16	$84.88	$76.84	1
Ohio	12	$92.56	$82.90	1

Related codes

74420Imaging of urinary tract following injection of a contrast agent$39.49
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.