CPT 74425Radiology

Urography antegrade rs&i

CPT 74425 covers the imaging portion of an antegrade urography, a specialized X-ray study where contrast dye is injected through a tube already placed in the kidney to visualize the urinary collecting system and ureters.

Showing rates for

National Average

Base Medicare rate

$129.39

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.51

PE RVU (NF)

3.45

MP RVU

0.04

Total RVU

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always verify whether the procedure was performed in facility or non-facility setting, though for 74425 both rates are identical at $129.39
Impact: Prevents claim rejections due to incorrect place of service; ensures proper payment in 2025
Document whether you are billing global service or split with modifier 26/TC based on equipment ownership
Impact: Incorrect modifier use can result in 40-60% payment reduction or complete denial
Bill the injection/access procedure separately (e.g., 50430, 50431, 50432) as 74425 covers only RS&I
Impact: Failure to bill injection code results in leaving approximately $200-400 on the table per procedure
Ensure written interpretation report is in patient record before claim submission with specific anatomic findings
Impact: Missing report is top audit trigger and can result in 100% recoupment ($129.39 per claim)
Append modifier 59 when performed with other urological imaging on same date if separate session and medically distinct
Impact: Prevents NCCI bundling denials that would eliminate $129.39 payment entirely
Code bilateral procedures correctly; 74425 is unilateral, so use RT/LT or bill twice with 50 modifier if bilateral imaging performed
Impact: Undercoding bilateral studies loses 50% of potential reimbursement ($129.39 vs $258.78)

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 74425?

The 2025 Medicare national average reimbursement for CPT 74425 is $129.39 for both facility and non-facility settings, based on 4.0 total RVUs and the 2025 conversion factor of 32.3465.

What is the difference between CPT 74425 and 74420?

CPT 74420 is retrograde urography (contrast injected through bladder/urethra going upward), while 74425 is antegrade urography (contrast injected through kidney/nephrostomy tube going downward). These represent different approaches and cannot be billed together for the same anatomic area on the same date.

Can I bill 74425 with nephrostomy tube placement codes?

Yes, 74425 can be billed separately with nephrostomy placement codes (50432, 50433) as it represents the RS&I component only. However, ensure you document a separate interpretation report and consider using modifier 59 if payer policies require it to prevent bundling.

Does CPT 74425 include the injection of contrast material?

No, CPT 74425 covers only the radiological supervision and interpretation. The contrast injection through existing access is typically bundled with the access procedure code (50430, 50431, 50432, 50433) or may be separately reportable depending on the clinical scenario.

How many RVUs is CPT code 74425 worth in 2025?

CPT 74425 has 4.0 total RVUs in 2025, consisting of 0.51 work RVUs, 3.45 practice expense RVUs, and 0.04 malpractice RVUs. Both facility and non-facility PE RVUs are identical at 3.45.

Do I need modifier 26 when billing 74425 in a hospital setting?

Use modifier 26 only when billing the professional component (interpretation only) while the hospital bills the technical component separately. If you own the equipment and perform both components, bill 74425 globally without modifier 26.

What documentation is required to support billing CPT 74425?

Required documentation includes a formal written interpretation report signed by the physician, documentation of contrast administration, description of anatomic structures visualized, specific findings, clinical indication, and permanently stored images. The interpretation must be separately documented, not just a procedural note.