CPT 74430Radiology

Contrast x-ray bladder

CPT code 74430 is for a contrast x-ray of the bladder (cystography), where a special dye is placed into the bladder through a catheter and x-ray images are taken to examine the bladder's structure and function.

Showing rates for

National Average

Base Medicare rate

$40.11

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

0.32

PE RVU (NF)

0.89

MP RVU

0.03

Total RVU

1.24

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

NCCI bundling edits

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Billing tips

Bill the global code 74430 only when your facility performs both the technical component (contrast administration, imaging) and professional component (interpretation). Split billing with 26/TC modifiers when services are performed at different locations.
Impact: Proper modifier use prevents claim rejection and ensures full $40.11 reimbursement is appropriately distributed
Document the type and volume of contrast material used, route of administration (retrograde via catheter), number of images obtained, and whether post-void images were captured. These elements differentiate 74430 from other cystography codes.
Impact: Comprehensive documentation prevents downcoding to lower-value codes and supports medical necessity during audits
Verify that catheter insertion is not separately billed when performed solely for the purpose of contrast administration for this study, as it is considered integral to 74430.
Impact: Prevents unbundling denials and recoupment; catheter insertion (51701-51703) bundled into 74430 saves audit exposure
When performed with voiding cystourethrography (74455), use modifier 59 on 74430 only if separate diagnostic indications exist and are documented. Most payers consider 74430 included in 74455.
Impact: Inappropriate billing of both codes can result in denial of the $40.11 for 74430 or recoupment during post-payment review
For pediatric patients, ensure documentation specifies whether the study was performed for vesicoureteral reflux evaluation, as this is the most defensible medical necessity indication for this age group.
Impact: Strong medical necessity documentation reduces denial rates by approximately 30-40% for pediatric cystography claims

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 74430 in 2025?

The 2025 Medicare national average payment for CPT 74430 is $40.11 for both facility and non-facility settings. This rate is based on 1.24 total RVUs (0.32 work RVU, 0.89 PE RVU, 0.03 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 74430 be billed with voiding cystourethrography code 74455?

Generally no. CPT 74455 (voiding cystourethrography) includes the retrograde cystography represented by 74430 as part of the complete study. Billing both together typically results in denial unless you can document separate diagnostic indications and use modifier 59, which requires clear medical necessity for performing both procedures independently.

Do I need to bill separately for catheter insertion when performing CPT 74430?

No. Urethral catheterization performed solely for the purpose of contrast administration during cystography is considered integral to CPT 74430 and should not be billed separately using codes 51701-51703. Separate billing will result in unbundling denials and potential recoupment.

What modifier should I use when the radiologist only reads the films for CPT 74430?

Use modifier 26 (Professional Component) when billing only for the physician's interpretation and report, without providing the equipment, technologist, or contrast materials. The facility performing the technical component would bill 74430-TC. The global code 74430 without modifiers should only be used when one entity provides both components.

What diagnosis codes support medical necessity for CPT 74430?

Common supporting diagnoses include N13.70 (vesicoureteral reflux unspecified), N32.89 (other specified bladder disorders), N39.0 (urinary tract infection), S37.20 (unspecified injury of bladder), R31.9 (hematuria), and N32.81 (overactive bladder). Documentation must clearly link the clinical indication to the need for contrast cystography specifically.

How many RVUs is CPT code 74430 worth in 2025?

CPT 74430 has a total of 1.24 RVUs in 2025, broken down as: 0.32 work RVUs, 0.89 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs. This is a relatively low-RVU procedure reflecting the straightforward nature of retrograde cystography.

Is CPT 74430 the same as a VCUG (voiding cystourethrogram)?

No. CPT 74430 is a simple contrast x-ray of the bladder (cystography) that evaluates bladder structure during filling. A VCUG (CPT 74455) is a more comprehensive study that includes bladder filling, voiding images, and evaluation of the urethra during urination, making it a separate and more extensive procedure that includes what 74430 covers plus additional imaging.