CPT 74455Radiology

X-ray urethra/bladder

CPT code 74455 covers an X-ray examination of the urethra and bladder, typically performed by injecting contrast dye to visualize these urinary structures. This imaging procedure helps diagnose urinary tract abnormalities, blockages, or structural problems.

Showing rates for

National Average

Base Medicare rate

$98.33

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

0.33

PE RVU (NF)

2.69

MP RVU

0.02

Total RVU

3.04

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

NCCI bundling edits

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Billing tips

Separate 74455 from other cystography codes (74420, 74430) by ensuring documentation clearly specifies retrograde urethrography component
Impact: Prevents bundling denials that could result in loss of $98.33 reimbursement when multiple urologic imaging studies performed same day
Document voiding phase separately from filling phase in the radiologist's report to justify complete procedure code versus reduced service
Impact: Ensures full reimbursement versus 50% reduction with modifier 52; protects full $98.33 payment
Bill professional and technical components separately when physician does not own imaging equipment (hospital-based radiologists)
Impact: Proper modifier 26/TC usage ensures accurate payment distribution; professional component typically represents 30-40% of total RVU value
Verify medical necessity documentation includes specific clinical indication (stricture evaluation, trauma assessment, or reflux study) to prevent LCD denials
Impact: Lack of specific indication is primary denial reason; proper documentation prevents 100% claim denial and appeals process
Link appropriate ICD-10 diagnosis codes for urethral stricture (N35.x), vesicoureteral reflux (N13.7x), or urethral injury (S37.3x) based on clinical scenario
Impact: Improper diagnosis coding results in medical necessity denials; correct linkage essential for $98.33 reimbursement
When performed in facility setting, ensure both facility and professional claims use identical date of service and procedure details to avoid coordination of benefits issues
Mismatched claims trigger payment delays or denials; coordination errors can delay reimbursement 30-60 days

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 74455 in 2025?

The 2025 Medicare national average reimbursement for CPT 74455 is $98.33 for both facility and non-facility settings, based on 3.04 total RVUs and the 2025 conversion factor of 32.3465.

What is the difference between CPT 74455 and 74420?

CPT 74455 includes retrograde urethrography and/or voiding cystourethrography (imaging of the urethra and bladder during filling/voiding), while CPT 74420 covers only standard cystography (bladder imaging). Code 74455 specifically requires urethral visualization, making it more comprehensive for urethral pathology evaluation.

Can CPT 74455 be billed with modifier 26 for professional component only?

Yes, CPT 74455 can be billed with modifier 26 when the physician provides only the interpretation and report without owning the imaging equipment. The facility bills the technical component (modifier TC) separately, splitting the total $98.33 reimbursement between professional and technical services.

What diagnosis codes support medical necessity for CPT 74455?

Common supporting ICD-10 codes include N35.x (urethral stricture), N13.70-N13.739 (vesicoureteral reflux), S37.30-S37.39 (urethral injury), R31.x (hematuria), N36.x (urethral disorders), and Q64.x (congenital urethral malformations). Documentation must link specific clinical indication to code selection.

How many RVUs is CPT code 74455 worth in 2025?

CPT 74455 has 3.04 total RVUs in 2025, comprised of 0.33 work RVUs, 2.69 practice expense RVUs, and 0.02 malpractice RVUs. Both facility and non-facility PE RVU values are identical at 2.69.

Can CPT 74455 be billed on the same day as a cystoscopy?

Yes, but it requires careful documentation and often modifier 59 to indicate a distinct procedural service. The radiographic study (74455) must be medically necessary and provide different diagnostic information than the endoscopic examination. Documentation should clearly show both procedures were clinically indicated and provided separate diagnostic value.

What are the most common reasons for CPT 74455 claim denials?

The most common denials include: lack of medical necessity documentation, bundling with other urologic procedures (especially cystoscopy or catheterization codes), duplicate service denials when billed with other cystography codes, and insufficient documentation of contrast administration and imaging phases performed. Proper documentation and modifier usage prevents most denials.