CPT 74485Radiology

Dilation urtr/urt rs&i

CPT 74485 covers the radiologic supervision and interpretation (RS&I) portion when a physician monitors and documents the imaging component of dilating a narrowed ureter or urethra. This is the imaging oversight service, not the actual dilation procedure itself.

Showing rates for

National Average

Base Medicare rate

$114.18

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

0.83

PE RVU (NF)

2.66

MP RVU

0.04

Total RVU

3.53

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

NCCI bundling edits

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Billing tips

Always bill 74485 with the corresponding dilation procedure code (e.g., 50395, 50706, 52341) on the same claim to demonstrate medical necessity
Impact: Prevents automatic denial for lack of corresponding procedure; failure to pair results in 80%+ denial rate
Submit separate written interpretation report that explicitly documents fluoroscopic guidance, stricture characteristics, and procedural monitoring
Impact: Required documentation element; absence triggers audit and recoupment of full $114.18 payment
Verify payer-specific policies on bilateral procedures - some require modifier 50 while others prefer RT/LT on separate lines
Impact: Incorrect bilateral billing can result in 50% underpayment or complete denial of second side
Do not bill 74485 if only pre-procedure or post-procedure static imaging is performed; real-time fluoroscopic guidance during dilation is required
Impact: Incorrect reporting without intra-procedural imaging results in denial and potential fraud investigation
Append modifier 26 in facility settings where hospital owns equipment unless you have a contractual arrangement documenting professional component billing rights
Impact: Prevents duplicate billing denials; incorrect global billing in facility setting triggers automatic $114.18 recoupment
Check NCCI edits before billing with other radiologic supervision codes from the same session; many RS&I codes are mutually exclusive
Impact: Bundling violations result in denial of secondary code; can lose $100+ in legitimate separate procedures if not properly documented with modifier 59

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 74485 in 2025?

The 2025 Medicare national average reimbursement for CPT 74485 is $114.18 for both facility and non-facility settings. This is based on a total RVU of 3.53 (Work RVU 0.83, PE RVU 2.66, MP RVU 0.04) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 74485 be billed separately from the dilation procedure code?

Yes, CPT 74485 is separately reportable from the primary dilation procedure code (such as 50395, 50706, or 52341) when a qualified physician provides and documents distinct radiologic supervision and interpretation services. A separate written interpretation report is required, and both codes should be billed together on the same claim to demonstrate medical necessity.

What modifiers are commonly used with CPT 74485?

The most common modifiers for 74485 are: modifier 26 (professional component only in facility settings), TC (technical component only), RT/LT (laterality for unilateral procedures), modifier 59 (distinct procedural service when billed with potentially bundled codes), and modifier 52 (reduced services if RS&I is incomplete).

What documentation is required to bill CPT 74485?

Required documentation includes a separate written interpretation report signed by a qualified radiologist or physician that documents real-time fluoroscopic guidance during the dilation, stricture location and characteristics, contrast used, fluoroscopic findings during the procedure, and post-dilation results. The report must demonstrate distinct cognitive work beyond the procedural note.

Who can bill CPT code 74485?

CPT 74485 can be billed by interventional radiologists, diagnostic radiologists, and urologists who are credentialed to perform fluoroscopic procedures and who personally provide or directly supervise the radiologic supervision and interpretation component. The billing physician must produce a separate written interpretation report.

What is the difference between CPT 74485 and the dilation procedure code?

CPT 74485 covers only the radiologic supervision and interpretation (imaging oversight) component of urinary tract dilation, while the dilation procedure code (such as 50395 or 52341) covers the actual interventional work of dilating the stricture. Both codes are typically billed together when a physician provides fluoroscopic guidance and produces a separate interpretation report.

Why was my CPT 74485 claim denied?

Common denial reasons for 74485 include: missing written interpretation report, bundling with the primary procedure code, lack of corresponding dilation procedure code on the claim, insufficient documentation of real-time fluoroscopic guidance (versus only pre/post imaging), missing laterality modifiers for unilateral procedures, or incorrect use of global code in facility settings without modifier 26.