CPT code 74420 represents a diagnostic imaging procedure—retrograde urography (retrograde pyelography)—in which contrast is introduced via catheter against normal urinary flow to visualize the ureters and renal collecting system. The code is used when clinicians need direct opacification of the upper urinary tract, commonly to investigate suspected obstruction, ureteral injury, or to define anatomy prior to intervention. Nationally, this code is relevant for facility and professional billing where fluoroscopic catheter-based imaging is required and where noninvasive modalities are inconclusive.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for CPT code 74420, typical sites of service, and the procedural purpose. The publication summarizes payer coverage patterns and common billing considerations, highlights benchmark metrics and utilization context where available, and outlines policy or coding guidance impacts that affect reimbursement and claim adjudication nationally. The content is intended to clarify clinical indications and billing classification for clinicians, coders, and revenue leaders managing procedures that require catheter-directed retrograde contrast imaging of the upper urinary tract.