CPT code 74177: CT abdomen and pelvis, with contrast only2026 Medicare rate & RVUs

Medicare pays $300.27 for 74177 nationally in the office. Local office rates run $264.78–$409.43.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 74177 covers

This study images the abdomen and pelvis, generally from the diaphragm through the pubic symphysis, during one combined examination. Diagnostic images are acquired after iodinated intravenous contrast, without a diagnostic precontrast series. Common indications include suspected appendicitis or diverticulitis, abscess, bowel obstruction, blunt trauma, and cancer staging or surveillance. Technologists perform the scan in hospital CT departments, emergency departments, and freestanding imaging centers; a radiologist interprets the images and issues a report.

Report one unit when both regions are imaged as a combined contrast-enhanced exam; do not substitute separate abdomen-only and pelvis-only CT codes. Documentation should identify the regions scanned, intravenous contrast administration, the series acquired, and the findings. On physician fee schedule claims, modifier 26 identifies the radiologist's interpretation and modifier TC identifies the equipment-and-staff portion. Report the global service without either modifier when the same billing entity provides both components. The diagnostic imaging multiple procedure reduction can affect both professional and technical components when another eligible imaging study, such as chest CT, is performed in the same session.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 74177 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

74177 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 74177 rate is calculated

Each of 74177’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 74177

The CMS indicators that decide how 74177 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

74177 compared with similar codes

How to choose

74178CT abdomen/pelvisWithout and with contrast

74178 includes diagnostic noncontrast imaging followed by contrast-enhanced imaging, as in some renal mass protocols. If the diagnostic images are acquired only after IV contrast, report 74177.

74174CTA abdomen/pelvisWith contrast

74174 is a CT angiogram with arterial-phase timing and angiographic image post-processing for vascular questions. A routine contrast-enhanced abdomen and pelvis CT is 74177.

74176CT abdomen and pelvisWithout contrast

74176 is the noncontrast study, used for kidney stone protocols or when IV contrast is contraindicated. Oral contrast alone still falls under 74176.

74160Abdominal CTWith contrast

74160 covers the abdomen only. If the pelvis is also scanned in the same combined exam, 74177 replaces separate abdomen and pelvis CT codes.

Codes related to 74177

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates