CPT code 74177: CT abdomen and pelvis, with contrast only2026 Medicare rate & RVUs in Louisiana
Computed tomography of the abdomen and pelvis after intravenous contrast, without a diagnostic precontrast series, is reported for abdominal pain, infection, trauma, or cancer staging.
Medicare pays $272.86–$286.89 for 74177 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | $286.89 | Unavailable |
| Rest of Louisiana | $272.86 | Unavailable |
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.
How the rate is built · 74177
RVUs × geographic indexes × conversion factor
Work1.77
1.77 RVUs× 1.000 GPCI
Practice expense7.09
7.09 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
8.9900
Conversion factor
$33.4009
Medicare rate
$300.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 74177
The CMS indicators that decide how 74177 is paid alongside other services.
CMS payment indicators · 74177
CT abdomen and pelvis, with contrast only
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
74177 without 26 · national office
$300.27
CT abdomen and pelvis, with contrast only
74177-26 · Professional component
$83.84
Pays only the interpretation and report.
74177 compared with similar codes
Compare codes · National
5 codes, side by side
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.
74177 billing questions
Can CT abdomen with contrast and CT pelvis with contrast be billed separately when both are done in the same combined exam?
No. Report one unit of 74177 for the combined exam rather than 74160 plus 72193. The regional codes describe exams limited to their respective regions.
When should 74178 be used instead of 74177?
Use 74178 when a diagnostic noncontrast series is followed by contrast-enhanced imaging of the abdomen and pelvis. Use 74177 when the diagnostic acquisition is contrast-enhanced without a diagnostic precontrast series.
Does giving only oral contrast qualify the study as with contrast?
No. Oral contrast alone does not make this an intravenous contrast study; an abdomen and pelvis CT performed with oral contrast but without intravenous contrast is reported with 74176.
Which modifiers apply for split billing?
On physician fee schedule claims, the interpreting radiologist reports modifier 26 for the interpretation, while the provider billing for equipment and staff reports modifier TC. A billing entity that provides both components reports the global code without either modifier.
How is payment affected when CT chest is performed in the same session?
The diagnostic imaging multiple procedure reduction can affect the professional and technical components of eligible studies performed in the same session. A contrast-enhanced chest, abdomen, and pelvis staging exam may be reported with 71260 and 74177.
Do delayed images after intravenous contrast change the code to 74178?
No. Additional postcontrast images do not make the exam a without-and-with-contrast study; 74178 requires diagnostic imaging before contrast followed by contrast-enhanced imaging.
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
Show the CMS file lines behind this rate
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