CPT code 74178: CT abdomen/pelvis, without and with contrast2026 Medicare rate & RVUs in Texas
Report this CT study when imaging covers both the abdomen and pelvis before contrast administration and again after contrast enhancement.
Medicare pays $313.58–$353.09 for 74178 in the office in Texas, from Beaumont, TX to Austin, TX. 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 74178 covers
This service includes CT images of both the abdomen and pelvis acquired without contrast and additional images acquired after contrast is administered. It may be used when the diagnostic question calls for comparison of unenhanced and contrast-enhanced findings, such as characterization of an abdominal or pelvic mass. A technologist performs the scan in a hospital imaging department, outpatient imaging center, or equipped physician office; a radiologist or other qualified physician interprets the images.
Select this code when the documented examination includes both body regions and both imaging phases. The report should support the anatomic coverage, use of contrast, and findings relevant to the clinical indication. Report the combined study rather than separate codes for its unenhanced and enhanced phases. The service may be billed globally, or the professional interpretation with modifier 26 and the technical portion with modifier TC. When multiple diagnostic imaging services are furnished, the CMS multiple procedure reduction applies to both the professional and technical components.
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 74178 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$313.58 to $353.09
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $353.09 | Unavailable |
| Beaumont, TX | $313.58 | Unavailable |
| Brazoria, TX | $335.03 | Unavailable |
| Dallas, TX | $336.82 | Unavailable |
| Fort Worth, TX | $334.21 | Unavailable |
| Galveston, TX | $335.81 | Unavailable |
| Houston, TX | $338.55 | Unavailable |
| Rest of Texas | $323.89 | Unavailable |
How the 74178 rate is calculated
Each of 74178’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 · 74178
RVUs × geographic indexes × conversion factor
Work1.96
1.96 RVUs× 1.000 GPCI
Practice expense8.01
8.01 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
10.1200
Conversion factor
$33.4009
Medicare rate
$338.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 74178
The CMS indicators that decide how 74178 is paid alongside other services.
CMS payment indicators · 74178
CT abdomen/pelvis, without and with contrast
| 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
74178 without 26 · national office
$338.02
CT abdomen/pelvis, without and with contrast
74178-26 · Professional component
$92.85
Pays only the interpretation and report.
74178 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 74176CT abdomen and pelvisWithout contrast
- Use 74176 for an abdomen-and-pelvis CT performed without contrast only. This code requires both unenhanced and post-contrast imaging.
- 74177CT abdomen and pelvisWith contrast only
- Use 74177 for an abdomen-and-pelvis CT with contrast when no unenhanced phase is performed. This code includes imaging both before and after contrast.
- 74170Abdominal CTWithout and with contrast
- 74170 covers the abdomen only with unenhanced and post-contrast imaging. Choose this code when the examination also includes the pelvis.
- 74174CTA abdomen/pelvisWith contrast
- 74174 is for angiographic imaging of the abdomen and pelvis, rather than a routine CT examination with unenhanced and contrast-enhanced phases.
74178 billing questions
When should this code be chosen over 74177?
Use this code when the abdomen and pelvis are imaged both before and after contrast. Code 74177 describes the abdomen-and-pelvis CT performed with contrast, without the added unenhanced phase.
Can the unenhanced and enhanced phases be billed separately?
Report the combined study under this code when both phases are part of the same examination; do not separately report the phase codes for that examination.
How are the professional and technical portions reported?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion, including equipment and staff. Without either modifier, the claim represents the global service.
Does the multiple procedure reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to both the technical and professional components.
What documentation supports selecting this code?
The imaging documentation should establish coverage of both the abdomen and pelvis, an unenhanced acquisition, and additional imaging after contrast administration.
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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