CPT code 74178: CT abdomen/pelvis, without and with contrast2026 Medicare rate & RVUs in Houston, TX
Report this CT study when imaging covers both the abdomen and pelvis before contrast administration and again after contrast enhancement.
In Houston, TX, Medicare pays $338.55 for 74178 in the office.
Check a contract rate as a % of Medicare · 74178 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How Houston, TX compares for 74178
Across 109 of 109 payment localities, the office rate for 74178 runs from $297.86 in Arkansas to $461.15 in San Benito County, CA. Houston, TX pays $338.55. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Houston, TX · this page$338.55
- Austin, TX · Texas$353.09+$14.54
- Beaumont, TX · Texas$313.58−$24.97
- Brazoria, TX · Texas$335.03−$3.52
- Dallas, TX · Texas$336.82−$1.73
- Fort Worth, TX · Texas$334.21−$4.34
- Galveston, TX · Texas$335.81−$2.74
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $323.89 | — |
| Los Angeles, CACalifornia | $387.98 | — |
| Washington, DC areaDistrict of Columbia | $389.74 | — |
| Miami, FLFlorida | $356.65 | — |
| Chicago, ILIllinois | $346.30 | — |
| Manhattan, NYNew York | $388.48 | — |
| AlaskaAlaska | $385.89 | — |
| AlabamaAlabama | $302.40 | — |
| ArkansasArkansas | $297.86 | — |
| ArizonaArizona | $329.00 | — |
| Bakersfield, CACalifornia | $362.99 | — |
| Chico, CACalifornia | $362.49 | — |
| El Centro, CACalifornia | $362.51 | — |
| Fresno, CACalifornia | $362.49 | — |
| Hanford, CACalifornia | $362.49 | — |
| Madera, CACalifornia | $362.49 | — |
| Merced, CACalifornia | $362.49 | — |
| Modesto, CACalifornia | $362.49 | — |
| Napa, CACalifornia | $424.75 | — |
| Oxnard, CACalifornia | $386.65 | — |
| Redding, CACalifornia | $362.49 | — |
| Rest of CaliforniaCalifornia | $362.49 | — |
| Riverside, CACalifornia | $364.14 | — |
| Sacramento, CACalifornia | $381.66 | — |
| Salinas, CACalifornia | $380.26 | — |
| San Diego, CACalifornia | $390.12 | — |
| Marin County, CACalifornia | $451.22 | — |
| San Francisco, CACalifornia | $451.05 | — |
| San Benito County, CACalifornia | $461.15 | — |
| Santa Clara County, CACalifornia | $460.45 | — |
| San Luis Obispo, CACalifornia | $373.99 | — |
| Santa Cruz, CACalifornia | $394.59 | — |
| Santa Maria, CACalifornia | $381.94 | — |
| Santa Rosa, CACalifornia | $398.66 | — |
| Stockton, CACalifornia | $362.49 | — |
| Vallejo, CACalifornia | $424.51 | — |
| Visalia, CACalifornia | $362.49 | — |
| Yuba City, CACalifornia | $362.49 | — |
| ColoradoColorado | $354.83 | — |
| ConnecticutConnecticut | $360.98 | — |
| DelawareDelaware | $334.63 | — |
| Fort Lauderdale, FLFlorida | $345.54 | — |
| Rest of FloridaFlorida | $328.77 | — |
| Atlanta, GAGeorgia | $343.50 | — |
| Rest of GeorgiaGeorgia | $310.08 | — |
| Hawaii, Guam, HIHawaii | $372.56 | — |
| IowaIowa | $312.25 | — |
| IdahoIdaho | $313.97 | — |
| East St. Louis, ILIllinois | $321.69 | — |
| Rest of IllinoisIllinois | $317.56 | — |
| Suburban Chicago, ILIllinois | $349.57 | — |
| IndianaIndiana | $315.91 | — |
| KansasKansas | $309.85 | — |
| KentuckyKentucky | $307.89 | — |
| New Orleans, LALouisiana | $322.91 | — |
| Rest of LouisianaLouisiana | $307.04 | — |
| Metropolitan Boston, MAMassachusetts | $392.05 | — |
| Rest of MassachusettsMassachusetts | $352.23 | — |
| Baltimore area, MDMaryland | $359.78 | — |
| Rest of MarylandMaryland | $341.47 | — |
| Rest of MaineMaine | $314.72 | — |
| Southern Maine, MEMaine | $333.76 | — |
| Detroit, MIMichigan | $332.09 | — |
| Rest of MichiganMichigan | $315.39 | — |
| MinnesotaMinnesota | $342.25 | — |
| Metropolitan Kansas City, MOMissouri | $321.58 | — |
| Metropolitan St. Louis, MOMissouri | $325.19 | — |
| Rest of MissouriMissouri | $300.97 | — |
| MississippiMississippi | $299.52 | — |
| MontanaMontana | $338.01 | — |
| North CarolinaNorth Carolina | $318.28 | — |
| North DakotaNorth Dakota | $335.04 | — |
| NebraskaNebraska | $314.30 | — |
| New HampshireNew Hampshire | $348.36 | — |
| Northern New JerseyNew Jersey | $385.29 | — |
| Rest of New JerseyNew Jersey | $365.74 | — |
| New MexicoNew Mexico | $316.82 | — |
| NevadaNevada | $337.45 | — |
| NYC suburbs and Long Island, NYNew York | $397.07 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $367.43 | — |
| Queens, NYNew York | $393.11 | — |
| Rest of New YorkNew York | $323.15 | — |
| OhioOhio | $314.78 | — |
| OklahomaOklahoma | $308.27 | — |
| Portland, OROregon | $367.48 | — |
| Rest of OregonOregon | $335.46 | — |
| Metropolitan Philadelphia, PAPennsylvania | $351.13 | — |
| Rest of PennsylvaniaPennsylvania | $315.80 | — |
| Puerto RicoPuerto Rico | $340.88 | — |
| Rhode IslandRhode Island | $347.55 | — |
| South CarolinaSouth Carolina | $316.93 | — |
| South DakotaSouth Dakota | $334.69 | — |
| TennesseeTennessee | $311.35 | — |
| UtahUtah | $321.45 | — |
| VirginiaVirginia | $332.00 | — |
| Virgin Islands, VIUnited States Virgin Islands | $340.88 | — |
| VermontVermont | $332.87 | — |
| Rest of WashingtonWashington | $351.85 | — |
| King County, WAWashington | $401.11 | — |
| WisconsinWisconsin | $323.31 | — |
| West VirginiaWest Virginia | $305.13 | — |
| WyomingWyoming | $336.71 | — |
74178 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$297.86
$411.82
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $385.89 | 1 |
| AL | $302.40 | 1 |
| AR | $297.86 | 1 |
| AZ | $329.00 | 1 |
| CA | $362.49–$461.15 | 29 |
| CO | $354.83 | 1 |
| CT | $360.98 | 1 |
| DC | $389.74 | 1 |
| DE | $334.63 | 1 |
| FL | $328.77–$356.65 | 3 |
| GA | $310.08–$343.50 | 2 |
| GU | $372.56 | 1 |
| HI | $372.56 | 1 |
| IA | $312.25 | 1 |
| ID | $313.97 | 1 |
| IL | $317.56–$349.57 | 4 |
| IN | $315.91 | 1 |
| KS | $309.85 | 1 |
| KY | $307.89 | 1 |
| LA | $307.04–$322.91 | 2 |
| MA | $352.23–$392.05 | 2 |
| MD | $341.47–$389.74 | 3 |
| ME | $314.72–$333.76 | 2 |
| MI | $315.39–$332.09 | 2 |
| MN | $342.25 | 1 |
| MO | $300.97–$325.19 | 3 |
| MS | $299.52 | 1 |
| MT | $338.01 | 1 |
| NC | $318.28 | 1 |
| ND | $335.04 | 1 |
| NE | $314.30 | 1 |
| NH | $348.36 | 1 |
| NJ | $365.74–$385.29 | 2 |
| NM | $316.82 | 1 |
| NV | $337.45 | 1 |
| NY | $323.15–$397.07 | 5 |
| OH | $314.78 | 1 |
| OK | $308.27 | 1 |
| OR | $335.46–$367.48 | 2 |
| PA | $315.80–$351.13 | 2 |
| PR | $340.88 | 1 |
| RI | $347.55 | 1 |
| SC | $316.93 | 1 |
| SD | $334.69 | 1 |
| TN | $311.35 | 1 |
| TX | $313.58–$353.09 | 8 |
| UT | $321.45 | 1 |
| VA | $332.00–$389.74 | 2 |
| VI | $340.88 | 1 |
| VT | $332.87 | 1 |
| WA | $351.85–$401.11 | 2 |
| WI | $323.31 | 1 |
| WV | $305.13 | 1 |
| WY | $336.71 | 1 |
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.
The exact Houston, TX inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,321
- Code
- 74178
- Physician work
- 1.96
- Practice expense
- 8.01
- Malpractice
- 0.15
GPCI2026.csv
102
- Locality
- Houston, TX
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 1.376
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.96 | × 1.008 | 1.9757 |
| Practice expense | 8.01 | × 0.993 | 7.9539 |
| Malpractice | 0.15 | × 1.376 | 0.2064 |
| Total RVUs | 10.1360 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Houston, TX$338.55
Office: (1.96 × 1.008 + 8.01 × 0.993 + 0.15 × 1.376) × $33.4009 = $338.55
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.
How 74178 has changed in Houston, TX
74178 · Office / nonfacility
$338.55
Effective 2026-10-01
The base rate is $2.28 higher than on 2025-10-01, moving from $336.27 to $338.55 (0.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$336.27changed to$338.55
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.01 changed to 1.96
- Practice expense RVU 8.15 changed to 8.01
- Malpractice RVU 0.13 changed to 0.15
- Work GPCI 1.014 changed to 1.008
- Practice expense GPCI 1.003 changed to 0.993
- Malpractice GPCI 1.409 changed to 1.376
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$352.39changed to$336.27
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.34 changed to 8.15
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$346.64changed to$352.39
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$368.06changed to$346.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.53 changed to 8.34
- Malpractice RVU 0.12 changed to 0.13
- Work GPCI 1.023 changed to 1.014
- Practice expense GPCI 1.016 changed to 1.003
- Malpractice GPCI 1.154 changed to 1.409
January 1, 2023
RVU23A
$383.59changed to$368.06
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.66 changed to 8.53
- Malpractice RVU 0.11 changed to 0.12
- Work GPCI 1.032 changed to 1.023
- Practice expense GPCI 1.029 changed to 1.016
- Malpractice GPCI 0.900 changed to 1.154
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$391.08changed to$383.59
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.78 changed to 8.66
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$381.03changed to$391.08
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.23 changed to 8.78
- Work GPCI 1.026 changed to 1.032
- Practice expense GPCI 1.020 changed to 1.029
- Malpractice GPCI 0.918 changed to 0.900
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$370.41changed to$381.03
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.01 changed to 8.23
- Malpractice RVU 0.13 changed to 0.11
- Work GPCI 1.020 changed to 1.026
- Practice expense GPCI 1.012 changed to 1.020
- Malpractice GPCI 0.936 changed to 0.918
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$370.41
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$361.89changed toNo rate
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$358.37changed to$361.89
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 7.79 changed to 7.84
- Work GPCI 1.019 changed to 1.020
- Practice expense GPCI 1.006 changed to 1.009
- Malpractice GPCI 0.955 changed to 0.946
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$358.23changed to$358.37
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 7.76 changed to 7.79
- Malpractice RVU 0.12 changed to 0.13
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$356.45changed to$358.23
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$383.12changed to$356.45
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.51 changed to 7.76
- Work GPCI 1.014 changed to 1.019
- Practice expense GPCI 1.004 changed to 1.006
- Malpractice GPCI 0.939 changed to 0.955
Held through RVU15B.
January 1, 2014
RVU14A
$410.59changed to$383.12
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.90 changed to 8.51
- Malpractice RVU 0.13 changed to 0.12
- Work GPCI 1.009 changed to 1.014
- Practice expense GPCI 1.002 changed to 1.004
- Malpractice GPCI 0.923 changed to 0.939
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $410.59
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $338.55 | Not available in this setting | RVU26D |
| 2026-07-01 | $338.55 | Not available in this setting | RVU26C |
| 2026-04-01 | $338.55 | Not available in this setting | RVU26B |
| 2026-01-01 | $338.55 | Not available in this setting | RVU26A |
| 2025-10-01 | $336.27 | Not available in this setting | RVU25D |
| 2025-07-01 | $336.27 | Not available in this setting | RVU25C |
| 2025-04-01 | $336.27 | Not available in this setting | RVU25B |
| 2025-01-01 | $336.27 | Not available in this setting | RVU25A |
| 2024-10-01 | $352.39 | Not available in this setting | RVU24D |
| 2024-07-01 | $352.39 | Not available in this setting | RVU24C |
| 2024-04-01 | $352.39 | Not available in this setting | RVU24B |
| 2024-03-09 | $352.39 | Not available in this setting | RVU24AR |
| 2024-01-01 | $346.64 | Not available in this setting | RVU24A |
| 2023-10-01 | $368.06 | Not available in this setting | RVU23D |
| 2023-07-01 | $368.06 | Not available in this setting | RVU23C |
| 2023-04-01 | $368.06 | Not available in this setting | RVU23B |
| 2023-01-01 | $368.06 | Not available in this setting | RVU23A |
| 2022-10-01 | $383.59 | Not available in this setting | RVU22D |
| 2022-07-01 | $383.59 | Not available in this setting | RVU22C |
| 2022-04-01 | $383.59 | Not available in this setting | RVU22B |
| 2022-01-01 | $383.59 | Not available in this setting | RVU22A |
| 2021-10-01 | $391.08 | Not available in this setting | RVU21D |
| 2021-07-01 | $391.08 | Not available in this setting | RVU21C |
| 2021-04-01 | $391.08 | Not available in this setting | RVU21B |
| 2021-01-01 | $391.08 | Not available in this setting | RVU21A |
| 2020-10-01 | $381.03 | Not available in this setting | RVU20D |
| 2020-07-01 | $381.03 | Not available in this setting | RVU20C |
| 2020-04-01 | $381.03 | Not available in this setting | RVU20B |
| 2020-01-01 | $381.03 | Not available in this setting | RVU20A |
| 2019-10-01 | $370.41 | Not available in this setting | RVU19D |
| 2019-07-01 | $370.41 | Not available in this setting | RVU19C |
| 2019-04-01 | $370.41 | Not available in this setting | RVU19B |
| 2019-01-01 | $370.41 | Not available in this setting | RVU19A |
| 2018-10-01 | Additional calculation required | Not available in this setting | RVU18D |
| 2018-07-01 | Additional calculation required | Not available in this setting | RVU18C |
| 2018-04-01 | Additional calculation required | Not available in this setting | RVU18B |
| 2018-01-01 | Additional calculation required | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $361.89 | Not available in this setting | RVU17D |
| 2017-07-01 | $361.89 | Not available in this setting | RVU17C |
| 2017-04-01 | $361.89 | Not available in this setting | RVU17B |
| 2017-01-01 | $361.89 | Not available in this setting | RVU17A |
| 2016-10-01 | $358.37 | Not available in this setting | RVU16D |
| 2016-07-01 | $358.37 | Not available in this setting | RVU16C |
| 2016-04-01 | $358.37 | Not available in this setting | RVU16B |
| 2016-01-01 | $358.37 | Not available in this setting | RVU16A |
| 2015-10-01 | $358.23 | Not available in this setting | RVU15D |
| 2015-07-01 | $358.23 | Not available in this setting | RVU15C |
| 2015-04-01 | $356.45 | Not available in this setting | RVU15B |
| 2015-01-01 | $356.45 | Not available in this setting | RVU15A |
| 2014-10-01 | $383.12 | Not available in this setting | RVU14D |
| 2014-07-01 | $383.12 | Not available in this setting | RVU14C |
| 2014-04-01 | $383.12 | Not available in this setting | RVU14B |
| 2014-01-01 | $383.12 | Not available in this setting | RVU14A |
| 2013-10-01 | $410.59 | Not available in this setting | RVU13D |
| 2013-07-01 | $410.59 | Not available in this setting | RVU13C |
| 2013-04-01 | $410.59 | Not available in this setting | RVU13B |
| 2013-01-01 | $410.59 | Not available in this setting | RVU13AR |
Where the Houston, TX rate applies
Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 74178 in Houston · multiple payment areas
- Aldine
- Atascocita
- Barrett
- 74178 in Baytown · multiple payment areas
- Bellaire
- Bunker Hill Village
- Channelview
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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