CPT code 74178: CT abdomen/pelvis, without and with contrast2026 Medicare rate & RVUs in Virginia

Report this CT study when imaging covers both the abdomen and pelvis before contrast administration and again after contrast enhancement.

CMS RVU26DEffective Oct 1, 2026One payment locality528.9K Medicare services in 2024

In Virginia, Medicare pays $332.00 for 74178 in the office.

$332.00Office (non-facility)
Not available in this settingHospital or facility
−1.8%vs the national office rate ($338.02)

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.

We’ll open 74178 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 74178 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Virginia 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. Virginia pays $332.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

74178 in Virginia vs other payment areas
  1. Virginia · this page$332.00
  2. Los Angeles, CA · California$387.98+$55.98
  3. Washington, DC area · District of Columbia$389.74+$57.74
  4. Miami, FL · Florida$356.65+$24.65
  5. Chicago, IL · Illinois$346.30+$14.30
  6. Manhattan, NY · New York$388.48+$56.48
  7. Alaska · Alaska$385.89+$53.89

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

74178 in every other Medicare payment locality
Payment localityOfficeFacility
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—

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
74178 office rate range by state
State / territoryOffice rate rangeLocalities
AK$385.891
AL$302.401
AR$297.861
AZ$329.001
CA$362.49–$461.1529
CO$354.831
CT$360.981
DC$389.741
DE$334.631
FL$328.77–$356.653
GA$310.08–$343.502
GU$372.561
HI$372.561
IA$312.251
ID$313.971
IL$317.56–$349.574
IN$315.911
KS$309.851
KY$307.891
LA$307.04–$322.912
MA$352.23–$392.052
MD$341.47–$389.743
ME$314.72–$333.762
MI$315.39–$332.092
MN$342.251
MO$300.97–$325.193
MS$299.521
MT$338.011
NC$318.281
ND$335.041
NE$314.301
NH$348.361
NJ$365.74–$385.292
NM$316.821
NV$337.451
NY$323.15–$397.075
OH$314.781
OK$308.271
OR$335.46–$367.482
PA$315.80–$351.132
PR$340.881
RI$347.551
SC$316.931
SD$334.691
TN$311.351
TX$313.58–$353.098
UT$321.451
VA$332.00–$389.742
VI$340.881
VT$332.871
WA$351.85–$401.112
WI$323.311
WV$305.131
WY$336.711

See 74178 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 74178 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.96× 1.0001.9600
Practice expense8.01× 0.9837.8738
Malpractice0.15× 0.7060.1059
Total RVUs9.9397
Conversion factor× 33.4009

Office rate, Virginia$332.00

Office: (1.96 × 1 + 8.01 × 0.983 + 0.15 × 0.706) × $33.4009 = $332.00

Open 74178 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

How 74178 has changed in Virginia

74178 · Office / nonfacility

$332.00

Effective 2026-10-01

The base rate is $4.27 higher than on 2025-10-01, moving from $327.73 to $332.00 (1.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $327.73changed to$332.00

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $343.48changed to$327.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.34 changed to 8.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $337.88changed to$343.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $357.64changed to$337.88

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $371.16changed to$357.64

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $378.41changed to$371.16

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.78 changed to 8.66

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $370.47changed to$378.41

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.23 changed to 8.78
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $361.32changed to$370.47

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$361.32

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $353.32changed toNo rate

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $349.98changed to$353.32

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.79 changed to 7.84
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $349.88changed to$349.98

    • 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.

  13. July 1, 2015

    RVU15C

    $348.14changed to$349.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $374.10changed to$348.14

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.51 changed to 7.76
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $400.70changed to$374.10

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $400.70

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$332.00Not available in this settingRVU26D
2026-07-01$332.00Not available in this settingRVU26C
2026-04-01$332.00Not available in this settingRVU26B
2026-01-01$332.00Not available in this settingRVU26A
2025-10-01$327.73Not available in this settingRVU25D
2025-07-01$327.73Not available in this settingRVU25C
2025-04-01$327.73Not available in this settingRVU25B
2025-01-01$327.73Not available in this settingRVU25A
2024-10-01$343.48Not available in this settingRVU24D
2024-07-01$343.48Not available in this settingRVU24C
2024-04-01$343.48Not available in this settingRVU24B
2024-03-09$343.48Not available in this settingRVU24AR
2024-01-01$337.88Not available in this settingRVU24A
2023-10-01$357.64Not available in this settingRVU23D
2023-07-01$357.64Not available in this settingRVU23C
2023-04-01$357.64Not available in this settingRVU23B
2023-01-01$357.64Not available in this settingRVU23A
2022-10-01$371.16Not available in this settingRVU22D
2022-07-01$371.16Not available in this settingRVU22C
2022-04-01$371.16Not available in this settingRVU22B
2022-01-01$371.16Not available in this settingRVU22A
2021-10-01$378.41Not available in this settingRVU21D
2021-07-01$378.41Not available in this settingRVU21C
2021-04-01$378.41Not available in this settingRVU21B
2021-01-01$378.41Not available in this settingRVU21A
2020-10-01$370.47Not available in this settingRVU20D
2020-07-01$370.47Not available in this settingRVU20C
2020-04-01$370.47Not available in this settingRVU20B
2020-01-01$370.47Not available in this settingRVU20A
2019-10-01$361.32Not available in this settingRVU19D
2019-07-01$361.32Not available in this settingRVU19C
2019-04-01$361.32Not available in this settingRVU19B
2019-01-01$361.32Not available in this settingRVU19A
2018-10-01Additional calculation requiredNot available in this settingRVU18D
2018-07-01Additional calculation requiredNot available in this settingRVU18C
2018-04-01Additional calculation requiredNot available in this settingRVU18B
2018-01-01Additional calculation requiredNot available in this settingRVU18AR1
2017-10-01$353.32Not available in this settingRVU17D
2017-07-01$353.32Not available in this settingRVU17C
2017-04-01$353.32Not available in this settingRVU17B
2017-01-01$353.32Not available in this settingRVU17A
2016-10-01$349.98Not available in this settingRVU16D
2016-07-01$349.98Not available in this settingRVU16C
2016-04-01$349.98Not available in this settingRVU16B
2016-01-01$349.98Not available in this settingRVU16A
2015-10-01$349.88Not available in this settingRVU15D
2015-07-01$349.88Not available in this settingRVU15C
2015-04-01$348.14Not available in this settingRVU15B
2015-01-01$348.14Not available in this settingRVU15A
2014-10-01$374.10Not available in this settingRVU14D
2014-07-01$374.10Not available in this settingRVU14C
2014-04-01$374.10Not available in this settingRVU14B
2014-01-01$374.10Not available in this settingRVU14A
2013-10-01$400.70Not available in this settingRVU13D
2013-07-01$400.70Not available in this settingRVU13C
2013-04-01$400.70Not available in this settingRVU13B
2013-01-01$400.70Not available in this settingRVU13AR

Price 74178 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 74178PPRRVU2026_Oct_nonQPP.csv, line 8,321 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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