$163.97–$241.76
Use 74176 for an abdomen-and-pelvis CT performed without contrast only. This code requires both unenhanced and post-contrast imaging.
On this page
CMS RVU26D · Effective 2026-10-01
74178 CT abdomen/pelvis Medicare reimbursement rates
Report this CT study when imaging covers both the abdomen and pelvis before contrast administration and again after contrast enhancement. Compare 74178 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 74178?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$297.86–$461.15
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $163.29 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 74178 pays more and less
109 payment localities
$297.86 to $461.15
Diagnostic imaging
About 74178: CT abdomen and pelvis without and with contrast
Report this CT study when imaging covers both the abdomen and pelvis before contrast administration and again after contrast enhancement.
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.
CMS billing rules for 74178
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
Where the value comes from
- Work RVU1.96 · 19%
- Practice expense (office) RVU8.01 · 79%
- Malpractice RVU0.15 · 1%
528.9K
Medicare services in 2024 · #223 by national volume
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.
74178 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$264.78–$409.43
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.
74170
No office rateCt abd wo cntrst flwd cntrst
74170 covers the abdomen only with unenhanced and post-contrast imaging. Choose this code when the examination also includes the pelvis.
$333.25–$516.71
74174 is for angiographic imaging of the abdomen and pelvis, rather than a routine CT examination with unenhanced and contrast-enhanced phases.
See how rates vary across the country
74178 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 74178 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $302.40 | Facility Unavailable |
| Alaska* | Office $385.89 | Facility Unavailable |
| Arizona | Office $329.00 | Facility Unavailable |
| Arkansas | Office $297.86 | Facility Unavailable |
| Atlanta | Office $343.50 | Facility Unavailable |
| Austin | Office $353.09 | Facility Unavailable |
| Bakersfield | Office $362.99 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $359.78 | Facility Unavailable |
| Beaumont | Office $313.58 | Facility Unavailable |
| Brazoria | Office $335.03 | Facility Unavailable |
| Chicago | Office $346.30 | Facility Unavailable |
| Chico | Office $362.49 | Facility Unavailable |
| Colorado | Office $354.83 | Facility Unavailable |
| Connecticut | Office $360.98 | Facility Unavailable |
| Dallas | Office $336.82 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $389.74 | Facility Unavailable |
| Delaware | Office $334.63 | Facility Unavailable |
| Detroit | Office $332.09 | Facility Unavailable |
| East St. Louis | Office $321.69 | Facility Unavailable |
| El Centro | Office $362.51 | Facility Unavailable |
| Fort Lauderdale | Office $345.54 | Facility Unavailable |
| Fort Worth | Office $334.21 | Facility Unavailable |
| Fresno | Office $362.49 | Facility Unavailable |
| Galveston | Office $335.81 | Facility Unavailable |
| Hanford-Corcoran | Office $362.49 | Facility Unavailable |
| Hawaii, Guam | Office $372.56 | Facility Unavailable |
| Houston | Office $338.55 | Facility Unavailable |
| Idaho | Office $313.97 | Facility Unavailable |
| Indiana | Office $315.91 | Facility Unavailable |
| Iowa | Office $312.25 | Facility Unavailable |
| Kansas | Office $309.85 | Facility Unavailable |
| Kentucky | Office $307.89 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $387.98 | Facility Unavailable |
| Madera | Office $362.49 | Facility Unavailable |
| Manhattan | Office $388.48 | Facility Unavailable |
| Merced | Office $362.49 | Facility Unavailable |
| Metropolitan Boston | Office $392.05 | Facility Unavailable |
| Metropolitan Kansas City | Office $321.58 | Facility Unavailable |
| Metropolitan Philadelphia | Office $351.13 | Facility Unavailable |
| Metropolitan St. Louis | Office $325.19 | Facility Unavailable |
| Miami | Office $356.65 | Facility Unavailable |
| Minnesota | Office $342.25 | Facility Unavailable |
| Mississippi | Office $299.52 | Facility Unavailable |
| Modesto | Office $362.49 | Facility Unavailable |
| Montana** | Office $338.01 | Facility Unavailable |
| Napa | Office $424.75 | Facility Unavailable |
| Nebraska | Office $314.30 | Facility Unavailable |
| Nevada** | Office $337.45 | Facility Unavailable |
| New Hampshire | Office $348.36 | Facility Unavailable |
| New Mexico | Office $316.82 | Facility Unavailable |
| New Orleans | Office $322.91 | Facility Unavailable |
| North Carolina | Office $318.28 | Facility Unavailable |
| North Dakota** | Office $335.04 | Facility Unavailable |
| Northern Nj | Office $385.29 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $397.07 | Facility Unavailable |
| Ohio | Office $314.78 | Facility Unavailable |
| Oklahoma | Office $308.27 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $386.65 | Facility Unavailable |
| Portland | Office $367.48 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $367.43 | Facility Unavailable |
| Puerto Rico | Office $340.88 | Facility Unavailable |
| Queens | Office $393.11 | Facility Unavailable |
| Redding | Office $362.49 | Facility Unavailable |
| Rest Of California | Office $362.49 | Facility Unavailable |
| Rest Of Florida | Office $328.77 | Facility Unavailable |
| Rest Of Georgia | Office $310.08 | Facility Unavailable |
| Rest Of Illinois | Office $317.56 | Facility Unavailable |
| Rest Of Louisiana | Office $307.04 | Facility Unavailable |
| Rest Of Maine | Office $314.72 | Facility Unavailable |
| Rest Of Maryland | Office $341.47 | Facility Unavailable |
| Rest Of Massachusetts | Office $352.23 | Facility Unavailable |
| Rest Of Michigan | Office $315.39 | Facility Unavailable |
| Rest Of Missouri | Office $300.97 | Facility Unavailable |
| Rest Of New Jersey | Office $365.74 | Facility Unavailable |
| Rest Of New York | Office $323.15 | Facility Unavailable |
| Rest Of Oregon | Office $335.46 | Facility Unavailable |
| Rest Of Pennsylvania | Office $315.80 | Facility Unavailable |
| Rest Of Texas | Office $323.89 | Facility Unavailable |
| Rest Of Washington | Office $351.85 | Facility Unavailable |
| Rhode Island | Office $347.55 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $364.14 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $381.66 | Facility Unavailable |
| Salinas | Office $380.26 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $390.12 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $451.22 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $451.05 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $461.15 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $460.45 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $373.99 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $394.59 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $381.94 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $398.66 | Facility Unavailable |
| Seattle (King Cnty) | Office $401.11 | Facility Unavailable |
| South Carolina | Office $316.93 | Facility Unavailable |
| South Dakota** | Office $334.69 | Facility Unavailable |
| Southern Maine | Office $333.76 | Facility Unavailable |
| Stockton | Office $362.49 | Facility Unavailable |
| Suburban Chicago | Office $349.57 | Facility Unavailable |
| Tennessee | Office $311.35 | Facility Unavailable |
| Utah | Office $321.45 | Facility Unavailable |
| Vallejo | Office $424.51 | Facility Unavailable |
| Vermont | Office $332.87 | Facility Unavailable |
| Virgin Islands | Office $340.88 | Facility Unavailable |
| Virginia | Office $332.00 | Facility Unavailable |
| Visalia | Office $362.49 | Facility Unavailable |
| West Virginia | Office $305.13 | Facility Unavailable |
| Wisconsin | Office $323.31 | Facility Unavailable |
| Wyoming** | Office $336.71 | Facility Unavailable |
| Yuba City | Office $362.49 | Facility Unavailable |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,31874177,,Ct abd & pelvis w/contrast,A,,1.77,7.09,,7.09,NA,0.13,8.99,8.99,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,09,0,88,11.27,11.27,0.14
8,31974177,26,Ct abd & pelvis w/contrast,A,,1.77,0.63,,0.63,,0.11,2.51,2.51,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,32074177,TC,Ct abd & pelvis w/contrast,A,,0.00,6.46,,6.46,NA,0.02,6.48,6.48,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,02,0,88,10.64,10.64,0.03
8,32174178,,Ct abd&plv wo cntr flwd cntr,A,,1.96,8.01,,8.01,NA,0.15,10.12,10.12,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,09,0,88,11.33,11.33,0.16
8,32274178,26,Ct abd&plv wo cntr flwd cntr,A,,1.96,0.70,,0.70,,0.12,2.78,2.78,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,32374178,TC,Ct abd&plv wo cntr flwd cntr,A,,0.00,7.31,,7.31,NA,0.03,7.34,7.34,1,XXX,0.00,0.00,0.00,4,0,9,0,0,9,,33.4009,02,0,88,10.63,10.63,0.04
8,32474181,,Mri abdomen w/o contrast,A,,1.42,4.29,,4.29,NA,0.09,5.80,5.80,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,7.76,7.76,0.11