CPT 74018Radiology

Radex abdomen 1 view

CPT code 74018 is used for a single-view X-ray of the abdomen, typically taken to evaluate abdominal pain, suspected obstruction, or foreign bodies. This is the most basic abdominal imaging study, capturing just one radiographic image.

Showing rates for

National Average

Base Medicare rate

$29.11

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.18

PE RVU (NF)

0.7

MP RVU

0.02

Total RVU

0.9

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify the exact number of views obtained before coding; use 74018 only for single-view studies
Impact: Prevents downcoding from multi-view codes (74019, 74021) which could reduce reimbursement by $10-15 per study, or upcoding which triggers audits
Bill the global code without modifiers when your facility provides both technical and professional components
Impact: Ensures full reimbursement of $29.11; splitting unnecessarily can lead to administrative costs exceeding any benefit
Document medical necessity clearly, especially for follow-up or repeat imaging within short timeframes
Impact: Reduces denial rate by approximately 30-40% for repeat studies; each denial costs $25-30 in administrative time to appeal
Confirm that more comprehensive imaging (CT, multi-view series) was not performed same day before billing 74018
Impact: Prevents bundling denials and potential compliance issues; unbundling violations can trigger audits with penalties exceeding $1,000
Use appropriate ICD-10 diagnosis codes that support medical necessity for single-view imaging rather than more comprehensive studies
Impact: Increases first-pass acceptance rate by 25-35%; common supporting diagnoses include R10.9 (abdominal pain), K59.00 (constipation), Z09 (follow-up)
When performed in hospital setting, ensure distinction between inpatient and outpatient status is coded correctly
Impact: Affects payment methodology; facility rate remains $29.11 but billing errors can delay payment by 15-30 days

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 74018 in 2025?

The 2025 Medicare national average reimbursement for CPT 74018 is $29.11 for both facility and non-facility settings. This rate is based on 0.9 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT codes 74018 and 74019?

CPT 74018 is for a single-view abdominal X-ray, while 74019 is for a two-view abdominal study. You must bill the code that matches the exact number of views obtained. Using 74018 when two views were taken constitutes undercoding, while billing 74019 for a single view is upcoding.

Can CPT 74018 be billed with modifier 26 for professional component only?

Yes, modifier 26 can be appended to 74018 when billing only the physician interpretation (professional component) separately, such as when a radiologist reads films from an outside facility. The technical component would be billed separately with modifier TC by the facility that performed the imaging.

What are the work RVUs for CPT code 74018?

CPT 74018 has 0.18 work RVUs, 0.7 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs, for a total of 0.9 RVUs in 2025 according to the CMS Physician Fee Schedule.

What diagnosis codes support medical necessity for CPT 74018?

Common supporting ICD-10 codes include R10.9 (unspecified abdominal pain), K59.00 (constipation), R19.4 (change in bowel habit), K56.60 (intestinal obstruction), and follow-up codes (Z09). Medical necessity depends on clinical presentation and appropriateness of single-view imaging for the clinical question.

Can CPT 74018 be billed on the same day as a complete abdominal series?

Generally no. If multiple views are obtained during the same session, you should bill the appropriate multi-view code (74019 for 2 views, 74021 for 3+ views) rather than separate single-view codes. Billing 74018 separately when part of a multi-view series constitutes unbundling and will likely be denied.

How often can CPT 74018 be billed for the same patient?

There is no specific frequency limitation, but each instance must be medically necessary and documented. Repeat imaging within short timeframes requires documentation of clinical change, new symptoms, or specific medical indication. Frequent repeat billing may trigger payer review for medical necessity.