CPT 74174Radiology

Cta abd&plvs w/contrast

CPT code 74174 covers a specialized CT scan (computed tomography angiography) of the abdomen and pelvis using contrast dye to visualize blood vessels. This advanced imaging helps doctors diagnose vascular problems, aneurysms, blockages, and bleeding in the abdominal region.

Showing rates for

National Average

Base Medicare rate

$374.25

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

2.2

PE RVU (NF)

9.2

MP RVU

0.17

Total RVU

11.57

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

NCCI bundling edits

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Billing tips

Verify and document contrast administration with type, volume, and route in radiology report - CTA codes require contrast by definition
Impact: Missing contrast documentation is the #1 reason for downcoding to non-contrast CT codes (74150/74176), resulting in $150-200 payment reduction
Bill complete global service (no modifier) when facility owns equipment and employs interpreting radiologist - most common in hospital outpatient settings
Impact: Ensures full $374.25 reimbursement rather than split component billing which creates administrative overhead
Do not bill 74174 with 74177 (CT abdomen/pelvis without and with contrast) on same encounter - 74177 is the more comprehensive code
Impact: Prevents automatic denial and recoupment; 74177 pays approximately $50-75 more than 74174 alone when both phases performed
Ensure medical necessity documentation includes specific clinical indication beyond screening - CTA requires vascular-specific indication
Impact: Prevents medical necessity denials that require appeal and delay payment by 30-90 days; vascular indications support 11.57 RVU complexity
Submit with appropriate ICD-10 codes indicating vascular pathology (I71.x for aortic aneurysm, K55.x for mesenteric ischemia, I70.x for atherosclerosis)
Impact: Increases first-pass acceptance rate by 35-40% compared to non-specific symptom codes; reduces denials requiring resubmission
Verify patient renal function (eGFR/creatinine) documented before contrast administration for compliance and liability protection
While not directly affecting reimbursement, missing renal function labs can trigger quality audits and compliance reviews that freeze payments

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 74174 in 2025?

The 2025 Medicare national average payment for CPT 74174 is $374.25 for both facility and non-facility settings. This rate is based on 11.57 total RVUs (2.2 work RVU, 9.2 practice expense RVU, 0.17 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 74174 and 74175?

CPT 74174 covers CT angiography of the abdomen AND pelvis together with contrast, while 74175 is specifically for CT angiography of the abdomen only. Code 74174 requires imaging and interpretation of both anatomic regions and typically has higher reimbursement due to the expanded coverage area.

Does CPT 74174 require prior authorization from Medicare or private insurance?

Medicare Advantage plans and most private insurers commonly require prior authorization for CPT 74174 due to its advanced imaging status and cost. Traditional Medicare Part B typically does not require prior auth but may conduct retrospective medical necessity reviews. Requirements vary by payer and state, so verify with specific insurance plans before scheduling.

Can you bill CPT 74174 with modifier 26 for professional component only?

Yes, modifier 26 can be appended to 74174 when billing only for the radiologist's interpretation and report, not the technical scanning service. This is common when an independent radiologist reads scans performed at a hospital or imaging center that bills the technical component separately with modifier TC.

What diagnosis codes support medical necessity for CPT 74174?

Strong supporting ICD-10 codes include I71.x (aortic aneurysm), K55.x (vascular disorders of intestine/mesenteric ischemia), I70.x (atherosclerosis), I74.x (arterial embolism/thrombosis), N28.0 (renal artery stenosis), and R10.0 (acute abdomen with vascular concerns). Non-specific symptom codes alone often trigger medical necessity denials.

How many RVUs is CPT code 74174 worth in 2025?

CPT 74174 has 11.57 total RVUs in 2025, consisting of 2.2 work RVUs, 9.2 practice expense RVUs (both facility and non-facility), and 0.17 malpractice RVUs. This makes it a moderately high-value diagnostic imaging code.

Can CPT 74174 and 74177 be billed together on the same day?

No, CPT 74174 (CTA abdomen/pelvis with contrast) and 74177 (CT abdomen/pelvis without and with contrast) should not be billed together for the same encounter. Code 74177 is the more comprehensive study that includes both non-contrast and contrast phases, and billing both would constitute improper unbundling that will result in denial.