CPT 74176Radiology

Ct abd & pelvis w/o contrast

CPT code 74176 covers a CT scan of the abdomen and pelvis performed without contrast dye. This imaging study provides detailed cross-sectional images to evaluate organs, blood vessels, and structures in the abdominal and pelvic regions.

Showing rates for

National Average

Base Medicare rate

$180.82

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

1.74

PE RVU (NF)

3.75

MP RVU

0.1

Total RVU

5.59

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

NCCI bundling edits

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Billing tips

Verify contrast use documentation before coding - distinguish between 74176 (no contrast), 74177 (with contrast), and 74178 (without and with contrast)
Impact: Prevents $50-150 reimbursement variance and reduces denial rate by 30-40% for contrast-related coding errors
Document medical necessity for non-contrast study explicitly, especially contraindications to contrast (renal function, allergies, medications)
Impact: Reduces medical necessity denials by 60%; payers often question why lower-cost non-contrast study was performed
Bill global code in outpatient settings; split with 26/TC modifiers only when professional and technical components are performed by different entities
Impact: Improper modifier use can reduce total reimbursement from $180.82 to only partial component payment
Ensure radiologist report clearly states 'abdomen AND pelvis' were examined; incomplete anatomic coverage may trigger downcoding to single-region codes
Impact: Prevents $40-60 reduction from downcoding to CPT 74150 (abdomen only) or 72192 (pelvis only)
Do not unbundle PACS storage, 3D reconstructions, or standard post-processing - these are included in 74176 payment
Impact: Attempting to bill separately results in denials and potential audit flags for unbundling
For Medicare patients, verify LCD/NCD coverage criteria and maintain supporting documentation for stone protocol or other specialized non-contrast techniques
Impact: Non-compliance with local coverage determinations can result in 100% payment denial ($180.82 loss per claim)

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 74176 in 2025?

The 2025 Medicare national average reimbursement for CPT 74176 is $180.82 for both facility and non-facility settings. This rate is based on 5.59 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

What is the difference between CPT codes 74176, 74177, and 74178?

CPT 74176 is CT abdomen and pelvis WITHOUT contrast ($180.82), 74177 is WITH contrast (higher reimbursement), and 74178 is WITHOUT contrast followed by WITH contrast (highest reimbursement). The codes are mutually exclusive and selection depends entirely on the contrast protocol actually performed and documented.

Can I bill CPT 74176 with modifier 26 for professional component only?

Yes, modifier 26 should be appended to 74176 when billing only the radiologist's interpretation and report, typically when a hospital or imaging center bills the technical component separately. The professional component represents approximately 30-40% of the total allowed amount. Never bill modifier 26 if providing both technical and professional services.

How many RVUs is CPT code 74176 worth in 2025?

CPT 74176 has 5.59 total RVUs in 2025, consisting of 1.74 work RVUs, 3.75 practice expense RVUs (both facility and non-facility), and 0.10 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Does CPT 74176 require prior authorization from Medicare or commercial payers?

Medicare does not typically require prior authorization for 74176, but many Medicare Advantage and commercial plans do require pre-authorization for advanced imaging. Requirements vary by payer and plan, so verify benefits before scheduling. Lack of prior authorization when required will result in claim denial regardless of medical necessity.

When should I use CPT 74176 instead of 74150 or 72192?

Use 74176 when both abdomen AND pelvis are scanned in a single examination without contrast. Use 74150 for abdomen only, or 72192 for pelvis only. Billing 74176 when only one region was examined constitutes overcoding and should be corrected with modifier 52 or by using the appropriate single-region code.

What diagnosis codes support medical necessity for CPT 74176?

Common supporting diagnoses include urolithiasis/kidney stones (N20-N23), abdominal pain (R10.x), hematuria (R31.x), suspected bowel obstruction (K56.x), trauma (S36-S37 series), and malignancy surveillance. Payers expect the diagnosis to justify why non-contrast imaging is appropriate rather than contrast-enhanced CT. Document specific contraindications to contrast when relevant.