CPT 74190Radiology

Peritoneogram rs&i

CPT code 74190 covers a peritoneogram, which is an imaging study where contrast dye is injected into the peritoneal cavity (the space around abdominal organs) and X-rays are taken to visualize the cavity and detect abnormalities like fluid collections or organ perforations.

Showing rates for

National Average

Base Medicare rate

$21.03

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

0.48

PE RVU (NF)

0.14

MP RVU

0.03

Total RVU

0.65

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

NCCI bundling edits

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Billing tips

Verify that the code descriptor 'RS&I' (radiologic supervision and interpretation) matches the actual service provided; if the physician only interprets images obtained elsewhere, consider whether this is the appropriate code
Impact: Prevents upcoding denials and potential compliance issues that could trigger audits of all radiology claims
Document the medical necessity for performing peritoneography rather than alternative imaging (CT, ultrasound) as payers may deny this older technique as not medically necessary
Impact: Reduces denial rate by 40-60% when clear clinical rationale is documented in the ordering physician's notes and radiologist's interpretation
Ensure the dictated report includes specific documentation of both the supervision of the injection and the interpretation of fluoroscopic/radiographic images, not just a final impression
Impact: Comprehensive documentation prevents the $21.03 payment from being denied or downcoded for incomplete service documentation
Bill on the date of interpretation, not the date of contrast injection if these occur on different days, and document the delay reason
Impact: Ensures timely filing and prevents claim denials for date-of-service discrepancies
When performed in conjunction with catheter placement or adjustment, verify whether the imaging is bundled into the procedure code or separately billable with modifier 59
Impact: Proper modifier use can preserve the full $21.03 payment; incorrect bundling results in 100% payment loss
For peritoneal dialysis patients, coordinate with nephrology to ensure the study meets LCD/NCD criteria and that ABN is obtained if coverage is questionable

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 74190?

The 2025 Medicare national average reimbursement for CPT 74190 is $21.03 for both facility and non-facility settings, based on 0.65 total RVUs and the 2025 conversion factor of 32.3465.

What is included in CPT code 74190 for peritoneogram billing?

CPT 74190 includes radiologic supervision and interpretation (RS&I) of a peritoneogram study. This encompasses the physician's supervision of contrast injection into the peritoneal cavity and the professional interpretation of the resulting fluoroscopic or radiographic images, but not the technical component of equipment or contrast materials.

Can CPT 74190 be billed with modifier 26 for professional component only?

While modifier 26 can technically be appended, the identical facility and non-facility rates ($21.03) suggest this code already represents primarily professional work. Verify with the specific payer whether they recognize a technical component split for this code, as many consider it a professional-only service.

What documentation is required to bill CPT 74190 successfully?

Required documentation includes medical necessity for choosing peritoneography over alternative imaging, informed consent, contrast type and volume, description of radiologic supervision during injection, number and type of images obtained, detailed interpretation of all images, and a physician-signed final report with impression.

How many RVUs is CPT 74190 worth in 2025?

CPT 74190 has 0.65 total RVUs in 2025, comprising 0.48 work RVUs, 0.14 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs.

What are common denial reasons for CPT code 74190?

Common denials include lack of medical necessity (payer prefers CT or ultrasound), incomplete documentation of supervision and interpretation components, inappropriate bundling with other procedures performed the same day, and frequency limitations when similar recent imaging exists.

What medical specialties typically bill CPT code 74190?

CPT 74190 is primarily billed by diagnostic radiologists, interventional radiologists, and abdominal imaging specialists who perform and interpret fluoroscopic or radiographic studies of the peritoneal cavity in hospital radiology departments or outpatient imaging centers.