CPT 74177
CT of the abdomen and pelvis, with contrast
A CT scan of the abdomen and pelvis with IV contrast, the go-to scan for abdominal pain in the ER: appendicitis, kidney stones, diverticulitis, bowel obstruction. The contrast agent itself is billed separately as a drug.
Billed to Medicare
$509
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$84
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
6x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 2,950,211 services.
Among the 8 imaging codes on this site with CMS figures, this gap ranks 2 of 8 (median 5.5x). The widest is CT scan of the head, without contrast at 6x.
Where this line goes wrong
Abdomen plus pelvis is one code
Coding rules combine the abdomen and pelvis into a single code. Two separate charges, one for a CT abdomen (74160) and one for a CT pelvis (72193), for the same session is an error.
With and without is another single code
If the scan was done without contrast first and then with, the correct code is 74178, not 74176 plus 74177.
Contrast units
The contrast dye appears under revenue code 0636 with its own code and unit count. Check the units against the volume in the imaging report.
Check it, then ask
- 1
Ask for the itemized bill and the imaging report, and check that each billed study has a report.
- 2
Check the two halves match: the facility line and the radiologist's line should carry the same code for the same date.
- 3
If the radiologist was out of network for an emergency visit or at an in-network facility, the No Surprises Act limits what you can be billed.
- 4
If you are self-pay, ask for the hospital's published cash price for the scan; it is usually a fraction of the list price.
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People also ask
Why is the contrast a separate charge?
Because it is a drug, billed by the millilitre under its own code. It is legitimate, but the units should match the dose recorded in the report.
Is a CT scan of the abdomen negotiable?
Yes, particularly the facility charge, which is where most of the cost sits. Hospitals publish a cash price for this code and many will accept a reduced amount on a self-pay balance.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.