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SpecialistBase2026 Compliant

CPT 74177

2026 Billing Guide

CT Abd & Pelv w/ Contrast

Reimbursement

$182.70

Threshold

N/A

2026 Status

Active

What is CPT Code 74177?

CPT 74177 is defined as: Computed tomography, abdomen and pelvis; with contrast material(s). This is a combination code used when both the abdominal and pelvic regions are imaged using computed tomography with the administration of intravenous contrast.

This code is primarily used for Specialist services. It falls under the category of Diagnostic Radiology / CT and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.18

Physician Effort

PE (Non-Fac)

4.2

Practice Expense

Malpractice

Risk Factor

Total RVU

5.47

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency adjustment

Non-time-based scanning is a primary target for the -2.5% productivity adjustment, reducing Technical Component (TC) value.

equipment throughput

CMS assumes modern scanners allow higher throughput, justifying the reduction in per-unit equipment cost allocation.

bundling mandate

74177 is a mandated combination code; separate billing of abdomen (74160) and pelvis (72193) components is prohibited.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)23 (Emergency Room)

NCCI Exclusions

Do not bill with:74160 (Bundled)72193 (Bundled)

Key Modifiers

26Professional Component (interpretation only).
59Distinct procedural service (rarely used with 74177 combo).

Operational Requirements

minimum time

Procedure-based

staff type

Radiologist (interpretation), Radiologic Technologist (scan)

frequency

Based on medical necessity for staging or acute evaluation.

add on codes

contrast definition

Requires intravenous contrast. Oral-only contrast is coded as 'without contrast' (74176).

Compliance Checklist

Medical necessity for both abdomen and pelvis imaging.
Type and amount of IV contrast administered.
Formal interpretation report by a radiologist.

Audit Defense

No specific audit defense elements defined.

Common Clinical Scenarios

Staging for ovarian cancer (requires both abdomen and pelvis imaging).
Evaluation of generalized abdominal pain with suspicion of complicated diverticulitis.

CMS Eligibility: Evaluation of multi-organ systems in the abdomen and pelvis.. Acute or chronic evaluation.

Target Specialties & Utilization

RadiologyOncologyEmergency MedicineGeneral Surgery

Typical Clinical Indications (ICD-10)

R10.9 (Unspecified abdominal pain)C56.9 (Malignant neoplasm of unspecified ovary)K57.32 (Diverticulitis of large intestine without perforation or abscess without hemorrhage)

Billing Differentiation

VS 74176

74176 is without contrast; 74177 is with contrast.

VS 74178

74178 is 'without, followed by with' (multi-phasic).

Frequently Asked Questions

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CPT Code 74177 for CT Abd & Pelv w/ Contrast - 2026 Reimbursement & Rules