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CPT 74177: CT Abdomen and Pelvis With Contrast
CPT code 74177 represents a contrast-enhanced computed tomography (CT) scan of the abdomen and pelvis used to diagnose abdominal or pelvic pain and detect internal organ abnormalities. This imaging procedure is a high-volume diagnostic study in acute and outpatient settings and is central to workups for suspected obstruction, nephrolithiasis, appendicitis, and metastatic disease. Nationally, contrast-enhanced abdominal and pelvic CTs are critical for rapid diagnosis and care pathway decisions across emergency departments, inpatient services, and outpatient imaging.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical indication and typical sites of service, comparisons to related CT abdomen/pelvis codes, and the payer landscape addressed in the analysis. The publication also outlines common diagnostic ICD-10 presentations that prompt use of this study and lists closely related CPT services for coding context.
This piece is intended to inform billing, clinical, and administrative stakeholders about the role of CPT code 74177 in diagnostic pathways, payer coverage considerations, and coding relationships to alternative CT abdomen and pelvis services.
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Billing Code Overview
CPT code 74177 describes a computed tomography (CT) scan of the abdomen and pelvis performed with contrast material. The service is intended to evaluate causes of abdominal or pelvic pain and to identify abnormalities of internal organs within the abdominal and pelvic cavities.
Service Type: Diagnostic imaging — CT with intravenous and/or oral contrast
Typical Site of Service: Hospital outpatient imaging centers, hospital emergency departments, and ambulatory radiology clinics
National Reimbursement Benchmarks
National averages show a clear split between government and commercial reimbursement for CPT 74177: Medicare’s mean of $208.5 sits well below BUCA’s mean commercial level of $790.4, highlighting that BUCA reimbursements are roughly $581.9 higher than Medicare on average. This gap underscores the material premium commercial networks can pay versus Medicare for the same imaging service.
Looking at dispersion (P75–P25) to gauge variability, Blue Cross Blue Shield has the widest interquartile spread at $486.0 ($1,380.2 − $907.2), followed by BUCA at $357.5 ($952.9 − $579.4). UnitedHealth Group’s spread is $226.8 and Cigna’s is $279.7, while Aetna shows the tightest spread at $221.0. Medicare’s interquartile spread is $201.5 ($289.5 − $88.0), reflecting relatively lower variability compared with most commercial payers.