# CPT 74178: CT abdomen and pelvis, without then with contrast

Medicare CPT 74178 pays $338.02 in a non-facility setting and $338.02 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $297.86 in Arkansas to $389.74 in District of Columbia, a 31% spread.

Web page: https://www.med-reveal.com/rates/74178-cpt-fee-schedule
Section: Diagnostic Imaging and Radiology
Billed by: Gastroenterology, Hematology & Oncology, Radiology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $338.02 |
| National facility | $338.02 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| District of Columbia | $389.74 | $389.74 |
| California | $387.10 | $387.10 |
| Alaska | $385.89 | $385.89 |
| Washington | $376.48 | $376.48 |
| New Jersey | $375.52 | $375.52 |
| New York | $373.85 | $373.85 |
| Hawaii | $372.56 | $372.56 |
| Massachusetts | $372.14 | $372.14 |
| Connecticut | $360.98 | $360.98 |
| Colorado | $354.83 | $354.83 |
| Oregon | $351.47 | $351.47 |
| Maryland | $350.63 | $350.63 |
| New Hampshire | $348.36 | $348.36 |
| Rhode Island | $347.55 | $347.55 |
| Florida | $343.65 | $343.65 |
| Minnesota | $342.25 | $342.25 |
| Puerto Rico | $340.88 | $340.88 |
| Virgin Islands | $340.88 | $340.88 |
| Montana | $338.01 | $338.01 |
| Nevada | $337.45 | $337.45 |
| Wyoming | $336.71 | $336.71 |
| North Dakota | $335.04 | $335.04 |
| South Dakota | $334.69 | $334.69 |
| Delaware | $334.63 | $334.63 |
| Texas | $333.87 | $333.87 |
| Illinois | $333.78 | $333.78 |
| Pennsylvania | $333.47 | $333.47 |
| Vermont | $332.87 | $332.87 |
| Virginia | $332.00 | $332.00 |
| Arizona | $329.00 | $329.00 |
| Georgia | $326.79 | $326.79 |
| Maine | $324.24 | $324.24 |
| Michigan | $323.74 | $323.74 |
| Wisconsin | $323.31 | $323.31 |
| Utah | $321.45 | $321.45 |
| North Carolina | $318.28 | $318.28 |
| South Carolina | $316.93 | $316.93 |
| New Mexico | $316.82 | $316.82 |
| Indiana | $315.91 | $315.91 |
| Missouri | $315.91 | $315.91 |
| Louisiana | $314.98 | $314.98 |
| Ohio | $314.78 | $314.78 |
| Nebraska | $314.30 | $314.30 |
| Idaho | $313.97 | $313.97 |
| Iowa | $312.25 | $312.25 |
| Tennessee | $311.35 | $311.35 |
| Kansas | $309.85 | $309.85 |
| Oklahoma | $308.27 | $308.27 |
| Kentucky | $307.89 | $307.89 |
| West Virginia | $305.13 | $305.13 |
| Alabama | $302.40 | $302.40 |
| Mississippi | $299.52 | $299.52 |
| Arkansas | $297.86 | $297.86 |

## Related codes

- 70450: CT head/brain, without contrast — https://www.med-reveal.com/rates/70450-cpt-fee-schedule
- 70460: CT head/brain, with contrast — https://www.med-reveal.com/rates/70460-cpt-fee-schedule
- 70470: CT head/brain, without then with contrast — https://www.med-reveal.com/rates/70470-cpt-fee-schedule
- 70480: CT orbit/sella/posterior fossa, without contrast — https://www.med-reveal.com/rates/70480-cpt-fee-schedule
- 70486: CT maxillofacial, without contrast — https://www.med-reveal.com/rates/70486-cpt-fee-schedule
- 70487: CT maxillofacial, with contrast — https://www.med-reveal.com/rates/70487-cpt-fee-schedule
- 70490: CT soft tissue neck, without contrast — https://www.med-reveal.com/rates/70490-cpt-fee-schedule
- 70491: CT soft tissue neck, with contrast — https://www.med-reveal.com/rates/70491-cpt-fee-schedule

Commercial negotiated rates for 74178 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules