CPT 74177: CT abdomen/pelvis w/contrast
What this code means, what it should cost, and how to dispute an overcharge.
Fair Price Reference
What is CPT 74177?
CPT 74177 (CT abdomen/pelvis w/contrast) is a radiology billing code defined by the American Medical Association. It's used to bill your insurance or you directly for this service.
What CPT 74177 should cost
The Centers for Medicare & Medicaid Services (CMS) pays approximately $264 for CPT 74177 under the 2025 Physician Fee Schedule. This is what the federal government has determined is a reasonable payment for this service.
Private insurance typically pays 1.2–1.8x Medicare rates ($317–$475). Hospital chargemaster prices for CPT 74177 often range from $600 to $3000 — a markup of 2.3x to 11.4x over Medicare.
Common overcharges on CPT 74177
Facility-fee stacking at hospital-owned imaging centers. Separate billing for contrast injection codes that are bundled with the scan code. Billing 'with and without contrast' codes when only one was performed.
About Radiology billing
Medical imaging has among the largest price variations of any medical service. The same MRI can cost $400 at an independent imaging center or $6,000 at a hospital-owned facility.
Request site-of-service information. Compare the charge against Medicare allowable and typical self-pay rates at independent imaging centers. Dispute any contrast charges not documented in the radiology report.
How to dispute a CPT 74177 overcharge
- Request the itemized bill. You are entitled to a detailed line-by-line bill showing every CPT code billed. Ask in writing.
- Compare to Medicare allowable. If the charge exceeds 150% of Medicare ($396), you have grounds to dispute.
- Request documentation. For E&M codes, ask for the visit note. For procedures, ask for the operative report. The documentation must justify the code billed.
- Send a formal dispute letter. Cite the specific discrepancy between the documentation and the code. Reference Medicare rates and NCCI edits where applicable.
- Follow up in writing. Give the provider 30 days to respond. If they don't, escalate to the state attorney general and insurance commissioner.
Got CPT 74177 on your bill?
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