CT of the abdomen and pelvis together, done without contrast, used for kidney stones, bleeding, and in orthopedic care for retroperitoneal hematoma or psoas abscess concerns.
- Medicare
- $183.04
- Work RVU
- 1.7
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Clinical reason (suspected hematoma, abscess, postoperative bleeding)
- Statement that no contrast was given
- Regions covered in the scan
- Signed interpretation
- Order source when ordered by the ortho service in a trauma setting
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
74176 is the combined CT of the abdomen and pelvis without contrast. Orthopedic surgeons do not order this often, but it shows up after spine surgery when a retroperitoneal hematoma is suspected, for psoas abscess in a patient with back pain and fever, and after hip or pelvic surgery when there is concern for bleeding.
The biggest coding rule: if both the abdomen and pelvis are scanned in the same session, use the combined code. Do not bill 74150 (abdomen) and 72192 (pelvis) separately. CPT also says not to report 74176 to 74178 with 72192 to 72194 or 74150 to 74170 for the same session. That matters to ortho, because a dedicated bony pelvis CT for a pelvic or acetabular fracture is 72192 to 72194. If the trauma team already scanned the abdomen and pelvis and the ortho service wants reformats of the pelvis, those reformats are usually part of the same study, not a new CT.
If contrast is given, move to 74177 or 74178.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.7) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.48) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.7 |
| Practice expense RVU | 3.67 |
| Malpractice RVU | 0.11 |
| Total RVU | 5.48 |
| Medicare national rate | $183.04 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $183.04 |
HOPD (APC 5523) Hospital outpatient department | $243.77 |
Common denial reasons
The recurring reasons claims for CPT 74176 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Abdomen and pelvis billed as two separate codes
- Billed with 72192 for the same session
- Contrast documented but 74176 billed
- Duplicate claim when pelvic reformats were billed as a new CT
- Missing 26 modifier on a hospital read
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 74176 and 72192 together?
02Why would an orthopedic surgeon order 74176?
03What code is CT abdomen and pelvis with contrast?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the postoperative or back pain findings that prompted the scan, giving a clear reason for an abdomen and pelvis CT ordered from an orthopedic service.
See how Mira captures CPT 74176 documentation