Magnetic resonance angiography of the abdomen, with or without contrast, to evaluate the aorta and its branches, renal arteries, or mesenteric vessels.
- Medicare
- $335.68
- Work RVU
- 1.76
- 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 ↓
- Vascular question being answered (vessel anatomy for anterior approach, vascular claudication)
- Coverage check against the Medicare MRA NCD
- ABN when the indication is not covered
- Signed interpretation describing the vessels
- Authorization for commercial plans
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 ↓
74185 is MR angiography of the abdomen. It is a vascular study, mostly ordered by vascular surgery, nephrology, or internal medicine. Orthopedic and spine practices see it in a few situations: planning an anterior lumbar interbody fusion when the surgeon needs to know where the aortic bifurcation and iliac vessels sit and the patient cannot have iodinated contrast, and evaluating vascular causes of leg symptoms that mimic spinal stenosis.
The status indicator is R. Medicare covers abdominal MRA only for indications listed in its national coverage determination for magnetic resonance angiography. Vascular mapping before spine surgery is not a use the NCD names, so expect to need an ABN for Medicare patients and prior authorization for commercial plans.
One code covers the study with or without contrast. If a separate MRI of the lumbar spine is done the same day, it is billed on its own code with its own report. Bill 26 when only reading the study.
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 (1.76) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (10.05) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.76 |
| Practice expense RVU | 8.14 |
| Malpractice RVU | 0.15 |
| Total RVU | 10.05 |
| Medicare national rate | $335.68 |
| 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 | $335.68 |
Common denial reasons
The recurring reasons claims for CPT 74185 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Indication not covered by the Medicare MRA NCD
- No ABN on file
- Spine diagnosis only, with no vascular reason
- Missing commercial authorization
- Bundling confusion with a same-day spine MRI
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Does Medicare cover abdominal MRA for spine surgery planning?
02Is there a separate code for abdominal MRA with contrast?
03What does status R mean on 74185?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes record why vascular imaging is needed before an anterior spine approach or for atypical leg symptoms, giving the payer a reason that fits an MRA.
See how Mira captures CPT 74185 documentation