How much does Medicare pay for CPT 74178?

Medicare allowed an average of $176.76 per service and paid $134.97 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $928.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 74178?

Ct scan of abdomen and pelvis before and after contrast. It was billed 442,968 times to 430,174 Medicare beneficiaries by 11,347 providers in 2024.

Does 74178 pay differently in an office than a hospital?

Yes. The allowed amount averaged $259.00 in an office setting and $92.53 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 74178 most?

Diagnostic Radiology, with 377,932 services from 9,787 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Urology, Interventional Radiology.

CPT 74178

Ct scan of abdomen and pelvis before and after contrast

$176.76Medicare-allowed amount per service, averaged across 442,968 services

Providers submitted

$928.75

Asking price, not received

Medicare allowed

$176.76

The fee schedule figure

Medicare paid

$134.97

Balance is patient coinsurance

Providers submitted an average of $928.75 for this code and Medicare allowed $176.76 — 5.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $134.97 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $259.00
Hospital / facility: $92.53

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 224,128 services were billed in an office setting and 218,840 in a facility.

Services: 442,968
Beneficiaries: 430,174
Providers billing it: 11,347
Total allowed: $78,299,024

What Medicare pays for CPT 74178

Across 442,968 services billed by 11,347 providers to 430,174 beneficiaries, Medicare allowed an average of $176.76 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 74178

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	377,932	367,979	$164.49	9,787
Independent Diagnostic Testing Facility (IDTF)	21,206	20,306	$318.79	345
Urology	18,026	17,604	$241.23	527
Interventional Radiology	12,077	11,720	$158.23	363
Hematology-Oncology	3,451	2,906	$230.66	51
Nuclear Medicine	1,469	1,261	$210.20	28
Radiation Oncology	1,362	1,330	$260.74	31
Internal Medicine	1,265	1,173	$236.81	46
Physician Assistant	1,134	1,114	$244.92	30
Nurse Practitioner	1,098	1,092	$230.75	46
Medical Oncology	1,059	903	$228.70	12
Family Practice	841	809	$240.61	34
Undefined Physician type	474	444	$113.17	3
Emergency Medicine	331	325	$218.41	9
Vascular Surgery	222	222	$91.32	2

74178 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	50,675	$233.81	$157.39	1,082
Texas	40,450	$173.68	$132.67	921
Florida	37,406	$222.04	$171.78	791
New York	31,294	$221.13	$149.26	701
Illinois	17,367	$140.83	$102.67	520
North Carolina	15,280	$148.19	$115.45	389
Pennsylvania	14,633	$127.70	$93.03	477
Arkansas	12,837	$147.68	$126.43	161
Virginia	12,210	$171.87	$129.27	286
New Jersey	11,204	$242.13	$165.06	270
Georgia	10,810	$152.40	$118.88	296
Minnesota	10,588	$184.68	$133.27	326
Maryland	10,366	$245.91	$175.39	245
Massachusetts	10,210	$127.93	$89.51	307
Tennessee	9,888	$163.16	$133.62	281
Missouri	9,855	$132.40	$104.37	293
Ohio	9,842	$117.10	$88.43	295
Arizona	8,885	$235.81	$180.71	194
South Carolina	8,481	$139.83	$111.44	226
Alabama	8,262	$154.56	$126.27	228
Indiana	7,876	$148.34	$116.82	206
Michigan	7,538	$126.05	$94.73	262
Louisiana	7,329	$139.00	$111.80	180
Mississippi	7,303	$134.78	$111.02	163
Kentucky	5,743	$112.03	$86.89	130
Oklahoma	5,738	$119.65	$93.73	163
Washington	5,557	$171.93	$123.13	185
Colorado	5,472	$162.27	$117.23	187
Kansas	5,039	$137.97	$108.15	129
Nebraska	4,627	$132.43	$105.45	128
Wisconsin	4,554	$126.15	$94.94	183
Oregon	4,102	$137.63	$102.03	126
Iowa	3,664	$135.92	$106.98	109
Nevada	3,223	$228.29	$174.70	91
Connecticut	2,955	$190.40	$135.77	112
New Hampshire	2,088	$128.58	$95.16	71
Idaho	1,895	$115.43	$87.33	63
New Mexico	1,832	$153.81	$117.06	45
West Virginia	1,830	$96.25	$70.57	69
Delaware	1,693	$171.10	$125.34	29
Rhode Island	1,639	$192.42	$136.82	43
Utah	1,593	$164.92	$128.80	59
South Dakota	1,376	$142.61	$106.72	53
North Dakota	1,356	$93.64	$69.05	40
District of Columbia	1,044	$210.82	$147.61	32
Wyoming	911	$194.60	$146.72	26
Montana	889	$104.94	$76.26	36
Maine	742	$112.15	$82.42	38
Hawaii	726	$213.60	$148.52	28
Alaska	683	$211.40	$135.59	25
Vermont	574	$125.24	$88.98	19
Puerto Rico	379	$232.56	$174.47	17
Guam	271	$371.81	$241.39	6
AA	87	$89.74	$67.40	2
AP	47	$92.18	$69.13	1
ZZ	35	$89.19	$63.87	1

Related codes

74177Ct scan of abdomen and pelvis$105.68
74176Ct scan of abdomen and pelvis without contrast$90.05
74183Mri scan of abdomen before and after contrast$175.35
74174Ct scan of blood vessels of abdomen and pelvis$117.69
74181Mri scan of abdomen without contrast$93.69
74170Ct scan of abdomen before and after contrast$127.64
74160Ct scan of abdomen$107.50
74150Ct scan of abdomen without contrast$93.55
74175Ct scan of blood vessels of abdomen$104.72
74185Mri scan of blood vessels of abdomen$211.76

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.