Every CT code by body area, with the contrast, CTA and abdomen-pelvis rules that decide which one you bill
Most CT coding errors come from three rules: abdomen and pelvis scanned together need a combined code, CTA is not “CT with contrast,” and oral contrast doesn’t count as contrast at all. This guide gives you the full code list first, then each of those rules.
Looking for X-ray, MRI, ultrasound or another modality? Start with our radiology CPT codes cheat sheet, which covers every imaging modality in one place.
CT scan CPT codes are the AMA codes used to bill computed tomography studies, mostly in the 70450–75574 range. You pick the code from two facts in the report: the body area scanned and whether IV contrast was given. Most areas have three codes: without contrast, with contrast, and without followed by with.
Descriptions below are written in our own words. Confirm the official AMA descriptor in your 2027 CPT manual or encoder before you code.
Every standard CT region follows the same three-code pattern. Read across the row to find the code that matches the contrast phases in the report.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Head/brain | 70450 | 70460 | 70470 |
| Orbit, sella or ear | 70480 | 70481 | 70482 |
| Maxillofacial/sinus | 70486 | 70487 | 70488 |
| Soft tissue neck | 70490 | 70491 | 70492 |
70450 is the workhorse, one of the highest-volume codes in any ED. A sinus CT ordered as “CT face” still lands in the 70486 family, not the head codes.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Chest/thorax | 71250 | 71260 | 71270 |
Two chest codes sit outside that pattern: 71271 for low-dose lung cancer screening and 71275 for CT angiography of the chest. Both are covered below.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Cervical spine | 72125 | 72126 | 72127 |
| Thoracic spine | 72128 | 72129 | 72130 |
| Lumbar spine | 72131 | 72132 | 72133 |
Spine CT is almost always without contrast. When you see 72126, 72129 or 72132, it’s usually a CT myelogram, where the contrast is intrathecal.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Abdomen only | 74150 | 74160 | 74170 |
| Pelvis only | 72192 | 72193 | 72194 |
| Abdomen and pelvis together | 74176 | 74177 | 74178 |
The third row is the one that matters. If both regions were scanned in the same session, you use 74176, 74177 or 74178. Never the two single-region codes together.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Upper extremity | 73200 | 73201 | 73202 |
| Lower extremity | 73700 | 73701 | 73702 |
Extremity codes are per side. A CT of both knees goes on two lines of 73700, one with RT and one with LT.
| CPT Code | Study |
|---|---|
| 70496 | CTA head |
| 70498 | CTA neck |
| 71275 | CTA chest (PE study) |
| 72191 | CTA pelvis |
| 74175 | CTA abdomen |
| 74174 | CTA abdomen and pelvis |
| 73206 | CTA upper extremity |
| 73706 | CTA lower extremity |
| 75635 | CTA abdominal aorta with bilateral iliofemoral runoff |
| CPT Code | Study |
|---|---|
| 71271 | Low-dose CT for lung cancer screening |
| 75571 | Coronary calcium scoring |
| 75574 | CT angiography of the heart and coronary arteries |
| 74261 | Diagnostic CT colonography, without contrast |
| 74262 | Diagnostic CT colonography, with contrast |
| 74263 | Screening CT colonography |
| 76380 | Limited or follow-up CT study |
CPT counts contrast given intravenously, intra-arterially, intrathecally or intra-articularly. Oral or rectal contrast alone doesn’t count. A CT abdomen and pelvis with oral contrast only is 74176, not 74177. It’s a frequent upcoding finding in CT audits, and it usually comes from a charge rule keyed off the protocol name instead of the report.
The same logic works in reverse. If the IV infiltrated before any post-contrast images were taken, the study is without contrast, whatever the order said.
Billing 74150 plus 72192 for the same session is an NCCI edit hit every time. Use the combined family instead:
74178 is broader than people think. An abdomen done without and with contrast, plus a pelvis done with contrast only, is still 74178.
A CTA code needs angiographic technique and image post-processing, and the report has to say so. A routine contrast-enhanced chest CT that happens to show the pulmonary arteries is 71260, not 71275. Ask for a report template line that names the post-processing, so the coder doesn’t have to guess.
Don’t add 76376 or 76377 for 3D rendering on top of a CTA code. Post-processing is already part of the CTA descriptor, and that pairing denies as bundled.
A chest, abdomen and pelvis scan is two codes: 71260 and 74177. There is no single “CAP” code. Expect Medicare’s multiple procedure payment reduction on the second code. The technical component of the lower-paid study is cut by 50%, and the professional component by 5%. That’s a payment rule, not a denial, so don’t appeal it.
Orders say “CT abdomen.” Reports say “CT abdomen and pelvis with IV contrast.” The report wins every time. When the two don’t match and the study needed prior auth, update the auth before the claim goes out.
71271 is for screening only, in patients with no symptoms. Medicare covers it once a year for people aged 50 to 77 with at least a 20 pack-year smoking history who still smoke or quit within the last 15 years. Before the first scan, there must be a documented shared decision-making visit (G0296).
Pair it with Z12.2 for the screening, plus the tobacco code: Z87.891 for a former smoker or F17.21- for a current one. If the patient has symptoms or a known nodule, it isn’t screening anymore. Code 71250 with the diagnosis instead.
75571 is coronary calcium scoring, done without contrast. 75574 is coronary CTA with contrast, and its descriptor includes 3D post-processing. Many payers treat calcium scoring as a non-covered screening test. For Medicare patients, get a signed ABN before the scan, or plan on writing it off.
74261 and 74262 are diagnostic studies. 74263 is screening. Medicare added screening CT colonography as a covered colorectal cancer screening test in 2025, so check that your fee schedule and frequency edits caught up.
This takes two codes. The lumbar puncture and contrast injection are billed with the myelography code from the 62302–62305 range. The CT of the spine is billed with the “with contrast” spine code: 72126, 72129 or 72132. The intrathecal contrast is what makes it “with.” If only the CT was done, with no conventional myelogram images, the injection is 62284 instead.
Most CT denials have nothing to do with the read. They come from the auth, the code combination or the diagnosis.
| Denial | What Happened | Fix |
|---|---|---|
| CPT doesn't match auth | Auth was for 70450, the radiologist added contrast and it became 70470 | Update the auth with the payer or RBM within their window, usually 1–2 business days after the scan |
| No prior auth on file | Outpatient CT done without auth, or the auth expired | Check auth at scheduling and again on the day of service |
| Bundling (NCCI) | 74150 + 72192 in the same session | Use 74176–74178 |
| Bundling (NCCI) | 76376 or 76377 billed with a CTA code | Drop the 3D code; it's included |
| Upcoded contrast | 74177 billed when only oral contrast was given | Code from the report's contrast statement |
| Medical necessity | CT head billed with R51.9 (headache, unspecified) and no red flags documented | Code the documented red flags or neuro findings, or query the ordering provider |
| LDCT eligibility | 71271 without pack-years, quit date or a prior shared decision-making visit | Build those fields into the order form |
| Missing laterality | Extremity CT without RT or LT | Make RT/LT required for 732xx and 737xx codes |
| Modifier | When to Use It on CT |
|---|---|
| 26 | Radiologist reading a hospital CT. The hospital bills the technical side on its own claim |
| TC | Imaging center billing only the scan, with an outside group reading |
| RT / LT | Every extremity CT (732xx, 737xx), one line per side |
| 59 / XU | Two separate sessions the same day, such as a CT head at 8 a.m. and a repeat after a fall at 6 p.m. |
| 76 / 77 | Same study repeated the same day by the same radiologist (76) or a different one (77) |
| CT | Scanner doesn't meet the NEMA XR-29 dose standard. Medicare cuts the technical payment by 15% |
The CT modifier catches older imaging centers off guard. If your scanner lacks the XR-29 dose-check features, the modifier is required on the technical or global claim. Leaving it off doesn’t avoid the cut. It turns it into an overpayment you’ll have to return.
Almost every commercial and Medicare Advantage plan requires prior auth for outpatient CT and CTA, usually through a radiology benefit manager such as eviCore or Carelon. ED and inpatient CTs are generally exempt. Traditional Medicare doesn’t require prior auth for diagnostic CT.
Three habits prevent most auth denials:
CT pays well, so every auth mismatch and bundling edit costs real money. Our certified radiology coders check each CT claim against the report, the auth and current NCCI edits before it goes out.
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