Choosing the correct CT scan CPT code depends on two main details: the body area scanned and whether the study was performed without contrast, with contrast, or without contrast followed by contrast.
For example, a CT of the head without contrast uses CPT code 70450, a CT of the head with contrast uses 70460, and a CT of the head performed without and then with contrast uses 70470. The American College of Radiology recognizes these as a related family of CT codes based on the contrast protocol.
That pattern appears across many common CT examinations.
For providers, hospitals, imaging centers, and revenue cycle teams, the important point is that the CPT code must match the actual imaging protocol. The order, authorization, technologist record, radiology report, and final claim should tell the same story.
At RCMGen, we see CT coding as part of the larger claim-to-cash process. Accurate procedure coding supports cleaner claims, while incorrect contrast selection can create authorization mismatches, coding edits, denials, and unnecessary A/R work. Our revenue cycle operations cover medical coding, claims, denial management, and A/R follow-up for U.S. hospitals and physician groups.
CT scan CPT code chart for common studies
The following chart covers several of the most common diagnostic CT scan CPT codes used for noncontrast, contrast, and without-and-with-contrast examinations. ACR’s current coding resources reflect the 2026 CPT updates for radiology.
| CT study | Without contrast | With contrast | Without and with contrast |
| Head or brain | 70450 | 70460 | 70470 |
| Soft tissue neck | 70490 | 70491 | 70492 |
| Chest or thorax | 71250 | 71260 | 71270 |
| Abdomen | 74150 | 74160 | 74170 |
| Pelvis | 72192 | 72193 | 72194 |
| Abdomen pelvis | 74176 | 74177 | 74178 |
These codes describe diagnostic CT studies. Screening examinations, CT angiography, CT perfusion, cardiac CT, and other specialized imaging services can use different CPT codes.
For example, CPT 71271 describes low-dose CT for lung cancer screening, while CPT 71250 describes a diagnostic CT of the thorax without contrast. ACR specifically distinguishes the diagnostic thorax code family 71250, 71260, and 71270 from lung cancer screening code 71271.
What without contrast, with contrast, and combined CT studies mean
The words describing contrast matter because they change the CPT code.
CT without contrast
A CT without contrast means the diagnostic CT acquisition covered by the code was performed without the contrast component required for a contrast-enhanced CPT study.
For a head CT, 70450 is the common example. For a diagnostic chest CT, the corresponding noncontrast code is 71250. For an abdomen and pelvis CT, the combined noncontrast code is 74176.
A noncontrast CT is not automatically a lower-level version of a contrast examination. The physician selects the imaging protocol according to the clinical question. CMS coverage guidance recognizes that CT examinations may be ordered without contrast, with contrast, or without contrast followed by contrast.
From a billing standpoint, coders should report what the documentation supports, not what the original order was expected to become.
CT with contrast
A CT with contrast uses the CPT code assigned to a contrast-enhanced study of that anatomical area.
Common examples include 70460 for the head, 71260 for the chest, 74160 for the abdomen, 72193 for the pelvis, and 74177 for the abdomen and pelvis.
The distinction becomes important when the original order says one protocol but the final study uses another. The claim should reflect the service that was actually performed and documented, while the billing team should also confirm that the payer authorization remains valid for that service.
CT without and with contrast
A CT described as “without and with contrast” includes an initial noncontrast acquisition followed by the contrast-enhanced portion and additional imaging as required by the procedure.
This is not the same as billing one noncontrast CPT code plus one contrast CPT code for the same examination.
For example, when the complete head examination includes both phases, CPT 70470 represents the without-and-with-contrast study. The corresponding code is 71270 for the chest, 74170 for the abdomen, 72194 for the pelvis, and 74178 for the abdomen and pelvis.
Why separate contrast codes can create problems
The coding structure already provides a comprehensive code when both portions form one combined examination. Reporting separate “without contrast” and “with contrast” codes for the same study can conflict with coding edits and overstate the service.
CMS coding policy has long recognized this principle. Its guidance explains that separately reporting the noncontrast and contrast versions of the same examination can contradict the actual service when the CPT family provides a more comprehensive code.
For revenue cycle teams, this is one of the most important rules in CT coding: use the code that describes the complete study performed.
CT scan CPT codes by body area
The anatomy is just as important as the contrast status. A correct contrast designation attached to the wrong anatomical CPT family is still an incorrect claim.
CT head or brain CPT codes
The standard CT head family includes CPT 70450 without contrast, 70460 with contrast, and 70470 without and with contrast.
ACR specifically identifies these three codes as the CT head code family.
CMS also recognizes CT head examinations performed without contrast, with contrast, or without contrast followed by contrast.
The radiology report should clearly support the protocol. Coders should not infer a contrast phase from the diagnosis alone.
CT neck CPT codes
For routine soft tissue CT of the neck, the common code family is 70490 without contrast, 70491 with contrast, and 70492 without and with contrast.
Do not confuse a standard CT of the neck with CT angiography of the neck. CTA represents a different service and follows separate CPT coding rules.
That distinction is particularly important in 2026 because ACR reports radiology code changes involving CTA of the head and neck. Teams should use the current CPT code set when coding vascular CT examinations.
CT chest CPT codes
The diagnostic chest or thorax family includes 71250 without contrast, 71260 with contrast, and 71270 without and with contrast.
ACR identifies all three as diagnostic thorax studies.
Do not automatically use 71250 for every low-dose chest examination. CPT 71271 applies specifically to low-dose CT lung cancer screening when the service meets the applicable screening requirements. Diagnostic follow-up imaging can use 71250 when appropriate.
This distinction affects more than code selection. Screening and diagnostic examinations can have different medical necessity, ordering, documentation, and payer requirements.
CT abdomen CPT codes
For an abdomen-only CT, the common codes are 74150 without contrast, 74160 with contrast, and 74170 without and with contrast.
The coder should confirm that the examination covered the abdomen alone before choosing one of these codes. If the study includes both the abdomen and pelvis, the combined abdomen-pelvis code family may apply instead.
This is a common area where reviewing only the order can cause an error. The final radiology documentation should confirm the actual anatomical coverage.
CT pelvis CPT codes
For pelvis-only CT studies, the common code family is 72192 without contrast, 72193 with contrast, and 72194 without and with contrast.
As with abdominal CT, the documentation must distinguish a pelvis-only examination from a combined abdomen and pelvis examination.
When both regions are part of the same diagnostic CT study, coders should review the combined codes rather than automatically reporting separate abdominal and pelvic CPT codes.
CT abdomen and pelvis CPT codes
The combined abdomen and pelvis code family is one of the most frequently used groups in CT billing.
CPT 74176 describes the noncontrast study. CPT 74177 represents the contrast-enhanced study. CPT 74178 applies to the combined without-and-with-contrast examination.
CMS maintains coverage guidance specifically addressing CT of the abdomen and pelvis, including medical necessity for abdominal and pelvic CT examinations.
The distinction between an abdomen-only study and an abdomen-pelvis study should appear clearly in the report because the anatomical coverage changes the CPT selection.
Combined CT studies can mean two different things
The phrase “combined CT study” can cause confusion because people use it in two different ways.
Combined contrast phases
The first meaning refers to a study performed without contrast and then with contrast.
Examples include 70470 for the head, 71270 for the chest, 74170 for the abdomen, 72194 for the pelvis, and 74178 for the abdomen and pelvis.
In this situation, “combined” describes the imaging phases.
Combined anatomical regions
The second meaning refers to a CPT code that combines anatomical areas.
CPT 74176, 74177, and 74178 combine the abdomen and pelvis into one code family.
In this situation, “combined” describes anatomy.
The two concepts can appear together. CPT 74178, for example, represents a combined abdomen and pelvis examination that also includes both noncontrast and contrast imaging.
That is why coders should identify anatomy first and then determine the contrast status.
CT contrast billing and documentation
Correct CT scan CPT coding depends on more than selecting a number from a code table. The supporting documentation needs to establish what happened during the examination.
Contrast administration and the CT procedure
When contrast administration forms an integral part of a radiologic procedure such as CT, CMS NCCI policy states that the vascular access and contrast administration service are generally not separately reportable as administration procedures.
The 2026 NCCI Policy Manual specifically explains that when a CT or other radiologic procedure requires parenteral contrast, the vascular access and contrast administration are integral to the procedure.
That does not mean every contrast-related supply or payment rule works the same way in every setting. Hospital outpatient, physician office, independent diagnostic testing facility, and payer-specific rules can differ. Billing teams should check the applicable payment system and payer policy.
Match the authorization to the final CT protocol
Prior authorization creates another point of risk.
A payer may authorize a specific CT CPT code or a related family of imaging codes. If the radiologist changes the protocol because the clinical situation requires a different contrast approach, the billing team should confirm whether the authorization still supports the final CPT code.
ACR has advocated for payer authorization policies that recognize related families of imaging codes because clinical circumstances can require changes between noncontrast, contrast, and combined studies.
From an RCM perspective, checking this before claim submission is preferable to discovering the mismatch after a denial.
Support medical necessity
A technically correct CPT code does not by itself establish coverage.
The diagnosis, order, clinical indication, final report, payer medical policy, and any applicable Medicare coverage requirements need to support the service.
CMS coverage articles for CT examinations link specific CT code families to medical necessity requirements and diagnosis coding.
A clean CT claim therefore requires both procedure-code accuracy and diagnosis-code support.
Common CT scan CPT coding errors
One frequent error occurs when staff select the code from the original order without checking the final radiology report. If the protocol changed, the ordered study and performed study may no longer match.
Another problem occurs when a coder bills the noncontrast and contrast codes separately even though the CPT family provides a comprehensive without-and-with-contrast code.
Anatomical mismatches also create problems. An abdomen-only CPT code should not replace a documented abdomen and pelvis study, and separate regional codes should not automatically replace an available combined code.
Screening and diagnostic CT services can also be confused. The chest CT example is important because diagnostic 71250 and screening 71271 both describe noncontrast thoracic imaging but represent different services.
Finally, authorization mismatches can turn a correctly coded examination into a denied claim. A coding workflow should compare the performed service with the authorization before submission when the payer requires prior approval.
How we approach CT coding at RCMGen
At RCMGen, we treat CT coding as part of the entire revenue cycle rather than as an isolated code-entry step.
Our teams work across medical coding, claim submission, denial management, and A/R follow-up for U.S. hospitals, health systems, clinics, and physician groups.
For CT claims, that means the workflow should connect the physician order, authorization, actual protocol, radiology documentation, CPT code, diagnosis coding, payer edits, and final claim.
When those records align, the claim has a stronger foundation. When they do not align, the goal is to identify the discrepancy before the payer does.
We also recommend that providers verify code selection against the current CPT code set and applicable payer policies. CPT coding and payer requirements can change, and a coding reference should support, not replace, review of the actual documentation.
Frequently asked questions about CT scan CPT codes
What is the CPT code for a CT scan without contrast?
There is no single CPT code for every CT scan without contrast. The code depends on the anatomical area. Common examples include 70450 for the head, 71250 for the chest, 74150 for the abdomen, 72192 for the pelvis, and 74176 for the abdomen and pelvis.
What is the CPT code for a CT scan with contrast?
The code again depends on anatomy. Common examples include 70460 for the head, 71260 for the chest, 74160 for the abdomen, 72193 for the pelvis, and 74177 for the abdomen and pelvis.
What is the CT with and without contrast CPT code?
There is no single universal code. Common without-and-with-contrast CPT codes include 70470 for the head, 71270 for the chest, 74170 for the abdomen, 72194 for the pelvis, and 74178 for the abdomen and pelvis.
What is CPT code 74177?
CPT 74177 is used for a CT examination of the abdomen and pelvis with contrast. The documented examination, medical necessity, and payer requirements should support the code.
What is CPT code 74178?
CPT 74178 represents a CT examination of the abdomen and pelvis performed without contrast followed by contrast imaging. It is the combined contrast-phase code within the abdomen and pelvis CT family.
Can 70450 and 70460 be billed together?
For one complete head CT examination that includes both the noncontrast and contrast portions, the comprehensive code 70470 generally describes the service rather than separately reporting 70450 and 70460. CMS coding policy recognizes the problem with reporting separate without-contrast and with-contrast procedures when the code set provides a comprehensive service.
Is oral contrast enough to choose a with-contrast CT CPT code?
Do not select the CPT code based only on seeing the word “contrast” somewhere in the record. Review the complete imaging protocol and the applicable CPT definition. The radiology report and technical documentation should clearly support whether the examination meets the requirements of the with-contrast code.
Is CT angiography coded the same as a CT with contrast?
No. CT angiography is a separate type of examination with its own CPT coding structure. Do not substitute a routine contrast-enhanced CT code for a documented CTA or use a CTA code simply because IV contrast was administered.
Does Medicare use the same CT scan CPT codes?
Medicare uses CPT and HCPCS codes for covered physician and outpatient services, but coverage and payment depend on additional rules, including medical necessity, local or national coverage requirements, NCCI edits, place of service, and the applicable payment system. CMS provides its Physician Fee Schedule lookup resources for current CPT and HCPCS payment information.
Final takeaway
The correct CT scan CPT code starts with two questions: what anatomy did the CT cover, and what contrast protocol did the imaging team actually perform?
For the most common diagnostic studies, CPT code families distinguish without contrast, with contrast, and without-and-with-contrast examinations. Head CT uses 70450, 70460, and 70470. Diagnostic chest CT uses 71250, 71260, and 71270. Abdomen and pelvis CT uses 74176, 74177, and 74178.
The number matters, but the documentation behind the number matters just as much.
A strong CT billing process aligns the order, authorization, performed protocol, radiology report, CPT code, diagnosis, and payer requirements before the claim goes out. That approach helps providers reduce preventable coding errors and gives revenue cycle teams a cleaner claim to manage from submission through payment.
For current coding decisions, always verify the final code against the current CPT code set, CMS requirements where applicable, payer policy, and the patient’s documented service.