CPT
70450 — CT scan of head/brain without contrast
Same scan can cost 5x more at a hospital than at an imaging center.
Imaging
74181 — MRI abdomen; without contrast material
An MRI of the abdominal organs (liver, spleen, pancreas, kidneys, and surrounding structures) performed without contrast dye injection.
- Typical setting: Hospital, imaging center
- National avg charge (illustrative): $250–$600 Medicare allowed; $400–$1,400 commercial; varies by region
- Most-disputed reason: Billing 74181 (without contrast) when contrast was administered — use 74182 (with contrast) or 74183 (without and with contrast)
What it means
What 74181 actually means
An MRI of the abdominal organs (liver, spleen, pancreas, kidneys, and surrounding structures) performed without contrast dye injection. It is used to characterize liver lesions, evaluate the pancreas, and assess abdominal pathology in patients who cannot receive iodine-based CT contrast.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 74181 (without contrast) when contrast was administered — use 74182 (with contrast) or 74183 (without and with contrast)
- Billing 74181 instead of the more specific liver/organ MRI codes when a targeted organ study was performed
- Professional and technical component split-billing errors when the interpreting radiologist and the facility each bill for the full global code
If you see 74181 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 74181 often also see these adjacent codes on the same bill.
CPT
70470 — CT head/brain with and without contrast
If contrast wasn't given, 70470 is the wrong code.
CPT
70486 — CT maxillofacial area; without contrast material
Imaging — verify professional + technical components weren't double-billed.
CPT
70551 — MRI brain without contrast
Same scan can be 5x cheaper at a freestanding imaging center.
CPT
71045 — Chest X-ray, single view
Same image can cost 10x more at a hospital than a freestanding imaging center.
CPT
71046 — Chest X-ray, two views (PA + lateral)
Two-view CXR is standard. Watch the price gap between hospital and freestanding.
Related BillBusted guides
Plain-English reads if you see 74181 on a bill.
74181 FAQ
Plain-English answers.
What does 74181 usually cost?
$250–$600 Medicare allowed; $400–$1,400 commercial; varies by region. Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 74181?
Billing 74181 (without contrast) when contrast was administered — use 74182 (with contrast) or 74183 (without and with contrast)
What should I do if I see 74181 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 74181 before paying.
Don't pay 74181 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.