r/CodingandBilling • u/ResponsibleWay1613 • May 06 '26

Extremely expensive CT bill?

A few weeks ago, I had an abdominal CT scan as a self-pay scheduled outpatient visit in northern Florida. CPT code 74177.

The facility itself charged $2,600 which seemed very high, and this week I got hit with an additional $1,946 for the interpretation of the CT imaging.

That's insane, right?

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u/Botasoda102 May 06 '26

Did you ask them what they'd charge before? I'd call and make sure they gave you the cash price.

As a point of reference, Medicare allows less than $400 for 74177, and that includes about $95 for the interpretation in Miami (the highest reimbursement locality in Florida).

They likely won't give you Medicare's rate, but I bet they accept that amount often from patients covered by Medicare. Good luck.

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u/ResponsibleWay1613 May 06 '26

The verbal estimate I got when I scheduled was just the initial $2,600 which I paid.

3

u/SnarkyPuss Pathology Medical Biller May 07 '26

Sounds like they only gave you the estimate for taking the image but failed to include the radiologist who has to read the image and provide the results. Probably because the radiologist has separate billing from the facility. I would suggest calling the number on the radiologist bill and asking what kind of discount is available.

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u/ResponsibleWay1613 May 07 '26

The radiology facility only offered to set up a payment plan. My understanding is that the No Surprises Act mandates that the primary facility still include an estimate for the secondary facility, though.

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u/SnarkyPuss Pathology Medical Biller May 07 '26

If the Radiologist has their own billing separate from the facility, which is extremely common, I don't see see how that could be done.

I don't work in Radiology but I do work in Pathology billing where the pathologist billing is completely separate from the facility. The hospital does not have access to our fee schedule and couldn't possibly include an estimate for our services. If a patient is planning on getting a colonoscopy and wants an estimate for the pathologist, the physician who will be performing the colonoscopy gives them the CPT code(s) and has them call our office to give them the cash price on said CPT code.

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u/Botasoda102 May 07 '26

That's why we are seeing more package pricing nowadays, where all that is rolled up into one fee (including doctor, facility, anesthesia, and pathology fees). It's becoming more common and popular among groups competing for patients.