Using the coda wave interferometry (CWI) method to obtain the ultrasonic coda wave characteristics of loaded concrete is an important method to evaluate the mechanical response of concrete. In this paper, the ultrasonic coda wave characteristics of C40–C70 concrete specimens (four strengths of concrete) under uniaxial compression were tested by laboratory experiments. Furthermore, to clarify the relationship between the internal damage process of concrete and the change rate of coda wave velocity, an ultrasonic coda wave discrete element simulation model combined with digital image processing technology was established. The results show that the coda wave is very sensitive to small changes in the compressive damage to concrete, and the change in coda wave velocity can correspond to the development process of concrete damage. This research is conducive to a better understanding of the complex material behavior of compressive concrete and proves the feasibility of ultrasonic field simulation and processing by using numerical simulation images of concrete damage.