| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,570 |
$13,925 |
4.3× |
| Abdomen 2 views (74019) |
$561.60 |
$1,404 |
5.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,572.40 |
$3,931 |
4.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,452.40 |
$11,131 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,675.60 |
$6,689 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,462 |
$6,155 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$6,882.40 |
$17,206 |
2.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,248 |
$8,120 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,847.20 |
$7,118 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,377.20 |
$8,443 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$7,548.40 |
$18,871 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,016.60 |
$7,541.50 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$667.20 |
$1,668 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,333.20 |
$8,333 |
1.1× |
| Ankle 2 views (73600) |
$365.60 |
$914 |
4.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$870 |
$2,175 |
2.7× |
| Aortogram thoracic (75605) |
$4,612.80 |
$11,532 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,120 |
$12,800 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,128.80 |
$10,322 |
1.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$7,011.60 |
$17,529 |
2.4× |
| Artery X-Rays Adrenal Gland (75731) |
$4,367.20 |
$10,918 |
1.5× |
| Arthrogram elbow (73085) |
$1,464.40 |
$3,661 |
4.5× |
| Arthrogram hip (73525) |
$799.60 |
$1,999 |
2.5× |
| Arthrogram shoulder (73040) |
$1,036.40 |
$2,591 |
3.2× |
| Arthrogram wrist (73115) |
$1,206 |
$3,015 |
3.7× |
| Arthrography knee lt (73580) |
$1,614.40 |
$4,036 |
5.0× |
| Basic radiation dosimetry calculation (77300) |
$644 |
$1,610 |
5.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,723.20 |
$4,308 |
4.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,081.20 |
$5,203 |
5.6× |
| Bone &/joint imaging whole body (78306) |
$2,238 |
$5,595 |
6.0× |
| Bone age studies (77072) |
$196 |
$490 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,640.40 |
$6,601 |
7.1× |
| Bone Marrow Imaging Limited Area (78102) |
$1,358 |
$3,395 |
3.7× |
| Bone survey complete (77075) |
$1,105.20 |
$2,763 |
11.4× |
| Brachytx isodose complex (77318) |
$1,579.20 |
$3,948 |
4.5× |
| Brachytx isodose intermed (77317) |
$1,090.40 |
$2,726 |
3.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$862.40 |
$2,156 |
2.5× |
| Brain image w/flow 4 + views (78606) |
$1,226 |
$3,065 |
2.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,977.20 |
$4,943 |
5.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$2,002.80 |
$5,007 |
4.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,000.80 |
$12,502 |
3.8× |
| Brain Imaging Vascular Flow Only (78610) |
$2,151.60 |
$5,379 |
4.3× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$1,056 |
$2,640 |
95.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,637.60 |
$4,094 |
3.2× |
| Cervical spine 2 or 3 views (72040) |
$464.40 |
$1,161 |
5.7× |
| Chest 1 view (71045) |
$320.80 |
$802 |
4.0× |
| Chest 3 views (71047) |
$364.80 |
$912 |
4.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$464.40 |
$1,161 |
2.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,464.40 |
$3,661 |
2.0× |
| Clavicle complete (73000) |
$381.20 |
$953 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$396.80 |
$992 |
4.1× |
| Continuing medical physics consltj pr wk (77336) |
$946.60 |
$2,366.50 |
7.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$648 |
$1,620 |
4.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,328.80 |
$15,822 |
19.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,707.20 |
$11,768 |
21.2× |
| CT abdomen w contrast (74160) |
$2,875.60 |
$7,189 |
17.6× |
| CT abdomen w wo contrast (74170) |
$4,970.80 |
$12,427 |
30.5× |
| CT abdomen w/o contrast (74150) |
$2,300.40 |
$5,751 |
23.7× |
| CT angio hrt w/3d image (75574) |
$908.80 |
$2,272 |
2.8× |
| CT angiography upper extremity lt (73206) |
$1,592.40 |
$3,981 |
9.8× |
| CT c-spine w/o contrast (72125) |
$2,665.60 |
$6,664 |
27.4× |
| CT cervical spine w&w/o contrast (72127) |
$4,051.60 |
$10,129 |
24.8× |
| CT cervical spine with contrast (72126) |
$3,465.20 |
$8,663 |
10.7× |
| CT chest w/wo contrast (71270) |
$3,626.40 |
$9,066 |
22.2× |
| CT chest with contrast (71260) |
$3,052.40 |
$7,631 |
18.7× |
| CT colonography w/dye (74262) |
$855.20 |
$2,138 |
5.2× |
| CT head/brain with contrast (70460) |
$2,592 |
$6,480 |
15.9× |
| CT head/brain without and with contrast (70470) |
$3,283.20 |
$8,208 |
20.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$908.80 |
$2,272 |
2.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$772.40 |
$1,931 |
9.5× |
| CT hrt w/3d image congen (75573) |
$908.80 |
$2,272 |
2.8× |
| CT iac w contrast (70481) |
$2,591.60 |
$6,479 |
15.9× |
| CT limited/localized follow up study (76380) |
$1,223.20 |
$3,058 |
15.1× |
| CT lower ext w/o (73700) |
$2,020 |
$5,050 |
20.8× |
| CT lower extremity w wo contrast (73702) |
$2,620.40 |
$6,551 |
16.1× |
| CT lower extremity with contrast (73701) |
$2,350.80 |
$5,877 |
14.4× |
| CT lumbar spine w & w/o contrast (72133) |
$4,102 |
$10,255 |
25.1× |
| CT lumbar spine w/o contrast (72131) |
$2,771.60 |
$6,929 |
28.5× |
| CT lumbar spine with contrast (72132) |
$3,464.40 |
$8,661 |
10.7× |
| CT maxillofacial w contrast (70487) |
$2,481.60 |
$6,204 |
15.2× |
| CT maxillofacial w/o contrast (70486) |
$2,085.20 |
$5,213 |
21.4× |
| CT maxillofacial w/wo contrast (70488) |
$3,003.20 |
$7,508 |
18.4× |
| CT neck soft tissue w contrast (70491) |
$2,430.40 |
$6,076 |
14.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,369.20 |
$8,423 |
20.7× |
| CT orbits w/o contrast (70480) |
$2,591.60 |
$6,479 |
26.7× |
| CT pelvis w & w/o contrast (72194) |
$3,678.40 |
$9,196 |
22.5× |
| CT pelvis w/o contrast (72192) |
$2,648 |
$6,620 |
27.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,916.80 |
$7,292 |
17.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,969.20 |
$4,923 |
20.3× |
| CT thoracic spine w/contrast (72129) |
$3,676.40 |
$9,191 |
22.5× |
| CT thoracic spine w/o contrast (72128) |
$2,806.40 |
$7,016 |
28.9× |
| CT thoracic spine w/wo contrast (72130) |
$4,321.60 |
$10,804 |
26.5× |
| CT thorax w/o contrast (71250) |
$2,789.60 |
$6,974 |
28.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,286 |
$8,215 |
20.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,091.60 |
$5,229 |
21.5× |
| CT upper extremity with contrast (73201) |
$2,578 |
$6,445 |
7.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,340 |
$3,350 |
8.2× |
| Cta Abdomen (74175) |
$1,658 |
$4,145 |
10.2× |
| CTA abdomen pelvis (74174) |
$2,072 |
$5,180 |
6.4× |
| CTA chest (71275) |
$1,732.80 |
$4,332 |
10.6× |
| Cta Head (70496) |
$1,575.60 |
$3,939 |
9.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,592.40 |
$3,981 |
9.8× |
| Cta Neck (70498) |
$1,732.80 |
$4,332 |
10.6× |
| Cta Pelvis (72191) |
$1,618 |
$4,045 |
9.9× |
| Cystography minimum 3 views rs&i (74430) |
$696.40 |
$1,741 |
2.1× |
| Diskogram cervical (72285) |
$4,795.20 |
$11,988 |
2.6× |
| Diskography lumbar (72295) |
$2,323.20 |
$5,808 |
1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$480.40 |
$1,201 |
4.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$536.80 |
$1,342 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$445.60 |
$1,114 |
5.5× |
| Echoencephalography real time imaging (76506) |
$590.40 |
$1,476 |
6.1× |
| Esophagus (74220) |
$675.60 |
$1,689 |
4.1× |
| Fetal biophysical profile non-stress testing (76818) |
$599.60 |
$1,499 |
6.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$431.60 |
$1,079 |
4.4× |
| Fluoroscopy up to 1 hr (76000) |
$646.40 |
$1,616 |
2.9× |
| Foot 2 views (73620) |
$316.40 |
$791 |
3.9× |
| Forearm 2 views (73090) |
$396.40 |
$991 |
4.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$449.20 |
$1,123 |
2.0× |
| Gated Heart Planar Single (78472) |
$2,624 |
$6,560 |
7.1× |
| Hand 2 views (73120) |
$332.40 |
$831 |
3.4× |
| Hand 3 views (73130) |
$390.80 |
$977 |
4.8× |
| Heart Infarct Image (78466) |
$1,226 |
$3,065 |
3.3× |
| Heart infarct image w ef (78468) |
$2,324 |
$5,810 |
4.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,203.60 |
$8,009 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,046 |
$2,615 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$764 |
$1,910 |
2.1× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$2,446.80 |
$6,117 |
4.8× |
| Ht muscle image spect sing (78451) |
$2,500.80 |
$6,252 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$415.20 |
$1,038 |
5.1× |
| Hyperthermia ntrstl prb 5/< (77610) |
$2,113.60 |
$5,284 |
4.1× |
| Hysterosalpingogram (74740) |
$818.40 |
$2,046 |
3.7× |
| Interstitial radiation source applic complex (77778) |
$6,927.20 |
$17,318 |
10.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,606 |
$4,015 |
2.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,090.40 |
$2,726 |
2.1× |
| Intracavitary radiation source applic simple (77761) |
$1,206.40 |
$3,016 |
2.3× |
| Kidney funcj study non-img radioisotopic study (78725) |
$1,257.60 |
$3,144 |
3.4× |
| Kidney imaging morphology (78700) |
$3,165.20 |
$7,913 |
8.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$4,312.80 |
$10,782 |
8.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,478.40 |
$8,696 |
6.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$6,748 |
$16,870 |
13.4× |
| Knee 3 views (73562) |
$460 |
$1,150 |
5.7× |
| Liver & spleen imaging static only (78215) |
$2,082.40 |
$5,206 |
5.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,453.20 |
$6,133 |
6.6× |
| Liver imaging static only (78201) |
$1,676.40 |
$4,191 |
3.3× |
| Liver imaging w/vascular flow (78202) |
$2,022 |
$5,055 |
4.0× |
| Lung perf&ventilat diferentl (78598) |
$1,192 |
$2,980 |
2.4× |
| Lung perfusion differential (78597) |
$763.60 |
$1,909 |
2.1× |
| Lung Ventilation Imaging (78579) |
$617.60 |
$1,544 |
1.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,741.60 |
$9,354 |
1.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$3,162.40 |
$7,906 |
5.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$3,398 |
$8,495 |
2.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,484 |
$8,710 |
1.2× |
| Lymphoscintigraphy (78195) |
$1,969.20 |
$4,923 |
3.9× |
| Mammary ductogram or galactogram single (77053) |
$1,424.80 |
$3,562 |
6.4× |
| Meckels Diverticulum (78290) |
$1,700 |
$4,250 |
4.6× |
| MRA head w & w/o contrast (70546) |
$3,724 |
$9,310 |
11.5× |
| MRA head w/o contrast (70544) |
$2,434 |
$6,085 |
11.0× |
| MRA head with contrast (70545) |
$2,555.60 |
$6,389 |
7.9× |
| MRA neck w contrast (70548) |
$2,668 |
$6,670 |
8.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,744.40 |
$9,361 |
11.5× |
| MRA neck w/o contrast (70547) |
$2,340.40 |
$5,851 |
10.5× |
| MRI abdomen w contrast (74182) |
$3,584 |
$8,960 |
11.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,982 |
$9,955 |
12.3× |
| MRI abdomen w/o contrast (74181) |
$3,384.40 |
$8,461 |
15.3× |
| MRI any jnt lwr ext with con lt (73722) |
$4,018.40 |
$10,046 |
5.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,834.80 |
$9,587 |
5.3× |
| MRI bone marrow blood supply (77084) |
$4,211.60 |
$10,529 |
19.0× |
| MRI breast w/o contrast bilateral (77047) |
$4,130.80 |
$10,327 |
18.6× |
| MRI breast w/o contrast unilat (77046) |
$4,130.80 |
$10,327 |
18.6× |
| MRI c-spine with contrast (72142) |
$4,594 |
$11,485 |
14.2× |
| MRI cervical spine w/o contrast (72141) |
$3,402.80 |
$8,507 |
15.3× |
| MRI chest w/o & w/contrast material (71552) |
$4,620.40 |
$11,551 |
14.2× |
| MRI chest w/o contrast (71550) |
$4,266.20 |
$10,665.50 |
19.2× |
| MRI chest with contrast (71551) |
$4,534.80 |
$11,337 |
6.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,369.60 |
$10,924 |
13.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,271.60 |
$10,679 |
13.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,883.20 |
$9,708 |
17.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,522.40 |
$6,306 |
11.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,764.80 |
$9,412 |
11.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,974 |
$7,435 |
9.2× |
| MRI pelvis w contrast (72196) |
$3,866.40 |
$9,666 |
11.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,114.80 |
$10,287 |
12.7× |
| MRI pelvis w/o contrast (72195) |
$3,641.60 |
$9,104 |
16.4× |
| MRI scan of arm joint before and after contrast (73223) |
$4,343.20 |
$10,858 |
13.4× |
| MRI scan of leg joint before and after contrast (73723) |
$4,190.40 |
$10,476 |
12.9× |
| MRI spectroscopy (76390) |
$5,287.20 |
$13,218 |
65.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,407.20 |
$13,518 |
16.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,678.40 |
$11,696 |
14.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,818 |
$12,045 |
14.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,136.40 |
$10,341 |
12.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,016 |
$12,540 |
15.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,505.60 |
$8,764 |
15.8× |
| MRI tmj (70336) |
$5,036.40 |
$12,591 |
22.7× |
| MRI upper ext joint w/o contrast (73221) |
$3,575.60 |
$8,939 |
16.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,412 |
$13,530 |
16.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,008.80 |
$10,022 |
18.1× |
| Myelogram Cervical (72240) |
$1,953.60 |
$4,884 |
2.7× |
| Myelogram Lumbar (72265) |
$1,885.60 |
$4,714 |
2.6× |
| Myelogram thoracic (72255) |
$1,720.80 |
$4,302 |
2.4× |
| Myelography 2 or more regions (72270) |
$1,041.60 |
$2,604 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,776.40 |
$11,941 |
4.0× |
| Myocardial infarct spect (78469) |
$2,967.20 |
$7,418 |
5.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,031.20 |
$10,078 |
3.3× |
| Neck soft tissue (70360) |
$381.20 |
$953 |
4.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$615.60 |
$1,539 |
1.7× |
| Nm adrenal scan (78075) |
$3,119.60 |
$7,799 |
2.6× |
| Nm bone marrow wb (78104) |
$2,516.40 |
$6,291 |
6.8× |
| Nm cisternogram (78630) |
$1,942.80 |
$4,857 |
3.8× |
| Nm csf leak detection (78650) |
$1,956.80 |
$4,892 |
1.6× |
| Nm gastric emptying study (78264) |
$2,402 |
$6,005 |
6.5× |
| Nm gastroesophageal reflux study (78262) |
$2,065.20 |
$5,163 |
5.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,518 |
$8,795 |
2.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$3,119.60 |
$7,799 |
2.6× |
| Nuclear medicine of heart pumping function (78473) |
$9,762.40 |
$24,406 |
26.3× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$4,668.40 |
$11,671 |
9.2× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,132 |
$10,330 |
3.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,535.60 |
$6,339 |
2.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$4,139.20 |
$10,348 |
11.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,270 |
$3,175 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$2,003.60 |
$5,009 |
9.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$595.20 |
$1,488 |
6.1× |
| Osseous survey infant (77076) |
$1,182.40 |
$2,956 |
12.2× |
| Osseous survey limited (77074) |
$718.40 |
$1,796 |
7.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,743.60 |
$4,359 |
3.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,406.40 |
$3,516 |
3.8× |
| Parathyroid imaging (78070) |
$1,870 |
$4,675 |
5.0× |
| Pelvis 1 or 2 views (72170) |
$388.40 |
$971 |
4.0× |
| Perineogram (74775) |
$663.20 |
$1,658 |
3.0× |
| Peritoneogram rs&i (74190) |
$913.80 |
$2,284.50 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$3,940.40 |
$9,851 |
3.0× |
| PET imaging CT for attenuation limited area (78814) |
$3,546.40 |
$8,866 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$4,019.60 |
$10,049 |
3.0× |
| PET imaging limited area chest head/neck (78811) |
$3,981.20 |
$9,953 |
3.3× |
| PET whole body (78813) |
$4,297.60 |
$10,744 |
3.2× |
| Pr heart first pass single,planar (78481) |
$3,097.60 |
$7,744 |
6.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,482.40 |
$11,206 |
13.8× |
| Proton tx delivery complex (77525) |
$1,834.80 |
$4,587 |
1.6× |
| Proton tx delivery simple w/o compensation (77520) |
$1,834.80 |
$4,587 |
3.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,782 |
$9,455 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,782 |
$9,455 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$780 |
$1,950 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,083.60 |
$2,709 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$502 |
$1,255 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$281.20 |
$703 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$657.20 |
$1,643 |
6.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$716.80 |
$1,792 |
7.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$396.40 |
$991 |
4.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,199.20 |
$5,498 |
4.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,682 |
$4,205 |
17.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,970.80 |
$4,927 |
5.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$346.80 |
$867 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$464.40 |
$1,161 |
5.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$561.60 |
$1,404 |
5.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$342.80 |
$857 |
4.2× |
| Radiologic exam colon single contrast study (74270) |
$864 |
$2,160 |
5.3× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$271.60 |
$679 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$939 |
$2,347.50 |
5.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$834.80 |
$2,087 |
5.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$448.40 |
$1,121 |
5.5× |
| Radiological examination surgical specimen (76098) |
$451.60 |
$1,129 |
0.9× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$2,353.60 |
$5,884 |
10.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$6,838.80 |
$17,097 |
2.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,214.80 |
$8,037 |
1.1× |
| Ribs bilateral 3 views (71110) |
$665.60 |
$1,664 |
6.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,526.40 |
$3,816 |
4.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,741.20 |
$4,353 |
3.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,149.60 |
$5,374 |
4.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,151.60 |
$5,379 |
9.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$3,237.60 |
$8,094 |
14.9× |
| Rp Therapy Intravenous Administration (79101) |
$2,068.40 |
$5,171 |
9.5× |
| Sacroiliac Joints < 3 Views (72200) |
$494 |
$1,235 |
5.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$629.60 |
$1,574 |
2.8× |
| Salivary gland imaging (78230) |
$1,292.40 |
$3,231 |
3.5× |
| Scanogram (77073) |
$413.20 |
$1,033 |
4.2× |
| Scapula complete (73010) |
$350 |
$875 |
3.6× |
| Sella turcica (70240) |
$522 |
$1,305 |
6.4× |
| Sialogram (70390) |
$716.80 |
$1,792 |
3.2× |
| Simulation intermediate (77285) |
$1,268 |
$3,170 |
3.6× |
| Small bowel series (74250) |
$352 |
$880 |
2.2× |
| Spec medical radj physics consltj (77370) |
$1,235.60 |
$3,089 |
9.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,596.40 |
$3,991 |
4.6× |
| Special dosimetry (77331) |
$952.80 |
$2,382 |
7.6× |
| Special treatment procedure (77470) |
$2,689.60 |
$6,724 |
5.2× |
| Speech evaluation complex (70371) |
$1,327.20 |
$3,318 |
6.0× |
| Spine thoracic 3 views (72072) |
$656.80 |
$1,642 |
6.8× |
| Splenoportograpy rs&i (75810) |
$6,838.80 |
$17,097 |
2.3× |
| Superior sagittal sinus venogram (75870) |
$3,487.60 |
$8,719 |
1.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$574.40 |
$1,436 |
6.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,374.40 |
$3,436 |
3.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$748.40 |
$1,871 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$1,614.40 |
$4,036 |
4.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,182 |
$5,455 |
6.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,235.60 |
$3,089 |
9.9× |
| Therapeutic Enema (74283) |
$2,604.40 |
$6,511 |
16.0× |
| Thoracolumbar 2 views (72080) |
$603.20 |
$1,508 |
7.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,206.40 |
$3,016 |
2.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,117.20 |
$2,793 |
3.0× |
| Thyroid uptake measurement (78012) |
$601.60 |
$1,504 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,391.20 |
$3,478 |
3.7× |
| Tmj unilateral (70328) |
$264.60 |
$661.50 |
3.3× |
| Tomogram (76100) |
$952 |
$2,380 |
9.8× |
| Treatment device intermediate (77333) |
$880.40 |
$2,201 |
7.0× |
| Treatment devices simple (77332) |
$772 |
$1,930 |
6.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,632.80 |
$9,082 |
7.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,440 |
$3,600 |
3.9× |
| Tx devices design & construction complex (77334) |
$1,538 |
$3,845 |
4.4× |
| Ultrasound elastography first target lesion (76982) |
$234.80 |
$587 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$966.40 |
$2,416 |
9.9× |
| Umbilical-artery Doppler (OB) (76820) |
$480.40 |
$1,201 |
4.9× |
| Unlisted magnetic resonance procedure (76498) |
$2,493.60 |
$6,234 |
30.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$4,091.60 |
$10,229 |
43.1× |
| Upper Extremity Infant (73092) |
$281.20 |
$703 |
2.9× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,421.60 |
$3,554 |
3.8× |
| Urethrocystography retrograde rs&i (74450) |
$773.60 |
$1,934 |
3.5× |
| Urethrocystography voiding (74455) |
$932.40 |
$2,331 |
4.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,739.60 |
$4,349 |
10.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$2,122.40 |
$5,306 |
13.0× |
| Us abdl aorta screen aaa (76706) |
$129.20 |
$323 |
1.3× |
| Us breast unilateral complete (76641) |
$813.20 |
$2,033 |
8.4× |
| Us breast unilateral limited (76642) |
$677.60 |
$1,694 |
8.4× |
| Us chest (76604) |
$542.40 |
$1,356 |
5.6× |
| Us compl joint r-t w/image documentation (76881) |
$725.60 |
$1,814 |
7.5× |
| Us elastography parenchyma (76981) |
$263.20 |
$658 |
2.7× |
| Us guided compression repair (76936) |
$1,668.80 |
$4,172 |
8.3× |
| Us infant hips dynamic (76885) |
$410.80 |
$1,027 |
5.1× |
| Us infant hips limited static (76886) |
$914.40 |
$2,286 |
11.3× |
| Us kidney transplant (76776) |
$716.80 |
$1,792 |
7.4× |
| Us ob transvaginal (76817) |
$500.40 |
$1,251 |
5.1× |
| Us pelvic non ob complete (76856) |
$898.80 |
$2,247 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$898.80 |
$2,247 |
9.2× |
| Us pregnancy ltd (76815) |
$440 |
$1,100 |
4.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$852 |
$2,130 |
8.8× |
| Us retroperitoneal complete (76770) |
$1,635.60 |
$4,089 |
16.8× |
| Us retroperitoneal limited (76775) |
$898.80 |
$2,247 |
9.2× |
| Us scrotum and contents (76870) |
$778.80 |
$1,947 |
8.0× |
| Us soft tissue head/neck (76536) |
$536.80 |
$1,342 |
5.5× |
| Us spinal canal and contents (76800) |
$874.80 |
$2,187 |
9.0× |
| Us transrectal (76872) |
$1,238 |
$3,095 |
12.7× |
| Us xtr non-vasc lmtd (76882) |
$864 |
$2,160 |
8.9× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$2,150 |
$5,375 |
4.2× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$2,113.60 |
$5,284 |
5.9× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$2,850 |
$7,125 |
4.4× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$2,832 |
$7,080 |
5.5× |
| Vascular flow imaging (78445) |
$734 |
$1,835 |
2.0× |
| Venogram extremity bilateral (75822) |
$1,812.40 |
$4,531 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$4,271.20 |
$10,678 |
1.5× |
| Venography caval superior serialography rs&i (75827) |
$2,135.60 |
$5,339 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$1,461.60 |
$3,654 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,012 |
$7,530 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,904.80 |
$7,262 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,816 |
$7,040 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$6,432.40 |
$16,081 |
1.2× |
| Wrist 2 views (73100) |
$394.80 |
$987 |
4.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$561.60 |
$1,404 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$360.80 |
$902 |
4.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$415.20 |
$1,038 |
5.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,209.60 |
$3,024 |
7.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$365.60 |
$914 |
4.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$415.20 |
$1,038 |
5.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$317.60 |
$794 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$366.40 |
$916 |
4.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$418 |
$1,045 |
5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$657.20 |
$1,643 |
6.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,052.40 |
$2,631 |
6.5× |
| X-ray eye for foreign body (70030) |
$345.60 |
$864 |
4.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$518.40 |
$1,296 |
5.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$352.40 |
$881 |
4.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$381.20 |
$953 |
4.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,111.40 |
$2,778.50 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$390.80 |
$977 |
4.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$1,809.20 |
$4,523 |
11.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$308.80 |
$772 |
3.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$531.20 |
$1,328 |
5.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$478 |
$1,195 |
5.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$304.40 |
$761 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$552.40 |
$1,381 |
5.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$845.20 |
$2,113 |
8.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$563.20 |
$1,408 |
5.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$381.20 |
$953 |
4.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$449.20 |
$1,123 |
5.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$538 |
$1,345 |
5.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$586.40 |
$1,466 |
6.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$2,170 |
$5,425 |
4.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$870 |
$2,175 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$557.20 |
$1,393 |
6.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$640.40 |
$1,601 |
6.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$800.40 |
$2,001 |
8.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$581.60 |
$1,454 |
6.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$484.40 |
$1,211 |
6.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$448.40 |
$1,121 |
5.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$584.40 |
$1,461 |
7.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$366.80 |
$917 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$476.80 |
$1,192 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$387.60 |
$969 |
4.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$276.40 |
$691 |
3.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$359.60 |
$899 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$292.80 |
$732 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$545.60 |
$1,364 |
5.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$742.80 |
$1,857 |
7.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$346.80 |
$867 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$431.20 |
$1,078 |
5.3× |
| Xr c-spine 6 or more views (72052) |
$733.20 |
$1,833 |
7.5× |
| Xr chest 4+ views (71048) |
$397.60 |
$994 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$346.80 |
$867 |
4.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$629.60 |
$1,574 |
6.5× |
| Xr shoulder 1 view (73020) |
$278 |
$695 |
3.4× |
| Xr spine cervical 4 or 5 views (72050) |
$626.40 |
$1,566 |
6.4× |
| Xr tibia/fibula 2 views (73590) |
$448.40 |
$1,121 |
5.5× |
| Xr tmj bilateral (70330) |
$542.40 |
$1,356 |
6.7× |
| Xray knee 1 or 2 views rt (73560) |
$385.20 |
$963 |
4.8× |