| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,049 |
$5,049 |
3.6× |
| Abdomen 2 views (74019) |
$730 |
$730 |
7.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$7,069 |
$7,069 |
17.6× |
| Acute venous thrombus image (78456) |
$3,517 |
$3,517 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$54,409 |
$54,409 |
17.2× |
| Angiography extremity bilateral rs&i (75716) |
$19,648 |
$19,648 |
6.2× |
| Angiography extremity unilateral rs&i (75710) |
$23,495 |
$23,495 |
7.4× |
| Angiography internal mammary rs&i (75756) |
$17,585 |
$17,585 |
5.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$18,426 |
$18,426 |
3.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$54,409 |
$54,409 |
17.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$54,409 |
$54,409 |
17.2× |
| Angiography Spinal Selective Rs&I (75705) |
$28,941 |
$28,941 |
5.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$32,262 |
$32,262 |
5.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$6,484 |
$6,484 |
2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$17,585 |
$17,585 |
5.5× |
| Ankle 2 views (73600) |
$665 |
$665 |
7.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$5,637 |
$5,637 |
16.1× |
| Aortogram thoracic (75605) |
$31,690 |
$31,690 |
5.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$36,915 |
$36,915 |
11.6× |
| Aortography abdominal serialography rs&i (75625) |
$7,812 |
$7,812 |
2.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$54,409 |
$54,409 |
17.2× |
| Artery X-Rays Adrenal Gland (75731) |
$54,409 |
$54,409 |
17.2× |
| Basic radiation dosimetry calculation (77300) |
$646 |
$646 |
4.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$7,069 |
$7,069 |
17.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$7,069 |
$7,069 |
17.6× |
| Bone &/joint imaging whole body (78306) |
$3,235 |
$3,235 |
8.1× |
| Bone age studies (77072) |
$2,495 |
$2,495 |
23.8× |
| Bone Imaging 3 Phase (78315) |
$3,940 |
$3,940 |
9.8× |
| Bone Marrow Imaging Limited Area (78102) |
$2,459 |
$2,459 |
6.1× |
| Bone survey complete (77075) |
$3,390 |
$3,390 |
32.3× |
| Brain image w/flow 4 + views (78606) |
$4,447 |
$4,447 |
8.2× |
| Brain imaging < 4 static views (78600) |
$2,988 |
$2,988 |
7.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$4,447 |
$4,447 |
11.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$5,307 |
$5,307 |
9.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$15,671 |
$15,671 |
10.9× |
| Brain Imaging Vascular Flow Only (78610) |
$2,988 |
$2,988 |
5.5× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$766 |
$766 |
69.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$3,469 |
$3,469 |
8.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$10,265 |
$10,265 |
29.3× |
| Cardiac shunt detection (78428) |
$3,311 |
$3,311 |
8.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$3,640 |
$3,640 |
6.7× |
| Cervical spine 2 or 3 views (72040) |
$713 |
$713 |
8.2× |
| Chest 1 view (71045) |
$660 |
$660 |
7.5× |
| Chest 3 views (71047) |
$841 |
$841 |
9.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$2,161 |
$2,161 |
12.3× |
| Cineradiography/videoradiography (76120) |
$3,390 |
$3,390 |
32.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$13,053 |
$13,053 |
16.6× |
| Clavicle complete (73000) |
$374 |
$374 |
4.3× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$36,043 |
$36,043 |
4.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$5,501 |
$5,501 |
52.4× |
| Continuing medical physics consltj pr wk (77336) |
$667 |
$667 |
4.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$2,161 |
$2,161 |
12.3× |
| Corpora cavernosography (74445) |
$3,026 |
$3,026 |
28.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$12,555 |
$12,555 |
35.8× |
| CT abdomen and pelvis without contrast (74176) |
$10,697 |
$10,697 |
44.6× |
| CT abdomen w contrast (74160) |
$6,581 |
$6,581 |
37.3× |
| CT abdomen w wo contrast (74170) |
$7,262 |
$7,262 |
41.2× |
| CT abdomen w/o contrast (74150) |
$5,966 |
$5,966 |
56.8× |
| CT angiography upper extremity lt (73206) |
$7,115 |
$7,115 |
40.4× |
| CT c-spine w/o contrast (72125) |
$8,000 |
$8,000 |
76.2× |
| CT cervical spine w&w/o contrast (72127) |
$6,824 |
$6,824 |
38.7× |
| CT cervical spine with contrast (72126) |
$5,862 |
$5,862 |
16.7× |
| CT chest w/wo contrast (71270) |
$6,209 |
$6,209 |
35.2× |
| CT chest with contrast (71260) |
$6,090 |
$6,090 |
34.6× |
| CT head/brain with contrast (70460) |
$5,120 |
$5,120 |
29.1× |
| CT head/brain without and with contrast (70470) |
$6,101 |
$6,101 |
34.6× |
| CT iac w contrast (70481) |
$5,120 |
$5,120 |
29.1× |
| CT limited/localized follow up study (76380) |
$2,227 |
$2,227 |
25.5× |
| CT lower ext w/o (73700) |
$4,309 |
$4,309 |
41.0× |
| CT lower extremity w wo contrast (73702) |
$6,408 |
$6,408 |
36.4× |
| CT lower extremity with contrast (73701) |
$5,120 |
$5,120 |
29.1× |
| CT lumbar spine w & w/o contrast (72133) |
$7,366 |
$7,366 |
41.8× |
| CT lumbar spine w/o contrast (72131) |
$6,490 |
$6,490 |
61.8× |
| CT lumbar spine with contrast (72132) |
$5,947 |
$5,947 |
17.0× |
| CT maxillofacial w contrast (70487) |
$5,120 |
$5,120 |
29.1× |
| CT maxillofacial w/o contrast (70486) |
$4,886 |
$4,886 |
46.5× |
| CT maxillofacial w/wo contrast (70488) |
$6,250 |
$6,250 |
35.5× |
| CT neck soft tissue w contrast (70491) |
$5,120 |
$5,120 |
29.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$6,502 |
$6,502 |
36.9× |
| CT orbits w/o contrast (70480) |
$4,777 |
$4,777 |
45.5× |
| CT pelvis w & w/o contrast (72194) |
$6,484 |
$6,484 |
36.8× |
| CT pelvis w/o contrast (72192) |
$4,702 |
$4,702 |
44.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$1,262 |
$1,262 |
14.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$6,650 |
$6,650 |
37.7× |
| CT soft tissue neck w/o contrast (70490) |
$5,140 |
$5,140 |
48.9× |
| CT thoracic spine w/contrast (72129) |
$5,910 |
$5,910 |
33.5× |
| CT thoracic spine w/o contrast (72128) |
$6,343 |
$6,343 |
60.4× |
| CT thoracic spine w/wo contrast (72130) |
$6,659 |
$6,659 |
37.8× |
| CT thorax w/o contrast (71250) |
$4,594 |
$4,594 |
43.7× |
| CT unlisted procedure (76497) |
$1,262 |
$1,262 |
14.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$6,044 |
$6,044 |
34.3× |
| CT upper extremity w/o contrast rt (73200) |
$3,344 |
$3,344 |
31.8× |
| CT upper extremity with contrast (73201) |
$5,120 |
$5,120 |
14.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$7,069 |
$7,069 |
40.1× |
| Cta Abdomen (74175) |
$6,043 |
$6,043 |
34.3× |
| CTA abdomen pelvis (74174) |
$10,369 |
$10,369 |
29.6× |
| CTA chest (71275) |
$6,080 |
$6,080 |
34.5× |
| Cta Head (70496) |
$7,000 |
$7,000 |
39.7× |
| CTA lwr ext w&w/o contrast (73706) |
$5,991 |
$5,991 |
34.0× |
| Cta Neck (70498) |
$7,010 |
$7,010 |
39.8× |
| Cta Pelvis (72191) |
$5,991 |
$5,991 |
34.0× |
| Cystography minimum 3 views rs&i (74430) |
$5,637 |
$5,637 |
16.1× |
| Dacryocystography (70170) |
$7,162 |
$7,162 |
29.9× |
| Diskogram cervical (72285) |
$7,212 |
$7,212 |
3.7× |
| Diskography lumbar (72295) |
$7,212 |
$7,212 |
3.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,589 |
$1,589 |
15.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,948 |
$1,948 |
18.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,948 |
$1,948 |
18.5× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$1,774 |
$1,774 |
16.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$2,019 |
$2,019 |
19.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,262 |
$1,262 |
14.4× |
| Echo exam of eye (76529) |
$2,866 |
$2,866 |
32.8× |
| Echo exam of fetal heart (76825) |
$8,983 |
$8,983 |
16.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$7,099 |
$7,099 |
29.6× |
| Echoencephalography real time imaging (76506) |
$2,866 |
$2,866 |
27.3× |
| Esophageal motility (78258) |
$2,215 |
$2,215 |
5.5× |
| Esophagus (74220) |
$2,161 |
$2,161 |
12.3× |
| Fetal biophysical profile non-stress testing (76818) |
$2,866 |
$2,866 |
27.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$2,866 |
$2,866 |
27.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,201 |
$1,201 |
5.0× |
| Foot 2 views (73620) |
$657 |
$657 |
7.5× |
| Forearm 2 views (73090) |
$661 |
$661 |
7.6× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$1,262 |
$1,262 |
5.3× |
| Functional MRI brain by phys/psych (70555) |
$7,549 |
$7,549 |
31.5× |
| Functional MRI brain by tech (70554) |
$7,091 |
$7,091 |
29.6× |
| Gastric mucosa imaging (78261) |
$2,928 |
$2,928 |
7.3× |
| Gastrointestinal Protein Loss (78282) |
$2,928 |
$2,928 |
7.3× |
| Gated Heart Planar Single (78472) |
$7,069 |
$7,069 |
17.6× |
| Hand 3 views (73130) |
$669 |
$669 |
7.7× |
| Heart Infarct Image (78466) |
$3,075 |
$3,075 |
7.7× |
| Heart infarct image w ef (78468) |
$1,880 |
$1,880 |
3.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$44,270 |
$44,270 |
14.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$7,069 |
$7,069 |
13.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$7,069 |
$7,069 |
17.6× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$6,136 |
$6,136 |
11.1× |
| Humerus Min 2 Views Left (73060) |
$374 |
$374 |
4.3× |
| Hyperthermia ntrstl prb 5/< (77610) |
$3,976 |
$3,976 |
7.2× |
| Hysterosalpingogram (74740) |
$7,162 |
$7,162 |
29.9× |
| Interstitial radiation source applic complex (77778) |
$9,657 |
$9,657 |
13.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$6,190 |
$6,190 |
8.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$4,110 |
$4,110 |
7.4× |
| Intracavitary radiation source applic simple (77761) |
$4,842 |
$4,842 |
8.7× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$14,591 |
$14,591 |
2.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$2,019 |
$2,019 |
19.2× |
| Kidney funcj study non-img radioisotopic study (78725) |
$2,686 |
$2,686 |
6.7× |
| Kidney imaging morphology (78700) |
$3,723 |
$3,723 |
9.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,861 |
$1,861 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$4,019 |
$4,019 |
7.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$5,399 |
$5,399 |
9.9× |
| Knee 3 views (73562) |
$1,262 |
$1,262 |
14.4× |
| Liver & spleen imaging static only (78215) |
$3,764 |
$3,764 |
9.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$3,785 |
$3,785 |
9.4× |
| Liver imaging static only (78201) |
$3,248 |
$3,248 |
6.0× |
| Liver imaging w/vascular flow (78202) |
$3,252 |
$3,252 |
6.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$17,281 |
$17,281 |
5.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$7,162 |
$7,162 |
11.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$17,281 |
$17,281 |
10.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$17,281 |
$17,281 |
5.4× |
| Lymphoscintigraphy (78195) |
$7,069 |
$7,069 |
13.0× |
| Mammary ductogram or galactogram multiple (77054) |
$7,162 |
$7,162 |
29.9× |
| Mammary ductogram or galactogram single (77053) |
$7,162 |
$7,162 |
29.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$581 |
$581 |
6.6× |
| Meckels Diverticulum (78290) |
$7,069 |
$7,069 |
17.6× |
| MRA head w & w/o contrast (70546) |
$10,265 |
$10,265 |
29.3× |
| MRA head w/o contrast (70544) |
$6,383 |
$6,383 |
26.6× |
| MRA head with contrast (70545) |
$9,075 |
$9,075 |
25.9× |
| MRA neck w contrast (70548) |
$9,075 |
$9,075 |
25.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$10,265 |
$10,265 |
29.3× |
| MRA neck w/o contrast (70547) |
$6,367 |
$6,367 |
26.6× |
| MRI abdomen w contrast (74182) |
$9,075 |
$9,075 |
25.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$10,265 |
$10,265 |
29.3× |
| MRI abdomen w/o contrast (74181) |
$6,668 |
$6,668 |
27.8× |
| MRI any jnt lwr ext with con lt (73722) |
$9,075 |
$9,075 |
11.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$9,075 |
$9,075 |
11.5× |
| MRI bone marrow blood supply (77084) |
$5,213 |
$5,213 |
21.7× |
| MRI c-spine with contrast (72142) |
$9,075 |
$9,075 |
25.9× |
| MRI cardiac w/o cont stress (75559) |
$6,604 |
$6,604 |
12.0× |
| MRI cardiac w/o contrast (75557) |
$6,086 |
$6,086 |
25.4× |
| MRI cervical spine w/o contrast (72141) |
$8,786 |
$8,786 |
36.7× |
| MRI chest w/o & w/contrast material (71552) |
$10,383 |
$10,383 |
29.6× |
| MRI chest w/o contrast (71550) |
$6,086 |
$6,086 |
25.4× |
| MRI chest with contrast (71551) |
$9,075 |
$9,075 |
11.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$9,075 |
$9,075 |
25.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,490 |
$7,490 |
21.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,916 |
$6,916 |
28.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$6,086 |
$6,086 |
25.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$10,265 |
$10,265 |
29.3× |
| MRI orbit/face/neck w/contrast (70542) |
$9,075 |
$9,075 |
25.9× |
| MRI pelvis w contrast (72196) |
$9,075 |
$9,075 |
25.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$10,265 |
$10,265 |
29.3× |
| MRI pelvis w/o contrast (72195) |
$8,080 |
$8,080 |
33.7× |
| MRI scan of arm joint before and after contrast (73223) |
$10,265 |
$10,265 |
29.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$24,236 |
$24,236 |
30.8× |
| MRI scan of leg joint before and after contrast (73723) |
$10,265 |
$10,265 |
29.3× |
| MRI spectroscopy (76390) |
$5,759 |
$5,759 |
65.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$10,265 |
$10,265 |
29.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$9,075 |
$9,075 |
25.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$12,204 |
$12,204 |
34.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$9,075 |
$9,075 |
25.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$10,265 |
$10,265 |
29.3× |
| MRI thoracic spine w/o contrast (72146) |
$8,695 |
$8,695 |
36.3× |
| MRI tmj (70336) |
$6,536 |
$6,536 |
27.3× |
| MRI upper ext joint w/o contrast (73221) |
$6,086 |
$6,086 |
25.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$10,265 |
$10,265 |
29.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$7,490 |
$7,490 |
31.2× |
| Myelogram Cervical (72240) |
$13,053 |
$13,053 |
16.6× |
| Myelogram Lumbar (72265) |
$7,196 |
$7,196 |
9.1× |
| Myelogram thoracic (72255) |
$3,181 |
$3,181 |
4.0× |
| Myelography 2 or more regions (72270) |
$13,053 |
$13,053 |
16.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$11,594 |
$11,594 |
8.9× |
| Myocardial infarct spect (78469) |
$3,273 |
$3,273 |
6.0× |
| Neck soft tissue (70360) |
$418 |
$418 |
4.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$2,326 |
$2,326 |
6.0× |
| Nm adrenal scan (78075) |
$6,419 |
$6,419 |
4.9× |
| Nm bone marrow multiple (78103) |
$2,794 |
$2,794 |
7.0× |
| Nm bone marrow wb (78104) |
$3,746 |
$3,746 |
9.3× |
| Nm cisternogram (78630) |
$4,765 |
$4,765 |
8.7× |
| Nm csf leak detection (78650) |
$4,549 |
$4,549 |
3.5× |
| Nm gastric emptying study (78264) |
$2,836 |
$2,836 |
7.1× |
| Nm gastroesophageal reflux study (78262) |
$3,971 |
$3,971 |
9.9× |
| Nm peritoneal-venous shunt patency (78291) |
$3,158 |
$3,158 |
7.9× |
| Nm red cell sequestration (78140) |
$4,287 |
$4,287 |
10.7× |
| Nm whole blood volume (78122) |
$4,295 |
$4,295 |
7.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,049 |
$5,049 |
3.6× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$13,726 |
$13,726 |
9.6× |
| Nuclear medicine of heart pumping function (78473) |
$5,812 |
$5,812 |
14.5× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$5,356 |
$5,356 |
9.8× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$13,113 |
$13,113 |
9.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$12,581 |
$12,581 |
8.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$4,009 |
$4,009 |
10.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$2,744 |
$2,744 |
6.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$3,517 |
$3,517 |
8.8× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$3,517 |
$3,517 |
6.4× |
| Nuclear Rx Oral Admin (79005) |
$3,668 |
$3,668 |
15.6× |
| Nuclr Rx Interstit Colloid (79300) |
$2,761 |
$2,761 |
11.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$2,866 |
$2,866 |
27.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$2,143 |
$2,143 |
16.0× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$1,948 |
$1,948 |
18.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$2,866 |
$2,866 |
27.3× |
| Orthopantogram (70355) |
$1,262 |
$1,262 |
14.4× |
| Osseous survey infant (77076) |
$2,019 |
$2,019 |
19.2× |
| Osseous survey limited (77074) |
$2,019 |
$2,019 |
19.2× |
| Parathyroid imaging (78070) |
$7,069 |
$7,069 |
17.6× |
| Pelvis 1 or 2 views (72170) |
$684 |
$684 |
6.5× |
| Perineogram (74775) |
$5,637 |
$5,637 |
23.5× |
| Peritoneogram rs&i (74190) |
$7,162 |
$7,162 |
13.0× |
| PET image w/CT, skull-thigh (78815) |
$27,332 |
$27,332 |
19.0× |
| PET imaging CT for attenuation limited area (78814) |
$15,819 |
$15,819 |
11.0× |
| PET imaging for CT attenuation whole body (78816) |
$27,332 |
$27,332 |
19.0× |
| PET imaging limited area chest head/neck (78811) |
$12,000 |
$12,000 |
9.2× |
| PET whole body (78813) |
$15,305 |
$15,305 |
10.7× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$4,287 |
$4,287 |
3.3× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$4,287 |
$4,287 |
3.3× |
| Platelet survival study (78191) |
$2,415 |
$2,415 |
6.0× |
| Pr csf ventriculography (78635) |
$4,447 |
$4,447 |
8.2× |
| Pr gi endoscopic ultrasound (76975) |
$4,029 |
$4,029 |
16.8× |
| Pr heart first pass single,planar (78481) |
$4,662 |
$4,662 |
8.5× |
| Pr MRI brain w/ dye (70558) |
$9,075 |
$9,075 |
51.5× |
| Pr MRI brain w/o & w/ dye (70559) |
$10,265 |
$10,265 |
58.3× |
| Pr MRI brain w/o dye (70557) |
$6,086 |
$6,086 |
11.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$10,265 |
$10,265 |
29.3× |
| Pr non-imaging heart function (78414) |
$1,975 |
$1,975 |
3.6× |
| Pr red cell survival study (78130) |
$4,287 |
$4,287 |
10.7× |
| Pr sono bone density measure,peripheral (76977) |
$1,113 |
$1,113 |
10.6× |
| Proton trmt simple w/comp (77522) |
$13,064 |
$13,064 |
10.4× |
| Proton tx delivery complex (77525) |
$18,150 |
$18,150 |
14.5× |
| Proton tx delivery intermediate (77523) |
$17,089 |
$17,089 |
13.6× |
| Proton tx delivery simple w/o compensation (77520) |
$10,345 |
$10,345 |
18.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$54,409 |
$54,409 |
17.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$17,585 |
$17,585 |
5.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,345 |
$3,345 |
8.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$3,716 |
$3,716 |
6.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,677 |
$1,677 |
16.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,318 |
$1,318 |
12.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$2,019 |
$2,019 |
19.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$40,040 |
$40,040 |
5.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,576 |
$1,576 |
2.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,387 |
$1,387 |
13.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$403 |
$403 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$2,019 |
$2,019 |
19.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$995 |
$995 |
11.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$882 |
$882 |
8.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$839 |
$839 |
9.6× |
| Radiologic exam colon single contrast study (74270) |
$3,209 |
$3,209 |
18.2× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$2,019 |
$2,019 |
8.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$3,209 |
$3,209 |
18.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$3,209 |
$3,209 |
18.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,262 |
$1,262 |
14.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$1,262 |
$1,262 |
14.4× |
| Radiological examination surgical specimen (76098) |
$7,162 |
$7,162 |
13.0× |
| Radiopharm Dacryocystography (78660) |
$2,348 |
$2,348 |
5.8× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$3,284 |
$3,284 |
14.0× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$3,721 |
$3,721 |
15.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$4,287 |
$4,287 |
10.7× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$4,287 |
$4,287 |
7.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$54,409 |
$54,409 |
17.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$36,915 |
$36,915 |
11.6× |
| Ribs bilateral 3 views (71110) |
$513 |
$513 |
4.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$4,579 |
$4,579 |
11.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,644 |
$3,644 |
6.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,677 |
$5,677 |
10.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$5,230 |
$5,230 |
22.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$3,450 |
$3,450 |
14.7× |
| Rp Therapy Intravenous Administration (79101) |
$3,127 |
$3,127 |
13.3× |
| Sacroiliac Joints < 3 Views (72200) |
$373 |
$373 |
3.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,481 |
$2,481 |
10.4× |
| Salivary gland function study (78232) |
$2,669 |
$2,669 |
6.6× |
| Salivary gland imaging (78230) |
$2,928 |
$2,928 |
7.3× |
| Salivary gland imaging serial images (78231) |
$2,928 |
$2,928 |
7.3× |
| Scanogram (77073) |
$2,019 |
$2,019 |
19.2× |
| Sella turcica (70240) |
$1,262 |
$1,262 |
14.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$2,019 |
$2,019 |
19.2× |
| Sialogram (70390) |
$7,162 |
$7,162 |
29.9× |
| Simulation intermediate (77285) |
$4,012 |
$4,012 |
10.7× |
| Spec medical radj physics consltj (77370) |
$646 |
$646 |
4.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,260 |
$1,260 |
3.3× |
| Special dosimetry (77331) |
$1,093 |
$1,093 |
8.1× |
| Special treatment procedure (77470) |
$5,755 |
$5,755 |
10.4× |
| Speech evaluation complex (70371) |
$3,390 |
$3,390 |
14.1× |
| Spine thoracic 3 views (72072) |
$699 |
$699 |
6.7× |
| Spleen imaging only (78185) |
$3,116 |
$3,116 |
7.8× |
| Splenoportograpy rs&i (75810) |
$54,409 |
$54,409 |
17.2× |
| Stereotactic body radiation delivery (77373) |
$24,376 |
$24,376 |
13.6× |
| Superior sagittal sinus venogram (75870) |
$7,162 |
$7,162 |
2.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$1,559 |
$1,559 |
15.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$7,196 |
$7,196 |
30.0× |
| Testicular Imaging With Vascular Flow (78761) |
$3,532 |
$3,532 |
8.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,147 |
$3,147 |
8.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,567 |
$1,567 |
11.6× |
| Therapeutic Enema (74283) |
$3,209 |
$3,209 |
18.2× |
| Thoracolumbar 2 views (72080) |
$2,019 |
$2,019 |
23.1× |
| Thyroid carcinoma metastases img addl study (78016) |
$3,277 |
$3,277 |
8.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$5,131 |
$5,131 |
9.4× |
| Tmj unilateral (70328) |
$1,262 |
$1,262 |
14.4× |
| Tomogram (76100) |
$2,019 |
$2,019 |
19.2× |
| Treatment device intermediate (77333) |
$2,093 |
$2,093 |
15.5× |
| Treatment devices simple (77332) |
$1,623 |
$1,623 |
12.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$8,235 |
$8,235 |
15.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$3,284 |
$3,284 |
8.2× |
| Tx devices design & construction complex (77334) |
$2,518 |
$2,518 |
6.7× |
| Ultrasound scan of cornea to determine thickness (76514) |
$621 |
$621 |
21.4× |
| Ultrasound scan to determine eye length and lens power (76519) |
$1,948 |
$1,948 |
18.5× |
| Ultrasound, abdomen limited (76705) |
$1,594 |
$1,594 |
15.2× |
| Umbilical-artery Doppler (OB) (76820) |
$1,948 |
$1,948 |
18.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,262 |
$1,262 |
14.4× |
| Unlisted fluoroscopic procedure (76496) |
$3,390 |
$3,390 |
38.8× |
| Unlisted magnetic resonance procedure (76498) |
$6,086 |
$6,086 |
69.6× |
| Unlisted Ultrasound Procedure (76999) |
$1,948 |
$1,948 |
22.3× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$936 |
$936 |
9.9× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,629 |
$2,629 |
6.5× |
| Urethrocystography retrograde rs&i (74450) |
$5,637 |
$5,637 |
23.5× |
| Urethrocystography voiding (74455) |
$5,637 |
$5,637 |
23.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$7,069 |
$7,069 |
40.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$5,637 |
$5,637 |
32.0× |
| Us abdl aorta screen aaa (76706) |
$618 |
$618 |
5.9× |
| Us breast unilateral complete (76641) |
$2,866 |
$2,866 |
27.3× |
| Us breast unilateral limited (76642) |
$1,941 |
$1,941 |
22.2× |
| Us chest (76604) |
$2,866 |
$2,866 |
27.3× |
| Us compl joint r-t w/image documentation (76881) |
$1,405 |
$1,405 |
13.4× |
| Us fetal nuchal translucency 1st gestation (76813) |
$2,866 |
$2,866 |
27.3× |
| Us guided compression repair (76936) |
$7,008 |
$7,008 |
32.3× |
| Us infant hips dynamic (76885) |
$1,948 |
$1,948 |
22.3× |
| Us infant hips limited static (76886) |
$1,948 |
$1,948 |
22.3× |
| Us kidney transplant (76776) |
$2,866 |
$2,866 |
27.3× |
| Us ob detailed single fetus (76811) |
$2,866 |
$2,866 |
12.0× |
| Us ob transvaginal (76817) |
$2,866 |
$2,866 |
27.3× |
| Us pelvic non ob complete (76856) |
$2,204 |
$2,204 |
21.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$2,550 |
$2,550 |
24.3× |
| Us pregnancy ltd (76815) |
$2,300 |
$2,300 |
21.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$2,866 |
$2,866 |
27.3× |
| Us retroperitoneal complete (76770) |
$2,866 |
$2,866 |
27.3× |
| Us retroperitoneal limited (76775) |
$1,755 |
$1,755 |
16.7× |
| Us scrotum and contents (76870) |
$1,590 |
$1,590 |
15.1× |
| Us soft tissue head/neck (76536) |
$2,866 |
$2,866 |
27.3× |
| Us spinal canal and contents (76800) |
$3,223 |
$3,223 |
30.7× |
| Us transrectal (76872) |
$2,866 |
$2,866 |
27.3× |
| Us transrectal prostate volume (76873) |
$4,029 |
$4,029 |
38.4× |
| Us xtr non-vasc lmtd (76882) |
$1,521 |
$1,521 |
14.5× |
| Us, eye b-scan (76512) |
$3,141 |
$3,141 |
29.9× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$3,976 |
$3,976 |
7.2× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$4,252 |
$4,252 |
11.0× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$3,976 |
$3,976 |
5.7× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$3,976 |
$3,976 |
7.2× |
| Vascular flow imaging (78445) |
$2,108 |
$2,108 |
5.2× |
| Vasogram (74440) |
$5,637 |
$5,637 |
23.5× |
| Venogram extremity bilateral (75822) |
$17,281 |
$17,281 |
10.9× |
| Venogram orbital (75880) |
$17,585 |
$17,585 |
27.9× |
| Venography caval inferior serialography rs&i (75825) |
$18,770 |
$18,770 |
5.9× |
| Venography caval superior serialography rs&i (75827) |
$17,585 |
$17,585 |
11.1× |
| Venography epidural rs&i (75872) |
$17,585 |
$17,585 |
27.9× |
| Venography extremity unilateral rs&i (75820) |
$11,282 |
$11,282 |
7.1× |
| Venography Renal Bilateral (75833) |
$54,409 |
$54,409 |
17.2× |
| Venography renal unilateral selective rs&i (75831) |
$41,698 |
$41,698 |
13.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$17,585 |
$17,585 |
5.5× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$23,005 |
$23,005 |
4.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,262 |
$1,262 |
12.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$669 |
$669 |
7.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$3,209 |
$3,209 |
18.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$687 |
$687 |
7.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$432 |
$432 |
4.9× |
| X-ray exam hip uni 1 view (73501) |
$2,572 |
$2,572 |
29.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$1,155 |
$1,155 |
13.2× |
| X-ray exam hip uni 4/> views (73503) |
$1,691 |
$1,691 |
16.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$2,019 |
$2,019 |
19.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$2,939 |
$2,939 |
28.0× |
| X-ray exam of femur 1 (73551) |
$1,262 |
$1,262 |
14.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$3,209 |
$3,209 |
18.2× |
| X-ray eye for foreign body (70030) |
$2,019 |
$2,019 |
23.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$2,019 |
$2,019 |
19.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$2,019 |
$2,019 |
23.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$669 |
$669 |
7.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$26,073 |
$26,073 |
12.4× |
| X-ray head for orthodontia (70350) |
$2,019 |
$2,019 |
23.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$5,637 |
$5,637 |
32.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$2,019 |
$2,019 |
19.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,379 |
$1,379 |
13.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$706 |
$706 |
6.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$2,019 |
$2,019 |
23.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$645 |
$645 |
7.4× |
| X-ray of voice box or throat (70370) |
$3,390 |
$3,390 |
38.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,348 |
$1,348 |
12.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$8,855 |
$8,855 |
16.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$5,637 |
$5,637 |
16.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$695 |
$695 |
8.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$47 |
$47 |
0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,019 |
$2,019 |
19.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$682 |
$682 |
6.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$351 |
$351 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$687 |
$687 |
7.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$716 |
$716 |
8.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$390 |
$390 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,151 |
$1,151 |
11.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$467 |
$467 |
4.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$2,019 |
$2,019 |
23.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$2,019 |
$2,019 |
23.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$410 |
$410 |
4.7× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$288 |
$288 |
3.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,740 |
$1,740 |
16.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$599 |
$599 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$644 |
$644 |
7.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$674 |
$674 |
7.7× |
| Xr c-spine 6 or more views (72052) |
$2,019 |
$2,019 |
19.2× |
| Xr chest 4+ views (71048) |
$831 |
$831 |
7.9× |
| Xr Cholecystography Oral Contrast (74290) |
$2,161 |
$2,161 |
12.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$1,262 |
$1,262 |
12.0× |
| Xr myelogram posterior fossa (70010) |
$13,053 |
$13,053 |
37.2× |
| Xr optic foramina (70190) |
$2,019 |
$2,019 |
23.1× |
| Xr shoulder 1 view (73020) |
$297 |
$297 |
3.4× |
| Xr spine cervical 4 or 5 views (72050) |
$1,620 |
$1,620 |
15.4× |
| Xr tibia/fibula 2 views (73590) |
$692 |
$692 |
7.9× |
| Xr tmj bilateral (70330) |
$1,262 |
$1,262 |
14.4× |
| Xray knee 1 or 2 views rt (73560) |
$387.50 |
$387.50 |
4.4× |