| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,717.29 |
$5,724.30 |
1.3× |
| Abdomen 2 views (74019) |
$83.18 |
$277.25 |
0.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$528.71 |
$1,762.35 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,055.34 |
$3,517.80 |
0.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,015.86 |
$3,386.20 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$854.82 |
$2,849.40 |
0.3× |
| Angiography internal mammary rs&i (75756) |
$783.65 |
$2,612.15 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$994.49 |
$3,314.95 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$946.82 |
$3,156.05 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$815.37 |
$2,717.90 |
0.3× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$994.49 |
$3,314.95 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$994.49 |
$3,314.95 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$270.27 |
$900.90 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$780.50 |
$2,601.65 |
0.3× |
| Ankle 2 views (73600) |
$81.39 |
$271.30 |
1.0× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$994.49 |
$3,314.95 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$916.14 |
$3,053.80 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$1,101.51 |
$3,671.70 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$897.47 |
$2,991.55 |
0.3× |
| Arthrogram elbow (73085) |
$205.79 |
$685.95 |
0.6× |
| Arthrogram hip (73525) |
$215.28 |
$717.60 |
0.6× |
| Arthrogram shoulder (73040) |
$200.49 |
$668.30 |
0.6× |
| Arthrography knee lt (73580) |
$194.49 |
$648.30 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$175.70 |
$585.65 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$494.72 |
$1,649.05 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$556.61 |
$1,855.35 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$738.80 |
$2,462.65 |
1.9× |
| Bone survey complete (77075) |
$350.94 |
$1,169.80 |
3.5× |
| Brachytx isodose complex (77318) |
$571.73 |
$1,905.75 |
1.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$503.97 |
$1,679.90 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$834.05 |
$2,780.15 |
2.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$691.43 |
$2,304.75 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$127.55 |
$425.15 |
1.5× |
| Chest 1 view (71045) |
$97.90 |
$326.35 |
1.2× |
| Chest 3 views (71047) |
$90.22 |
$300.72 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$167.01 |
$556.70 |
1.0× |
| Clavicle complete (73000) |
$92.33 |
$307.75 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$277.83 |
$926.10 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,946.21 |
$6,487.35 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,409.82 |
$4,699.40 |
6.2× |
| CT abdomen w contrast (74160) |
$874.64 |
$2,915.45 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,020.18 |
$3,400.60 |
6.1× |
| CT abdomen w/o contrast (74150) |
$784.58 |
$2,615.25 |
7.8× |
| CT angio hrt w/3d image (75574) |
$1,085.27 |
$3,617.55 |
3.2× |
| CT angiography upper extremity lt (73206) |
$941.18 |
$3,137.25 |
5.6× |
| CT c-spine w/o contrast (72125) |
$784.19 |
$2,613.95 |
7.8× |
| CT cervical spine w&w/o contrast (72127) |
$861.72 |
$2,872.40 |
5.1× |
| CT cervical spine with contrast (72126) |
$812.40 |
$2,708 |
2.4× |
| CT chest w/wo contrast (71270) |
$1,007.36 |
$3,357.85 |
6.0× |
| CT chest with contrast (71260) |
$882.89 |
$2,942.95 |
5.2× |
| CT head/brain with contrast (70460) |
$746.24 |
$2,487.45 |
4.4× |
| CT head/brain without and with contrast (70470) |
$802.22 |
$2,674.05 |
4.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,008.18 |
$3,360.60 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$101.15 |
$337.15 |
1.2× |
| CT iac w contrast (70481) |
$672.63 |
$2,242.10 |
4.0× |
| CT limited/localized follow up study (76380) |
$235.70 |
$785.65 |
2.8× |
| CT lower ext w/o (73700) |
$640.52 |
$2,135.05 |
6.4× |
| CT lower extremity w wo contrast (73702) |
$718.02 |
$2,393.40 |
4.3× |
| CT lower extremity with contrast (73701) |
$687.89 |
$2,292.95 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$861.72 |
$2,872.40 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$746.63 |
$2,488.75 |
7.4× |
| CT lumbar spine with contrast (72132) |
$812.40 |
$2,708 |
2.4× |
| CT maxillofacial w contrast (70487) |
$622.91 |
$2,076.35 |
3.7× |
| CT maxillofacial w/o contrast (70486) |
$554.03 |
$1,846.75 |
5.5× |
| CT maxillofacial w/wo contrast (70488) |
$658.53 |
$2,195.10 |
3.9× |
| CT neck soft tissue w contrast (70491) |
$807.32 |
$2,691.05 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$705.11 |
$2,350.35 |
4.2× |
| CT orbits w/o contrast (70480) |
$540.69 |
$1,802.30 |
5.4× |
| CT pelvis w & w/o contrast (72194) |
$926.33 |
$3,087.75 |
5.5× |
| CT pelvis w/o contrast (72192) |
$625.65 |
$2,085.50 |
6.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$826.49 |
$2,754.95 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$707.07 |
$2,356.90 |
7.0× |
| CT thoracic spine w/contrast (72129) |
$745.83 |
$2,486.10 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$710.19 |
$2,367.30 |
7.1× |
| CT thoracic spine w/wo contrast (72130) |
$835.10 |
$2,783.65 |
5.0× |
| CT thorax w/o contrast (71250) |
$817.11 |
$2,723.70 |
8.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$811.20 |
$2,704 |
4.8× |
| CT upper extremity w/o contrast rt (73200) |
$573.59 |
$1,911.95 |
5.7× |
| CT upper extremity with contrast (73201) |
$668.72 |
$2,229.05 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$813.95 |
$2,713.15 |
4.8× |
| Cta Abdomen (74175) |
$856.64 |
$2,855.45 |
5.1× |
| CTA abdomen pelvis (74174) |
$1,707.77 |
$5,692.55 |
5.1× |
| CTA chest (71275) |
$868.77 |
$2,895.90 |
5.2× |
| Cta Head (70496) |
$779.51 |
$2,598.35 |
4.6× |
| CTA lwr ext w&w/o contrast (73706) |
$731.75 |
$2,439.15 |
4.3× |
| Cta Neck (70498) |
$779.51 |
$2,598.35 |
4.6× |
| Cta Pelvis (72191) |
$851.15 |
$2,837.15 |
5.1× |
| Cystography minimum 3 views rs&i (74430) |
$473.94 |
$1,579.80 |
1.4× |
| Diskogram cervical (72285) |
$725.16 |
$2,417.20 |
0.4× |
| Diskography lumbar (72295) |
$787.17 |
$2,623.90 |
0.4× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$206.72 |
$689.05 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$161.37 |
$537.90 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$69.42 |
$231.40 |
0.8× |
| Esophagus (74220) |
$173 |
$576.65 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$179.36 |
$597.85 |
0.8× |
| Foot 2 views (73620) |
$66.95 |
$223.15 |
0.8× |
| Forearm 2 views (73090) |
$86.67 |
$288.90 |
1.0× |
| Gated Heart Planar Single (78472) |
$759.08 |
$2,530.28 |
2.0× |
| Hand 2 views (73120) |
$87.17 |
$290.55 |
0.9× |
| Hand 3 views (73130) |
$86.67 |
$288.90 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,809.11 |
$6,030.35 |
2.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$897.47 |
$2,991.55 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$647.19 |
$2,157.30 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$647.19 |
$2,157.30 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,895.22 |
$6,317.40 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$97.26 |
$324.20 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$3,474.99 |
$11,583.30 |
5.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$568.20 |
$1,894 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$750.63 |
$2,502.10 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$607.71 |
$2,025.70 |
1.2× |
| Knee 3 views (73562) |
$90.93 |
$303.10 |
1.1× |
| Liver & spleen imaging static only (78215) |
$541.35 |
$1,804.50 |
1.4× |
| Liver imaging static only (78201) |
$550.59 |
$1,835.30 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$982.62 |
$3,275.40 |
1.9× |
| Lung Ventilation Imaging (78579) |
$323.34 |
$1,077.80 |
0.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,266.86 |
$7,556.20 |
0.7× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$446.75 |
$1,489.15 |
0.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,138.98 |
$3,796.60 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,266.86 |
$7,556.20 |
0.7× |
| Lymphoscintigraphy (78195) |
$903.40 |
$3,011.35 |
1.7× |
| Mammary ductogram or galactogram multiple (77054) |
$186.77 |
$622.55 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$186.77 |
$622.55 |
0.8× |
| Meckels Diverticulum (78290) |
$419.16 |
$1,397.20 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$997.56 |
$3,325.20 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$75.90 |
$253 |
0.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$51.21 |
$170.70 |
0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$21.11 |
$70.35 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$78.39 |
$261.30 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$208.35 |
$694.50 |
0.9× |
| MRA head w & w/o contrast (70546) |
$1,187.03 |
$3,956.75 |
3.5× |
| MRA head w/o contrast (70544) |
$780.50 |
$2,601.65 |
3.4× |
| MRA head with contrast (70545) |
$897.47 |
$2,991.55 |
2.7× |
| MRA neck w contrast (70548) |
$859.07 |
$2,863.55 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$987.66 |
$3,292.20 |
3.0× |
| MRA neck w/o contrast (70547) |
$747.02 |
$2,490.05 |
3.3× |
| MRI abdomen w contrast (74182) |
$1,085.64 |
$3,618.80 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,248.42 |
$4,161.40 |
3.7× |
| MRI abdomen w/o contrast (74181) |
$943.95 |
$3,146.50 |
4.1× |
| MRI any jnt lwr ext with con lt (73722) |
$846.02 |
$2,820.05 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$990.14 |
$3,300.45 |
1.3× |
| MRI c-spine with contrast (72142) |
$1,152.21 |
$3,840.70 |
3.4× |
| MRI cardiac w/o contrast (75557) |
$630.71 |
$2,102.35 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$1,002.12 |
$3,340.40 |
4.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,186.41 |
$3,954.70 |
3.5× |
| MRI chest w/o contrast (71550) |
$897.12 |
$2,990.40 |
3.9× |
| MRI chest with contrast (71551) |
$1,031.73 |
$3,439.10 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$905.22 |
$3,017.40 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,015.17 |
$3,383.90 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$882.66 |
$2,942.20 |
3.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$870.69 |
$2,902.30 |
3.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,152.21 |
$3,840.70 |
3.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,002.12 |
$3,340.40 |
3.0× |
| MRI pelvis w contrast (72196) |
$948.54 |
$3,161.80 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,090.92 |
$3,636.40 |
3.3× |
| MRI pelvis w/o contrast (72195) |
$824.88 |
$2,749.60 |
3.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,138.83 |
$3,796.10 |
3.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,160.82 |
$3,869.40 |
1.5× |
| MRI scan of leg joint before and after contrast (73723) |
$972.87 |
$3,242.90 |
2.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,325.22 |
$4,417.40 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,152.21 |
$3,840.70 |
3.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,325.22 |
$4,417.40 |
4.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,152.21 |
$3,840.70 |
3.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,325.22 |
$4,417.40 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,002.12 |
$3,340.40 |
4.4× |
| MRI tmj (70336) |
$612.53 |
$2,041.75 |
2.7× |
| MRI upper ext joint w/o contrast (73221) |
$861.18 |
$2,870.60 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,041.24 |
$3,470.80 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$787.17 |
$2,623.90 |
3.4× |
| Myelogram Cervical (72240) |
$509.51 |
$1,698.35 |
0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$734.81 |
$2,449.35 |
0.6× |
| Myocardial infarct spect (78469) |
$458.67 |
$1,528.90 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,450.22 |
$8,167.40 |
2.0× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$788.76 |
$2,629.20 |
0.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$788.76 |
$2,629.20 |
0.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$790.86 |
$2,636.20 |
0.4× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,007.75 |
$3,359.15 |
0.5× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$1,007.75 |
$3,359.15 |
0.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,413.53 |
$8,045.10 |
2.9× |
| Neck soft tissue (70360) |
$94.07 |
$313.55 |
1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$252.27 |
$840.90 |
0.7× |
| Nm cisternogram (78630) |
$908.91 |
$3,029.70 |
1.7× |
| Nm gastric emptying study (78264) |
$418.64 |
$1,395.45 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$289.59 |
$965.30 |
0.8× |
| Nm peritoneal-venous shunt patency (78291) |
$243.83 |
$812.75 |
0.6× |
| Nm whole blood volume (78122) |
$1,793.84 |
$5,979.45 |
3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,288.09 |
$10,960.30 |
2.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$788.88 |
$2,629.60 |
0.6× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$788.76 |
$2,629.20 |
0.6× |
| Nuclear medicine study of endocrine organs (78099) |
$569.91 |
$1,899.70 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$481.85 |
$1,606.15 |
2.2× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$178.55 |
$595.15 |
1.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$178.55 |
$595.15 |
1.8× |
| Osseous survey limited (77074) |
$174.78 |
$582.60 |
1.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,096.34 |
$3,654.45 |
2.1× |
| Parathyrd planar w/wo subtrj (78071) |
$1,311.71 |
$4,372.35 |
3.4× |
| Parathyroid imaging (78070) |
$539.24 |
$1,797.45 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$90.57 |
$301.90 |
0.9× |
| Pr gi endoscopic ultrasound (76975) |
$159.75 |
$532.50 |
0.7× |
| Pr MRI brain w/ dye (70558) |
$4,643.76 |
$15,479.20 |
27.6× |
| Pr MRI brain w/o & w/ dye (70559) |
$4,643.76 |
$15,479.20 |
27.6× |
| Pr MRI brain w/o dye (70557) |
$4,628.64 |
$15,428.80 |
8.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,167.39 |
$3,891.30 |
3.5× |
| Pr red cell survival study (78130) |
$518.16 |
$1,727.20 |
1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,380.90 |
$4,603 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$559.20 |
$1,864 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$545.01 |
$1,816.70 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$869.94 |
$2,899.80 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$174.78 |
$582.60 |
0.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$291.93 |
$973.10 |
2.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$118.41 |
$394.70 |
1.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$5,535.86 |
$18,452.88 |
0.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$264.74 |
$882.45 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$171.50 |
$571.65 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$155.90 |
$519.65 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$149.40 |
$498 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$99.72 |
$332.40 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$108.54 |
$361.80 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$115.77 |
$385.90 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$179.36 |
$597.85 |
1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$173 |
$576.65 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$202.23 |
$674.10 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$217.79 |
$725.95 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$106.05 |
$353.50 |
1.3× |
| Radiological examination surgical specimen (76098) |
$142.64 |
$475.45 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$897.47 |
$2,991.55 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$897.47 |
$2,991.55 |
0.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$721.88 |
$2,406.25 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$772.52 |
$2,575.05 |
1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$607.16 |
$2,023.85 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$453.33 |
$1,511.10 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$607.16 |
$2,023.85 |
2.7× |
| Scapula complete (73010) |
$85.62 |
$285.40 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$32.45 |
$108.15 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$336.15 |
$1,120.50 |
3.4× |
| Simulation intermediate (77285) |
$579.60 |
$1,931.98 |
1.6× |
| Small bowel series (74250) |
$257.81 |
$859.35 |
1.5× |
| Spec medical radj physics consltj (77370) |
$396.15 |
$1,320.50 |
3.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,086.99 |
$3,623.30 |
3.0× |
| Special dosimetry (77331) |
$244.74 |
$815.80 |
1.9× |
| Special treatment procedure (77470) |
$785.24 |
$2,617.45 |
1.5× |
| Spine thoracic 3 views (72072) |
$140.25 |
$467.50 |
1.4× |
| Splenoportograpy rs&i (75810) |
$1,751.63 |
$5,838.75 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$1,646.52 |
$5,488.40 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$913.80 |
$3,046 |
0.3× |
| Tbs Technical Calculation Only (77091) |
$129.47 |
$431.55 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,086.99 |
$3,623.30 |
3.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$370.44 |
$1,234.80 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$592.46 |
$1,974.85 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$479.94 |
$1,599.78 |
3.7× |
| Thoracolumbar 2 views (72080) |
$108.20 |
$360.65 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$576.63 |
$1,922.10 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$370.20 |
$1,234 |
1.0× |
| Thyroid uptake measurement (78012) |
$325.98 |
$1,086.60 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$538.16 |
$1,793.85 |
1.4× |
| Tmj unilateral (70328) |
$97.26 |
$324.20 |
1.2× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$129.47 |
$431.55 |
1.6× |
| Treatment device intermediate (77333) |
$190.83 |
$636.10 |
1.5× |
| Treatment devices simple (77332) |
$136.28 |
$454.25 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$492.90 |
$1,643 |
0.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$168.95 |
$563.15 |
0.4× |
| Tx devices design & construction complex (77334) |
$308.12 |
$1,027.05 |
0.9× |
| Ultrasound elastography first target lesion (76982) |
$369.77 |
$1,232.55 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$227.54 |
$758.45 |
2.3× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) |
$569.91 |
$1,899.70 |
1.5× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$542.78 |
$1,809.25 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$342.51 |
$1,141.70 |
1.5× |
| Urethrocystography voiding (74455) |
$242.43 |
$808.10 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$284.01 |
$946.70 |
1.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$251.94 |
$839.80 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$170.31 |
$567.70 |
1.7× |
| Us breast unilateral complete (76641) |
$173.48 |
$578.25 |
1.7× |
| Us breast unilateral limited (76642) |
$165.20 |
$550.65 |
2.0× |
| Us chest (76604) |
$188.28 |
$627.60 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$209.46 |
$698.20 |
2.1× |
| Us kidney transplant (76776) |
$570.44 |
$1,901.45 |
5.7× |
| Us ob transvaginal (76817) |
$304.19 |
$1,013.95 |
3.0× |
| Us pelvic non ob complete (76856) |
$286.97 |
$956.55 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$156.23 |
$520.75 |
1.6× |
| Us pregnancy ltd (76815) |
$163.14 |
$543.80 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$253.24 |
$844.12 |
2.5× |
| Us retroperitoneal complete (76770) |
$280.32 |
$934.40 |
2.8× |
| Us retroperitoneal limited (76775) |
$252.51 |
$841.70 |
2.5× |
| Us scrotum and contents (76870) |
$264.30 |
$881 |
2.6× |
| Us soft tissue head/neck (76536) |
$200.36 |
$667.88 |
2.0× |
| Us transrectal prostate volume (76873) |
$241.58 |
$805.25 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$209.40 |
$697.98 |
2.1× |
| Us, eye b-scan (76512) |
$249.02 |
$830.05 |
2.5× |
| Venogram extremity bilateral (75822) |
$1,338.96 |
$4,463.20 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,712.93 |
$9,043.10 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$1,338.96 |
$4,463.20 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,338.96 |
$4,463.20 |
0.9× |
| Venography Renal Bilateral (75833) |
$897.47 |
$2,991.55 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$897.47 |
$2,991.55 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$822.42 |
$2,741.40 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$994.49 |
$3,314.95 |
0.2× |
| Wrist 2 views (73100) |
$82.40 |
$274.65 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$136.02 |
$453.40 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$83.87 |
$279.55 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$82.80 |
$276 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$286.13 |
$953.75 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$87.41 |
$291.35 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$85.98 |
$286.60 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$181.80 |
$606 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$191.36 |
$637.85 |
2.3× |
| X-ray exam hip uni 4/> views (73503) |
$191.45 |
$638.15 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$291.93 |
$973.10 |
2.9× |
| X-ray exam of femur 1 (73551) |
$101.12 |
$337.08 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$527.13 |
$1,757.10 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$113.81 |
$379.35 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$93.36 |
$311.20 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$82.13 |
$273.75 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$416.43 |
$1,388.10 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$75.41 |
$251.35 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$120.17 |
$400.55 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$128.24 |
$427.45 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$122.97 |
$409.90 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$244.16 |
$813.85 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$139.19 |
$463.95 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$91.26 |
$304.20 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$69.08 |
$230.25 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$383.01 |
$1,276.70 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$104.31 |
$347.70 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$111 |
$370 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$150.80 |
$502.65 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$131.09 |
$436.95 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$125.45 |
$418.15 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$94.07 |
$313.55 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$130.37 |
$434.55 |
1.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$77.18 |
$257.25 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$135.30 |
$451 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$95.84 |
$319.45 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$91.95 |
$306.50 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$82.44 |
$274.80 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$106.43 |
$354.75 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$108.20 |
$360.65 |
1.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$139.19 |
$463.95 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$82.13 |
$273.75 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$84.90 |
$283 |
1.0× |
| Xr arthrogram ankle (73615) |
$194.49 |
$648.30 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$223.76 |
$745.85 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$75.41 |
$251.35 |
0.9× |
| Xr shoulder 1 view (73020) |
$89.75 |
$299.15 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$146.24 |
$487.45 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$88.44 |
$294.80 |
1.1× |
| Xr tmj bilateral (70330) |
$118.41 |
$394.70 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$94.26 |
$314.18 |
1.1× |