| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,942.50 |
$5,250 |
1.5× |
| Abdomen 2 views (74019) |
$158.73 |
$429 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$417.92 |
$1,129.50 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,119.92 |
$5,729.50 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,674.84 |
$9,932 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$1,500.35 |
$4,055 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$2,895.07 |
$7,824.50 |
1.0× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,274.28 |
$3,444 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,898.93 |
$5,132.25 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,190.85 |
$3,218.50 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,633.29 |
$7,117 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,633.29 |
$7,117 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$429.76 |
$1,161.50 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$703.56 |
$1,901.50 |
0.2× |
| Ankle 2 views (73600) |
$115.26 |
$311.50 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$297.67 |
$804.50 |
0.9× |
| Aortogram thoracic (75605) |
$2,701.56 |
$7,301.50 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,149.24 |
$5,808.75 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,568.06 |
$4,238 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,134.14 |
$3,065.25 |
0.4× |
| Arthrogram elbow (73085) |
$258.63 |
$699 |
0.8× |
| Arthrogram hip (73525) |
$248.64 |
$672 |
0.7× |
| Arthrogram shoulder (73040) |
$267.14 |
$722 |
0.8× |
| Arthrogram wrist (73115) |
$248.64 |
$672 |
0.7× |
| Arthrography knee lt (73580) |
$372.96 |
$1,008 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$139.21 |
$376.25 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$378.88 |
$1,024 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$295.17 |
$797.75 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$606.15 |
$1,638.25 |
1.6× |
| Bone age studies (77072) |
$170.57 |
$461 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$591.91 |
$1,599.75 |
1.5× |
| Bone Marrow Imaging Limited Area (78102) |
$350.95 |
$948.50 |
0.9× |
| Bone survey complete (77075) |
$330.04 |
$892 |
3.3× |
| Brain image w/flow 4 + views (78606) |
$657.95 |
$1,778.25 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,792.56 |
$4,844.75 |
1.3× |
| Brain Imaging Vascular Flow Only (78610) |
$500.89 |
$1,353.75 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$884.49 |
$2,390.50 |
2.6× |
| Cardiac shunt detection (78428) |
$332.54 |
$898.75 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$350.02 |
$946 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$148.46 |
$401.25 |
1.8× |
| Chest 1 view (71045) |
$86.03 |
$232.50 |
1.0× |
| Chest 3 views (71047) |
$130.80 |
$353.50 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$240.41 |
$649.75 |
1.4× |
| Cineradiography/videoradiography (76120) |
$187.41 |
$506.50 |
1.9× |
| Clavicle complete (73000) |
$121.18 |
$327.50 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$952.66 |
$2,574.75 |
9.5× |
| Continuing medical physics consltj pr wk (77336) |
$147.45 |
$398.50 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,216.01 |
$3,286.50 |
3.6× |
| CT abdomen and pelvis without contrast (74176) |
$920.93 |
$2,489 |
4.0× |
| CT abdomen w contrast (74160) |
$1,019.81 |
$2,756.25 |
6.0× |
| CT abdomen w wo contrast (74170) |
$1,093.17 |
$2,954.50 |
6.5× |
| CT abdomen w/o contrast (74150) |
$954.97 |
$2,581 |
9.5× |
| CT angio hrt w/3d image (75574) |
$1,166.70 |
$3,153.25 |
3.5× |
| CT angiography upper extremity lt (73206) |
$1,229.70 |
$3,323.50 |
7.3× |
| CT c-spine w/o contrast (72125) |
$826.21 |
$2,233 |
8.2× |
| CT cervical spine w&w/o contrast (72127) |
$920.65 |
$2,488.25 |
5.5× |
| CT cervical spine with contrast (72126) |
$855.16 |
$2,311.25 |
2.5× |
| CT chest w/wo contrast (71270) |
$1,043.49 |
$2,820.25 |
6.2× |
| CT chest with contrast (71260) |
$1,108.34 |
$2,995.50 |
6.6× |
| CT head/brain with contrast (70460) |
$883.28 |
$2,387.25 |
5.2× |
| CT head/brain without and with contrast (70470) |
$1,065.14 |
$2,878.75 |
6.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$514.67 |
$1,391 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$277.50 |
$750 |
3.3× |
| CT iac w contrast (70481) |
$753.23 |
$2,035.75 |
4.5× |
| CT limited/localized follow up study (76380) |
$275 |
$743.25 |
3.3× |
| CT lower ext w/o (73700) |
$1,234.88 |
$3,337.50 |
12.3× |
| CT lower extremity w wo contrast (73702) |
$790.69 |
$2,137 |
4.7× |
| CT lower extremity with contrast (73701) |
$989.29 |
$2,673.75 |
5.9× |
| CT lumbar spine w & w/o contrast (72133) |
$715.30 |
$1,933.25 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$843.69 |
$2,280.25 |
8.4× |
| CT lumbar spine with contrast (72132) |
$902.80 |
$2,440 |
2.7× |
| CT maxillofacial w contrast (70487) |
$741.48 |
$2,004 |
4.4× |
| CT maxillofacial w/o contrast (70486) |
$756 |
$2,043.25 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$786.90 |
$2,126.75 |
4.7× |
| CT neck soft tissue w contrast (70491) |
$917.14 |
$2,478.75 |
5.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,023.14 |
$2,765.25 |
6.1× |
| CT orbits w/o contrast (70480) |
$790.88 |
$2,137.50 |
7.9× |
| CT pelvis w & w/o contrast (72194) |
$813.08 |
$2,197.50 |
4.8× |
| CT pelvis w/o contrast (72192) |
$943.69 |
$2,550.50 |
9.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,042.01 |
$2,816.25 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$725.29 |
$1,960.25 |
7.2× |
| CT thoracic spine w/contrast (72129) |
$859.79 |
$2,323.75 |
5.1× |
| CT thoracic spine w/o contrast (72128) |
$843.69 |
$2,280.25 |
8.4× |
| CT thoracic spine w/wo contrast (72130) |
$715.30 |
$1,933.25 |
4.2× |
| CT thorax w/o contrast (71250) |
$952.66 |
$2,574.75 |
9.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$738.24 |
$1,995.25 |
4.4× |
| CT upper extremity w/o contrast rt (73200) |
$793.65 |
$2,145 |
7.9× |
| CT upper extremity with contrast (73201) |
$885.60 |
$2,393.50 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,528.75 |
$4,131.75 |
9.1× |
| Cta Abdomen (74175) |
$1,341.62 |
$3,626 |
8.0× |
| CTA abdomen pelvis (74174) |
$2,483.63 |
$6,712.50 |
7.4× |
| CTA chest (71275) |
$1,499.24 |
$4,052 |
8.9× |
| Cta Head (70496) |
$1,328.95 |
$3,591.75 |
7.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,329.13 |
$3,592.25 |
7.9× |
| Cta Neck (70498) |
$1,315.72 |
$3,556 |
7.8× |
| Cta Pelvis (72191) |
$1,012.14 |
$2,735.50 |
6.0× |
| Cystography minimum 3 views rs&i (74430) |
$265.85 |
$718.50 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$220.98 |
$597.25 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$109.34 |
$295.50 |
1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$80.11 |
$216.50 |
1.0× |
| Echoencephalography real time imaging (76506) |
$226.26 |
$611.50 |
2.3× |
| Esophagus (74220) |
$221.54 |
$598.75 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$294.06 |
$794.75 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$164.47 |
$444.50 |
0.7× |
| Foot 2 views (73620) |
$116.09 |
$313.75 |
1.4× |
| Forearm 2 views (73090) |
$117.66 |
$318 |
1.4× |
| Gated Heart Planar Single (78472) |
$515.41 |
$1,393 |
1.3× |
| Hand 2 views (73120) |
$120.16 |
$324.75 |
1.2× |
| Hand 3 views (73130) |
$131.35 |
$355 |
1.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,396.01 |
$3,773 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$564.90 |
$1,526.75 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$528.18 |
$1,427.50 |
1.4× |
| Ht muscle image spect sing (78451) |
$1,379.27 |
$3,727.75 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$124.23 |
$335.75 |
1.5× |
| Hysterosalpingogram (74740) |
$252.25 |
$681.75 |
1.1× |
| Interstitial radiation source applic complex (77778) |
$2,614.70 |
$7,066.75 |
3.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,409.72 |
$6,512.75 |
3.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,401.67 |
$6,491 |
4.5× |
| Intracavitary radiation source applic simple (77761) |
$2,393.99 |
$6,470.25 |
4.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$284.16 |
$768 |
2.8× |
| Kidney imaging morphology (78700) |
$769.51 |
$2,079.75 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$782.83 |
$2,115.75 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$818.07 |
$2,211 |
1.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,257.54 |
$3,398.75 |
2.4× |
| Knee 3 views (73562) |
$121.82 |
$329.25 |
1.5× |
| Liver & spleen imaging static only (78215) |
$406.08 |
$1,097.50 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$429.48 |
$1,160.75 |
1.1× |
| Liver imaging static only (78201) |
$321.62 |
$869.25 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$664.15 |
$1,795 |
1.3× |
| Lung perfusion differential (78597) |
$328.56 |
$888 |
0.9× |
| Lung Ventilation Imaging (78579) |
$328.56 |
$888 |
0.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$711.05 |
$1,921.75 |
0.2× |
| Lymphoscintigraphy (78195) |
$563.97 |
$1,524.25 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$233.56 |
$631.25 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$171.22 |
$462.75 |
0.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$45.70 |
$123.50 |
0.5× |
| Meckels Diverticulum (78290) |
$314.22 |
$849.25 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,282.33 |
$3,465.75 |
3.6× |
| MRA head w & w/o contrast (70546) |
$838.98 |
$2,267.50 |
2.5× |
| MRA head w/o contrast (70544) |
$599.59 |
$1,620.50 |
2.6× |
| MRA head with contrast (70545) |
$686.07 |
$1,854.25 |
2.0× |
| MRA neck w contrast (70548) |
$624.38 |
$1,687.50 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$915.20 |
$2,473.50 |
2.7× |
| MRA neck w/o contrast (70547) |
$587.47 |
$1,587.75 |
2.6× |
| MRI abdomen w contrast (74182) |
$954.14 |
$2,578.75 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,188.35 |
$3,211.75 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$979.02 |
$2,646 |
4.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,113.05 |
$3,008.25 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,025.64 |
$2,772 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$869.96 |
$2,351.25 |
3.8× |
| MRI breast w/o contrast unilat (77046) |
$663.69 |
$1,793.75 |
2.9× |
| MRI c-spine with contrast (72142) |
$972.27 |
$2,627.75 |
2.9× |
| MRI cardiac w/o contrast (75557) |
$717.52 |
$1,939.25 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$963.02 |
$2,602.75 |
4.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,182.06 |
$3,194.75 |
3.5× |
| MRI chest w/o contrast (71550) |
$901.97 |
$2,437.75 |
3.9× |
| MRI chest with contrast (71551) |
$927.41 |
$2,506.50 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$927.04 |
$2,505.50 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$976.80 |
$2,640 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,025.64 |
$2,772 |
4.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$932.86 |
$2,521.25 |
4.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,270.49 |
$3,433.75 |
3.8× |
| MRI orbit/face/neck w/contrast (70542) |
$940.26 |
$2,541.25 |
2.8× |
| MRI pelvis w contrast (72196) |
$842.49 |
$2,277 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,192.60 |
$3,223.25 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$889.67 |
$2,404.50 |
3.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,070.87 |
$2,894.25 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,070.87 |
$2,894.25 |
3.2× |
| MRI spectroscopy (76390) |
$442.89 |
$1,197 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,276.04 |
$3,448.75 |
3.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,054.87 |
$2,851 |
3.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,396.84 |
$3,775.25 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$972.27 |
$2,627.75 |
2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,390.28 |
$3,757.50 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$976.62 |
$2,639.50 |
4.3× |
| MRI tmj (70336) |
$372.68 |
$1,007.25 |
1.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,025.64 |
$2,772 |
4.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,124.43 |
$3,039 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$966.16 |
$2,611.25 |
4.2× |
| Myelogram Cervical (72240) |
$436.60 |
$1,180 |
0.6× |
| Myelogram Lumbar (72265) |
$482.85 |
$1,305 |
0.6× |
| Myelogram thoracic (72255) |
$464.81 |
$1,256.25 |
0.6× |
| Myelography 2 or more regions (72270) |
$542.14 |
$1,465.25 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,001.05 |
$5,408.25 |
1.6× |
| Neck soft tissue (70360) |
$109.15 |
$295 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$145.60 |
$393.50 |
0.4× |
| Nm adrenal scan (78075) |
$716.04 |
$1,935.25 |
0.6× |
| Nm bone marrow multiple (78103) |
$395.44 |
$1,068.75 |
1.0× |
| Nm cisternogram (78630) |
$440.30 |
$1,190 |
0.8× |
| Nm csf leak detection (78650) |
$1,171.61 |
$3,166.50 |
0.9× |
| Nm gastric emptying study (78264) |
$557.68 |
$1,507.25 |
1.5× |
| Nm gastroesophageal reflux study (78262) |
$395.62 |
$1,069.25 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$272.41 |
$736.25 |
0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,138.05 |
$5,778.50 |
1.6× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,783.07 |
$7,521.80 |
2.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$585.53 |
$1,582.50 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$352.15 |
$951.75 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$446.22 |
$1,206 |
4.4× |
| Osseous survey infant (77076) |
$158.36 |
$428 |
1.6× |
| Osseous survey limited (77074) |
$240.22 |
$649.25 |
2.4× |
| Parathyroid imaging (78070) |
$402.84 |
$1,088.75 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$116 |
$313.50 |
1.2× |
| Perineogram (74775) |
$160.95 |
$435 |
0.7× |
| Peritoneogram rs&i (74190) |
$295.26 |
$798 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$2,937.43 |
$7,939 |
2.1× |
| PET imaging CT for attenuation limited area (78814) |
$2,098.18 |
$5,670.75 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,959.91 |
$7,999.75 |
2.2× |
| PET imaging limited area chest head/neck (78811) |
$2,480.20 |
$6,703.25 |
2.0× |
| PET whole body (78813) |
$758.40 |
$2,049.72 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,070.87 |
$2,894.25 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,213.60 |
$3,280 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$766.36 |
$2,071.25 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$394.33 |
$1,065.75 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$703.19 |
$1,900.50 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$245.22 |
$662.75 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$143.38 |
$387.50 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$148.46 |
$401.25 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$107.67 |
$291 |
1.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$93.61 |
$253 |
0.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,766.05 |
$10,178.50 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$214.88 |
$580.75 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$89.73 |
$242.50 |
0.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$150.96 |
$408 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$113.31 |
$306.25 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$116.83 |
$315.75 |
1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$158.73 |
$429 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$118.40 |
$320 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$287.68 |
$777.50 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$321.62 |
$869.25 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$299.98 |
$810.75 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$116.09 |
$313.75 |
1.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$53.47 |
$144.50 |
0.6× |
| Radiological examination surgical specimen (76098) |
$209.61 |
$566.50 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,190.85 |
$3,218.50 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,274.28 |
$3,444 |
0.4× |
| Ribs bilateral 3 views (71110) |
$197.49 |
$533.75 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$627.52 |
$1,696 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$587.75 |
$1,588.50 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$727.51 |
$1,966.25 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,555.57 |
$4,204.25 |
6.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$230.05 |
$621.75 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$960.06 |
$2,594.75 |
4.3× |
| Sacroiliac Joints < 3 Views (72200) |
$120.71 |
$326.25 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$242.07 |
$654.25 |
1.1× |
| Salivary gland imaging (78230) |
$272.41 |
$736.25 |
0.7× |
| Scanogram (77073) |
$150.41 |
$406.50 |
1.5× |
| Scapula complete (73010) |
$129.78 |
$350.75 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$34.97 |
$94.50 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$99.25 |
$268.25 |
1.0× |
| Sialogram (70390) |
$168.72 |
$456 |
0.7× |
| Simulation intermediate (77285) |
$474.62 |
$1,282.75 |
1.3× |
| Small bowel series (74250) |
$172.14 |
$465.25 |
1.0× |
| Spec medical radj physics consltj (77370) |
$224.41 |
$606.50 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$389.33 |
$1,052.25 |
1.1× |
| Special dosimetry (77331) |
$138.75 |
$375 |
1.1× |
| Special treatment procedure (77470) |
$609.48 |
$1,647.25 |
1.1× |
| Spine thoracic 3 views (72072) |
$172.24 |
$465.50 |
1.7× |
| Stereotactic body radiation delivery (77373) |
$2,206.50 |
$5,963.50 |
1.3× |
| Superior sagittal sinus venogram (75870) |
$348.82 |
$942.75 |
0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$122.66 |
$331.50 |
1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$277.22 |
$749.25 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$200.36 |
$541.50 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$342.62 |
$926 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$647.59 |
$1,750.25 |
1.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$350.76 |
$948 |
2.7× |
| Therapeutic Enema (74283) |
$254.19 |
$687 |
1.5× |
| Thoracolumbar 2 views (72080) |
$141.43 |
$382.25 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$589.32 |
$1,592.75 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$176.21 |
$476.25 |
0.5× |
| Thyroid uptake measurement (78012) |
$134.03 |
$362.25 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$302.48 |
$817.50 |
0.8× |
| Tmj unilateral (70328) |
$57.44 |
$155.25 |
0.7× |
| Tomogram (76100) |
$240.59 |
$650.25 |
2.4× |
| Treatment device intermediate (77333) |
$298.50 |
$806.75 |
2.3× |
| Treatment devices simple (77332) |
$244.76 |
$661.50 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$809.28 |
$2,187.25 |
1.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$398.21 |
$1,076.25 |
1.0× |
| Tx devices design & construction complex (77334) |
$447.24 |
$1,208.75 |
1.2× |
| Ultrasound elastography first target lesion (76982) |
$114.33 |
$309 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$362.60 |
$980 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$340.03 |
$919 |
3.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$59.39 |
$160.50 |
0.7× |
| Unlisted Ultrasound Procedure (76999) |
$74.09 |
$200.25 |
0.9× |
| Upper Extremity Infant (73092) |
$83.53 |
$225.75 |
0.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$406.35 |
$1,098.25 |
1.1× |
| Urethrocystography retrograde rs&i (74450) |
$257.15 |
$695 |
1.1× |
| Urethrocystography voiding (74455) |
$269.36 |
$728 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$330.32 |
$892.75 |
2.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$322.92 |
$872.75 |
1.9× |
| Us breast unilateral complete (76641) |
$347.62 |
$939.50 |
3.5× |
| Us breast unilateral limited (76642) |
$347.62 |
$939.50 |
4.2× |
| Us chest (76604) |
$263.90 |
$713.25 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$205.63 |
$555.75 |
2.0× |
| Us elastography parenchyma (76981) |
$114.33 |
$309 |
1.1× |
| Us guided compression repair (76936) |
$699.76 |
$1,891.25 |
3.4× |
| Us infant hips dynamic (76885) |
$175.75 |
$475 |
2.1× |
| Us infant hips limited static (76886) |
$93.80 |
$253.50 |
1.1× |
| Us kidney transplant (76776) |
$398.49 |
$1,077 |
4.0× |
| Us ob detailed single fetus (76811) |
$479.89 |
$1,297 |
2.1× |
| Us ob transvaginal (76817) |
$272.04 |
$735.25 |
2.7× |
| Us pelvic non ob complete (76856) |
$485.35 |
$1,311.75 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$301.27 |
$814.25 |
3.0× |
| Us pregnancy ltd (76815) |
$350.02 |
$946 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$488.77 |
$1,321 |
4.9× |
| Us retroperitoneal complete (76770) |
$400.16 |
$1,081.50 |
4.0× |
| Us retroperitoneal limited (76775) |
$277.13 |
$749 |
2.8× |
| Us scrotum and contents (76870) |
$299.15 |
$808.50 |
3.0× |
| Us soft tissue head/neck (76536) |
$408.02 |
$1,102.75 |
4.1× |
| Us spinal canal and contents (76800) |
$175.01 |
$473 |
1.7× |
| Us transrectal (76872) |
$295.45 |
$798.50 |
2.9× |
| Us transrectal prostate volume (76873) |
$193.14 |
$522 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$154.75 |
$418.25 |
1.5× |
| Us, eye b-scan (76512) |
$256.50 |
$693.25 |
2.6× |
| Venogram extremity bilateral (75822) |
$890.50 |
$2,406.75 |
0.6× |
| Venogram orbital (75880) |
$815.39 |
$2,203.75 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,395.64 |
$3,772 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$867.10 |
$2,343.50 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$610.50 |
$1,650 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,329.50 |
$3,593.25 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,190.85 |
$3,218.50 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,517.48 |
$6,804 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,171.01 |
$11,273 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$87.14 |
$235.50 |
1.0× |
| Wrist 2 views (73100) |
$123.21 |
$333 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$199.80 |
$540 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$117.94 |
$318.75 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$202.30 |
$546.75 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$340.40 |
$920 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$112.94 |
$305.25 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$238.28 |
$644 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$195.36 |
$528 |
1.9× |
| X-ray exam hip uni 1 view (73501) |
$100.27 |
$271 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$122.10 |
$330 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$161.69 |
$437 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$159.19 |
$430.25 |
1.6× |
| X-ray exam of femur 1 (73551) |
$110.54 |
$298.75 |
1.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$425.78 |
$1,150.75 |
2.5× |
| X-ray eye for foreign body (70030) |
$45.70 |
$123.50 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$95.18 |
$257.25 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$60.03 |
$162.25 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$136.99 |
$370.25 |
1.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,213.69 |
$3,280.25 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$110.08 |
$297.50 |
1.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$292.12 |
$789.50 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$81.12 |
$219.25 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$151.61 |
$409.75 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$89.82 |
$242.75 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$113.96 |
$308 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$148.46 |
$401.25 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$266.22 |
$719.50 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$192.03 |
$519 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$95.37 |
$257.75 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$66.51 |
$179.75 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$74.93 |
$202.50 |
0.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$127.74 |
$345.25 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$289.25 |
$781.75 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$172.88 |
$467.25 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$206.74 |
$558.75 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$225.61 |
$609.75 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$129.04 |
$348.75 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$124.32 |
$336 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$131.91 |
$356.50 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$95.37 |
$257.75 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$70.67 |
$191 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$115.35 |
$311.75 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$95.37 |
$257.75 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$120.99 |
$327 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$125.80 |
$340 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$114.33 |
$309 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$148.46 |
$401.25 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$175.01 |
$473 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$100.46 |
$271.50 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$131.91 |
$356.50 |
1.6× |
| Xr arthrogram ankle (73615) |
$258.63 |
$699 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$217.93 |
$589 |
2.2× |
| Xr chest 4+ views (71048) |
$119.33 |
$322.50 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$120.16 |
$324.75 |
1.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$48.01 |
$129.75 |
0.5× |
| Xr shoulder 1 view (73020) |
$112.02 |
$302.75 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$184.82 |
$499.50 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$116.09 |
$313.75 |
1.4× |
| Xr tmj bilateral (70330) |
$101.47 |
$274.25 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$155.40 |
$420 |
1.9× |