| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,559.92 |
$9,325 |
3.1× |
| Abdomen 1 View (74018) |
$48.58 |
$138 |
0.5× |
| Abdomen 2 views (74019) |
$71.10 |
$202 |
0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$912.91 |
$1,848 |
2.2× |
| Adrenal Cortex & Medulla Img (78075) |
$856.10 |
$1,733 |
0.6× |
| Angio internal mammary (75756) |
$1,102.05 |
$3,950 |
0.3× |
| Angio pulmonary bilat (75743) |
$2,777.45 |
$9,955 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,618.48 |
$5,801 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,264.99 |
$4,534 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,627.69 |
$5,834 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,262.69 |
$8,110 |
0.7× |
| Ankle 2 views (73600) |
$46.82 |
$133 |
0.5× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
| Arthrogram ankle (73615) |
$270.90 |
$671 |
0.7× |
| Arthrogram hip (73525) |
$226.08 |
$560 |
0.6× |
| Arthrogram Wrist (73115) |
$307.23 |
$761 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$434.72 |
$889 |
3.1× |
| Bone age studies (77072) |
$56.67 |
$161 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$1,508.18 |
$3,053 |
3.6× |
| Bone Imaging Limited Area (78300) |
$977.13 |
$1,978 |
2.3× |
| Bone Imaging Multiple Areas (78305) |
$1,172.26 |
$2,373 |
2.8× |
| Bone Imaging Whole Body (78306) |
$1,371.84 |
$2,777 |
3.2× |
| Bone marrow imaging limited area (78102) |
$404.59 |
$819 |
1.0× |
| Bone marrow imaging; multiple areas (78103) |
$517.71 |
$1,048 |
1.2× |
| Bone marrow imaging; whole body (78104) |
$590.33 |
$1,195 |
1.4× |
| Bone survey infant (77076) |
$95.04 |
$270 |
0.9× |
| Brachytx isodose complex (77318) |
$800.98 |
$1,638 |
2.0× |
| Brachytx isodose intermed (77317) |
$742.30 |
$1,518 |
1.9× |
| Brachytx Isodose Plan Simple (77316) |
$444.99 |
$910 |
1.1× |
| Brain Flow Imaging Only (78610) |
$401.13 |
$812 |
0.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$705.43 |
$1,428 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,457.85 |
$6,088 |
1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$817.16 |
$2,117 |
2.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$759.65 |
$1,968 |
0.9× |
| Cat Scan Follow-Up Study (76380) |
$218.55 |
$470 |
2.4× |
| Cerebrospinal Fluid Scan (78630) |
$965.28 |
$1,954 |
1.7× |
| Chest 1 view (71045) |
$75.20 |
$188 |
0.8× |
| Chest 2 views (71046) |
$76.40 |
$191 |
0.8× |
| Chest 3 views (71047) |
$96.40 |
$241 |
1.0× |
| Chest 4 or more views (71048) |
$104 |
$260 |
0.9× |
| Cholecystography Oral Contrast (74290) |
$127.42 |
$362 |
0.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$233.02 |
$662 |
2.1× |
| Clavicle complete (73000) |
$53.86 |
$153 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$158.32 |
$474 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$748.66 |
$1,531 |
5.3× |
| Contrast Exam Abdominl Aorta (75625) |
$1,102.05 |
$3,950 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$206.62 |
$587 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$226.08 |
$560 |
0.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$331.45 |
$821 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$541.75 |
$1,622 |
1.5× |
| CT abdomen and pelvis without contrast (74176) |
$361.05 |
$1,081 |
1.4× |
| CT abdomen w contrast (74160) |
$311.62 |
$933 |
1.7× |
| CT abdomen w wo contrast (74170) |
$373.75 |
$1,119 |
2.0× |
| CT abdomen w/o contrast (74150) |
$249.16 |
$746 |
2.3× |
| CT Angio Abdomen and Pelvis (74174) |
$569.14 |
$1,704 |
1.5× |
| CT Angio Chest (71275) |
$482.96 |
$1,446 |
2.6× |
| CT Angio Head (70496) |
$574.78 |
$1,774 |
3.1× |
| CT angio hrt w/3d image (75574) |
$611.94 |
$1,316 |
1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$466.26 |
$1,396 |
2.5× |
| CT Angio Neck (70498) |
$479.84 |
$1,481 |
2.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$481.96 |
$1,443 |
2.6× |
| CT cervical spine w/ contrast (72126) |
$478.29 |
$1,432 |
1.3× |
| CT cervical spine w/o contrast (72125) |
$382.43 |
$1,145 |
3.5× |
| CT cervical spine w/wo cont (72127) |
$573.81 |
$1,718 |
3.1× |
| CT chest w contrast (71260) |
$383.43 |
$1,148 |
2.1× |
| CT chest w/wo contrast (71270) |
$459.92 |
$1,377 |
2.5× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$804.45 |
$1,730 |
4.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$643.56 |
$1,384 |
5.8× |
| CT head/brain with contrast (70460) |
$456.19 |
$1,408 |
2.5× |
| CT head/brain without and with contrast (70470) |
$547.24 |
$1,689 |
3.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$459.89 |
$989 |
1.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$55.80 |
$120 |
0.6× |
| CT hrt w/3d image congen (75573) |
$582.64 |
$1,253 |
1.6× |
| CT iac w contrast (70481) |
$380.70 |
$1,175 |
2.1× |
| CT l-spine w&w/o contrast (72133) |
$458.92 |
$1,374 |
2.5× |
| CT lower ext w/o (73700) |
$295.92 |
$886 |
2.7× |
| CT lower extremity w/contrast material (73701) |
$370.07 |
$1,108 |
2.0× |
| CT lumbar spine w contrast (72132) |
$382.43 |
$1,145 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$305.94 |
$916 |
2.8× |
| CT maxillofacial w contrast (70487) |
$370.98 |
$1,145 |
2.0× |
| CT maxillofacial wo contrast (70486) |
$296.78 |
$916 |
2.7× |
| CT neck tissue combo (70492) |
$456.84 |
$1,410 |
2.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$456.84 |
$1,410 |
2.5× |
| CT orbits w/o contrast (70480) |
$304.56 |
$940 |
2.8× |
| CT pelvis w&w/o contrast (72194) |
$511.02 |
$1,530 |
2.8× |
| CT pelvis w/o contrast (72192) |
$340.68 |
$1,020 |
3.1× |
| CT scan of leg combo (73702) |
$443.89 |
$1,329 |
2.4× |
| CT scans face/jaw combo (70488) |
$445.18 |
$1,374 |
2.4× |
| CT soft tissue neck w contrast (70491) |
$380.70 |
$1,175 |
2.1× |
| CT soft tissue neck w/o contrast (70490) |
$304.56 |
$940 |
2.8× |
| CT thoracic spine w contrast (72129) |
$476.62 |
$1,427 |
2.6× |
| CT thoracic spine w/o contrast (72128) |
$381.09 |
$1,141 |
3.5× |
| CT thorax w/o contrast (71250) |
$306.61 |
$918 |
2.8× |
| CT upper ext wo (73200) |
$305.94 |
$916 |
2.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$458.92 |
$1,374 |
2.5× |
| CT upper extremity with contrast (73201) |
$382.43 |
$1,145 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$759.34 |
$1,633 |
4.1× |
| Cta Abdomen (74175) |
$392.45 |
$1,175 |
2.1× |
| CTA pelvis (72191) |
$536.74 |
$1,607 |
2.9× |
| Dilation ureters/urethra rs&i (74485) |
$539.97 |
$1,534 |
0.2× |
| Discography Cerv/Thor Spine (72285) |
$1,964.86 |
$5,582 |
1.0× |
| Diskography lumbar (72295) |
$1,963.10 |
$5,577 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$192.44 |
$348 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$163.14 |
$295 |
1.5× |
| Dxa Bone Density Axial (77080) |
$101.02 |
$287 |
0.9× |
| Dxa bone density study (77085) |
$170.72 |
$485 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$94.34 |
$268 |
1.0× |
| Echo exam of fetal heart (76825) |
$624.89 |
$1,130 |
1.1× |
| Echo exam uterus (76831) |
$345.63 |
$625 |
1.4× |
| Echograp Trans R Pros Study (76873) |
$291.43 |
$527 |
2.6× |
| Esophagram (74220) |
$127.42 |
$362 |
0.7× |
| Fetal Biophys Profile W/Nst (76818) |
$320.19 |
$579 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$275.39 |
$498 |
2.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$382.53 |
$991 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$194.66 |
$553 |
0.8× |
| Follow-Up Angiography (75898) |
$616.03 |
$2,208 |
0.2× |
| Foot 2 views (73620) |
$46.82 |
$133 |
0.5× |
| Forearm 2 views (73090) |
$58.78 |
$167 |
0.6× |
| Gastric emptying imaging study (78264) |
$1,241.42 |
$2,513 |
2.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,473.11 |
$2,982 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$694.07 |
$1,405 |
1.6× |
| Gated Heart Planar Single (78472) |
$934.65 |
$1,892 |
2.2× |
| Gated Heart, Multiple (78473) |
$1,177.70 |
$2,384 |
2.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,669.23 |
$3,379 |
2.9× |
| Hand 2 views (73120) |
$56.67 |
$161 |
0.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,715.43 |
$9,643 |
6.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$4,326.67 |
$8,848 |
5.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,883.63 |
$5,897 |
3.9× |
| Heart first pass single,planar (78481) |
$857.09 |
$1,735 |
1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,576.61 |
$4,479 |
0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,432.99 |
$4,071 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$2,036.76 |
$4,123 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$1,189.55 |
$2,408 |
2.8× |
| Ht Muscle Image Spect Sing (78451) |
$654.55 |
$1,325 |
0.5× |
| Hysterosalpingogram (74740) |
$410.78 |
$1,167 |
1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$197.97 |
$358 |
2.2× |
| Infant hip ultrasound, limited static exam (76886) |
$140.46 |
$254 |
1.5× |
| Interstitial radiation source applic complex (77778) |
$1,940.35 |
$3,968 |
2.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,310.03 |
$2,679 |
1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$916.88 |
$1,875 |
1.6× |
| Intracavitary radiation source applic simple (77761) |
$694.38 |
$1,420 |
1.2× |
| Joint Survey Single View (77077) |
$66.18 |
$188 |
0.6× |
| K Flow/Funct Image Multiple (78709) |
$1,150.53 |
$2,329 |
2.0× |
| K Flow/Funct Image W/Drug (78708) |
$743.96 |
$1,506 |
1.3× |
| K Flow/Funct Image W/O Drug (78707) |
$883.27 |
$1,788 |
1.5× |
| Knee 3 Views (73562) |
$59.14 |
$168 |
0.6× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$670.36 |
$1,357 |
1.6× |
| Leveen/Shunt Patency Exam (78291) |
$644.67 |
$1,305 |
1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$426.82 |
$864 |
1.0× |
| Liver imaging static only (78201) |
$680.24 |
$1,377 |
1.2× |
| Liver imaging w/vascular flow (78202) |
$749.40 |
$1,517 |
1.3× |
| Lung Perf&Ventilat Diferentl (78598) |
$904.02 |
$1,830 |
1.6× |
| Lung perfusion differential (78597) |
$873.39 |
$1,768 |
2.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,526.95 |
$3,091 |
2.7× |
| Lung Ventilation Imaging (78579) |
$506.84 |
$1,026 |
1.2× |
| Lymph System Imaging (78195) |
$905.01 |
$1,832 |
1.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,250.66 |
$3,553 |
0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$591.36 |
$1,680 |
0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,390.40 |
$3,950 |
0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$997.92 |
$2,835 |
0.3× |
Magnetic Image Jaw Joint (70336)
range across 3 matching MRF lines |
$411.09–$616.83 |
$1,065–$1,598 |
varies |
| Mammary ductogram or galactogram multiple (77054) |
$193.95 |
$551 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$147.49 |
$419 |
0.6× |
| Meckels Divert Exam (78290) |
$743.96 |
$1,506 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$722.25 |
$1,477 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$46.82 |
$133 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$13.38 |
$38 |
0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$72.16 |
$205 |
0.7× |
| Mr safety implt pos&/immoblj (76019) |
$110.18 |
$313 |
1.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$171.42 |
$487 |
0.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$561.05 |
$1,737 |
1.5× |
| MRA head w/o contrast (70544) |
$374.03 |
$1,158 |
1.5× |
| MRA head with contrast (70545) |
$467.70 |
$1,448 |
1.3× |
| MRA neck w contrast (70548) |
$706.40 |
$2,187 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$847.55 |
$2,624 |
2.3× |
| MRA neck w/o contrast (70547) |
$564.93 |
$1,749 |
2.2× |
| MRI abdomen w contrast (74182) |
$501.41 |
$1,299 |
1.4× |
| MRI abdomen w/o contrast (74181) |
$401.05 |
$1,039 |
1.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$514.92 |
$1,334 |
0.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$617.99 |
$1,601 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$514.92 |
$1,334 |
0.6× |
| MRI bone marrow blood supply (77084) |
$687.85 |
$1,782 |
2.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$608.34 |
$1,576 |
2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$409.55 |
$1,061 |
1.6× |
| MRI cardiac w/o cont stress (75559) |
$506.43 |
$1,312 |
0.9× |
| MRI cardiac w/o contrast (75557) |
$544.65 |
$1,411 |
2.2× |
| MRI cervical spine w contrast (72142) |
$381.52 |
$1,334 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$305.16 |
$1,067 |
1.2× |
| MRI chest w/o contrast (71550) |
$799.02 |
$2,070 |
3.2× |
| MRI chest with contrast (71551) |
$998.97 |
$2,588 |
1.2× |
| MRI chest wo w contrast (71552) |
$1,198.53 |
$3,105 |
3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$558.93 |
$1,448 |
1.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$670.48 |
$1,737 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$446.99 |
$1,158 |
1.8× |
| MRI lumbar spine w contrast (72149) |
$381.52 |
$1,334 |
1.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$457.89 |
$1,601 |
1.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$332.35 |
$1,158 |
1.3× |
| MRI orbit face neck w contrast (70542) |
$415.58 |
$1,448 |
1.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$498.52 |
$1,737 |
1.4× |
| MRI pelvis w contrast (72196) |
$514.92 |
$1,334 |
1.4× |
| MRI pelvis w/o & w contrast (72197) |
$617.99 |
$1,601 |
1.7× |
| MRI pelvis w/o contrast (72195) |
$411.86 |
$1,067 |
1.6× |
| MRI thoracic spine w/o contrast (72146) |
$296.87 |
$1,038 |
1.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$630.72 |
$1,634 |
1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$504.50 |
$1,307 |
2.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$756.95 |
$1,961 |
2.1× |
| MRI, abdomen, combo (74183) |
$601.77 |
$1,559 |
1.6× |
| MRI, dorsal spine combo (72157) |
$445.30 |
$1,557 |
1.2× |
| MRI, dorsal spine contrast (72147) |
$371.23 |
$1,298 |
1.0× |
| MRI, joint upper extrem (73221) |
$411.86 |
$1,067 |
1.6× |
| MRI, joint upper extrem combo (73223) |
$617.99 |
$1,601 |
1.7× |
| MRI, lumbar spine combo (72158) |
$457.89 |
$1,601 |
1.2× |
| Myelogram cervical (72240) |
$581.15 |
$1,651 |
0.7× |
| Myelogram Lumbar (72265) |
$511.10 |
$1,452 |
0.6× |
| Myelography thoracic (72255) |
$536.80 |
$1,525 |
0.6× |
| Myelograpy 2/more regions rs&i (72270) |
$519.55 |
$1,476 |
0.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$532.04 |
$1,077 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$789.41 |
$1,598 |
0.6× |
| N-invas est c ffr sw aly CTA (75580) |
$1,370.70 |
$4,569 |
1.5× |
| Neck soft tissue (70360) |
$61.60 |
$175 |
0.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$275.65 |
$558 |
0.7× |
| Nonvascular Shunt X-Ray (75809) |
$241.12 |
$685 |
2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,000.02 |
$8,180 |
2.7× |
| Nuclear Rx Intra-Arterial (79445) |
$344.45 |
$828 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,428.54 |
$3,434 |
5.8× |
| Ob us nuchal meas 1 gest (76813) |
$220.65 |
$399 |
2.0× |
| Optic foramina (70190) |
$49.98 |
$142 |
0.5× |
| Panoramic X-ray of jaws (70355) |
$44.70 |
$127 |
0.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$754.34 |
$1,527 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$538.95 |
$1,091 |
1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$691.60 |
$1,400 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$56.67 |
$161 |
0.5× |
| Pet Image W/Ct Lmtd (78814) |
$2,131.24 |
$5,279 |
1.4× |
| PET image w/CT, full body (78816) |
$2,415.46 |
$5,983 |
1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,368.22 |
$5,866 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$866.97 |
$1,755 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$87.65 |
$249 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$318.56 |
$905 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$52.45 |
$149 |
0.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$46.82 |
$133 |
0.5× |
| Radex elbow complete minimum 3 views (73080) |
$66.18 |
$188 |
0.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$64.77 |
$184 |
0.6× |
| Radex fingr minimum 2 views (73140) |
$58.78 |
$167 |
0.6× |
| Radex foot complete minimum 3 views (73630) |
$48.93 |
$139 |
0.5× |
| Radex Hand Minimum 3 Views (73130) |
$62.30 |
$177 |
0.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$63.71 |
$181 |
0.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$68.64 |
$195 |
0.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$54.91 |
$156 |
0.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$48.93 |
$139 |
0.5× |
| Radex shoulder complete minimum 2 views (73030) |
$57.73 |
$164 |
0.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$46.82 |
$133 |
0.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$467.46 |
$1,328 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$52.80 |
$150 |
0.6× |
| Radex Sternum Minimum 2 Views (71120) |
$46.82 |
$133 |
0.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$114.40 |
$325 |
1.2× |
| Radex Toe Minimum 2 Views (73660) |
$55.62 |
$158 |
0.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$64.42 |
$183 |
0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$61.25 |
$174 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$120.38 |
$342 |
1.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,241.63 |
$27,079 |
1.7× |
| Radiation treatment delivery level 1 (77402) |
$408.80 |
$836 |
3.8× |
| Radiation treatment delivery level 2 (77407) |
$462.10 |
$945 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$864.55 |
$1,768 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$66.18 |
$188 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$109.47 |
$311 |
1.0× |
| Radiologic exam colon double contrast study (74280) |
$200.64 |
$570 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$131.30 |
$373 |
0.7× |
| Radiologic exam knee complete 4/more views (73564) |
$73.22 |
$208 |
0.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$62.66 |
$178 |
0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$127.42 |
$362 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$127.42 |
$362 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$145.73 |
$414 |
0.8× |
| Radiologic examination femur 1 view (73551) |
$46.82 |
$133 |
0.5× |
| Radiologic examination femur minimum 2 views (73552) |
$49.98 |
$142 |
0.5× |
| Radiologic examination knee 1/2 views (73560) |
$57.73 |
$164 |
0.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$76.03 |
$216 |
0.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$64.42 |
$183 |
0.7× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$109.47 |
$311 |
0.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$4,280.71 |
$8,754 |
10.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$2,779.48 |
$5,684 |
6.8× |
| Renal Cyst Study (74470) |
$291.46 |
$828 |
0.5× |
| Ribs bilateral 3 views (71110) |
$63.71 |
$181 |
0.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$606.14 |
$1,227 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$646.15 |
$1,308 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,742.34 |
$3,527 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$973.67 |
$1,971 |
1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,386.16 |
$2,806 |
2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,871.77 |
$3,789 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,887.08 |
$3,820 |
1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,435.56 |
$2,906 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$561.60 |
$1,350 |
2.3× |
Rp Therapy Intravenous Administration (79101)
range across 2 matching MRF lines |
$1,230.94–$1,268.38 |
$3,049 |
varies |
| Salivary Gland Imaging (78230) |
$374.45 |
$758 |
0.9× |
| Scapula (73010) |
$66.18 |
$188 |
0.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$33.51 |
$83 |
1.4× |
| Sella turcica (70240) |
$46.82 |
$133 |
0.5× |
| Shoulder 1 view (73020) |
$52.45 |
$149 |
0.6× |
| Shoulder Arthrography (73040) |
$317.73 |
$787 |
0.9× |
| Sialogram (70390) |
$205.22 |
$583 |
0.8× |
| Skull less than 4 views (70250) |
$66.18 |
$188 |
0.6× |
| Special dosimetry (77331) |
$368.22 |
$753 |
2.6× |
| Special Physics Consult (77370) |
$700.74 |
$1,433 |
4.9× |
| Special teletherapy port plan (77321) |
$802.45 |
$1,641 |
2.0× |
| Special treatment procedure (77470) |
$1,719.32 |
$3,516 |
2.9× |
| Stereotactic Body Radiation Delivery (77373) |
$4,753.57 |
$9,721 |
2.5× |
| Sternoclavicular joints (71130) |
$59.14 |
$168 |
0.6× |
| Superior sagittal sinus venogram (75870) |
$1,320.70 |
$3,752 |
0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$317.85 |
$650 |
2.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$777.51 |
$1,590 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$323.23 |
$661 |
0.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$147.36 |
$365 |
0.6× |
| Testicular Imaging W/Flow (78761) |
$401.13 |
$812 |
0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,403.92 |
$2,871 |
3.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$876.29 |
$1,792 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$730.57 |
$1,494 |
5.1× |
| Thoracic spine 2 views (72070) |
$56.67 |
$161 |
0.5× |
| Thoracic spine 3 views (72072) |
$69.70 |
$198 |
0.6× |
| Thoracolumbar 2 views (72080) |
$70.05 |
$199 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$565.14 |
$1,144 |
1.3× |
| Thyroid Met Imaging Body (78018) |
$1,113.97 |
$2,255 |
1.9× |
| Thyroid Uptake Measurement (78012) |
$327.52 |
$663 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,192.52 |
$2,414 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,076.78 |
$2,202 |
2.7× |
| Tx devices design & construction intermediate (77333) |
$916.39 |
$1,874 |
6.5× |
| Tx devices design & construction simple (77332) |
$442.06 |
$904 |
3.1× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$154.29–$231.71 |
$279–$419 |
varies |
| Ultrasound elastography first target lesion (76982) |
$190.23 |
$344 |
1.7× |
| Ultrasound Elastography Parenchyma (76981) |
$221.75 |
$401 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$235.58 |
$426 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$191.34 |
$346 |
1.7× |
| Umbilical-artery Doppler (OB) (76820) |
$142.12 |
$257 |
1.3× |
| Upper gi w/o kub (74240) |
$127.42 |
$362 |
0.7× |
| Ureteral Reflux Study (78740) |
$393.22 |
$796 |
0.9× |
| Urethrocystogram voiding (74455) |
$182.69 |
$519 |
0.7× |
| Urethrocystography retrograde (74450) |
$228.45 |
$649 |
0.9× |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
$198.53–$298.07 |
$359–$539 |
varies |
| Us chest (76604) |
$142.12 |
$257 |
1.3× |
| Us complete joint (76881) |
$275.39 |
$498 |
2.5× |
| Us exam, pelvic, limited (76857) |
$195.76 |
$354 |
1.8× |
| Us head (76506) |
$191.89 |
$347 |
1.7× |
| Us kidney transplant (76776) |
$249.40 |
$451 |
2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$142.12 |
$257 |
1.3× |
| Us ob detailed single fetus (76811) |
$565.72 |
$1,023 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$168.67 |
$305 |
1.5× |
| Us ob transvaginal (76817) |
$244.98 |
$443 |
2.2× |
| Us pelvic non ob complete (76856) |
$219.54 |
$397 |
2.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$294.75 |
$533 |
2.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$203.50 |
$368 |
1.8× |
| Us retroperitoneal complete (76770) |
$214.01 |
$387 |
1.9× |
| Us retroperitoneal limited (76775) |
$114.47 |
$207 |
1.0× |
| Us scrotum and contents (76870) |
$204.61 |
$370 |
1.9× |
| Us spinal canal and contents (76800) |
$296.41 |
$536 |
2.7× |
| Us thyroid (76536) |
$244.43 |
$442 |
2.2× |
| Us transrectal (76872) |
$492.17 |
$890 |
4.5× |
| Vascular Flow Imaging (78445) |
$389.77 |
$789 |
0.9× |
| Vein X-Ray Chest (75827) |
$1,474.18 |
$4,188 |
0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,434.75 |
$4,076 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$1,320.70 |
$3,752 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,390.40 |
$3,950 |
0.4× |
| Venography extremity bilateral rs&i (75822) |
$1,312.26 |
$3,728 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$680.42 |
$1,933 |
0.4× |
| Venography Renal Bilateral (75833) |
$3,216.58 |
$9,138 |
1.0× |
| Venography Renal Unilateral (75831) |
$1,817.38 |
$5,163 |
0.5× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,405.22 |
$6,833 |
0.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$653.07 |
$1,322 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$47.52 |
$135 |
0.5× |
| Wrist 2 views (73100) |
$48.22 |
$137 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$87.30 |
$248 |
0.9× |
| X-ray antegrade pyelogram tube (74425) |
$315.39 |
$896 |
0.9× |
| X-Ray Aorta Leg Arteries (75630) |
$3,191.48 |
$11,439 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$58.78 |
$167 |
0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$55.26 |
$157 |
0.6× |
| X-Ray Exam Breast Specimen (76098) |
$140.80 |
$400 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$67.23 |
$191 |
0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$87.65 |
$249 |
0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$103.14 |
$293 |
0.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$90.46 |
$257 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$99.62 |
$283 |
1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$109.82 |
$312 |
1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$114.05 |
$324 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$107.71 |
$306 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$172.83 |
$491 |
1.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$84.13 |
$239 |
0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$53.86 |
$153 |
0.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$86.59 |
$246 |
0.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$68.64 |
$195 |
0.6× |
| X-ray eye for foreign body (70030) |
$46.82 |
$133 |
0.5× |
| X-ray humerus (73060) |
$59.84 |
$170 |
0.7× |
| X-ray IV pyelogram (ivp) (74400) |
$372.77 |
$1,059 |
2.0× |
| X-ray IV pyelogram+tomography (74415) |
$454.78 |
$1,292 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$57.02 |
$162 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$59.14 |
$168 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$56.67 |
$161 |
0.5× |
| X-ray nose-rectum child f.b. (76010) |
$46.82 |
$133 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$75.33 |
$214 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$64.42 |
$183 |
0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$56.67 |
$161 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$48.93 |
$139 |
0.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$63.01 |
$179 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$76.03 |
$216 |
0.7× |
| X-ray thoracic spine 4 vw (72074) |
$80.26 |
$228 |
0.7× |
| X-Ray Tmj Unilat (70328) |
$48.22 |
$137 |
0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$197.12 |
$560 |
0.5× |
| X-Rays Bone Length Studies (77073) |
$59.84 |
$170 |
0.5× |
| X-Rays Bone Survey Complete (77075) |
$91.87 |
$261 |
0.8× |
| Xr c-spine 4 or 5 views (72050) |
$76.03 |
$216 |
0.7× |
| Xr facial bones less than 3 views (70140) |
$46.82 |
$133 |
0.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$56.67 |
$161 |
0.5× |
| Xr orbits complete 4 views (70200) |
$64.06 |
$182 |
0.6× |
| Xr Tomogram Single Plane (76100) |
$87.65 |
$249 |
0.8× |