| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,559.92 |
$9,325 |
3.1× |
| Abdomen 2 views (74019) |
$71.10 |
$202 |
0.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$912.91 |
$1,848 |
2.2× |
| 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 internal mammary rs&i (75756) |
$1,102.05 |
$3,950 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,777.45 |
$9,955 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,627.69 |
$5,834 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$616.03 |
$2,208 |
0.2× |
| 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× |
| Antegrade urography radiological supvj & interpj (74425) |
$315.39 |
$896 |
0.9× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,906.41 |
$6,833 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,191.48 |
$11,439 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$1,102.05 |
$3,950 |
0.3× |
| Arthrogram elbow (73085) |
$226.08 |
$560 |
0.6× |
| Arthrogram hip (73525) |
$226.08 |
$560 |
0.6× |
| Arthrogram shoulder (73040) |
$317.73 |
$787 |
0.9× |
| Arthrogram wrist (73115) |
$307.23 |
$761 |
0.8× |
| Arthrography knee lt (73580) |
$331.45 |
$821 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$434.72 |
$889 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$977.13 |
$1,978 |
2.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,172.26 |
$2,373 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,371.84 |
$2,777 |
3.2× |
| Bone age studies (77072) |
$56.67 |
$161 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$1,508.18 |
$3,053 |
3.6× |
| Bone Marrow Imaging Limited Area (78102) |
$404.59 |
$819 |
1.0× |
| Bone survey complete (77075) |
$91.87 |
$261 |
0.8× |
| Brachytx isodose complex (77318) |
$800.98 |
$1,638 |
2.0× |
| Brachytx isodose intermed (77317) |
$742.30 |
$1,518 |
1.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$444.99 |
$910 |
1.1× |
| Brain image w/flow 4 + views (78606) |
$705.43 |
$1,428 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,457.85 |
$6,088 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$401.13 |
$812 |
0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$817.16 |
$2,117 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$53.86 |
$153 |
0.6× |
| Chest 1 view (71045) |
$75.20 |
$188 |
0.8× |
| Chest 3 views (71047) |
$96.40 |
$241 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$127.42 |
$362 |
0.7× |
| Cineradiography/videoradiography (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× |
| 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 hrt w/3d image (75574) |
$611.94 |
$1,316 |
1.7× |
| CT angiography upper extremity lt (73206) |
$481.96 |
$1,443 |
2.6× |
| CT c-spine w/o contrast (72125) |
$382.43 |
$1,145 |
3.5× |
| CT cervical spine w&w/o contrast (72127) |
$573.81 |
$1,718 |
3.1× |
| CT cervical spine with contrast (72126) |
$478.29 |
$1,432 |
1.3× |
| CT chest w/wo contrast (71270) |
$459.92 |
$1,377 |
2.5× |
| CT chest with contrast (71260) |
$383.43 |
$1,148 |
2.1× |
| CT colonography w/dye (74262) |
$804.45 |
$1,730 |
4.3× |
| CT colonography w/o cntrst (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 limited/localized follow up study (76380) |
$218.55 |
$470 |
2.4× |
| CT lower ext w/o (73700) |
$295.92 |
$886 |
2.7× |
| CT lower extremity w wo contrast (73702) |
$443.89 |
$1,329 |
2.4× |
| CT lower extremity with contrast (73701) |
$370.07 |
$1,108 |
2.0× |
| CT lumbar spine w & w/o contrast (72133) |
$458.92 |
$1,374 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$305.94 |
$916 |
2.8× |
| CT lumbar spine with contrast (72132) |
$382.43 |
$1,145 |
1.0× |
| CT maxillofacial w contrast (70487) |
$370.98 |
$1,145 |
2.0× |
| CT maxillofacial w/o contrast (70486) |
$296.78 |
$916 |
2.7× |
| CT maxillofacial w/wo contrast (70488) |
$445.18 |
$1,374 |
2.4× |
| CT neck soft tissue w contrast (70491) |
$380.70 |
$1,175 |
2.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$456.84 |
$1,410 |
2.5× |
| 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 extremity w/o & w/contrast material (73202) |
$458.92 |
$1,374 |
2.5× |
| CT upper extremity w/o contrast rt (73200) |
$305.94 |
$916 |
2.8× |
| 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 abdomen pelvis (74174) |
$569.14 |
$1,704 |
1.5× |
| CTA chest (71275) |
$482.96 |
$1,446 |
2.6× |
| Cta Head (70496) |
$574.78 |
$1,774 |
3.1× |
| CTA lwr ext w&w/o contrast (73706) |
$466.26 |
$1,396 |
2.5× |
| Cta Neck (70498) |
$479.84 |
$1,481 |
2.6× |
| Cta Pelvis (72191) |
$536.74 |
$1,607 |
2.9× |
| Cystography minimum 3 views rs&i (74430) |
$206.62 |
$587 |
0.6× |
| Diskogram cervical (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 study 1/> sites axial skel (77080) |
$101.02 |
$287 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$94.34 |
$268 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$170.72 |
$485 |
1.5× |
| Echo exam of fetal heart (76825) |
$624.89 |
$1,130 |
1.1× |
| Echoencephalography real time imaging (76506) |
$191.89 |
$347 |
1.7× |
| Esophagus (74220) |
$127.42 |
$362 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$320.19 |
$579 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$275.39 |
$498 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$194.66 |
$553 |
0.8× |
| Foot 2 views (73620) |
$46.82 |
$133 |
0.5× |
| Forearm 2 views (73090) |
$58.78 |
$167 |
0.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,669.23 |
$3,379 |
2.9× |
| Gated Heart Planar Single (78472) |
$934.65 |
$1,892 |
2.2× |
| Hand 2 views (73120) |
$56.67 |
$161 |
0.5× |
| Hand 3 views (73130) |
$62.30 |
$177 |
0.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,883.63 |
$5,897 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,326.67 |
$8,848 |
5.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,715.43 |
$9,643 |
6.4× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$4,280.71 |
$8,754 |
10.5× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,779.48 |
$5,684 |
6.8× |
| Heart Infarct Image (78466) |
$532.04 |
$1,077 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,432.99 |
$4,071 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,036.76 |
$4,123 |
3.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,189.55 |
$2,408 |
2.8× |
| Ht muscle image spect sing (78451) |
$654.55 |
$1,325 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$59.84 |
$170 |
0.7× |
| Hysterosalpingogram (74740) |
$410.78 |
$1,167 |
1.6× |
| 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 - Xr Joint Anteroposterior 2+ Joints (77077) |
$66.18 |
$188 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$883.27 |
$1,788 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$743.96 |
$1,506 |
1.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,150.53 |
$2,329 |
2.0× |
| Knee 3 views (73562) |
$59.14 |
$168 |
0.6× |
| 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 Ventilation Imaging (78579) |
$506.84 |
$1,026 |
1.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,390.40 |
$3,950 |
0.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$591.36 |
$1,680 |
0.9× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,250.66 |
$3,553 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$997.92 |
$2,835 |
0.3× |
| Lymphoscintigraphy (78195) |
$905.01 |
$1,832 |
1.6× |
| Mammary ductogram or galactogram multiple (77054) |
$193.95 |
$551 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$147.49 |
$419 |
0.6× |
| Meckels Diverticulum (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 pos&/immoblj supvj phys/qhp (76019) |
$110.18 |
$313 |
1.8× |
| 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 med physics xm customization plng&mntr (76017) |
$171.42 |
$487 |
0.7× |
| MRA head w & w/o contrast (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 & w/contrast material (74183) |
$601.77 |
$1,559 |
1.6× |
| MRI abdomen w/o contrast (74181) |
$401.05 |
$1,039 |
1.6× |
| MRI any jnt lwr ext with con lt (73722) |
$514.92 |
$1,334 |
0.6× |
| 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 w/o contrast unilat (77046) |
$409.55 |
$1,061 |
1.6× |
| MRI c-spine with contrast (72142) |
$381.52 |
$1,334 |
1.0× |
| 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/o contrast (72141) |
$305.16 |
$1,067 |
1.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,198.53 |
$3,105 |
3.3× |
| MRI chest w/o contrast (71550) |
$799.02 |
$2,070 |
3.2× |
| MRI chest with contrast (71551) |
$998.97 |
$2,588 |
1.2× |
| MRI fetal sngl/1st gestation (74712) |
$382.53 |
$991 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$630.72 |
$1,634 |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$558.93 |
$1,448 |
1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$446.99 |
$1,158 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$332.35 |
$1,158 |
1.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$498.52 |
$1,737 |
1.4× |
| MRI orbit/face/neck w/contrast (70542) |
$415.58 |
$1,448 |
1.1× |
| MRI pelvis w contrast (72196) |
$514.92 |
$1,334 |
1.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$617.99 |
$1,601 |
1.7× |
| MRI pelvis w/o contrast (72195) |
$411.86 |
$1,067 |
1.6× |
| MRI scan of arm joint before and after contrast (73223) |
$617.99 |
$1,601 |
1.7× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$759.65 |
$1,968 |
0.9× |
| MRI scan of leg joint before and after contrast (73723) |
$617.99 |
$1,601 |
1.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$457.89 |
$1,601 |
1.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$381.52 |
$1,334 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$457.89 |
$1,601 |
1.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$371.23 |
$1,298 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$445.30 |
$1,557 |
1.2× |
| MRI thoracic spine w/o contrast (72146) |
$296.87 |
$1,038 |
1.2× |
| MRI tmj (70336) |
$411.09 |
$1,065 |
1.6× |
| MRI upper ext joint w/o contrast (73221) |
$411.86 |
$1,067 |
1.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$756.95 |
$1,961 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$504.50 |
$1,307 |
2.0× |
| Myelogram Cervical (72240) |
$581.15 |
$1,651 |
0.7× |
| Myelogram Lumbar (72265) |
$511.10 |
$1,452 |
0.6× |
| Myelogram thoracic (72255) |
$536.80 |
$1,525 |
0.6× |
| Myelography 2 or more regions (72270) |
$519.55 |
$1,476 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$789.41 |
$1,598 |
0.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (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× |
| Nm adrenal scan (78075) |
$856.10 |
$1,733 |
0.6× |
| Nm bone marrow multiple (78103) |
$517.71 |
$1,048 |
1.2× |
| Nm bone marrow wb (78104) |
$590.33 |
$1,195 |
1.4× |
| Nm cisternogram (78630) |
$965.28 |
$1,954 |
1.7× |
| Nm gastric emptying study (78264) |
$1,241.42 |
$2,513 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$694.07 |
$1,405 |
1.6× |
| Nm peritoneal-venous shunt patency (78291) |
$644.67 |
$1,305 |
1.5× |
| Nm red cell sequestration (78140) |
$670.36 |
$1,357 |
1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,000.02 |
$8,180 |
2.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,177.70 |
$2,384 |
2.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,473.11 |
$2,982 |
3.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$653.07 |
$1,322 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$1,428.54 |
$3,434 |
5.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$203.50 |
$368 |
1.8× |
| Orthopantogram (70355) |
$44.70 |
$127 |
0.5× |
| Osseous survey infant (77076) |
$95.04 |
$270 |
0.9× |
| Osseous survey limited (77074) |
$76.03 |
$216 |
0.7× |
| Parathyrd planar w/spect&CT (78072) |
$754.34 |
$1,527 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$691.60 |
$1,400 |
1.6× |
| Parathyroid imaging (78070) |
$538.95 |
$1,091 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$56.67 |
$161 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$2,368.22 |
$5,866 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,131.24 |
$5,279 |
1.4× |
| PET imaging for CT attenuation whole body (78816) |
$2,415.46 |
$5,983 |
1.6× |
| Pr heart first pass single,planar (78481) |
$857.09 |
$1,735 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$670.48 |
$1,737 |
1.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,434.75 |
$4,076 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$866.97 |
$1,755 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,526.95 |
$3,091 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$318.56 |
$905 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$67.23 |
$191 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$87.65 |
$249 |
0.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$114.05 |
$324 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$68.64 |
$195 |
0.6× |
| 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 1 mev >= complex (77412) |
$864.55 |
$1,768 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$408.80 |
$836 |
3.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$462.10 |
$945 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$66.18 |
$188 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$48.58 |
$138 |
0.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$109.47 |
$311 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$76.40 |
$191 |
0.8× |
| Radiologic exam colon single contrast study (74270) |
$131.30 |
$373 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$145.73 |
$414 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$127.42 |
$362 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$49.98 |
$142 |
0.5× |
| Radiological examination surgical specimen (76098) |
$140.80 |
$400 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,576.61 |
$4,479 |
0.5× |
| Ribs bilateral 3 views (71110) |
$63.71 |
$181 |
0.6× |
| 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 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 1 day imaging (78830) |
$1,435.56 |
$2,906 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$561.60 |
$1,350 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$344.45 |
$828 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,249.66 |
$3,049 |
5.1× |
| Sacroiliac Joints < 3 Views (72200) |
$56.67 |
$161 |
0.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$345.63 |
$625 |
1.4× |
| Salivary gland imaging (78230) |
$374.45 |
$758 |
0.9× |
| Scanogram (77073) |
$59.84 |
$170 |
0.5× |
| Scapula complete (73010) |
$66.18 |
$188 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$33.51 |
$83 |
1.4× |
| Sella turcica (70240) |
$46.82 |
$133 |
0.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$241.12 |
$685 |
2.2× |
| Sialogram (70390) |
$205.22 |
$583 |
0.8× |
| Simulation intermediate (77285) |
$876.29 |
$1,792 |
2.2× |
| Small bowel series (74250) |
$127.42 |
$362 |
0.7× |
| Spec medical radj physics consltj (77370) |
$700.74 |
$1,433 |
4.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$802.45 |
$1,641 |
2.0× |
| Special dosimetry (77331) |
$368.22 |
$753 |
2.6× |
| Special treatment procedure (77470) |
$1,719.32 |
$3,516 |
2.9× |
| Spine thoracic 3 views (72072) |
$69.70 |
$198 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$4,753.57 |
$9,721 |
2.5× |
| 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 With Vascular 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 simple (77280) |
$730.57 |
$1,494 |
5.1× |
| Thoracolumbar 2 views (72080) |
$70.05 |
$199 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,113.97 |
$2,255 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$565.14 |
$1,144 |
1.3× |
| 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× |
| Tmj unilateral (70328) |
$48.22 |
$137 |
0.5× |
| Tomogram (76100) |
$87.65 |
$249 |
0.8× |
| Treatment device intermediate (77333) |
$916.39 |
$1,874 |
6.5× |
| Treatment devices simple (77332) |
$442.06 |
$904 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,742.34 |
$3,527 |
3.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$606.14 |
$1,227 |
1.4× |
| Tx devices design & construction complex (77334) |
$1,076.78 |
$2,202 |
2.7× |
| Ultrasound elastography first target lesion (76982) |
$190.23 |
$344 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$191.34 |
$346 |
1.7× |
| Umbilical-artery Doppler (OB) (76820) |
$142.12 |
$257 |
1.3× |
| Upper Extremity Infant (73092) |
$64.42 |
$183 |
0.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$393.22 |
$796 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$228.45 |
$649 |
0.9× |
| Urethrocystography voiding (74455) |
$182.69 |
$519 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$372.77 |
$1,059 |
2.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$454.78 |
$1,292 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$235.58 |
$426 |
2.1× |
| Us breast unilateral complete (76641) |
$198.53 |
$359 |
1.8× |
| Us breast unilateral limited (76642) |
$154.29 |
$279 |
1.7× |
| Us chest (76604) |
$142.12 |
$257 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$275.39 |
$498 |
2.5× |
| Us elastography parenchyma (76981) |
$221.75 |
$401 |
2.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$220.65 |
$399 |
2.0× |
| Us infant hips dynamic (76885) |
$197.97 |
$358 |
2.2× |
| Us infant hips limited static (76886) |
$140.46 |
$254 |
1.5× |
| Us kidney transplant (76776) |
$249.40 |
$451 |
2.3× |
| Us ob detailed single fetus (76811) |
$565.72 |
$1,023 |
2.2× |
| Us ob transvaginal (76817) |
$244.98 |
$443 |
2.2× |
| Us pelvic non ob complete (76856) |
$219.54 |
$397 |
2.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$195.76 |
$354 |
1.8× |
| Us pregnancy ltd (76815) |
$168.67 |
$305 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$294.75 |
$533 |
2.7× |
| 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 soft tissue head/neck (76536) |
$244.43 |
$442 |
2.2× |
| Us spinal canal and contents (76800) |
$296.41 |
$536 |
2.7× |
| Us transrectal (76872) |
$492.17 |
$890 |
4.5× |
| Us transrectal prostate volume (76873) |
$291.43 |
$527 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$142.12 |
$257 |
1.3× |
| Vascular flow imaging (78445) |
$389.77 |
$789 |
0.9× |
| Venogram extremity bilateral (75822) |
$1,312.26 |
$3,728 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$1,390.40 |
$3,950 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$1,474.18 |
$4,188 |
0.9× |
| 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 selective rs&i (75831) |
$1,817.38 |
$5,163 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,320.70 |
$3,752 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,405.22 |
$6,833 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$47.52 |
$135 |
0.5× |
| Wrist 2 views (73100) |
$48.22 |
$137 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$87.65 |
$249 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$87.30 |
$248 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$52.45 |
$149 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$200.64 |
$570 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$55.26 |
$157 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$66.18 |
$188 |
0.7× |
| 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 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 of femur 1 (73551) |
$46.82 |
$133 |
0.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$467.46 |
$1,328 |
2.5× |
| X-ray eye for foreign body (70030) |
$46.82 |
$133 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$64.77 |
$184 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$46.82 |
$133 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$48.93 |
$139 |
0.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$539.97 |
$1,534 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$46.82 |
$133 |
0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$57.02 |
$162 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$73.22 |
$208 |
0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$59.14 |
$168 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$63.71 |
$181 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$56.67 |
$161 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$84.13 |
$239 |
0.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$58.78 |
$167 |
0.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$54.91 |
$156 |
0.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$46.82 |
$133 |
0.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$64.06 |
$182 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$62.66 |
$178 |
0.6× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$291.46 |
$828 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$197.12 |
$560 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$48.93 |
$139 |
0.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$68.64 |
$195 |
0.6× |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$48.93 |
$139 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$57.73 |
$164 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$63.01 |
$179 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$46.82 |
$133 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$76.03 |
$216 |
0.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$66.18 |
$188 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$52.80 |
$150 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$59.14 |
$168 |
0.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$46.82 |
$133 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$56.67 |
$161 |
0.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$80.26 |
$228 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$55.62 |
$158 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$61.25 |
$174 |
0.7× |
| Xr arthrogram ankle (73615) |
$270.90 |
$671 |
0.7× |
| Xr c-spine 6 or more views (72052) |
$86.59 |
$246 |
0.8× |
| Xr chest 4+ views (71048) |
$104 |
$260 |
0.9× |
| Xr Cholecystography Oral Contrast (74290) |
$127.42 |
$362 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$58.78 |
$167 |
0.6× |
| Xr internal auditory meati complete (70134) |
$109.47 |
$311 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$56.67 |
$161 |
0.5× |
| Xr optic foramina (70190) |
$49.98 |
$142 |
0.5× |
| Xr shoulder 1 view (73020) |
$52.45 |
$149 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$76.03 |
$216 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$64.42 |
$183 |
0.7× |
| Xr tmj bilateral (70330) |
$114.40 |
$325 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$57.73 |
$164 |
0.6× |