| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,049.88 |
$4,929 |
0.7× |
| Abdomen 2 views (74019) |
$159.90 |
$533 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$540.46 |
$1,987 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,590.32 |
$6,682 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,656.96 |
$6,962 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,557.47 |
$6,544 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$643.31 |
$2,703 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,133.59 |
$4,763 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,288.53 |
$5,414 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$937.24 |
$3,938 |
0.3× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$443.39 |
$1,863 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$937.24 |
$3,938 |
0.3× |
| Ankle 2 views (73600) |
$117.90 |
$393 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$177 |
$590 |
0.5× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,472.03 |
$6,185 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,355.41 |
$5,695 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,619.19 |
$11,005 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$1,472.51 |
$6,187 |
0.4× |
| Arthrogram elbow (73085) |
$148.76 |
$506 |
0.4× |
| Arthrogram hip (73525) |
$218.74 |
$744 |
0.6× |
| Arthrogram shoulder (73040) |
$284 |
$966 |
0.8× |
| Arthrogram wrist (73115) |
$217.56 |
$740 |
0.6× |
| Arthrography knee lt (73580) |
$227.85 |
$775 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$91.16 |
$428 |
0.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$503.20 |
$1,850 |
1.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$609.01 |
$2,239 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$662.05 |
$2,434 |
1.6× |
| Bone age studies (77072) |
$57.90 |
$193 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$761.33 |
$2,799 |
1.8× |
| Bone Marrow Imaging Limited Area (78102) |
$390.05 |
$1,434 |
0.9× |
| Bone survey complete (77075) |
$253.80 |
$846 |
2.3× |
| Brachytx isodose complex (77318) |
$411.52 |
$1,932 |
1.0× |
| Brachytx isodose intermed (77317) |
$288.19 |
$1,353 |
0.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$220.24 |
$1,034 |
0.6× |
| Brain image w/flow 4 + views (78606) |
$1,032.24 |
$3,795 |
1.8× |
| Brain imaging < 4 static views (78600) |
$573.92 |
$2,110 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$676.74 |
$2,488 |
1.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$622.88 |
$2,290 |
1.1× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$165.65 |
$609 |
15.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$574.46 |
$2,112 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$815.11 |
$4,406 |
2.2× |
| Cardiac shunt detection (78428) |
$390.59 |
$1,436 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$315.52 |
$1,160 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$152.10 |
$507 |
1.6× |
| Chest 1 view (71045) |
$112.14 |
$420 |
1.2× |
| Chest 3 views (71047) |
$135.37 |
$507 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$217.50 |
$725 |
1.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$357 |
$1,190 |
0.4× |
| Clavicle complete (73000) |
$124.80 |
$416 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$168.48 |
$1,296 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$163.16 |
$766 |
1.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$84.90 |
$283 |
0.5× |
| Corpora cavernosography (74445) |
$164.70 |
$549 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$514.67 |
$3,959 |
1.4× |
| CT abdomen and pelvis without contrast (74176) |
$343.07 |
$2,639 |
1.3× |
| CT abdomen w contrast (74160) |
$320.19 |
$2,463 |
1.7× |
| CT abdomen w wo contrast (74170) |
$384.15 |
$2,955 |
2.1× |
| CT abdomen w/o contrast (74150) |
$256.10 |
$1,970 |
2.3× |
| CT angio hrt w/3d image (75574) |
$480.06 |
$2,308 |
1.3× |
| CT angiography upper extremity lt (73206) |
$299.39 |
$2,303 |
1.6× |
| CT c-spine w/o contrast (72125) |
$285.09 |
$2,193 |
2.6× |
| CT cervical spine w&w/o contrast (72127) |
$427.70 |
$3,290 |
2.3× |
| CT cervical spine with contrast (72126) |
$356.46 |
$2,742 |
1.0× |
| CT chest w/wo contrast (71270) |
$384.80 |
$2,960 |
2.1× |
| CT chest with contrast (71260) |
$320.71 |
$2,467 |
1.7× |
| CT colonography screening (74263) |
$466.96 |
$2,245 |
1.8× |
| CT colonography w/dye (74262) |
$362.96 |
$1,745 |
1.9× |
| CT colonography w/o cntrst (74261) |
$290.37 |
$1,396 |
2.6× |
| CT head/brain with contrast (70460) |
$308.73 |
$2,072 |
1.6× |
| CT head/brain without and with contrast (70470) |
$370.41 |
$2,486 |
2.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$365.66 |
$1,758 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$310.96 |
$1,495 |
3.3× |
| CT hrt w/3d image congen (75573) |
$457.18 |
$2,198 |
1.2× |
| CT iac w contrast (70481) |
$343 |
$2,302 |
1.8× |
| CT limited/localized follow up study (76380) |
$103.79 |
$499 |
1.1× |
| CT lower ext w/o (73700) |
$233.87 |
$1,799 |
2.1× |
| CT lower extremity w wo contrast (73702) |
$350.87 |
$2,699 |
1.9× |
| CT lower extremity with contrast (73701) |
$292.37 |
$2,249 |
1.6× |
| CT lumbar spine w & w/o contrast (72133) |
$409.37 |
$3,149 |
2.2× |
| CT lumbar spine w/o contrast (72131) |
$272.87 |
$2,099 |
2.4× |
| CT lumbar spine with contrast (72132) |
$341.12 |
$2,624 |
0.9× |
| CT maxillofacial w contrast (70487) |
$321.54 |
$2,158 |
1.7× |
| CT maxillofacial w/o contrast (70486) |
$257.17 |
$1,726 |
2.3× |
| CT maxillofacial w/wo contrast (70488) |
$385.76 |
$2,589 |
2.1× |
| CT neck soft tissue w contrast (70491) |
$378.16 |
$2,538 |
2.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$411.54 |
$2,762 |
2.2× |
| CT orbits w/o contrast (70480) |
$274.31 |
$1,841 |
2.5× |
| CT pelvis w & w/o contrast (72194) |
$450.84 |
$3,468 |
2.4× |
| CT pelvis w/o contrast (72192) |
$300.56 |
$2,312 |
2.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$453.70 |
$3,045 |
2.4× |
| CT soft tissue neck w/o contrast (70490) |
$302.47 |
$2,030 |
2.7× |
| CT thoracic spine w/contrast (72129) |
$362.96 |
$2,792 |
1.9× |
| CT thoracic spine w/o contrast (72128) |
$290.29 |
$2,233 |
2.6× |
| CT thoracic spine w/wo contrast (72130) |
$435.50 |
$3,350 |
2.3× |
| CT thorax w/o contrast (71250) |
$256.49 |
$1,973 |
2.3× |
| CT unlisted procedure (76497) |
$525.59 |
$4,043 |
5.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$285.09 |
$2,193 |
1.5× |
| CT upper extremity w/o contrast rt (73200) |
$190.06 |
$1,462 |
1.7× |
| CT upper extremity with contrast (73201) |
$237.64 |
$1,828 |
0.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$355.47 |
$1,709 |
1.9× |
| Cta Abdomen (74175) |
$403.39 |
$3,103 |
2.2× |
| CTA abdomen pelvis (74174) |
$540.41 |
$4,157 |
1.5× |
| CTA chest (71275) |
$404.04 |
$3,108 |
2.2× |
| Cta Head (70496) |
$389.04 |
$2,611 |
2.1× |
| CTA lwr ext w&w/o contrast (73706) |
$368.42 |
$2,834 |
2.0× |
| Cta Neck (70498) |
$476.50 |
$3,198 |
2.5× |
| Cta Pelvis (72191) |
$473.46 |
$3,642 |
2.5× |
| Cystography minimum 3 views rs&i (74430) |
$226.20 |
$754 |
0.6× |
| Diskography lumbar (72295) |
$997.20 |
$3,324 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$165 |
$550 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$122.10 |
$407 |
1.3× |
| Echo exam of eye (76529) |
$100.23 |
$301 |
1.1× |
| Echoencephalography real time imaging (76506) |
$184.15 |
$553 |
1.7× |
| Esophagus (74220) |
$147 |
$490 |
0.8× |
| Fetal biophysical profile non-stress testing (76818) |
$137.86 |
$414 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$127.20 |
$424 |
0.5× |
| Foot 2 views (73620) |
$92.40 |
$308 |
1.0× |
| Forearm 2 views (73090) |
$84.90 |
$283 |
0.9× |
| Functional MRI brain by phys/psych (70555) |
$467.12 |
$2,525 |
1.8× |
| Functional MRI brain by tech (70554) |
$622.90 |
$3,367 |
2.4× |
| Gated Heart Planar Single (78472) |
$634.85 |
$2,334 |
1.5× |
| Hand 2 views (73120) |
$107.40 |
$358 |
1.0× |
| Hand 3 views (73130) |
$123.30 |
$411 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$692.46 |
$3,251 |
0.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,232.20 |
$5,785 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,862.26 |
$8,743 |
2.5× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,038.38 |
$4,875 |
2.5× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$692.46 |
$3,251 |
1.7× |
| Heart Infarct Image (78466) |
$492.32 |
$1,810 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,192.20 |
$3,974 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$498.85 |
$1,834 |
0.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$364.21 |
$1,339 |
0.9× |
| Ht muscle image spect sing (78451) |
$958.53 |
$3,524 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$139.80 |
$466 |
1.5× |
| Hysterosalpingogram (74740) |
$210.30 |
$701 |
0.8× |
| Interstitial radiation source applic complex (77778) |
$735.28 |
$3,452 |
1.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$505.24 |
$2,372 |
0.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$358.48 |
$1,683 |
0.6× |
| Intracavitary radiation source applic simple (77761) |
$270.94 |
$1,272 |
0.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$120.90 |
$403 |
1.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$372.64 |
$1,370 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$778.19 |
$2,861 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$442.27 |
$1,626 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,532.45 |
$5,634 |
2.6× |
| Knee 3 views (73562) |
$151.20 |
$504 |
1.6× |
| Liver & spleen imaging static only (78215) |
$442 |
$1,625 |
1.0× |
| Liver imaging static only (78201) |
$434.66 |
$1,598 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$580.99 |
$2,136 |
1.0× |
| Lung perfusion differential (78597) |
$377.54 |
$1,388 |
0.9× |
| Lung Ventilation Imaging (78579) |
$354.96 |
$1,305 |
0.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$636.90 |
$2,123 |
0.2× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$547.50 |
$1,825 |
0.8× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$821.10 |
$2,737 |
0.5× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$440.40 |
$1,468 |
0.1× |
| Lymphoscintigraphy (78195) |
$479.54 |
$1,763 |
0.8× |
| Mammary ductogram or galactogram multiple (77054) |
$268.50 |
$895 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$207.30 |
$691 |
0.8× |
| Meckels Diverticulum (78290) |
$478.99 |
$1,761 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$341.86 |
$1,605 |
0.9× |
| Mr elastography (76391) |
$156.14 |
$844 |
0.6× |
| Mr safety determination physician/other qhp (76016) |
$40.50 |
$135 |
0.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$87 |
$290 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$12 |
$40 |
0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$62.10 |
$207 |
0.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$163.20 |
$544 |
0.6× |
| MRA head w & w/o contrast (70546) |
$508.70 |
$3,083 |
1.4× |
| MRA head w/o contrast (70544) |
$339.08 |
$2,055 |
1.3× |
| MRA head with contrast (70545) |
$423.89 |
$2,569 |
1.1× |
| MRA neck w contrast (70548) |
$360.36 |
$2,184 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$432.47 |
$2,621 |
1.2× |
| MRA neck w/o contrast (70547) |
$288.26 |
$1,747 |
1.1× |
| MRI abdomen w contrast (74182) |
$593.48 |
$3,208 |
1.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$712.06 |
$3,849 |
1.9× |
| MRI abdomen w/o contrast (74181) |
$474.71 |
$2,566 |
1.9× |
| MRI any jnt lwr ext with con lt (73722) |
$857.10 |
$4,633 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$749.25 |
$4,050 |
0.9× |
| MRI bone marrow blood supply (77084) |
$540.76 |
$2,923 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$419.58 |
$2,268 |
1.6× |
| MRI breast w/o contrast unilat (77046) |
$279.72 |
$1,512 |
1.1× |
| MRI c-spine with contrast (72142) |
$657.47 |
$3,673 |
1.8× |
| MRI cardiac w/o cont stress (75559) |
$575.90 |
$3,113 |
1.0× |
| MRI cardiac w/o contrast (75557) |
$543.34 |
$2,937 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$525.90 |
$2,938 |
2.1× |
| MRI chest w/o & w/contrast material (71552) |
$561.48 |
$3,035 |
1.5× |
| MRI chest w/o contrast (71550) |
$374.26 |
$2,023 |
1.5× |
| MRI chest with contrast (71551) |
$467.86 |
$2,529 |
0.6× |
| MRI fetal sngl/1st gestation (74712) |
$771.26 |
$4,169 |
3.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$584.04 |
$3,157 |
1.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$653.98 |
$3,535 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$523.18 |
$2,828 |
2.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$289.98 |
$1,611 |
1.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$435.06 |
$2,417 |
1.2× |
| MRI orbit/face/neck w/contrast (70542) |
$362.52 |
$2,014 |
1.0× |
| MRI pelvis w contrast (72196) |
$657.30 |
$3,553 |
1.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$788.66 |
$4,263 |
2.1× |
| MRI pelvis w/o contrast (72195) |
$525.77 |
$2,842 |
2.1× |
| MRI scan of arm joint before and after contrast (73223) |
$899.10 |
$4,860 |
2.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$863.95 |
$4,670 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,028.41 |
$5,559 |
2.8× |
| MRI spectroscopy (76390) |
$481.37 |
$2,602 |
5.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$788.85 |
$4,407 |
2.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$661.40 |
$3,695 |
1.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$793.69 |
$4,434 |
2.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$566 |
$3,162 |
1.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$679.13 |
$3,794 |
1.8× |
| MRI thoracic spine w/o contrast (72146) |
$452.69 |
$2,529 |
1.8× |
| MRI tmj (70336) |
$328 |
$1,773 |
1.3× |
| MRI upper ext joint w/o contrast (73221) |
$599.40 |
$3,240 |
2.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$700.78 |
$3,788 |
1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$467.12 |
$2,525 |
1.8× |
| Myelogram Cervical (72240) |
$357 |
$1,190 |
0.4× |
| Myelogram Lumbar (72265) |
$357 |
$1,190 |
0.4× |
| Myelography 2 or more regions (72270) |
$579.60 |
$1,932 |
0.7× |
| Myocardial infarct spect (78469) |
$546.72 |
$2,010 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,154.64 |
$4,245 |
0.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,716.86 |
$6,528 |
1.9× |
| Neck soft tissue (70360) |
$151.80 |
$506 |
1.6× |
| Nm adrenal scan (78075) |
$733.31 |
$2,696 |
0.5× |
| Nm bone marrow multiple (78103) |
$482.26 |
$1,773 |
1.1× |
| Nm bone marrow wb (78104) |
$555.42 |
$2,042 |
1.3× |
| Nm cisternogram (78630) |
$368.83 |
$1,356 |
0.6× |
| Nm csf leak detection (78650) |
$574.19 |
$2,111 |
0.4× |
| Nm gastric emptying study (78264) |
$508.10 |
$1,868 |
1.2× |
| Nm peritoneal-venous shunt patency (78291) |
$297.02 |
$1,092 |
0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,299.94 |
$6,103 |
0.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,154.64 |
$4,245 |
0.8× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$958.53 |
$3,524 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$518.98 |
$1,908 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$1,068.09 |
$2,433 |
4.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$242.76 |
$729 |
2.2× |
| Orthopantogram (70355) |
$82.50 |
$275 |
0.9× |
| Osseous survey infant (77076) |
$365.40 |
$1,218 |
3.3× |
| Osseous survey limited (77074) |
$167.70 |
$559 |
1.5× |
| Parathyrd planar w/spect&CT (78072) |
$582.35 |
$2,141 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$474.37 |
$1,744 |
1.1× |
| Parathyroid imaging (78070) |
$374.82 |
$1,378 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$129.60 |
$432 |
1.2× |
| Perineogram (74775) |
$209.40 |
$698 |
0.8× |
| Peritoneogram rs&i (74190) |
$245.70 |
$819 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$784.77 |
$4,242 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,315.50 |
$4,385 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$970.50 |
$3,235 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$381.07 |
$1,401 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$475.18 |
$1,747 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$246 |
$820 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$84.60 |
$282 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$119.40 |
$398 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$127.50 |
$425 |
1.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$115.80 |
$386 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$206.40 |
$688 |
1.9× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,213.10 |
$15,085 |
0.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$235.15 |
$1,104 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$170.40 |
$800 |
1.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$219.60 |
$1,031 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$159 |
$530 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$120.30 |
$401 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$213.30 |
$711 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$132.17 |
$495 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$282.30 |
$941 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$184.20 |
$614 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$161.40 |
$538 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$132.30 |
$441 |
1.4× |
| Radiological examination surgical specimen (76098) |
$246 |
$820 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,467.60 |
$4,892 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,181.40 |
$3,938 |
0.4× |
| Ribs bilateral 3 views (71110) |
$147.90 |
$493 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$538.02 |
$1,978 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$574.19 |
$2,111 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$606.02 |
$2,228 |
1.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,108.67 |
$4,076 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,443.50 |
$5,307 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$766.50 |
$2,818 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$667.28 |
$1,520 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$334.96 |
$763 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$392.03 |
$893 |
1.6× |
| Sacroiliac Joints < 3 Views (72200) |
$100.20 |
$334 |
0.9× |
| Salivary gland imaging serial images (78231) |
$275.54 |
$1,013 |
0.6× |
| Scanogram (77073) |
$150.60 |
$502 |
1.3× |
| Scapula complete (73010) |
$103.80 |
$346 |
0.9× |
| Sella turcica (70240) |
$56.70 |
$189 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$145.50 |
$485 |
1.3× |
| Sialogram (70390) |
$192.30 |
$641 |
0.8× |
| Simulation intermediate (77285) |
$351.24 |
$1,649 |
0.9× |
| Small bowel series (74250) |
$130.50 |
$435 |
0.7× |
| Spec medical radj physics consltj (77370) |
$254.11 |
$1,193 |
1.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$329.72 |
$1,548 |
0.8× |
| Special dosimetry (77331) |
$129.72 |
$609 |
0.9× |
| Special treatment procedure (77470) |
$817.71 |
$3,839 |
1.4× |
| Spine thoracic 3 views (72072) |
$135.60 |
$452 |
1.2× |
| Splenoportograpy rs&i (75810) |
$1,181.40 |
$3,938 |
0.4× |
| Stereotactic body radiation delivery (77373) |
$2,173.45 |
$10,204 |
1.1× |
| Superior sagittal sinus venogram (75870) |
$1,024.80 |
$3,416 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$219.60 |
$1,031 |
0.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$116.94 |
$549 |
0.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$554.44 |
$2,603 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$195.11 |
$916 |
1.4× |
| Therapeutic Enema (74283) |
$259.20 |
$864 |
1.4× |
| Thoracolumbar 2 views (72080) |
$115.20 |
$384 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$668.30 |
$2,457 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$193.12 |
$710 |
0.5× |
| Thyroid uptake measurement (78012) |
$166.74 |
$613 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$301.65 |
$1,109 |
0.7× |
| Tmj unilateral (70328) |
$77.70 |
$259 |
0.8× |
| Treatment device intermediate (77333) |
$164.01 |
$770 |
1.1× |
| Treatment devices simple (77332) |
$116.72 |
$548 |
0.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,029.52 |
$3,785 |
1.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$504.02 |
$1,853 |
1.2× |
| Tx devices design & construction complex (77334) |
$251.13 |
$1,179 |
0.6× |
| Ultrasound elastography first target lesion (76982) |
$200.13 |
$601 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$280.39 |
$842 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$747.96 |
$4,043 |
8.1× |
| Unlisted Ultrasound Procedure (76999) |
$134.86 |
$405 |
1.5× |
| Upper Extremity Infant (73092) |
$94.20 |
$314 |
0.8× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$1,378.77 |
$5,069 |
14.6× |
| Urethrocystography retrograde rs&i (74450) |
$161.70 |
$539 |
0.6× |
| Urethrocystography voiding (74455) |
$215.70 |
$719 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$353.70 |
$1,179 |
1.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$575.10 |
$1,917 |
3.1× |
| Us abdl aorta screen aaa (76706) |
$129.54 |
$389 |
1.2× |
| Us breast unilateral complete (76641) |
$147.85 |
$444 |
1.3× |
| Us breast unilateral limited (76642) |
$103.90 |
$312 |
1.1× |
| Us chest (76604) |
$153.85 |
$462 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$184.48 |
$554 |
1.7× |
| Us elastography parenchyma (76981) |
$224.44 |
$674 |
2.0× |
| Us guided compression repair (76936) |
$232.77 |
$699 |
1.0× |
| Us infant hips dynamic (76885) |
$202.46 |
$608 |
2.2× |
| Us infant hips limited static (76886) |
$147.85 |
$444 |
1.6× |
| Us kidney transplant (76776) |
$173.49 |
$521 |
1.6× |
| Us ob detailed single fetus (76811) |
$270.06 |
$811 |
1.1× |
| Us ob transvaginal (76817) |
$205.79 |
$618 |
1.8× |
| Us pelvic non ob complete (76856) |
$351.65 |
$1,056 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$263.74 |
$792 |
2.4× |
| Us pregnancy ltd (76815) |
$180.82 |
$543 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$179.15 |
$538 |
1.6× |
| Us retroperitoneal complete (76770) |
$216.12 |
$649 |
1.9× |
| Us retroperitoneal limited (76775) |
$112.55 |
$338 |
1.0× |
| Us scrotum and contents (76870) |
$233.77 |
$702 |
2.1× |
| Us soft tissue head/neck (76536) |
$167.83 |
$504 |
1.5× |
| Us spinal canal and contents (76800) |
$251.42 |
$755 |
2.3× |
| Us transrectal (76872) |
$136.86 |
$411 |
1.2× |
| Us transrectal prostate volume (76873) |
$122.21 |
$367 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$101.23 |
$304 |
0.9× |
| Us, eye b-scan (76512) |
$116.22 |
$349 |
1.0× |
| Vascular flow imaging (78445) |
$195.02 |
$717 |
0.5× |
| Venogram extremity bilateral (75822) |
$631.80 |
$2,106 |
0.4× |
| Venogram orbital (75880) |
$386.40 |
$1,288 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,349.40 |
$4,498 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$517.50 |
$1,725 |
0.3× |
| Venography epidural rs&i (75872) |
$579.60 |
$1,932 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$570.90 |
$1,903 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,367.40 |
$4,558 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,181.40 |
$3,938 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$772.20 |
$2,574 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,053.50 |
$6,845 |
0.3× |
| Wrist 2 views (73100) |
$103.80 |
$346 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$246 |
$820 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$114.90 |
$383 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$129.30 |
$431 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$410.10 |
$1,367 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$146.70 |
$489 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$159 |
$530 |
1.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$173.70 |
$579 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$101.40 |
$338 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$120 |
$400 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$152.40 |
$508 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$153.90 |
$513 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$180.90 |
$603 |
1.6× |
| X-ray exam of femur 1 (73551) |
$90 |
$300 |
1.0× |
| X-ray eye for foreign body (70030) |
$120.30 |
$401 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$162.60 |
$542 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$105.30 |
$351 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$108.60 |
$362 |
1.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$567.90 |
$1,893 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$103.80 |
$346 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$492.60 |
$1,642 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$138.30 |
$461 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$169.20 |
$564 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$149.70 |
$499 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$102.30 |
$341 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$178.20 |
$594 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$277.80 |
$926 |
2.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$182.10 |
$607 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$130.80 |
$436 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$84.90 |
$283 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$147.30 |
$491 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$138.90 |
$463 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$236.10 |
$787 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$132.30 |
$441 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$144.60 |
$482 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$155.70 |
$519 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$119.70 |
$399 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$98.10 |
$327 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$150.90 |
$503 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$201.30 |
$671 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$135.60 |
$452 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$178.50 |
$595 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$144 |
$480 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$96 |
$320 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$159.60 |
$532 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$130.80 |
$436 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$109.20 |
$364 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$151.50 |
$505 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$78.60 |
$262 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.30 |
$411 |
1.3× |
| Xr arthrogram ankle (73615) |
$221.97 |
$755 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$236.70 |
$789 |
2.1× |
| Xr chest 4+ views (71048) |
$147.12 |
$551 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$91.80 |
$306 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$71.10 |
$237 |
0.6× |
| Xr shoulder 1 view (73020) |
$96.60 |
$322 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$201.90 |
$673 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$97.20 |
$324 |
1.0× |
| Xr tmj bilateral (70330) |
$119.40 |
$398 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$128.40 |
$428 |
1.4× |