| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,049.88 |
$4,929 |
0.7× |
| Abdomen 1 View (74018) |
$120.30 |
$401 |
1.3× |
| Abdomen 2 views (74019) |
$159.90 |
$533 |
1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$540.46 |
$1,987 |
1.3× |
| Adrenal Cortex & Medulla Img (78075) |
$733.31 |
$2,696 |
0.5× |
| Angio internal mammary (75756) |
$643.31 |
$2,703 |
0.2× |
| Angio pulmonary bilat (75743) |
$1,288.53 |
$5,414 |
0.4× |
| 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 pulmonary unilateral slctv rs&i (75741) |
$937.24 |
$3,938 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$937.24 |
$3,938 |
0.3× |
| Ankle 2 views (73600) |
$117.90 |
$393 |
1.3× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,619.19 |
$11,005 |
0.8× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$1,472.51 |
$6,187 |
0.4× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,133.59 |
$4,763 |
0.2× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,629.11 |
$6,845 |
0.3× |
| Arthrogram ankle (73615) |
$221.97 |
$755 |
0.6× |
| Arthrogram hip (73525) |
$218.74 |
$744 |
0.6× |
| Arthrogram Wrist (73115) |
$217.56 |
$740 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$91.16 |
$428 |
0.6× |
| Bone age studies (77072) |
$57.90 |
$193 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$761.33 |
$2,799 |
1.8× |
| Bone Imaging Limited Area (78300) |
$503.20 |
$1,850 |
1.2× |
| Bone Imaging Multiple Areas (78305) |
$609.01 |
$2,239 |
1.4× |
| Bone Imaging Whole Body (78306) |
$662.05 |
$2,434 |
1.6× |
| Bone marrow imaging limited area (78102) |
$390.05 |
$1,434 |
0.9× |
| Bone marrow imaging; multiple areas (78103) |
$482.26 |
$1,773 |
1.1× |
| Bone marrow imaging; whole body (78104) |
$555.42 |
$2,042 |
1.3× |
| Bone survey infant (77076) |
$365.40 |
$1,218 |
3.3× |
| Brachytx isodose complex (77318) |
$411.52 |
$1,932 |
1.0× |
| Brachytx isodose intermed (77317) |
$288.19 |
$1,353 |
0.7× |
| Brachytx Isodose Plan Simple (77316) |
$220.24 |
$1,034 |
0.6× |
| Brain Image W/Flow < 4 Views (78601) |
$676.74 |
$2,488 |
1.6× |
| Brain imaging < 4 static views (78600) |
$573.92 |
$2,110 |
1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,032.24 |
$3,795 |
1.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$622.88 |
$2,290 |
1.1× |
| 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 MRI w/w/o contrast w/stress (75563) |
$863.95 |
$4,670 |
1.0× |
| Cardiac Shunt Detection (78428) |
$390.59 |
$1,436 |
0.9× |
| Cat Scan Follow-Up Study (76380) |
$103.79 |
$499 |
1.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$315.52 |
$1,160 |
0.5× |
| Cerebrospinal Fluid Scan (78630) |
$368.83 |
$1,356 |
0.6× |
| Chest 1 view (71045) |
$112.14 |
$420 |
1.2× |
| Chest 2 views (71046) |
$132.17 |
$495 |
1.4× |
| Chest 3 views (71047) |
$135.37 |
$507 |
1.5× |
| Chest 4 or more views (71048) |
$147.12 |
$551 |
1.3× |
| 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 Exam Abdominl Aorta (75625) |
$1,355.41 |
$5,695 |
0.4× |
| Contrast X-Ray Bladder (74430) |
$226.20 |
$754 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$148.76 |
$506 |
0.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$227.85 |
$775 |
0.6× |
| Contrast Xray Throat/Cerv Esopha (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 Abdomen and Pelvis (74174) |
$540.41 |
$4,157 |
1.5× |
| CT Angio Chest (71275) |
$404.04 |
$3,108 |
2.2× |
| CT Angio Head (70496) |
$389.04 |
$2,611 |
2.1× |
| CT angio hrt w/3d image (75574) |
$480.06 |
$2,308 |
1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$368.42 |
$2,834 |
2.0× |
| CT Angio Neck (70498) |
$476.50 |
$3,198 |
2.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$299.39 |
$2,303 |
1.6× |
| CT cervical spine w/ contrast (72126) |
$356.46 |
$2,742 |
1.0× |
| CT cervical spine w/o contrast (72125) |
$285.09 |
$2,193 |
2.6× |
| CT cervical spine w/wo cont (72127) |
$427.70 |
$3,290 |
2.3× |
| CT chest w contrast (71260) |
$320.71 |
$2,467 |
1.7× |
| CT chest w/wo contrast (71270) |
$384.80 |
$2,960 |
2.1× |
| CT colonography screening (74263) |
$466.96 |
$2,245 |
1.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$362.96 |
$1,745 |
1.9× |
| CT colonogrphy dx image postprocess w/o contrast (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 l-spine w&w/o contrast (72133) |
$409.37 |
$3,149 |
2.2× |
| CT lower ext w/o (73700) |
$233.87 |
$1,799 |
2.1× |
| CT lower extremity w/contrast material (73701) |
$292.37 |
$2,249 |
1.6× |
| CT lumbar spine w contrast (72132) |
$341.12 |
$2,624 |
0.9× |
| CT lumbar spine w/o contrast (72131) |
$272.87 |
$2,099 |
2.4× |
| CT maxillofacial w contrast (70487) |
$321.54 |
$2,158 |
1.7× |
| CT maxillofacial wo contrast (70486) |
$257.17 |
$1,726 |
2.3× |
| CT neck tissue combo (70492) |
$453.70 |
$3,045 |
2.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) |
$350.87 |
$2,699 |
1.9× |
| CT scans face/jaw combo (70488) |
$385.76 |
$2,589 |
2.1× |
| CT soft tissue neck w contrast (70491) |
$378.16 |
$2,538 |
2.0× |
| 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 cont (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 ext wo (73200) |
$190.06 |
$1,462 |
1.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$285.09 |
$2,193 |
1.5× |
| 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 pelvis (72191) |
$473.46 |
$3,642 |
2.5× |
| Dilation ureters/urethra rs&i (74485) |
$567.90 |
$1,893 |
0.3× |
| Diskography lumbar (72295) |
$997.20 |
$3,324 |
0.5× |
| Dxa Bone Density Axial (77080) |
$165 |
$550 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$122.10 |
$407 |
1.3× |
| Echo Guide For Artery Repair (76936) |
$232.77 |
$699 |
1.0× |
| Echograp Trans R Pros Study (76873) |
$122.21 |
$367 |
1.1× |
| Esophagram (74220) |
$147 |
$490 |
0.8× |
| Fetal Biophys Profile W/Nst (76818) |
$137.86 |
$414 |
1.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$771.26 |
$4,169 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$127.20 |
$424 |
0.5× |
| Follow-Up Angiography (75898) |
$443.39 |
$1,863 |
0.1× |
| Foot 2 views (73620) |
$92.40 |
$308 |
1.0× |
| Forearm 2 views (73090) |
$84.90 |
$283 |
0.9× |
| Gastric emptying imaging study (78264) |
$508.10 |
$1,868 |
1.2× |
| Gated Heart Planar Single (78472) |
$634.85 |
$2,334 |
1.5× |
| Hand 2 views (73120) |
$107.40 |
$358 |
1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,862.26 |
$8,743 |
2.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,232.20 |
$5,785 |
1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$692.46 |
$3,251 |
0.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,181.40 |
$3,938 |
0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,192.20 |
$3,974 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$498.85 |
$1,834 |
0.9× |
| Hepatobiliary System Imaging (78226) |
$364.21 |
$1,339 |
0.9× |
| Ht Musc Image Planar Mult (78454) |
$1,154.64 |
$4,245 |
0.8× |
| Ht Muscle Image Spect Sing (78451) |
$958.53 |
$3,524 |
0.7× |
| Hysterosalpingogram (74740) |
$210.30 |
$701 |
0.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$202.46 |
$608 |
2.2× |
| Infant hip ultrasound, limited static exam (76886) |
$147.85 |
$444 |
1.6× |
| Infusion Ivp (74410) |
$492.60 |
$1,642 |
2.6× |
| 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 (77077) |
$120.90 |
$403 |
1.1× |
| K Flow/Funct Image Multiple (78709) |
$1,532.45 |
$5,634 |
2.6× |
| K Flow/Funct Image W/Drug (78708) |
$442.27 |
$1,626 |
0.8× |
| K Flow/Funct Image W/O Drug (78707) |
$778.19 |
$2,861 |
1.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$372.64 |
$1,370 |
0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$518.98 |
$1,908 |
1.2× |
| Knee 3 Views (73562) |
$151.20 |
$504 |
1.6× |
| Leveen/Shunt Patency Exam (78291) |
$297.02 |
$1,092 |
0.7× |
| 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 Ventilat&Perfus Imaging (78582) |
$475.18 |
$1,747 |
0.8× |
| Lung Ventilation Imaging (78579) |
$354.96 |
$1,305 |
0.8× |
| Lymph System Imaging (78195) |
$479.54 |
$1,763 |
0.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$821.10 |
$2,737 |
0.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$547.50 |
$1,825 |
0.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$636.90 |
$2,123 |
0.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$440.40 |
$1,468 |
0.1× |
Magnetic Image Jaw Joint (70336)
range across 3 matching MRF lines |
$328–$492.10 |
$1,773–$2,660 |
varies |
| Magnetic Resonance Elastography (76391) |
$156.14 |
$844 |
0.6× |
| Mammary ductogram or galactogram multiple (77054) |
$268.50 |
$895 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$207.30 |
$691 |
0.8× |
| Meckels Divert Exam (78290) |
$478.99 |
$1,761 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$341.86 |
$1,605 |
0.9× |
| Mr safety determination physician/other qhp (76016) |
$40.50 |
$135 |
0.4× |
| 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 implt pos&/immoblj (76019) |
$87 |
$290 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$163.20 |
$544 |
0.6× |
| Mra Head W/O & W/Contrast Material (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 contrast (74181) |
$474.71 |
$2,566 |
1.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$857.10 |
$4,633 |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,028.41 |
$5,559 |
2.8× |
| 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 brain functional w/o physician admnistration (70554) |
$622.90 |
$3,367 |
2.4× |
| MRI brain functional w/physician admnistration (70555) |
$467.12 |
$2,525 |
1.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$419.58 |
$2,268 |
1.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$279.72 |
$1,512 |
1.1× |
| 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 contrast (72142) |
$657.47 |
$3,673 |
1.8× |
| MRI cervical spine w/o cont (72141) |
$525.90 |
$2,938 |
2.1× |
| MRI chest w/o contrast (71550) |
$374.26 |
$2,023 |
1.5× |
| MRI chest with contrast (71551) |
$467.86 |
$2,529 |
0.6× |
| MRI chest wo w contrast (71552) |
$561.48 |
$3,035 |
1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$653.98 |
$3,535 |
1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$784.77 |
$4,242 |
2.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$523.18 |
$2,828 |
2.1× |
| MRI lumbar spine w contrast (72149) |
$661.40 |
$3,695 |
1.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$788.85 |
$4,407 |
2.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$289.98 |
$1,611 |
1.1× |
| MRI orbit face neck w contrast (70542) |
$362.52 |
$2,014 |
1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$435.06 |
$2,417 |
1.2× |
| MRI pelvis w contrast (72196) |
$657.30 |
$3,553 |
1.8× |
| MRI pelvis w/o & w contrast (72197) |
$788.66 |
$4,263 |
2.1× |
| MRI pelvis w/o contrast (72195) |
$525.77 |
$2,842 |
2.1× |
| MRI spectroscopy (76390) |
$481.37 |
$2,602 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$452.69 |
$2,529 |
1.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$584.04 |
$3,157 |
1.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$467.12 |
$2,525 |
1.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$700.78 |
$3,788 |
1.9× |
| MRI, abdomen, combo (74183) |
$712.06 |
$3,849 |
1.9× |
| MRI, dorsal spine combo (72157) |
$679.13 |
$3,794 |
1.8× |
| MRI, dorsal spine contrast (72147) |
$566 |
$3,162 |
1.5× |
| MRI, joint upper extrem (73221) |
$599.40 |
$3,240 |
2.4× |
| MRI, joint upper extrem combo (73223) |
$899.10 |
$4,860 |
2.4× |
| MRI, lumbar spine combo (72158) |
$793.69 |
$4,434 |
2.1× |
| Myelogram cervical (72240) |
$357 |
$1,190 |
0.4× |
| Myelogram Lumbar (72265) |
$357 |
$1,190 |
0.4× |
| Myelograpy 2/more regions rs&i (72270) |
$579.60 |
$1,932 |
0.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$492.32 |
$1,810 |
1.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$958.53 |
$3,524 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,154.64 |
$4,245 |
0.8× |
| N-invas est c ffr sw aly CTA (75580) |
$1,716.86 |
$6,528 |
1.9× |
| Neck soft tissue (70360) |
$151.80 |
$506 |
1.6× |
| Nm csf leak detection (78650) |
$574.19 |
$2,111 |
0.4× |
| Nm myocard infarct spect (78469) |
$546.72 |
$2,010 |
0.9× |
| Nonvascular Shunt X-Ray (75809) |
$145.50 |
$485 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,299.94 |
$6,103 |
0.9× |
| Nuclear Rx Intra-Arterial (79445) |
$334.96 |
$763 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$1,068.09 |
$2,433 |
4.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$100.23 |
$301 |
1.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$116.22 |
$349 |
1.0× |
| Panoramic X-ray of jaws (70355) |
$82.50 |
$275 |
0.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$582.35 |
$2,141 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$374.82 |
$1,378 |
0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$474.37 |
$1,744 |
1.1× |
| 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× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,315.50 |
$4,385 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$381.07 |
$1,401 |
0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$246 |
$820 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$246 |
$820 |
0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$129.30 |
$431 |
1.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$103.80 |
$346 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$159 |
$530 |
1.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$162.60 |
$542 |
1.5× |
| Radex fingr minimum 2 views (73140) |
$91.80 |
$306 |
1.0× |
| Radex foot complete minimum 3 views (73630) |
$108.60 |
$362 |
1.2× |
| Radex Hand Minimum 3 Views (73130) |
$123.30 |
$411 |
1.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$102.30 |
$341 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$115.80 |
$386 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$130.80 |
$436 |
1.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$132.30 |
$441 |
1.4× |
| Radex shoulder complete minimum 2 views (73030) |
$150.90 |
$503 |
1.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$135.60 |
$452 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$96 |
$320 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$130.80 |
$436 |
1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$119.40 |
$398 |
1.3× |
| Radex Toe Minimum 2 Views (73660) |
$78.60 |
$262 |
0.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$94.20 |
$314 |
0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$123.30 |
$411 |
1.3× |
| 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 level 1 (77402) |
$170.40 |
$800 |
1.6× |
| Radiation treatment delivery level 2 (77407) |
$219.60 |
$1,031 |
0.5× |
| Radiation treatment delivery level 3 (77412) |
$235.15 |
$1,104 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$159 |
$530 |
1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$213.30 |
$711 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$410.10 |
$1,367 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$282.30 |
$941 |
1.5× |
| Radiologic exam knee complete 4/more views (73564) |
$169.20 |
$564 |
1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$138.90 |
$463 |
1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$130.50 |
$435 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$217.50 |
$725 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$184.20 |
$614 |
1.0× |
| Radiologic examination femur 1 view (73551) |
$90 |
$300 |
1.0× |
| Radiologic examination femur minimum 2 views (73552) |
$132.30 |
$441 |
1.4× |
| Radiologic examination knee 1/2 views (73560) |
$128.40 |
$428 |
1.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$167.70 |
$559 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$97.20 |
$324 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,038.38 |
$4,875 |
2.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$692.46 |
$3,251 |
1.7× |
| Ribs bilateral 3 views (71110) |
$147.90 |
$493 |
1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$504.02 |
$1,853 |
1.2× |
| 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 2+ Days Imaging (78804) |
$1,029.52 |
$3,785 |
1.8× |
| 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/acquisj 1day img (78830) |
$766.50 |
$2,818 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$667.28 |
$1,520 |
2.7× |
| Rp Therapy Intravenous Administration (79101) |
$392.03 |
$893 |
1.6× |
| Salivary Gland Imaging Serial Images (78231) |
$275.54 |
$1,013 |
0.6× |
| Scapula (73010) |
$103.80 |
$346 |
0.9× |
| Sella turcica (70240) |
$56.70 |
$189 |
0.6× |
| Shoulder 1 view (73020) |
$96.60 |
$322 |
1.0× |
| Shoulder Arthrography (73040) |
$284 |
$966 |
0.8× |
| Sialogram (70390) |
$192.30 |
$641 |
0.8× |
| Skull less than 4 views (70250) |
$144 |
$480 |
1.3× |
| Special dosimetry (77331) |
$129.72 |
$609 |
0.9× |
| Special Physics Consult (77370) |
$254.11 |
$1,193 |
1.8× |
| Special teletherapy port plan (77321) |
$329.72 |
$1,548 |
0.8× |
| Special treatment procedure (77470) |
$817.71 |
$3,839 |
1.4× |
| Stereotactic Body Radiation Delivery (77373) |
$2,173.45 |
$10,204 |
1.1× |
| Sternoclavicular joints (71130) |
$159.60 |
$532 |
1.7× |
| 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 Intermed (77285) |
$351.24 |
$1,649 |
0.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$195.11 |
$916 |
1.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$259.20 |
$864 |
1.4× |
| Thoracic spine 2 views (72070) |
$109.20 |
$364 |
1.0× |
| Thoracic spine 3 views (72072) |
$135.60 |
$452 |
1.2× |
| Thoracolumbar 2 views (72080) |
$115.20 |
$384 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$193.12 |
$710 |
0.5× |
| Thyroid Met Imaging Body (78018) |
$668.30 |
$2,457 |
1.2× |
| 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× |
| Tx Devices Design & Construction Complex (77334) |
$251.13 |
$1,179 |
0.6× |
| Tx devices design & construction intermediate (77333) |
$164.01 |
$770 |
1.1× |
| Tx devices design & construction simple (77332) |
$116.72 |
$548 |
0.8× |
Ultrasound Breast Limited (76642)
range across 6 matching MRF lines |
$103.90–$155.84 |
$312–$468 |
varies |
| Ultrasound elastography first target lesion (76982) |
$200.13 |
$601 |
1.8× |
| Ultrasound Elastography Parenchyma (76981) |
$224.44 |
$674 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$129.54 |
$389 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$280.39 |
$842 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$747.96 |
$4,043 |
8.1× |
| Unlisted us procedure (76999) |
$134.86 |
$405 |
1.5× |
| Upper gi w/o kub (74240) |
$161.40 |
$538 |
0.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$165.65 |
$609 |
15.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$1,378.77 |
$5,069 |
14.6× |
| Urethrocystogram voiding (74455) |
$215.70 |
$719 |
0.8× |
| Urethrocystography retrograde (74450) |
$161.70 |
$539 |
0.6× |
Us breast unilateral complete (76641)
range across 6 matching MRF lines |
$147.85–$221.78 |
$444–$666 |
varies |
| Us chest (76604) |
$153.85 |
$462 |
1.4× |
| Us complete joint (76881) |
$184.48 |
$554 |
1.7× |
| Us exam, pelvic, limited (76857) |
$263.74 |
$792 |
2.4× |
| Us head (76506) |
$184.15 |
$553 |
1.7× |
| Us kidney transplant (76776) |
$173.49 |
$521 |
1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$101.23 |
$304 |
0.9× |
| Us ob detailed single fetus (76811) |
$270.06 |
$811 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$180.82 |
$543 |
1.6× |
| Us ob transvaginal (76817) |
$205.79 |
$618 |
1.8× |
| Us pelvic non ob complete (76856) |
$351.65 |
$1,056 |
3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$179.15 |
$538 |
1.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$242.76 |
$729 |
2.2× |
| 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 spinal canal and contents (76800) |
$251.42 |
$755 |
2.3× |
| Us thyroid (76536) |
$167.83 |
$504 |
1.5× |
| Us transrectal (76872) |
$136.86 |
$411 |
1.2× |
| Vascular Flow Imaging (78445) |
$195.02 |
$717 |
0.5× |
| Vein X-Ray Chest (75827) |
$517.50 |
$1,725 |
0.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$970.50 |
$3,235 |
0.3× |
| Vein X-Ray Skull Epidural (75872) |
$579.60 |
$1,932 |
0.9× |
| Vein X-Ray Spleen/Liver (75810) |
$1,181.40 |
$3,938 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$772.20 |
$2,574 |
0.2× |
| Venography Adrenal Unilateral (75840) |
$1,467.60 |
$4,892 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,349.40 |
$4,498 |
0.4× |
| Venography extremity bilateral rs&i (75822) |
$631.80 |
$2,106 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$570.90 |
$1,903 |
0.3× |
| Venography Orbital Rs&I (75880) |
$386.40 |
$1,288 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,367.40 |
$4,558 |
0.4× |
| Venography Renal Unilateral (75831) |
$1,181.40 |
$3,938 |
0.4× |
Venous sampling by catheter (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 Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$114.90 |
$383 |
1.2× |
| X-ray antegrade pyelogram tube (74425) |
$177 |
$590 |
0.5× |
| X-Ray Aorta Leg Arteries (75630) |
$1,472.03 |
$6,185 |
0.4× |
| X-Ray Bend Only L-S Spine (72120) |
$182.10 |
$607 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$146.70 |
$489 |
1.6× |
| X-Ray Exam Breast Specimen (76098) |
$246 |
$820 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$84.60 |
$282 |
0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$119.40 |
$398 |
1.1× |
| 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 2 Views (73521) |
$127.50 |
$425 |
1.1× |
| 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 L-S Spine Bending (72114) |
$277.80 |
$926 |
2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$152.10 |
$507 |
1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$236.70 |
$789 |
2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$144.60 |
$482 |
1.3× |
| X-ray eye for foreign body (70030) |
$120.30 |
$401 |
1.3× |
| X-ray humerus (73060) |
$139.80 |
$466 |
1.5× |
| X-ray IV pyelogram (ivp) (74400) |
$353.70 |
$1,179 |
1.9× |
| X-ray IV pyelogram+tomography (74415) |
$575.10 |
$1,917 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$138.30 |
$461 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$149.70 |
$499 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$178.20 |
$594 |
1.6× |
| X-ray nose-rectum child f.b. (76010) |
$84.90 |
$283 |
0.9× |
| 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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$100.20 |
$334 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$98.10 |
$327 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$201.30 |
$671 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$178.50 |
$595 |
1.6× |
| X-ray thoracic spine 4 vw (72074) |
$151.50 |
$505 |
1.4× |
| X-Ray Tmj Unilat (70328) |
$77.70 |
$259 |
0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$236.10 |
$787 |
0.6× |
| X-Rays Bone Length Studies (77073) |
$150.60 |
$502 |
1.3× |
| X-Rays Bone Survey Complete (77075) |
$253.80 |
$846 |
2.3× |
| Xr c-spine 4 or 5 views (72050) |
$201.90 |
$673 |
1.8× |
| Xr facial bones less than 3 views (70140) |
$105.30 |
$351 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$71.10 |
$237 |
0.6× |
| Xr orbits complete 4 views (70200) |
$147.30 |
$491 |
1.3× |