| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,270.12 |
$11,726 |
5.0× |
| Abdomen 1 View (74018) |
$460.66 |
$743 |
5.1× |
| Abdomen 2 views (74019) |
$623.72 |
$1,006 |
5.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$956.04 |
$1,542 |
2.3× |
| Angio internal mammary (75756) |
$2,310.12 |
$3,726 |
0.7× |
| Angio pulmonary bilat (75743) |
$4,816.16 |
$7,768 |
1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,507.28 |
$4,044 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,496.12 |
$4,026 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,429.78 |
$3,919 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,512.24 |
$4,052 |
0.8× |
| Ankle 2 views (73600) |
$492.90 |
$795 |
5.4× |
| Aortography thoracic serialography rs&i (75605) |
$3,940.10 |
$6,355 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,295.24 |
$3,702 |
0.7× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$2,817.90 |
$4,545 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$2,009.42 |
$3,241 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$8,841.20 |
$14,260 |
1.5× |
| Artery X-Rays Spine (75705) |
$3,503 |
$5,650 |
0.6× |
| Arthrogram ankle (73615) |
$619.38 |
$999 |
1.7× |
| Arthrogram hip (73525) |
$950.46 |
$1,533 |
2.6× |
| Arthrogram Wrist (73115) |
$1,063.92 |
$1,716 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$886.60 |
$1,430 |
6.3× |
| Bone age studies (77072) |
$452.60 |
$730 |
4.1× |
| Bone Imaging 3 Phase (78315) |
$3,146.50 |
$5,075 |
7.5× |
| Bone Imaging Limited Area (78300) |
$2,077.62 |
$3,351 |
5.0× |
| Bone Imaging Whole Body (78306) |
$2,683.98 |
$4,329 |
6.4× |
| Bone survey infant (77076) |
$920.08 |
$1,484 |
8.4× |
| Brachytx isodose complex (77318) |
$2,212.78 |
$3,569 |
5.7× |
| Brachytx isodose intermed (77317) |
$1,634.94 |
$2,637 |
4.2× |
| Brachytx Isodose Plan Simple (77316) |
$1,240.62 |
$2,001 |
3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,644.24 |
$2,652 |
2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,698.30 |
$5,965 |
2.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,995.78 |
$3,219 |
5.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,095.60 |
$3,380 |
2.6× |
| Cardiac Shunt Detection (78428) |
$324.88 |
$524 |
0.8× |
| Cat Scan Follow-Up Study (76380) |
$433.38 |
$699 |
4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,051.52 |
$1,696 |
1.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$1,232.56 |
$1,988 |
2.2× |
| Cerebrospinal Fluid Scan (78630) |
$1,156.92 |
$1,866 |
2.0× |
| Chest 1 view (71045) |
$184.76 |
$298 |
2.0× |
| Chest 2 views (71046) |
$511.50 |
$825 |
5.6× |
| Chest 4 or more views (71048) |
$703.70 |
$1,135 |
6.4× |
| Clavicle complete (73000) |
$496.62 |
$801 |
5.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$728.50 |
$1,175 |
6.7× |
| Continuing medical physics consltj pr wk (77336) |
$847.54 |
$1,367 |
6.0× |
| Contrast Exam Abdominl Aorta (75625) |
$2,582.30 |
$4,165 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$627.44 |
$1,012 |
1.7× |
| Contrast X-Ray Of Elbow (73085) |
$633.64 |
$1,022 |
1.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$845.68 |
$1,364 |
2.3× |
| Corpora cavernosography (74445) |
$94.24 |
$152 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,113.02 |
$5,021 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,918.28 |
$3,094 |
7.7× |
| CT abdomen w contrast (74160) |
$1,454.52 |
$2,346 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,594.64 |
$2,572 |
8.7× |
| CT abdomen w/o contrast (74150) |
$1,027.34 |
$1,657 |
9.4× |
| CT Angio Abdomen and Pelvis (74174) |
$3,268.64 |
$5,272 |
9.0× |
| CT Angio Chest (71275) |
$1,983.38 |
$3,199 |
10.8× |
| CT Angio Head (70496) |
$2,126.60 |
$3,430 |
11.6× |
| CT angio hrt w/3d image (75574) |
$1,108.56 |
$1,788 |
3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,784.36 |
$2,878 |
9.7× |
| CT Angio Neck (70498) |
$2,093.12 |
$3,376 |
11.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,703.76 |
$2,748 |
9.3× |
| CT cervical spine w/ contrast (72126) |
$1,600.84 |
$2,582 |
4.4× |
| CT cervical spine w/o contrast (72125) |
$1,272.24 |
$2,052 |
11.7× |
| CT cervical spine w/wo cont (72127) |
$2,412.42 |
$3,891 |
13.2× |
| CT chest w contrast (71260) |
$1,516.52 |
$2,446 |
8.3× |
| CT chest w/wo contrast (71270) |
$1,763.28 |
$2,844 |
9.6× |
| CT head/brain with contrast (70460) |
$1,269.76 |
$2,048 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,530.16 |
$2,468 |
8.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$772.52 |
$1,246 |
2.1× |
CT heart no contrast quant eval coronry calcium (75571)
range across 3 matching MRF lines |
$61.38–$99.08 |
$99–$159.80 |
varies |
| CT hrt w/3d image congen (75573) |
$978.36 |
$1,578 |
2.7× |
| CT iac w contrast (70481) |
$3,308.94 |
$5,337 |
18.1× |
| CT l-spine w&w/o contrast (72133) |
$1,715.54 |
$2,767 |
9.4× |
| CT lower ext w/o (73700) |
$982.70 |
$1,585 |
9.0× |
| CT lower extremity w/contrast material (73701) |
$1,174.28 |
$1,894 |
6.4× |
| CT lumbar spine w contrast (72132) |
$1,319.98 |
$2,129 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$1,127.16 |
$1,818 |
10.3× |
| CT maxillofacial w contrast (70487) |
$1,540.70 |
$2,485 |
8.4× |
| CT maxillofacial wo contrast (70486) |
$1,383.22 |
$2,231 |
12.7× |
| CT neck tissue combo (70492) |
$1,979.04 |
$3,192 |
10.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,911.58 |
$6,309 |
21.4× |
| CT orbits w/o contrast (70480) |
$1,200.32 |
$1,936 |
11.0× |
| CT pelvis w&w/o contrast (72194) |
$1,726.70 |
$2,785 |
9.4× |
| CT pelvis w/o contrast (72192) |
$1,179.24 |
$1,902 |
10.8× |
| CT scan of leg combo (73702) |
$1,699.42 |
$2,741 |
9.3× |
| CT scans face/jaw combo (70488) |
$1,650.44 |
$2,662 |
9.0× |
| CT soft tissue neck w contrast (70491) |
$1,605.18 |
$2,589 |
8.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,182.96 |
$1,908 |
10.8× |
| CT thoracic spine w contrast (72129) |
$1,430.96 |
$2,308 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$1,174.90 |
$1,895 |
10.8× |
| CT thoracic spine w/wo cont (72130) |
$1,585.34 |
$2,557 |
8.7× |
| CT thorax w/o contrast (71250) |
$1,245.58 |
$2,009 |
11.4× |
| CT upper ext wo (73200) |
$1,148.86 |
$1,853 |
10.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,622.54 |
$2,617 |
8.9× |
| CT upper extremity with contrast (73201) |
$1,246.82 |
$2,011 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,158.22 |
$3,481 |
11.8× |
| Cta Abdomen (74175) |
$1,674.62 |
$2,701 |
9.1× |
| CTA pelvis (72191) |
$1,812.88 |
$2,924 |
9.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,373.30 |
$2,215 |
0.6× |
| Diskography lumbar (72295) |
$2,903.46 |
$4,683 |
1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$606.98 |
$979 |
5.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$897.14 |
$1,447 |
8.2× |
| Dxa Bone Density Axial (77080) |
$983.32 |
$1,586 |
9.0× |
| Echo exam of fetal heart (76825) |
$2,277.88 |
$3,674 |
4.0× |
| Echo exam uterus (76831) |
$742.76 |
$1,198 |
3.0× |
| Echo Guide For Artery Repair (76936) |
$714.86 |
$1,153 |
3.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$968.44 |
$1,562 |
3.9× |
| Echograp Trans R Pros Study (76873) |
$389.36 |
$628 |
3.6× |
| Esophagram (74220) |
$841.34 |
$1,357 |
4.6× |
| Fetal Biophys Profile W/Nst (76818) |
$1,641.14 |
$2,647 |
15.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,175.52 |
$1,896 |
10.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,082.58 |
$3,359 |
8.4× |
| Fluoroscopy up to 1 hr (76000) |
$1,194.74 |
$1,927 |
4.8× |
| Follow-Up Angiography (75898) |
$1,628.74 |
$2,627 |
0.5× |
| Foot 2 views (73620) |
$490.42 |
$791 |
5.4× |
| Forearm 2 views (73090) |
$560.48 |
$904 |
6.2× |
| Gastric emptying imaging study (78264) |
$2,486.20 |
$4,010 |
6.0× |
| Gastroesophageal Reflux Exam (78262) |
$1,636.18 |
$2,639 |
3.9× |
| GI Endoscopic US S&I (76975) |
$411.68 |
$664 |
1.7× |
| Hand 2 views (73120) |
$517.70 |
$835 |
4.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,917.96 |
$11,158 |
9.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$5,549.62 |
$8,951 |
7.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,723.10 |
$6,005 |
5.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,905.38 |
$6,299 |
1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,729.86 |
$4,403 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$2,472.56 |
$3,988 |
4.4× |
| Hepatobiliary System Imaging (78226) |
$2,081.96 |
$3,358 |
5.0× |
| Ht Musc Image Planar Mult (78454) |
$3,061.56 |
$4,938 |
2.3× |
| Ht Muscle Image Spect Sing (78451) |
$3,300.26 |
$5,323 |
2.4× |
| Hysterosalpingogram (74740) |
$1,427.86 |
$2,303 |
5.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$881.02 |
$1,421 |
9.7× |
| Interstitial radiation source applic complex (77778) |
$4,257.54 |
$6,867 |
5.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,683.92 |
$2,716 |
2.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$721.68 |
$1,164 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$629.30 |
$1,015 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$2,410.56 |
$3,888 |
4.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,397.48 |
$2,254 |
2.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,558.68 |
$2,514 |
3.7× |
| Knee 3 Views (73562) |
$684.48 |
$1,104 |
7.5× |
| Leveen/Shunt Patency Exam (78291) |
$1,181.10 |
$1,905 |
2.8× |
| Liver & Spleen Imaging Static Only (78215) |
$1,654.16 |
$2,668 |
4.0× |
| Liver imaging w/vascular flow (78202) |
$1,070.12 |
$1,726 |
1.9× |
| Lung perfusion differential (78597) |
$971.54 |
$1,567 |
2.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,434.06 |
$2,313 |
2.5× |
| Lymph System Imaging (78195) |
$2,496.12 |
$4,026 |
4.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$936.20 |
$1,510 |
0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,919.58 |
$4,709 |
0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,443.42 |
$3,941 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$1,688.88 |
$2,724 |
6.8× |
| Meckels Divert Exam (78290) |
$2,517.82 |
$4,061 |
6.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$1,228.22 |
$1,981 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,253.76 |
$5,248 |
8.3× |
| Mr safety determination physician/other qhp (76016) |
$82.46 |
$133 |
0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$23.56 |
$38 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$114.08 |
$184 |
1.1× |
| Mr safety implt pos&/immoblj (76019) |
$173.60 |
$280 |
2.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$272.18 |
$439 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,207.82 |
$3,561 |
6.1× |
| MRA head w/o contrast (70544) |
$1,696.94 |
$2,737 |
6.8× |
| MRA head with contrast (70545) |
$1,825.90 |
$2,945 |
5.0× |
| MRA neck w contrast (70548) |
$1,656.02 |
$2,671 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,112.34 |
$3,407 |
5.8× |
| MRA neck w/o contrast (70547) |
$1,502.26 |
$2,423 |
6.0× |
| MRI abdomen w contrast (74182) |
$2,408.70 |
$3,885 |
6.6× |
| MRI abdomen w/o contrast (74181) |
$2,059.02 |
$3,321 |
8.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,530.84 |
$4,082 |
3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,036.76 |
$4,898 |
8.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,922.62 |
$3,101 |
2.3× |
| MRI brain functional w/o physician admnistration (70554) |
$1,652.30 |
$2,665 |
6.6× |
| MRI brain functional w/physician admnistration (70555) |
$1,709.96 |
$2,758 |
6.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,999.50 |
$3,225 |
8.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,569.22 |
$2,531 |
6.3× |
| MRI cardiac w/o cont stress (75559) |
$2,406.22 |
$3,881 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$2,209.06 |
$3,563 |
8.9× |
| MRI cervical spine w contrast (72142) |
$2,216.50 |
$3,575 |
6.1× |
| MRI cervical spine w/o cont (72141) |
$1,929.44 |
$3,112 |
7.7× |
| MRI chest w/o contrast (71550) |
$1,789.94 |
$2,887 |
7.2× |
| MRI chest with contrast (71551) |
$1,832.10 |
$2,955 |
2.2× |
| MRI chest wo w contrast (71552) |
$2,316.32 |
$3,736 |
6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,490.54 |
$4,017 |
6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,610.82 |
$4,211 |
7.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,770.72 |
$2,856 |
7.1× |
| MRI lumbar spine w contrast (72149) |
$2,143.96 |
$3,458 |
5.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,463.26 |
$3,973 |
6.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,938.12 |
$3,126 |
7.8× |
| MRI orbit face neck w contrast (70542) |
$2,276.64 |
$3,672 |
6.2× |
| MRI pelvis w contrast (72196) |
$1,895.96 |
$3,058 |
5.2× |
| MRI pelvis w/o & w contrast (72197) |
$2,782.56 |
$4,488 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$1,574.80 |
$2,540 |
6.3× |
| MRI spectroscopy (76390) |
$1,582.86 |
$2,553 |
17.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,969.12 |
$3,176 |
7.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,801.10 |
$2,905 |
4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,656.64 |
$2,672 |
6.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,285.32 |
$3,686 |
6.3× |
| MRI, abdomen, combo (74183) |
$2,561.84 |
$4,132 |
7.0× |
| MRI, dorsal spine combo (72157) |
$2,587.26 |
$4,173 |
7.1× |
| MRI, dorsal spine contrast (72147) |
$2,860.06 |
$4,613 |
7.9× |
| MRI, joint upper extrem (73221) |
$1,752.12 |
$2,826 |
7.0× |
| MRI, joint upper extrem combo (73223) |
$2,931.36 |
$4,728 |
8.0× |
| MRI, lumbar spine combo (72158) |
$2,808.60 |
$4,530 |
7.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,988.34 |
$3,207 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,024.42 |
$6,491 |
3.0× |
| Neck soft tissue (70360) |
$472.44 |
$762 |
5.2× |
| Nonvascular Shunt X-Ray (75809) |
$528.86 |
$853 |
4.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,383.70 |
$15,135 |
6.5× |
| Nuclear Rx Intra-Arterial (79445) |
$833.28 |
$1,344 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$1,659.12 |
$2,676 |
6.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$310.62 |
$501 |
2.8× |
| Optic foramina (70190) |
$571.64 |
$922 |
6.3× |
| Panoramic X-ray of jaws (70355) |
$155.62 |
$251 |
1.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,646.78 |
$4,269 |
4.7× |
| Parathyroid Planar Imaging (78070) |
$1,900.30 |
$3,065 |
4.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,165.04 |
$3,492 |
5.2× |
| Pelvis 1 or 2 views (72170) |
$274.66 |
$443 |
2.5× |
| Perineogram (74775) |
$650.38 |
$1,049 |
2.6× |
| Peritoneogram Rs&I (74190) |
$731.60 |
$1,180 |
1.3× |
| Pet Image Skull-Thigh (78812) |
$4,933.34 |
$7,957 |
3.3× |
| Pet Image W/Ct Lmtd (78814) |
$3,226.48 |
$5,204 |
2.2× |
| PET image w/CT, full body (78816) |
$6,483.34 |
$10,457 |
4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,542.18 |
$8,939 |
3.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,090.02 |
$3,371 |
1.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,442.24 |
$5,552 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,094.30 |
$1,765 |
2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$955.42 |
$1,541 |
8.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$798.56 |
$1,288 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$620.62 |
$1,001 |
6.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$455.70 |
$735 |
5.0× |
| Radex elbow complete minimum 3 views (73080) |
$615.66 |
$993 |
6.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$748.34 |
$1,207 |
6.9× |
| Radex fingr minimum 2 views (73140) |
$469.96 |
$758 |
5.2× |
| Radex foot complete minimum 3 views (73630) |
$602.64 |
$972 |
6.6× |
| Radex Hand Minimum 3 Views (73130) |
$634.26 |
$1,023 |
7.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$538.78 |
$869 |
5.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$293.26 |
$473 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$548.08 |
$884 |
6.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$561.72 |
$906 |
6.2× |
| Radex shoulder complete minimum 2 views (73030) |
$734.70 |
$1,185 |
8.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,505.98 |
$2,429 |
8.2× |
| Radex Spine 1 View Specify Level (72020) |
$551.80 |
$890 |
6.1× |
| Radex Sternum Minimum 2 Views (71120) |
$566.06 |
$913 |
6.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$654.72 |
$1,056 |
7.2× |
| Radex Toe Minimum 2 Views (73660) |
$437.10 |
$705 |
4.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$620.62 |
$1,001 |
5.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$796.08 |
$1,284 |
8.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,274.10 |
$2,055 |
11.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,745.02 |
$28,621 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$347.82 |
$561 |
3.3× |
| Radiation treatment delivery level 2 (77407) |
$644.18 |
$1,039 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$1,290.84 |
$2,082 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$761.36 |
$1,228 |
7.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$636.74 |
$1,027 |
5.8× |
| Radiologic exam colon double contrast study (74280) |
$1,639.28 |
$2,644 |
8.9× |
| Radiologic exam colon single contrast study (74270) |
$1,486.76 |
$2,398 |
8.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$932.48 |
$1,504 |
5.1× |
| Radiologic exam knee complete 4/more views (73564) |
$762.60 |
$1,230 |
7.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$804.14 |
$1,297 |
7.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$539.40 |
$870 |
2.9× |
| Radiologic exam swallow function contrast study (74230) |
$365.80 |
$590 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,473.12 |
$2,376 |
8.0× |
| Radiologic examination femur 1 view (73551) |
$254.82 |
$411 |
2.8× |
| Radiologic examination femur minimum 2 views (73552) |
$410.44 |
$662 |
4.5× |
| Radiologic examination knee 1/2 views (73560) |
$596.44 |
$962 |
6.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$530.10 |
$855 |
4.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$614.42 |
$991 |
6.8× |
| Radiopharm Dacryocystography (78660) |
$1,674.62 |
$2,701 |
4.0× |
| Ribs bilateral 3 views (71110) |
$823.98 |
$1,329 |
7.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$946.74 |
$1,527 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,286.50 |
$2,075 |
3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,481.36 |
$7,228 |
7.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,760.18 |
$2,839 |
3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,913.94 |
$3,087 |
3.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,150.84 |
$5,082 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,723.60 |
$2,780 |
7.1× |
| Scapula (73010) |
$575.36 |
$928 |
5.3× |
| Shoulder 1 view (73020) |
$229.40 |
$370 |
2.5× |
| Shoulder Arthrography (73040) |
$1,567.98 |
$2,529 |
4.3× |
| Skull less than 4 views (70250) |
$661.54 |
$1,067 |
6.1× |
| Special dosimetry (77331) |
$347.82 |
$561 |
2.5× |
| Special Physics Consult (77370) |
$941.78 |
$1,519 |
6.7× |
| Special teletherapy port plan (77321) |
$1,901.54 |
$3,067 |
4.9× |
| Special treatment procedure (77470) |
$3,520.36 |
$5,678 |
6.1× |
| Stereotactic Body Radiation Delivery (77373) |
$5,268.76 |
$8,498 |
2.8× |
| Sternoclavicular joints (71130) |
$542.50 |
$875 |
6.0× |
| Superior sagittal sinus venogram (75870) |
$1,628.74 |
$2,627 |
0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$192.20 |
$310 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,367.72 |
$2,206 |
3.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$553.66 |
$893 |
1.4× |
| Testicular Imaging W/Flow (78761) |
$1,310.68 |
$2,114 |
3.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$3,663.58 |
$5,909 |
9.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,975.94 |
$3,187 |
5.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,876.12 |
$3,026 |
13.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,497.30 |
$2,415 |
8.2× |
| Thoracic spine 2 views (72070) |
$430.28 |
$694 |
3.9× |
| Thoracic spine 3 views (72072) |
$535.06 |
$863 |
4.9× |
| Thoracolumbar 2 views (72080) |
$325.50 |
$525 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,060.20 |
$1,710 |
2.5× |
| Thyroid Met Imaging Body (78018) |
$2,715.60 |
$4,380 |
4.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,964.78 |
$3,169 |
4.7× |
| Tx Devices Design & Construction Complex (77334) |
$1,868.06 |
$3,013 |
4.8× |
| Tx devices design & construction intermediate (77333) |
$1,073.84 |
$1,732 |
7.7× |
| Tx devices design & construction simple (77332) |
$898.38 |
$1,449 |
6.4× |
| Ultrasound Breast Limited (76642) |
$576.60 |
$930 |
6.3× |
| Ultrasound Exam Aaa Screen (76706) |
$393.08 |
$634 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$1,126.54 |
$1,817 |
10.3× |
Unlisted Dx Radiographic Procedure (76499)
range across 4 matching MRF lines |
$114.70–$265.36 |
$185–$428 |
varies |
| Unlisted fluoroscopic procedure (76496) |
$605.12 |
$976 |
6.7× |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
$189.72–$2,067.70 |
$306–$3,335 |
varies |
| Unlisted us procedure (76999) |
$532.58 |
$859 |
5.9× |
| Upper gi w/o kub (74240) |
$1,200.32 |
$1,936 |
6.6× |
| Ureteral Reflux Study (78740) |
$623.72 |
$1,006 |
1.5× |
| Urethrocystogram voiding (74455) |
$1,256.12 |
$2,026 |
5.0× |
| Urethrocystography retrograde (74450) |
$1,153.20 |
$1,860 |
4.6× |
| Us breast unilateral complete (76641) |
$853.74 |
$1,377 |
7.8× |
| Us chest (76604) |
$478.02 |
$771 |
4.4× |
| Us complete joint (76881) |
$938.68 |
$1,514 |
8.6× |
| Us exam, pelvic, limited (76857) |
$529.48 |
$854 |
4.9× |
| Us head (76506) |
$1,001.92 |
$1,616 |
9.2× |
| Us kidney transplant (76776) |
$435.86 |
$703 |
4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$726.02 |
$1,171 |
6.7× |
| Us ob limited 1 or more fetuses (76815) |
$673.32 |
$1,086 |
6.2× |
| Us ob transvaginal (76817) |
$1,009.98 |
$1,629 |
9.3× |
| Us pelvic non ob complete (76856) |
$1,362.76 |
$2,198 |
12.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$376.34 |
$607 |
3.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$514.60 |
$830 |
4.7× |
| Us retroperitoneal complete (76770) |
$1,261.70 |
$2,035 |
11.6× |
| Us retroperitoneal limited (76775) |
$510.88 |
$824 |
4.7× |
| Us scrotum and contents (76870) |
$1,158.78 |
$1,869 |
10.6× |
| Us spinal canal and contents (76800) |
$664.64 |
$1,072 |
6.1× |
| Us thyroid (76536) |
$1,176.14 |
$1,897 |
10.8× |
| Us transrectal (76872) |
$1,232.56 |
$1,988 |
11.3× |
| Vein X-Ray Chest (75827) |
$2,174.96 |
$3,508 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,394.44 |
$3,862 |
0.7× |
| Vein X-Ray Spleen/Liver (75810) |
$1,642.38 |
$2,649 |
0.5× |
| Venogram Sinus/Jugular (75860) |
$1,628.74 |
$2,627 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,051.58 |
$3,309 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$2,092.50 |
$3,375 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,932.54 |
$3,117 |
1.2× |
| Venography Orbital Rs&I (75880) |
$788.02 |
$1,271 |
1.2× |
| Venography Renal Bilateral (75833) |
$5,313.40 |
$8,570 |
1.6× |
| Venography Renal Unilateral (75831) |
$3,688.38 |
$5,949 |
1.1× |
| Venous sampling by catheter (75893) |
$4,351.78 |
$7,019 |
0.7× |
| Wrist 2 views (73100) |
$627.44 |
$1,012 |
6.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$396.18 |
$639 |
4.4× |
| X-ray antegrade pyelogram tube (74425) |
$748.96 |
$1,208 |
2.1× |
| X-Ray Aorta Leg Arteries (75630) |
$3,474.48 |
$5,604 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$660.30 |
$1,065 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$474.30 |
$765 |
5.2× |
| X-Ray Exam Breast Specimen (76098) |
$1,034.16 |
$1,668 |
1.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$579.08 |
$934 |
6.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$675.18 |
$1,089 |
6.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$1,127.78 |
$1,819 |
10.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$246.14 |
$397 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$265.98 |
$429 |
2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$600.16 |
$968 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$783.06 |
$1,263 |
7.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$967.20 |
$1,560 |
8.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$753.30 |
$1,215 |
8.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$967.82 |
$1,561 |
8.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$670.22 |
$1,081 |
6.1× |
| X-ray eye for foreign body (70030) |
$316.20 |
$510 |
3.5× |
| X-ray humerus (73060) |
$539.40 |
$870 |
5.9× |
| X-ray IV pyelogram (ivp) (74400) |
$1,009.36 |
$1,628 |
5.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$533.20 |
$860 |
5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$587.14 |
$947 |
6.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$668.98 |
$1,079 |
6.1× |
| X-ray nose-rectum child f.b. (76010) |
$137.02 |
$221 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$879.16 |
$1,418 |
8.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$683.86 |
$1,103 |
6.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$597.06 |
$963 |
5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$562.34 |
$907 |
6.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,026.72 |
$1,656 |
9.4× |
| X-Ray Stress View (77071) |
$82.46 |
$133 |
0.9× |
| X-ray thoracic spine 4 vw (72074) |
$846.92 |
$1,366 |
7.8× |
| X-Ray Tmj Unilat (70328) |
$389.36 |
$628 |
4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,517.76 |
$2,448 |
4.2× |
| X-Rays Bone Length Studies (77073) |
$647.90 |
$1,045 |
5.9× |
| X-Rays Bone Survey Complete (77075) |
$596.44 |
$962 |
5.5× |
| Xr c-spine 4 or 5 views (72050) |
$881.02 |
$1,421 |
8.1× |
| Xr facial bones less than 3 views (70140) |
$513.98 |
$829 |
5.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$283.96 |
$458 |
2.6× |
| Xr myelogram posterior fossa (70010) |
$317.44 |
$512 |
0.9× |
| Xr orbits complete 4 views (70200) |
$894.04 |
$1,442 |
8.2× |