| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,333.20 |
$6,666 |
1.0× |
| Abdomen 2 views (74019) |
$97.60 |
$488 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$302.80 |
$1,514 |
0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,637.60 |
$8,188 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,559.60 |
$7,798 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,084 |
$5,420 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$1,247.80 |
$6,239 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,559.60 |
$7,798 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,559.60 |
$7,798 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,637.60 |
$8,188 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,559.60 |
$7,798 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,559.60 |
$7,798 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$376.20 |
$1,881 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$664.80 |
$3,324 |
0.2× |
| Ankle 2 views (73600) |
$53.90 |
$269.50 |
0.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$271.40 |
$1,357 |
0.8× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,328 |
$6,640 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,820 |
$9,100 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,559.60 |
$7,798 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$895.40 |
$4,477 |
0.3× |
| Arthrogram elbow (73085) |
$263.20 |
$1,316 |
0.8× |
| Arthrogram hip (73525) |
$241 |
$1,205 |
0.7× |
| Arthrogram shoulder (73040) |
$250.60 |
$1,253 |
0.8× |
| Arthrogram wrist (73115) |
$252.40 |
$1,262 |
0.8× |
| Arthrography knee lt (73580) |
$250.60 |
$1,253 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$151.80 |
$759 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$276.40 |
$1,382 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$250.40 |
$1,252 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$302 |
$1,510 |
0.8× |
| Bone age studies (77072) |
$56.60 |
$283 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$316.80 |
$1,584 |
0.9× |
| Bone survey complete (77075) |
$190.60 |
$953 |
2.0× |
| Brachytx isodose complex (77318) |
$414 |
$2,070 |
1.2× |
| Brachytx isodose intermed (77317) |
$332.90 |
$1,664.50 |
1.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$231.80 |
$1,159 |
0.7× |
| Brain image w/flow 4 + views (78606) |
$426.40 |
$2,132 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,300 |
$11,500 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$856.20 |
$4,281 |
2.6× |
| Cardiac shunt detection (78428) |
$188 |
$940 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$71.40 |
$357 |
0.9× |
| Chest 1 view (71045) |
$80 |
$400 |
1.0× |
| Chest 3 views (71047) |
$94.80 |
$474 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$86.40 |
$432 |
0.5× |
| Clavicle complete (73000) |
$77 |
$385 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$44.40 |
$222 |
0.5× |
| Continuing medical physics consltj pr wk (77336) |
$238.60 |
$1,193 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,142.80 |
$10,714 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,224.80 |
$6,124 |
5.5× |
| CT abdomen w contrast (74160) |
$718 |
$3,590 |
4.4× |
| CT abdomen w wo contrast (74170) |
$856.60 |
$4,283 |
5.3× |
| CT abdomen w/o contrast (74150) |
$613.20 |
$3,066 |
6.3× |
| CT angio hrt w/3d image (75574) |
$989.20 |
$4,946 |
3.1× |
| CT angiography upper extremity lt (73206) |
$742.60 |
$3,713 |
4.6× |
| CT c-spine w/o contrast (72125) |
$877.20 |
$4,386 |
9.1× |
| CT cervical spine w&w/o contrast (72127) |
$984 |
$4,920 |
6.1× |
| CT cervical spine with contrast (72126) |
$944.60 |
$4,723 |
2.9× |
| CT chest w/wo contrast (71270) |
$875.80 |
$4,379 |
5.4× |
| CT chest with contrast (71260) |
$731.80 |
$3,659 |
4.5× |
| CT head/brain with contrast (70460) |
$647.20 |
$3,236 |
4.0× |
| CT head/brain without and with contrast (70470) |
$1,036.40 |
$5,182 |
6.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$833.80 |
$4,169 |
2.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$53.80 |
$269 |
0.7× |
| CT iac w contrast (70481) |
$917.40 |
$4,587 |
5.6× |
| CT limited/localized follow up study (76380) |
$320.60 |
$1,603 |
4.0× |
| CT lower ext w/o (73700) |
$649.20 |
$3,246 |
6.7× |
| CT lower extremity w wo contrast (73702) |
$707.60 |
$3,538 |
4.4× |
| CT lower extremity with contrast (73701) |
$683.40 |
$3,417 |
4.2× |
| CT lumbar spine w & w/o contrast (72133) |
$749.40 |
$3,747 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$702.20 |
$3,511 |
7.2× |
| CT lumbar spine with contrast (72132) |
$755 |
$3,775 |
2.3× |
| CT maxillofacial w contrast (70487) |
$624.70 |
$3,123.50 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$423 |
$2,115 |
4.4× |
| CT maxillofacial w/wo contrast (70488) |
$910.40 |
$4,552 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$647.20 |
$3,236 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$986.20 |
$4,931 |
6.1× |
| CT orbits w/o contrast (70480) |
$460.20 |
$2,301 |
4.8× |
| CT pelvis w & w/o contrast (72194) |
$900.80 |
$4,504 |
5.5× |
| CT pelvis w/o contrast (72192) |
$598.70 |
$2,993.50 |
6.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$657.20 |
$3,286 |
4.0× |
| CT soft tissue neck w/o contrast (70490) |
$594.80 |
$2,974 |
6.1× |
| CT thoracic spine w/contrast (72129) |
$719.20 |
$3,596 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$702.20 |
$3,511 |
7.2× |
| CT thoracic spine w/wo contrast (72130) |
$749.40 |
$3,747 |
4.6× |
| CT thorax w/o contrast (71250) |
$613.20 |
$3,066 |
6.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$707.60 |
$3,538 |
4.4× |
| CT upper extremity w/o contrast rt (73200) |
$649.20 |
$3,246 |
6.7× |
| CT upper extremity with contrast (73201) |
$683.40 |
$3,417 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$856.60 |
$4,283 |
5.3× |
| Cta Abdomen (74175) |
$856.60 |
$4,283 |
5.3× |
| CTA abdomen pelvis (74174) |
$1,714.80 |
$8,574 |
5.3× |
| CTA chest (71275) |
$875.80 |
$4,379 |
5.4× |
| Cta Head (70496) |
$828.60 |
$4,143 |
5.1× |
| CTA lwr ext w&w/o contrast (73706) |
$742.60 |
$3,713 |
4.6× |
| Cta Neck (70498) |
$690 |
$3,450 |
4.2× |
| Cta Pelvis (72191) |
$856.60 |
$4,283 |
5.3× |
| Cystography minimum 3 views rs&i (74430) |
$136.20 |
$681 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$237.20 |
$1,186 |
2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$92 |
$460 |
1.1× |
| Echoencephalography real time imaging (76506) |
$146.60 |
$733 |
1.5× |
| Esophagus (74220) |
$113.20 |
$566 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$235 |
$1,175 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$247.20 |
$1,236 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$130.20 |
$651 |
0.6× |
| Foot 2 views (73620) |
$45.50 |
$227.50 |
0.6× |
| Forearm 2 views (73090) |
$47.40 |
$237 |
0.6× |
| Gated Heart Planar Single (78472) |
$381 |
$1,905 |
1.0× |
| Hand 2 views (73120) |
$47.40 |
$237 |
0.5× |
| Hand 3 views (73130) |
$77.20 |
$386 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,637.60 |
$8,188 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$531.80 |
$2,659 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$418.40 |
$2,092 |
1.1× |
| Ht muscle image spect sing (78451) |
$1,252.20 |
$6,261 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$47.40 |
$237 |
0.6× |
| Hysterosalpingogram (74740) |
$157.20 |
$786 |
0.7× |
| Image fusion (77399) |
$110 |
$550 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$2,077 |
$10,385 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$398.40 |
$1,992 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$541.40 |
$2,707 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$638.60 |
$3,193 |
1.3× |
| Knee 3 views (73562) |
$71.40 |
$357 |
0.9× |
| Liver & spleen imaging static only (78215) |
$193.40 |
$967 |
0.5× |
| Liver imaging w/vascular flow (78202) |
$303.40 |
$1,517 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$609.80 |
$3,049 |
1.2× |
| Lung perfusion differential (78597) |
$398.80 |
$1,994 |
1.1× |
| Lung Ventilation Imaging (78579) |
$221.80 |
$1,109 |
0.6× |
| Lymphoscintigraphy (78195) |
$284.80 |
$1,424 |
0.6× |
| Meckels Diverticulum (78290) |
$302.40 |
$1,512 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$676.40 |
$3,382 |
1.9× |
| MRA head w & w/o contrast (70546) |
$1,267.40 |
$6,337 |
3.9× |
| MRA head w/o contrast (70544) |
$748.80 |
$3,744 |
3.4× |
| MRA head with contrast (70545) |
$880.80 |
$4,404 |
2.7× |
| MRA neck w contrast (70548) |
$880.80 |
$4,404 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,207.60 |
$6,038 |
3.7× |
| MRA neck w/o contrast (70547) |
$748.80 |
$3,744 |
3.4× |
| MRI abdomen w contrast (74182) |
$858.40 |
$4,292 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,207.60 |
$6,038 |
3.7× |
| MRI abdomen w/o contrast (74181) |
$748.80 |
$3,744 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$817 |
$4,085 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$817 |
$4,085 |
1.1× |
| MRI c-spine with contrast (72142) |
$817 |
$4,085 |
2.5× |
| MRI cardiac w/o contrast (75557) |
$710.20 |
$3,551 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$540.10 |
$2,700.50 |
2.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,207.60 |
$6,038 |
3.7× |
| MRI chest w/o contrast (71550) |
$748.80 |
$3,744 |
3.4× |
| MRI chest with contrast (71551) |
$817 |
$4,085 |
1.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$858.40 |
$4,292 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$748.80 |
$3,744 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$540.10 |
$2,700.50 |
2.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,119.70 |
$5,598.50 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,434.80 |
$7,174 |
4.4× |
| MRI pelvis w/o contrast (72195) |
$540.10 |
$2,700.50 |
2.4× |
| MRI scan of arm joint before and after contrast (73223) |
$939.20 |
$4,696 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$939.20 |
$4,696 |
2.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,207.60 |
$6,038 |
3.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$817 |
$4,085 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,207.60 |
$6,038 |
3.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$817 |
$4,085 |
2.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,207.60 |
$6,038 |
3.7× |
| MRI thoracic spine w/o contrast (72146) |
$540.10 |
$2,700.50 |
2.4× |
| MRI tmj (70336) |
$792 |
$3,960 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$748.80 |
$3,744 |
3.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$939.20 |
$4,696 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$748.80 |
$3,744 |
3.4× |
| Myelogram Cervical (72240) |
$397 |
$1,985 |
0.5× |
| Myelogram Lumbar (72265) |
$397 |
$1,985 |
0.5× |
| Myelogram thoracic (72255) |
$416.80 |
$2,084 |
0.6× |
| Myelography 2 or more regions (72270) |
$497.60 |
$2,488 |
0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,190.20 |
$10,951 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,991.40 |
$9,957 |
1.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$560.80 |
$2,804 |
0.7× |
| Neck soft tissue (70360) |
$93.20 |
$466 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$138.60 |
$693 |
0.4× |
| Nm cisternogram (78630) |
$500.60 |
$2,503 |
1.0× |
| Nm gastric emptying study (78264) |
$513.60 |
$2,568 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$183.60 |
$918 |
0.5× |
| Nm whole blood volume (78122) |
$379.60 |
$1,898 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,315.80 |
$6,579 |
1.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$2,300 |
$11,500 |
1.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,095 |
$5,475 |
0.9× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,300 |
$11,500 |
1.7× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,300 |
$11,500 |
1.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$955.60 |
$4,778 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$438.20 |
$2,191 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$131 |
$655 |
0.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$145.20 |
$726 |
1.5× |
| Osseous survey infant (77076) |
$74 |
$370 |
0.8× |
| Osseous survey limited (77074) |
$158 |
$790 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$377.60 |
$1,888 |
0.8× |
| Parathyrd planar w/wo subtrj (78071) |
$298.40 |
$1,492 |
0.8× |
| Parathyroid imaging (78070) |
$373.80 |
$1,869 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$76.60 |
$383 |
0.8× |
| Peritoneogram rs&i (74190) |
$228.40 |
$1,142 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$2,472.20 |
$12,361 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$2,472.20 |
$12,361 |
1.9× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$805.20 |
$4,026 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$939.20 |
$4,696 |
2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,559.60 |
$7,798 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,637.60 |
$8,188 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$252.40 |
$1,262 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$609.80 |
$3,049 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$263.20 |
$1,316 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$79.40 |
$397 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$88 |
$440 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$99.60 |
$498 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$124.80 |
$624 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$145.60 |
$728 |
1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,500.20 |
$17,501 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$238.60 |
$1,193 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$104.80 |
$524 |
1.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$182.70 |
$913.50 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$90.80 |
$454 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$76.60 |
$383 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$97.60 |
$488 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$91.60 |
$458 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$129.20 |
$646 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$269.40 |
$1,347 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$235 |
$1,175 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$85.20 |
$426 |
1.1× |
| Radiological examination surgical specimen (76098) |
$287.30 |
$1,436.50 |
0.6× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$301.80 |
$1,509 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,637.60 |
$8,188 |
0.6× |
| Ribs bilateral 3 views (71110) |
$74.40 |
$372 |
0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$411.40 |
$2,057 |
1.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$407.20 |
$2,036 |
0.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$677 |
$3,385 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$932 |
$4,660 |
0.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$111.20 |
$556 |
0.5× |
| Rp Therapy Intravenous Administration (79101) |
$473 |
$2,365 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$38.20 |
$191 |
0.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$232.60 |
$1,163 |
1.1× |
| Scanogram (77073) |
$71.40 |
$357 |
0.7× |
| Scapula complete (73010) |
$77 |
$385 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$21 |
$105 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$258.80 |
$1,294 |
2.7× |
| Simulation intermediate (77285) |
$288.40 |
$1,442 |
0.8× |
| Small bowel series (74250) |
$118.80 |
$594 |
0.7× |
| Spec medical radj physics consltj (77370) |
$265.20 |
$1,326 |
2.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$334.40 |
$1,672 |
1.0× |
| Special dosimetry (77331) |
$86.60 |
$433 |
0.7× |
| Special treatment procedure (77470) |
$824 |
$4,120 |
1.6× |
| Spine thoracic 3 views (72072) |
$139.80 |
$699 |
1.4× |
| Stereotactic body radiation delivery (77373) |
$2,557.40 |
$12,787 |
1.5× |
| Superior sagittal sinus venogram (75870) |
$547.80 |
$2,739 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$414 |
$2,070 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$332.90 |
$1,664.50 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$422.40 |
$2,112 |
1.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$214.80 |
$1,074 |
1.7× |
| Thoracolumbar 2 views (72080) |
$77.20 |
$386 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$377.60 |
$1,888 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$309 |
$1,545 |
0.8× |
| Thyroid uptake measurement (78012) |
$266.60 |
$1,333 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$366.40 |
$1,832 |
1.0× |
| Tmj unilateral (70328) |
$34.60 |
$173 |
0.4× |
| Tomogram (76100) |
$129 |
$645 |
1.3× |
| Treatment device intermediate (77333) |
$162.20 |
$811 |
1.3× |
| Treatment devices simple (77332) |
$134.40 |
$672 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$964.80 |
$4,824 |
1.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$316.20 |
$1,581 |
0.9× |
| Tx devices design & construction complex (77334) |
$422.40 |
$2,112 |
1.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$95 |
$475 |
0.3× |
| Ultrasound, abdomen limited (76705) |
$177.80 |
$889 |
1.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$63.60 |
$318 |
0.8× |
| Unlisted fluoroscopic procedure (76496) |
$70.80 |
$354 |
0.9× |
| Unlisted magnetic resonance procedure (76498) |
$390.10 |
$1,950.50 |
4.8× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$2,047.40 |
$10,237 |
5.5× |
| Upper Extremity Infant (73092) |
$56.60 |
$283 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$179.20 |
$896 |
0.8× |
| Urethrocystography voiding (74455) |
$118.80 |
$594 |
0.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$301.60 |
$1,508 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$76.40 |
$382 |
0.8× |
| Us breast unilateral complete (76641) |
$141.80 |
$709 |
1.5× |
| Us breast unilateral limited (76642) |
$106.80 |
$534 |
1.3× |
| Us chest (76604) |
$98.80 |
$494 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$153.80 |
$769 |
1.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$127.60 |
$638 |
1.3× |
| Us guided compression repair (76936) |
$391.80 |
$1,959 |
2.0× |
| Us infant hips dynamic (76885) |
$164.40 |
$822 |
2.0× |
| Us infant hips limited static (76886) |
$118.40 |
$592 |
1.5× |
| Us kidney transplant (76776) |
$177.40 |
$887 |
1.8× |
| Us ob detailed single fetus (76811) |
$407.20 |
$2,036 |
1.8× |
| Us ob transvaginal (76817) |
$157.20 |
$786 |
1.6× |
| Us pelvic non ob complete (76856) |
$254.20 |
$1,271 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$127.60 |
$638 |
1.3× |
| Us pregnancy ltd (76815) |
$141.60 |
$708 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$109.20 |
$546 |
1.1× |
| Us retroperitoneal complete (76770) |
$193.50 |
$967.50 |
2.0× |
| Us retroperitoneal limited (76775) |
$145.20 |
$726 |
1.5× |
| Us scrotum and contents (76870) |
$175.60 |
$878 |
1.8× |
| Us soft tissue head/neck (76536) |
$156.40 |
$782 |
1.6× |
| Us spinal canal and contents (76800) |
$98.80 |
$494 |
1.0× |
| Us transrectal (76872) |
$209.20 |
$1,046 |
2.2× |
| Us transrectal prostate volume (76873) |
$219.20 |
$1,096 |
2.3× |
| Us xtr non-vasc lmtd (76882) |
$107.20 |
$536 |
1.1× |
| Us, eye b-scan (76512) |
$62.60 |
$313 |
0.6× |
| Venogram extremity bilateral (75822) |
$530.60 |
$2,653 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,577.80 |
$7,889 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$552.80 |
$2,764 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$505.20 |
$2,526 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,637.60 |
$8,188 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$1,559.60 |
$7,798 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,247.80 |
$6,239 |
0.4× |
| Wrist 2 views (73100) |
$56.60 |
$283 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$93.20 |
$466 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$73.80 |
$369 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$77.20 |
$386 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$246.20 |
$1,231 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$47.40 |
$237 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$74 |
$370 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$126.20 |
$631 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$52.60 |
$263 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$102.80 |
$514 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$113.80 |
$569 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$113.80 |
$569 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$131.80 |
$659 |
1.4× |
| X-ray exam of femur 1 (73551) |
$47.20 |
$236 |
0.6× |
| X-ray eye for foreign body (70030) |
$109.40 |
$547 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$83.40 |
$417 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$77.20 |
$386 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$71.40 |
$357 |
0.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$881.20 |
$4,406 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$38.60 |
$193 |
0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$52.60 |
$263 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$85.20 |
$426 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$59.20 |
$296 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$61.20 |
$306 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$113.20 |
$566 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$162.20 |
$811 |
1.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$57.40 |
$287 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$64.80 |
$324 |
0.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$88 |
$440 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$56.60 |
$283 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$77.20 |
$386 |
0.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$123 |
$615 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$66 |
$330 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$97.80 |
$489 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$102.80 |
$514 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.40 |
$357 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$71.40 |
$357 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$77.20 |
$386 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86.60 |
$433 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$56.60 |
$283 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$104.60 |
$523 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$54 |
$270 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$42.30 |
$211.50 |
0.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$74.40 |
$372 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$64.20 |
$321 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$93.20 |
$466 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$111.60 |
$558 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$38.20 |
$191 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$77.20 |
$386 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$138.60 |
$693 |
1.4× |
| Xr chest 4+ views (71048) |
$102.80 |
$514 |
1.1× |
| Xr Cholecystography Oral Contrast (74290) |
$112.80 |
$564 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$50.80 |
$254 |
0.6× |
| Xr shoulder 1 view (73020) |
$39.80 |
$199 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$124.80 |
$624 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$87.80 |
$439 |
1.1× |
| Xr tmj bilateral (70330) |
$81 |
$405 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$74 |
$370 |
0.9× |