| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,533.18 |
$6,666 |
1.2× |
| Abdomen 2 views (74019) |
$81.65 |
$355 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$498.64 |
$2,168 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,883.24 |
$8,188 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$1,883.24 |
$8,188 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,309.39 |
$5,693 |
0.5× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,793.54 |
$7,798 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,883.24 |
$8,188 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,883.24 |
$8,188 |
0.7× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,793.54 |
$7,798 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$454.48 |
$1,976 |
0.2× |
| Ankle 2 views (73600) |
$61.98 |
$269.50 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$379.04 |
$1,648 |
1.2× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,527.20 |
$6,640 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,793.54 |
$7,798 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,793.54 |
$7,798 |
0.6× |
| Arthrogram elbow (73085) |
$324.76 |
$1,412 |
1.0× |
| Arthrogram hip (73525) |
$391.92 |
$1,704 |
1.2× |
| Arthrogram shoulder (73040) |
$293.94 |
$1,278 |
0.9× |
| Arthrogram wrist (73115) |
$308.89 |
$1,343 |
1.0× |
| Arthrography knee lt (73580) |
$356.73 |
$1,551 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$174.57 |
$759 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$356.50 |
$1,550 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$429.18 |
$1,866 |
1.2× |
| Bone age studies (77072) |
$65.09 |
$283 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$408.02 |
$1,774 |
1.1× |
| Bone Marrow Imaging Limited Area (78102) |
$166.06 |
$722 |
0.5× |
| Bone survey complete (77075) |
$208.61 |
$907 |
2.2× |
| Brachytx isodose complex (77318) |
$602.83 |
$2,621 |
1.8× |
| Brachytx isodose intermed (77317) |
$503.01 |
$2,187 |
1.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$339.25 |
$1,475 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$514.97 |
$2,239 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,843.03 |
$12,361 |
2.2× |
| Brain Imaging Vascular Flow Only (78610) |
$575.69 |
$2,503 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$82.11 |
$357 |
1.0× |
| Chest 1 view (71045) |
$88.09 |
$383 |
1.1× |
| Chest 3 views (71047) |
$116.38 |
$506 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$111.55 |
$485 |
0.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$523.02 |
$2,274 |
0.7× |
| Clavicle complete (73000) |
$79.46 |
$345.50 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$51.06 |
$222 |
0.5× |
| Continuing medical physics consltj pr wk (77336) |
$274.39 |
$1,193 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,236.52 |
$9,724 |
7.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,631.62 |
$7,094 |
7.6× |
| CT abdomen w contrast (74160) |
$924.83 |
$4,021 |
5.8× |
| CT abdomen w wo contrast (74170) |
$1,120.33 |
$4,871 |
7.1× |
| CT abdomen w/o contrast (74150) |
$778.78 |
$3,386 |
8.3× |
| CT angio hrt w/3d image (75574) |
$1,083.53 |
$4,711 |
3.4× |
| CT angiography upper extremity lt (73206) |
$919.54 |
$3,998 |
5.8× |
| CT c-spine w/o contrast (72125) |
$773.49 |
$3,363 |
8.2× |
| CT cervical spine w&w/o contrast (72127) |
$861.81 |
$3,747 |
5.4× |
| CT cervical spine with contrast (72126) |
$342.70 |
$1,490 |
1.1× |
| CT chest w/wo contrast (71270) |
$1,116.65 |
$4,855 |
7.1× |
| CT chest with contrast (71260) |
$1,021.20 |
$4,440 |
6.5× |
| CT colonography screening (74263) |
$297.16 |
$1,292 |
1.4× |
| CT head/brain with contrast (70460) |
$753.71 |
$3,277 |
4.8× |
| CT head/brain without and with contrast (70470) |
$835.36 |
$3,632 |
5.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$958.87 |
$4,169 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$61.87 |
$269 |
0.8× |
| CT iac w contrast (70481) |
$724.73 |
$3,151 |
4.6× |
| CT limited/localized follow up study (76380) |
$368.58 |
$1,602.50 |
4.7× |
| CT lower ext w/o (73700) |
$710.93 |
$3,091 |
7.5× |
| CT lower extremity w wo contrast (73702) |
$813.74 |
$3,538 |
5.1× |
| CT lower extremity with contrast (73701) |
$785.91 |
$3,417 |
5.0× |
| CT lumbar spine w & w/o contrast (72133) |
$861.81 |
$3,747 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$773.49 |
$3,363 |
8.2× |
| CT lumbar spine with contrast (72132) |
$827.08 |
$3,596 |
2.6× |
| CT maxillofacial w contrast (70487) |
$687.47 |
$2,989 |
4.3× |
| CT maxillofacial w/o contrast (70486) |
$647.45 |
$2,815 |
6.9× |
| CT maxillofacial w/wo contrast (70488) |
$907.81 |
$3,947 |
5.7× |
| CT neck soft tissue w contrast (70491) |
$1,021.20 |
$4,440 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$851.69 |
$3,703 |
5.4× |
| CT orbits w/o contrast (70480) |
$448.16 |
$1,948.50 |
4.8× |
| CT pelvis w & w/o contrast (72194) |
$1,116.65 |
$4,855 |
7.1× |
| CT pelvis w/o contrast (72192) |
$852.61 |
$3,707 |
9.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$165.60 |
$720 |
2.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,075.94 |
$4,678 |
6.8× |
| CT soft tissue neck w/o contrast (70490) |
$773.49 |
$3,363 |
8.2× |
| CT thoracic spine w/contrast (72129) |
$827.08 |
$3,596 |
5.2× |
| CT thoracic spine w/o contrast (72128) |
$773.49 |
$3,363 |
8.2× |
| CT thoracic spine w/wo contrast (72130) |
$905.05 |
$3,935 |
5.7× |
| CT thorax w/o contrast (71250) |
$773.49 |
$3,363 |
8.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$813.74 |
$3,538 |
5.1× |
| CT upper extremity w/o contrast rt (73200) |
$710.93 |
$3,091 |
7.5× |
| CT upper extremity with contrast (73201) |
$785.91 |
$3,417 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$938.86 |
$4,082 |
5.9× |
| Cta Abdomen (74175) |
$1,206.58 |
$5,246 |
7.6× |
| CTA abdomen pelvis (74174) |
$2,347.38 |
$10,206 |
7.5× |
| CTA chest (71275) |
$1,149.08 |
$4,996 |
7.3× |
| Cta Head (70496) |
$919.54 |
$3,998 |
5.8× |
| CTA lwr ext w&w/o contrast (73706) |
$919.54 |
$3,998 |
5.8× |
| Cta Neck (70498) |
$919.54 |
$3,998 |
5.8× |
| Cta Pelvis (72191) |
$1,149.08 |
$4,996 |
7.3× |
| Cystography minimum 3 views rs&i (74430) |
$224.02 |
$974 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$272.78 |
$1,186 |
2.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$111.32 |
$484 |
1.4× |
| Dxa bone density study axial skeleton (77085) |
$60.03 |
$261 |
0.6× |
| Echoencephalography real time imaging (76506) |
$168.59 |
$733 |
1.8× |
| Esophagus (74220) |
$130.18 |
$566 |
0.8× |
| Fetal biophysical profile non-stress testing (76818) |
$196.42 |
$854 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$284.28 |
$1,236 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$194.81 |
$847 |
0.9× |
| Foot 2 views (73620) |
$52.32 |
$227.50 |
0.7× |
| Forearm 2 views (73090) |
$54.51 |
$237 |
0.7× |
| Gated Heart Planar Single (78472) |
$417.68 |
$1,816 |
1.2× |
| Hand 2 views (73120) |
$54.51 |
$237 |
0.6× |
| Hand 3 views (73130) |
$88.78 |
$386 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,835.86 |
$7,982 |
2.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,603.83 |
$11,321 |
4.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,571.17 |
$11,179 |
4.1× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$117.07 |
$509 |
0.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$117.07 |
$509 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$498.87 |
$2,169 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$524.17 |
$2,279 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,515.47 |
$6,589 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$60.49 |
$263 |
0.8× |
| Hysterosalpingogram (74740) |
$261.74 |
$1,138 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$2,508.15 |
$10,905 |
4.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,508.15 |
$10,905 |
4.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,508.15 |
$10,905 |
5.0× |
| Intracavitary radiation source applic simple (77761) |
$2,508.15 |
$10,905 |
5.0× |
| Kidney imaging morphology (78700) |
$174.57 |
$759 |
0.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$436.08 |
$1,896 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$538.43 |
$2,341 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$734.39 |
$3,193 |
1.5× |
| Knee 3 views (73562) |
$82.11 |
$357 |
1.0× |
| Liver & spleen imaging static only (78215) |
$264.96 |
$1,152 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$330.05 |
$1,435 |
0.9× |
| Liver imaging w/vascular flow (78202) |
$380.88 |
$1,656 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$701.27 |
$3,049 |
1.4× |
| Lung perfusion differential (78597) |
$458.62 |
$1,994 |
1.3× |
| Lung Ventilation Imaging (78579) |
$255.07 |
$1,109 |
0.7× |
| Lymphoscintigraphy (78195) |
$327.52 |
$1,424 |
0.7× |
| Mammary ductogram or galactogram single (77053) |
$148.81 |
$647 |
0.7× |
| Meckels Diverticulum (78290) |
$295.78 |
$1,286 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$762.22 |
$3,314 |
2.3× |
| MRA head w & w/o contrast (70546) |
$1,457.51 |
$6,337 |
4.6× |
| MRA head w/o contrast (70544) |
$861.12 |
$3,744 |
4.0× |
| MRA head with contrast (70545) |
$885.96 |
$3,852 |
2.8× |
| MRA neck w contrast (70548) |
$1,012.92 |
$4,404 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,388.74 |
$6,038 |
4.4× |
| MRA neck w/o contrast (70547) |
$893.55 |
$3,885 |
4.2× |
| MRI abdomen w contrast (74182) |
$1,075.25 |
$4,675 |
3.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,325.49 |
$5,763 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,037.76 |
$4,512 |
4.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,093.88 |
$4,756 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,301.80 |
$5,660 |
1.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,012.92 |
$4,404 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$792.81 |
$3,447 |
3.7× |
| MRI c-spine with contrast (72142) |
$1,206.12 |
$5,244 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$711.28 |
$3,092.50 |
3.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,457.74 |
$6,338 |
4.6× |
| MRI chest w/o contrast (71550) |
$805.92 |
$3,504 |
3.7× |
| MRI chest with contrast (71551) |
$939.55 |
$4,085 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,093.88 |
$4,756 |
3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,093.88 |
$4,756 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,041.44 |
$4,528 |
4.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$711.28 |
$3,092.50 |
3.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,292.94 |
$5,621.50 |
4.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,186.57 |
$5,159 |
3.8× |
| MRI pelvis w contrast (72196) |
$1,089.51 |
$4,737 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,670.72 |
$7,264 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$805.92 |
$3,504 |
3.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,367.35 |
$5,945 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,367.35 |
$5,945 |
4.3× |
| MRI spectroscopy (76390) |
$123.05 |
$535 |
1.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,817 |
$7,900 |
5.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,142.87 |
$4,969 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,753.29 |
$7,623 |
5.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,318.36 |
$5,732 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,388.74 |
$6,038 |
4.4× |
| MRI thoracic spine w/o contrast (72146) |
$761.99 |
$3,313 |
3.5× |
| MRI tmj (70336) |
$845.71 |
$3,677 |
3.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,230.27 |
$5,349 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,094.11 |
$4,757 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,041.44 |
$4,528 |
4.8× |
| Myelogram Cervical (72240) |
$781.77 |
$3,399 |
1.1× |
| Myelogram Lumbar (72265) |
$781.77 |
$3,399 |
1.1× |
| Myelogram thoracic (72255) |
$781.77 |
$3,399 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,010.20 |
$8,740 |
1.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,098.48 |
$4,776 |
0.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,098.48 |
$4,776 |
0.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,713.04 |
$7,448 |
0.9× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,093.69 |
$9,103 |
1.1× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$2,093.69 |
$9,103 |
1.5× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$644.92 |
$2,804 |
0.8× |
| Neck soft tissue (70360) |
$81.88 |
$356 |
1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$130.18 |
$566 |
0.4× |
| Nm gastric emptying study (78264) |
$567.87 |
$2,469 |
1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,513.17 |
$6,579 |
1.2× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,840.69 |
$8,003 |
1.4× |
| Nuclear medicine study of digestive tracts (78299) |
$538.20 |
$2,340 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,157.59 |
$5,033 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$529.46 |
$2,302 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$228.62 |
$994 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$148.12 |
$644 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$166.98 |
$726 |
1.8× |
| Osseous survey infant (77076) |
$89.24 |
$388 |
0.9× |
| Osseous survey limited (77074) |
$181.70 |
$790 |
1.9× |
| Parathyrd planar w/spect&CT (78072) |
$434.24 |
$1,888 |
0.9× |
| Parathyrd planar w/wo subtrj (78071) |
$327.75 |
$1,425 |
0.9× |
| Parathyroid imaging (78070) |
$330.28 |
$1,436 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$54.28 |
$236 |
0.6× |
| Peritoneogram rs&i (74190) |
$270.02 |
$1,174 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$2,843.03 |
$12,361 |
2.2× |
| PET imaging for CT attenuation whole body (78816) |
$2,843.03 |
$12,361 |
2.2× |
| PET imaging limited area chest head/neck (78811) |
$1,840.69 |
$8,003 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,041.44 |
$4,528 |
3.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,265.92 |
$5,504 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,201.52 |
$5,224 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$356.50 |
$1,550 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$701.27 |
$3,049 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$302.68 |
$1,316 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$91.31 |
$397 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$101.20 |
$440 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$114.54 |
$498 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$167.44 |
$728 |
1.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,782.81 |
$16,447 |
0.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$250.93 |
$1,091 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$119.14 |
$518 |
1.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$182.85 |
$795 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$104.42 |
$454 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$60.26 |
$262 |
0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$107.18 |
$466 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$112.47 |
$489 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$148.58 |
$646 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$311.88 |
$1,356 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$270.25 |
$1,175 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$97.98 |
$426 |
1.2× |
| Radiological examination surgical specimen (76098) |
$330.40 |
$1,436.50 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,793.54 |
$7,798 |
0.6× |
| Ribs bilateral 3 views (71110) |
$105.34 |
$458 |
1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$450.57 |
$1,959 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$432.63 |
$1,881 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$957.72 |
$4,164 |
2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$968.30 |
$4,210 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$968.30 |
$4,210 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,098.48 |
$4,776 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$302.68 |
$1,316 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$50.60 |
$220 |
0.5× |
| Scanogram (77073) |
$125.35 |
$545 |
1.3× |
| Scapula complete (73010) |
$70.38 |
$306 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$24.15 |
$105 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$297.62 |
$1,294 |
3.2× |
| Simulation intermediate (77285) |
$320.62 |
$1,394 |
0.9× |
| Small bowel series (74250) |
$151.57 |
$659 |
1.0× |
| Spec medical radj physics consltj (77370) |
$312.11 |
$1,357 |
2.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$372.83 |
$1,621 |
1.1× |
| Special dosimetry (77331) |
$119.14 |
$518 |
1.0× |
| Special treatment procedure (77470) |
$947.60 |
$4,120 |
1.9× |
| Spine thoracic 3 views (72072) |
$122.13 |
$531 |
1.3× |
| Stereotactic body radiation delivery (77373) |
$1,382.99 |
$6,013 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$494.73 |
$2,151 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$397.78 |
$1,729.50 |
1.2× |
| Testicular Imaging With Vascular Flow (78761) |
$338.33 |
$1,471 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$485.76 |
$2,112 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$315.79 |
$1,373 |
2.6× |
| Thoracolumbar 2 views (72080) |
$82.34 |
$358 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$434.24 |
$1,888 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$355.35 |
$1,545 |
1.0× |
| Thyroid uptake measurement (78012) |
$292.33 |
$1,271 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$421.36 |
$1,832 |
1.2× |
| Tmj unilateral (70328) |
$39.79 |
$173 |
0.5× |
| Tomogram (76100) |
$100.74 |
$438 |
1.1× |
| Treatment device intermediate (77333) |
$172.73 |
$751 |
1.4× |
| Treatment devices simple (77332) |
$150.42 |
$654 |
1.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,056.39 |
$4,593 |
2.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$363.63 |
$1,581 |
1.0× |
| Tx devices design & construction complex (77334) |
$485.76 |
$2,112 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$120.29 |
$523 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$381.11 |
$1,657 |
4.9× |
| Upper Extremity Infant (73092) |
$65.09 |
$283 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$166.52 |
$724 |
0.8× |
| Urethrocystography voiding (74455) |
$267.49 |
$1,163 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$346.84 |
$1,508 |
2.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$415.38 |
$1,806 |
2.6× |
| Us abdl aorta screen aaa (76706) |
$92 |
$400 |
1.0× |
| Us breast unilateral complete (76641) |
$124.20 |
$540 |
1.3× |
| Us breast unilateral limited (76642) |
$105.34 |
$458 |
1.3× |
| Us chest (76604) |
$113.62 |
$494 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$168.59 |
$733 |
1.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$109.02 |
$474 |
1.2× |
| Us guided compression repair (76936) |
$450.57 |
$1,959 |
2.3× |
| Us infant hips dynamic (76885) |
$92.92 |
$404 |
1.2× |
| Us infant hips limited static (76886) |
$87.17 |
$379 |
1.1× |
| Us kidney transplant (76776) |
$204.01 |
$887 |
2.2× |
| Us ob detailed single fetus (76811) |
$468.28 |
$2,036 |
2.2× |
| Us ob transvaginal (76817) |
$180.78 |
$786 |
1.9× |
| Us pelvic non ob complete (76856) |
$240.35 |
$1,045 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$146.74 |
$638 |
1.6× |
| Us pregnancy ltd (76815) |
$171.12 |
$744 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$125.58 |
$546 |
1.3× |
| Us retroperitoneal complete (76770) |
$238.97 |
$1,039 |
2.5× |
| Us retroperitoneal limited (76775) |
$224.71 |
$977 |
2.4× |
| Us scrotum and contents (76870) |
$153.87 |
$669 |
1.6× |
| Us soft tissue head/neck (76536) |
$136.62 |
$594 |
1.4× |
| Us spinal canal and contents (76800) |
$118.91 |
$517 |
1.3× |
| Us transrectal (76872) |
$233.68 |
$1,016 |
2.5× |
| Us transrectal prostate volume (76873) |
$252.08 |
$1,096 |
2.7× |
| Us xtr non-vasc lmtd (76882) |
$112.01 |
$487 |
1.2× |
| Us, eye b-scan (76512) |
$71.99 |
$313 |
0.8× |
| Venogram extremity bilateral (75822) |
$610.19 |
$2,653 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,904.40 |
$8,280 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$667.23 |
$2,901 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$610.19 |
$2,653 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,883.24 |
$8,188 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,408.52 |
$6,124 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,883.24 |
$8,188 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$37.49 |
$163 |
0.5× |
| Wrist 2 views (73100) |
$65.09 |
$283 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$112.24 |
$488 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$88.78 |
$386 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$283.13 |
$1,231 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$54.51 |
$237 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$89.24 |
$388 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$145.13 |
$631 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$60.49 |
$263 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$118.22 |
$514 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$130.87 |
$569 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$130.87 |
$569 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$151.57 |
$659 |
1.6× |
| X-ray exam of femur 1 (73551) |
$54.28 |
$236 |
0.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$143.75 |
$625 |
0.9× |
| X-ray eye for foreign body (70030) |
$125.81 |
$547 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$95.91 |
$417 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$88.78 |
$386 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$82.11 |
$357 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$991.76 |
$4,312 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$60.26 |
$262 |
0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$60.49 |
$263 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$92.92 |
$404 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$68.08 |
$296 |
0.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$65.09 |
$283 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$80.50 |
$350 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$195.04 |
$848 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$101.20 |
$440 |
1.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$74.52 |
$324 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$76.13 |
$331 |
0.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$92.46 |
$402 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$256.68 |
$1,116 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$224.02 |
$974 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$85.56 |
$372 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$85.56 |
$372 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$118.22 |
$514 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$82.11 |
$357 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$60.26 |
$262 |
0.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$88.78 |
$386 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$99.59 |
$433 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$68.08 |
$296 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$120.29 |
$523 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$84.30 |
$366.50 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$47.84 |
$208 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$85.56 |
$372 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$73.83 |
$321 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$85.56 |
$372 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$122.13 |
$531 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$47.84 |
$208 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$88.78 |
$386 |
1.1× |
| Xr arthrogram ankle (73615) |
$293.94 |
$1,278 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$209.53 |
$911 |
2.2× |
| Xr chest 4+ views (71048) |
$118.22 |
$514 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$78.66 |
$342 |
1.0× |
| Xr shoulder 1 view (73020) |
$45.77 |
$199 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$189.98 |
$826 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$73.14 |
$318 |
0.9× |
| Xr tmj bilateral (70330) |
$100.74 |
$438 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$65.09 |
$283 |
0.8× |