| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,195.40 |
$13,659 |
5.9× |
| Abdomen 1 View (74018) |
$257.40 |
$429 |
3.0× |
| Abdomen 2 views (74019) |
$273 |
$455 |
2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$818.40 |
$1,364 |
2.0× |
| Angio internal mammary (75756) |
$3,006 |
$5,010 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,063 |
$5,105 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,078 |
$5,130 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,006 |
$5,010 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,006 |
$5,010 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,006 |
$5,010 |
1.0× |
| Ankle 2 views (73600) |
$163.80 |
$273 |
1.9× |
| Aortography thoracic serialography rs&i (75605) |
$5,200.20 |
$8,667 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$5,200.20 |
$8,667 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,878.20 |
$4,797 |
0.9× |
| Artery X-Rays Pelvis (75736) |
$5,200.20 |
$8,667 |
0.9× |
| Artery X-Rays Spine (75705) |
$5,200.20 |
$8,667 |
0.9× |
| Arthrogram Wrist (73115) |
$460.20 |
$767 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$995.40 |
$1,659 |
7.4× |
| Bone age studies (77072) |
$286.80 |
$478 |
2.7× |
| Bone Imaging 3 Phase (78315) |
$1,276.80 |
$2,128 |
3.2× |
| Bone Imaging Limited Area (78300) |
$585 |
$975 |
1.5× |
| Bone Imaging Multiple Areas (78305) |
$694.80 |
$1,158 |
1.7× |
| Bone Imaging Whole Body (78306) |
$1,131.60 |
$1,886 |
2.8× |
| Bone marrow imaging; multiple areas (78103) |
$607.80 |
$1,013 |
1.5× |
| Brachytx isodose complex (77318) |
$1,881.60 |
$3,136 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,392.60 |
$2,321 |
3.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,052.40 |
$1,754 |
2.8× |
| Brain Image W/Flow < 4 Views (78601) |
$582.60 |
$971 |
1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,305 |
$2,175 |
2.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$533.40 |
$889 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,118 |
$8,530 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,243.40 |
$3,739 |
6.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,439 |
$4,065 |
3.1× |
| Cat Scan Follow-Up Study (76380) |
$531 |
$885 |
6.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$791.40 |
$1,319 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$840.60 |
$1,401 |
1.5× |
| Chest 1 view (71045) |
$249 |
$415 |
2.9× |
| Chest 2 views (71046) |
$289.80 |
$483 |
3.3× |
| Chest 3 views (71047) |
$360 |
$600 |
4.1× |
| Chest 4 or more views (71048) |
$385.20 |
$642 |
3.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$364.80 |
$608 |
3.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$907.80 |
$1,513 |
1.2× |
| Clavicle complete (73000) |
$187.20 |
$312 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$649.20 |
$1,082 |
6.2× |
| Continuing medical physics consltj pr wk (77336) |
$966.60 |
$1,611 |
7.2× |
| Contrast Exam Abdominl Aorta (75625) |
$3,006 |
$5,010 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$410.40 |
$684 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,703.60 |
$4,506 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,737 |
$2,895 |
7.3× |
| CT abdomen w contrast (74160) |
$933 |
$1,555 |
5.3× |
| CT abdomen w wo contrast (74170) |
$1,149.60 |
$1,916 |
6.5× |
| CT abdomen w/o contrast (74150) |
$861.60 |
$1,436 |
8.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,974.20 |
$4,957 |
8.5× |
| CT Angio Chest (71275) |
$1,874.40 |
$3,124 |
10.7× |
| CT Angio Head (70496) |
$2,296.80 |
$3,828 |
13.1× |
| CT angio hrt w/3d image (75574) |
$997.80 |
$1,663 |
2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,501.80 |
$2,503 |
8.5× |
| CT Angio Neck (70498) |
$1,836.60 |
$3,061 |
10.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,412.40 |
$2,354 |
8.0× |
| CT cervical spine w/ contrast (72126) |
$1,065 |
$1,775 |
3.0× |
| CT cervical spine w/o contrast (72125) |
$940.20 |
$1,567 |
9.0× |
| CT cervical spine w/wo cont (72127) |
$1,995.60 |
$3,326 |
11.4× |
| CT chest w contrast (71260) |
$1,549.20 |
$2,582 |
8.8× |
| CT chest w/wo contrast (71270) |
$1,704 |
$2,840 |
9.7× |
| CT colonography screening (74263) |
$795.60 |
$1,326 |
3.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$907.20 |
$1,512 |
5.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$805.80 |
$1,343 |
7.7× |
| CT head/brain with contrast (70460) |
$1,898.40 |
$3,164 |
10.8× |
| CT head/brain without and with contrast (70470) |
$2,088 |
$3,480 |
11.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$731.40 |
$1,219 |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$102 |
$170 |
1.2× |
| CT hrt w/3d image congen (75573) |
$907.20 |
$1,512 |
2.6× |
| CT iac w contrast (70481) |
$1,064.40 |
$1,774 |
6.1× |
| CT l-spine w&w/o contrast (72133) |
$1,168.80 |
$1,948 |
6.7× |
| CT lower ext w/o (73700) |
$913.20 |
$1,522 |
8.7× |
| CT lower extremity w/contrast material (73701) |
$1,059.60 |
$1,766 |
6.0× |
| CT lumbar spine w contrast (72132) |
$1,057.20 |
$1,762 |
3.0× |
| CT lumbar spine w/o contrast (72131) |
$793.20 |
$1,322 |
7.6× |
| CT maxillofacial w contrast (70487) |
$940.20 |
$1,567 |
5.4× |
| CT maxillofacial wo contrast (70486) |
$841.80 |
$1,403 |
8.0× |
| CT neck tissue combo (70492) |
$1,669.80 |
$2,783 |
9.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,085.40 |
$1,809 |
6.2× |
| CT orbits w/o contrast (70480) |
$661.20 |
$1,102 |
6.3× |
| CT pelvis w&w/o contrast (72194) |
$1,128.60 |
$1,881 |
6.4× |
| CT pelvis w/o contrast (72192) |
$754.80 |
$1,258 |
7.2× |
| CT scan of leg combo (73702) |
$1,365 |
$2,275 |
7.8× |
| CT scans face/jaw combo (70488) |
$1,944.60 |
$3,241 |
11.1× |
| CT soft tissue neck w contrast (70491) |
$1,398.60 |
$2,331 |
8.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,188.60 |
$1,981 |
11.4× |
| CT thoracic spine w contrast (72129) |
$979.20 |
$1,632 |
5.6× |
| CT thoracic spine w/o contrast (72128) |
$754.80 |
$1,258 |
7.2× |
| CT thoracic spine w/wo cont (72130) |
$1,620.60 |
$2,701 |
9.2× |
| CT thorax w/o contrast (71250) |
$792 |
$1,320 |
7.6× |
| CT unlisted procedure (76497) |
$494.40 |
$824 |
5.7× |
| CT upper ext wo (73200) |
$741.60 |
$1,236 |
7.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,284 |
$2,140 |
7.3× |
| CT upper extremity with contrast (73201) |
$1,177.80 |
$1,963 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,167.60 |
$1,946 |
6.6× |
| Cta Abdomen (74175) |
$1,264.80 |
$2,108 |
7.2× |
| CTA pelvis (72191) |
$1,241.40 |
$2,069 |
7.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$163.80 |
$273 |
1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$226.20 |
$377 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$250.20 |
$417 |
2.4× |
| Dxa Bone Density Axial (77080) |
$229.80 |
$383 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$114 |
$190 |
1.3× |
| Echo exam of fetal heart (76825) |
$630 |
$1,050 |
1.2× |
| Echo exam uterus (76831) |
$455.40 |
$759 |
1.9× |
| Echo Guide For Artery Repair (76936) |
$465 |
$775 |
2.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$421.80 |
$703 |
1.8× |
| Echograp Trans R Pros Study (76873) |
$437.40 |
$729 |
4.2× |
| Esophageal Motility Study (78258) |
$520.20 |
$867 |
1.3× |
| Esophagram (74220) |
$351 |
$585 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$298.20 |
$497 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$195 |
$325 |
1.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,818.20 |
$4,697 |
11.8× |
| Fluoroscopy up to 1 hr (76000) |
$658.80 |
$1,098 |
2.8× |
| Follow-Up Angiography (75898) |
$2,301 |
$3,835 |
0.7× |
| Foot 2 views (73620) |
$157.80 |
$263 |
1.8× |
| Forearm 2 views (73090) |
$159 |
$265 |
1.8× |
| Gastric emptying imaging study (78264) |
$820.20 |
$1,367 |
2.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,515 |
$2,525 |
3.8× |
| Gated Heart Planar Single (78472) |
$766.80 |
$1,278 |
1.9× |
| Hand 2 views (73120) |
$168 |
$280 |
1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,769.20 |
$6,282 |
5.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,181.80 |
$5,303 |
4.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,602.20 |
$4,337 |
3.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,527.60 |
$7,546 |
1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,006 |
$5,010 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,114.20 |
$1,857 |
2.0× |
| Hepatobiliary System Imaging (78226) |
$859.20 |
$1,432 |
2.1× |
| Ht Musc Image Planar Mult (78454) |
$1,948.20 |
$3,247 |
1.5× |
| Ht Muscle Image Spect Sing (78451) |
$1,500 |
$2,500 |
1.2× |
| Hyperthermia external generated superficial (77600) |
$1,756.80 |
$2,928 |
4.5× |
| Hysterosalpingogram (74740) |
$1,173 |
$1,955 |
4.9× |
| Image fusion (77399) |
$267 |
$445 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$2,752.80 |
$4,588 |
3.9× |
| Joint Survey Single View (77077) |
$166.80 |
$278 |
1.6× |
| K Flow/Funct Image W/Drug (78708) |
$876.60 |
$1,461 |
1.6× |
| K Flow/Funct Image W/O Drug (78707) |
$807 |
$1,345 |
1.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$462 |
$770 |
1.2× |
| Kidney Imaging Morphol (78700) |
$575.40 |
$959 |
1.4× |
| Knee 3 Views (73562) |
$229.20 |
$382 |
2.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$920.40 |
$1,534 |
1.7× |
| Lung perfusion differential (78597) |
$687.60 |
$1,146 |
1.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$838.80 |
$1,398 |
1.5× |
| Lung Ventilation Imaging (78579) |
$462 |
$770 |
1.2× |
| Lymph System Imaging (78195) |
$1,053.60 |
$1,756 |
1.9× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,170.80 |
$3,618 |
3.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,259.20 |
$5,432 |
1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,006 |
$5,010 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$1,187.40 |
$1,979 |
5.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$2,582.40 |
$4,304 |
14.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$2,347.80 |
$3,913 |
4.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,840.40 |
$4,734 |
16.2× |
| Magnetic Resonance Elastography (76391) |
$2,034 |
$3,390 |
8.5× |
| Meckels Divert Exam (78290) |
$763.80 |
$1,273 |
1.9× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$330 |
$550 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$7,182 |
$11,970 |
19.2× |
| Mr safety determination physician/other qhp (76016) |
$126.60 |
$211 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$35.40 |
$59 |
1.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,521.40 |
$5,869 |
10.1× |
| MRA head w/o contrast (70544) |
$2,647.80 |
$4,413 |
11.1× |
| MRA head with contrast (70545) |
$2,833.80 |
$4,723 |
8.1× |
| MRA neck w contrast (70548) |
$1,383 |
$2,305 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,753.40 |
$4,589 |
7.9× |
| MRA neck w/o contrast (70547) |
$1,630.20 |
$2,717 |
6.8× |
| MRI abdomen w contrast (74182) |
$2,043 |
$3,405 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,331.40 |
$2,219 |
5.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,537.80 |
$2,563 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,838.40 |
$3,064 |
5.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,796.60 |
$4,661 |
3.6× |
| MRI bone marrow blood supply (77084) |
$412.80 |
$688 |
1.7× |
| MRI brain functional w/o physician admnistration (70554) |
$2,145 |
$3,575 |
9.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,487.40 |
$2,479 |
6.2× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$920.40 |
$1,534 |
3.9× |
| MRI cardiac w/o cont stress (75559) |
$1,617.60 |
$2,696 |
3.0× |
| MRI cardiac w/o contrast (75557) |
$975.60 |
$1,626 |
4.1× |
| MRI cervical spine w contrast (72142) |
$2,208.60 |
$3,681 |
6.3× |
| MRI cervical spine w/o cont (72141) |
$1,422 |
$2,370 |
6.0× |
| MRI chest w/o contrast (71550) |
$1,342.80 |
$2,238 |
5.6× |
| MRI chest with contrast (71551) |
$1,824.60 |
$3,041 |
2.3× |
| MRI chest wo w contrast (71552) |
$2,145 |
$3,575 |
6.1× |
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 2 matching MRF lines |
$1,347–$2,694 |
$2,245–$4,490 |
varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,546.80 |
$2,578 |
4.4× |
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 5 matching MRF lines |
$1,239.60–$2,479.20 |
$2,066–$4,132 |
varies |
| MRI lumbar spine w contrast (72149) |
$1,860.60 |
$3,101 |
5.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,468.40 |
$4,114 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,463.40 |
$2,439 |
6.1× |
| MRI orbit face neck w contrast (70542) |
$1,715.40 |
$2,859 |
4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,105.40 |
$3,509 |
6.0× |
MRI pelvis w contrast (72196)
range across 3 matching MRF lines |
$1,693.80–$3,387.60 |
$2,823–$5,646 |
varies |
| MRI pelvis w/o & w contrast (72197) |
$2,060.40 |
$3,434 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,530 |
$2,550 |
6.4× |
| MRI spectroscopy (76390) |
$1,311 |
$2,185 |
15.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,462.80 |
$2,438 |
6.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,632.60 |
$2,721 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,187.40 |
$1,979 |
5.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,863.60 |
$3,106 |
5.3× |
| MRI, abdomen, combo (74183) |
$2,167.20 |
$3,612 |
6.2× |
| MRI, dorsal spine combo (72157) |
$2,391 |
$3,985 |
6.8× |
| MRI, dorsal spine contrast (72147) |
$1,923 |
$3,205 |
5.5× |
| MRI, joint upper extrem (73221) |
$1,434.60 |
$2,391 |
6.0× |
| MRI, joint upper extrem combo (73223) |
$2,892.60 |
$4,821 |
8.3× |
| MRI, lumbar spine combo (72158) |
$2,376.60 |
$3,961 |
6.8× |
| Myelograpy 2/more regions rs&i (72270) |
$922.20 |
$1,537 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,674.80 |
$4,458 |
2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,500 |
$2,500 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,121.60 |
$3,536 |
1.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$3,413.40 |
$5,689 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,232 |
$3,720 |
1.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,583.40 |
$7,639 |
2.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,917.20 |
$9,862 |
2.7× |
| N-invas est c ffr sw aly CTA (75580) |
$3,591.60 |
$5,986 |
4.2× |
| Neck soft tissue (70360) |
$133.80 |
$223 |
1.5× |
| Nervous system nuclear exam (78699) |
$557.40 |
$929 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$619.80 |
$1,033 |
1.5× |
| Nm csf leak detection (78650) |
$1,500 |
$2,500 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$12,150 |
$20,250 |
8.8× |
| Nuclear Rx Intra-Arterial (79445) |
$375 |
$625 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$867.60 |
$1,446 |
3.7× |
| Ob us nuchal meas 1 gest (76813) |
$208.80 |
$348 |
2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$144 |
$240 |
1.4× |
| Panoramic X-ray of jaws (70355) |
$152.40 |
$254 |
1.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$932.40 |
$1,554 |
1.7× |
| Parathyroid Planar Imaging (78070) |
$720.60 |
$1,201 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$170.40 |
$284 |
1.6× |
| Perineogram (74775) |
$292.80 |
$488 |
1.2× |
| Peritoneogram Rs&I (74190) |
$630 |
$1,050 |
1.2× |
| Pet Image Skull-Thigh (78812) |
$3,160.20 |
$5,267 |
2.2× |
| Pet Image W/Ct Lmtd (78814) |
$2,674.80 |
$4,458 |
1.9× |
| PET image w/CT, full body (78816) |
$4,395.60 |
$7,326 |
3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,396.60 |
$5,661 |
2.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,875 |
$3,125 |
1.4× |
| PET whole body (78813) |
$3,475.20 |
$5,792 |
2.4× |
| Proton tx delivery complex (77525) |
$7,806 |
$13,010 |
6.2× |
| Proton tx delivery intermediate (77523) |
$6,888.60 |
$11,481 |
5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,934.20 |
$6,557 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$601.80 |
$1,003 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$340.20 |
$567 |
3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$800.40 |
$1,334 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$215.40 |
$359 |
2.5× |
Radex Calcaneus Minimum 2 Views (73650)
range across 22 matching MRF lines |
$102–$135.60 |
$170–$226 |
varies |
| Radex elbow complete minimum 3 views (73080) |
$207 |
$345 |
2.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$266.40 |
$444 |
2.5× |
| Radex fingr minimum 2 views (73140) |
$165 |
$275 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$234.60 |
$391 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$183 |
$305 |
2.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$222.60 |
$371 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$144.60 |
$241 |
1.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$211.80 |
$353 |
2.4× |
| Radex shoulder complete minimum 2 views (73030) |
$232.80 |
$388 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$136.80 |
$228 |
1.6× |
| Radex Spine 1 View Specify Level (72020) |
$205.20 |
$342 |
2.4× |
Radex Sternum Minimum 2 Views (71120)
range across 4 matching MRF lines |
$123.60–$164.40 |
$206–$274 |
varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$265.20 |
$442 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$148.80 |
$248 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$291.60 |
$486 |
2.8× |
Radex Wrist Complete Minimum 3 Views (73110)
range across 4 matching MRF lines |
$205.20–$410.40 |
$342–$684 |
varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$387.60 |
$646 |
3.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,251.80 |
$33,753 |
2.7× |
| Radiation treatment delivery level 1 (77402) |
$2,296.20 |
$3,827 |
22.5× |
| Radiation treatment delivery level 2 (77407) |
$3,547.80 |
$5,913 |
9.2× |
Radiation treatment delivery level 3 (77412)
range across 6 matching MRF lines |
$3,961.80–$7,923.60 |
$6,603–$13,206 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$192.60 |
$321 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$304.80 |
$508 |
2.9× |
| Radiologic exam colon double contrast study (74280) |
$490.80 |
$818 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$394.20 |
$657 |
2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$633 |
$1,055 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$238.80 |
$398 |
2.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$234.60 |
$391 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$332.40 |
$554 |
1.9× |
| Radiologic exam swallow function contrast study (74230) |
$315 |
$525 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$414.60 |
$691 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$116.40 |
$194 |
1.3× |
| Radiologic examination femur minimum 2 views (73552) |
$148.80 |
$248 |
1.7× |
| Radiologic examination knee 1/2 views (73560) |
$154.20 |
$257 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$262.20 |
$437 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$180 |
$300 |
2.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$3,109.20 |
$5,182 |
8.0× |
| Ribs bilateral 3 views (71110) |
$224.40 |
$374 |
2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$558.60 |
$931 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$945 |
$1,575 |
2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,989 |
$3,315 |
3.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,500 |
$2,500 |
2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,989 |
$3,315 |
3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,277 |
$3,795 |
1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,041.60 |
$6,736 |
2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,245.40 |
$5,409 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$901.20 |
$1,502 |
3.9× |
| Scapula (73010) |
$202.80 |
$338 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$30 |
$50 |
1.3× |
| Shoulder 1 view (73020) |
$101.40 |
$169 |
1.2× |
| Shoulder Arthrography (73040) |
$514.20 |
$857 |
1.5× |
| Sialogram (70390) |
$325.20 |
$542 |
1.4× |
| Skull less than 4 views (70250) |
$205.80 |
$343 |
2.0× |
| Special dosimetry (77331) |
$239.40 |
$399 |
1.8× |
| Special Physics Consult (77370) |
$1,416 |
$2,360 |
10.5× |
| Special teletherapy port plan (77321) |
$724.20 |
$1,207 |
1.9× |
| Special treatment procedure (77470) |
$2,168.40 |
$3,614 |
3.9× |
| Spleen Imaging (78185) |
$552 |
$920 |
1.4× |
| Srs Multisource (77371) |
$45,262.80 |
$75,438 |
6.1× |
| Stereotactic Body Radiation Delivery (77373) |
$21,266.40 |
$35,444 |
11.9× |
| Sternoclavicular joints (71130) |
$165 |
$275 |
1.9× |
| Superior sagittal sinus venogram (75870) |
$3,006 |
$5,010 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,769.40 |
$2,949 |
4.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$827.40 |
$1,379 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$3,106.20 |
$5,177 |
8.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,163.60 |
$3,606 |
5.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,290.60 |
$2,151 |
9.6× |
| Thoracic spine 2 views (72070) |
$205.20 |
$342 |
2.0× |
| Thoracic spine 3 views (72072) |
$290.40 |
$484 |
2.8× |
| Thoracolumbar 2 views (72080) |
$225.60 |
$376 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$479.40 |
$799 |
1.2× |
| Thyroid Met Imaging Body (78018) |
$1,549.20 |
$2,582 |
2.8× |
| Thyroid Uptake Measurement (78012) |
$462 |
$770 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$621 |
$1,035 |
1.6× |
| Tx Devices Design & Construction Complex (77334) |
$1,853.40 |
$3,089 |
4.9× |
| Tx devices design & construction intermediate (77333) |
$625.20 |
$1,042 |
4.6× |
| Tx devices design & construction simple (77332) |
$429.60 |
$716 |
3.2× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$355.80–$711.60 |
$593–$1,186 |
varies |
| Ultrasound elastography first target lesion (76982) |
$256.80 |
$428 |
2.5× |
| Ultrasound Elastography Parenchyma (76981) |
$279.60 |
$466 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$198.60 |
$331 |
1.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$700.80 |
$1,168 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$415.20 |
$692 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$130.80 |
$218 |
1.2× |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$341.40–$1,210.20 |
$569–$2,017 |
varies |
| Unlisted magnetic resonance procedure (76498) |
$1,508.40 |
$2,514 |
17.3× |
Unlisted us procedure (76999)
range across 2 matching MRF lines |
$130.80–$160.80 |
$218–$268 |
varies |
| Upper gi w/o kub (74240) |
$391.80 |
$653 |
2.2× |
| Urethrocystogram voiding (74455) |
$480 |
$800 |
2.0× |
| Urethrocystography retrograde (74450) |
$403.20 |
$672 |
1.7× |
Us breast unilateral complete (76641)
range across 4 matching MRF lines |
$609–$1,218 |
$1,015–$2,030 |
varies |
| Us chest (76604) |
$263.40 |
$439 |
2.5× |
| Us complete joint (76881) |
$382.20 |
$637 |
3.7× |
| Us exam, pelvic, limited (76857) |
$321.60 |
$536 |
3.1× |
| Us head (76506) |
$301.80 |
$503 |
2.9× |
| Us kidney transplant (76776) |
$400.20 |
$667 |
3.8× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 10 matching MRF lines |
$227.40–$454.80 |
$379–$758 |
varies |
| Us ob detailed single fetus (76811) |
$388.80 |
$648 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$217.80 |
$363 |
2.1× |
| Us ob transvaginal (76817) |
$159 |
$265 |
1.5× |
| Us pelvic non ob complete (76856) |
$509.40 |
$849 |
4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$397.80 |
$663 |
3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$340.20 |
$567 |
3.2× |
| Us retroperitoneal complete (76770) |
$486.60 |
$811 |
4.6× |
| Us retroperitoneal limited (76775) |
$320.40 |
$534 |
3.1× |
| Us scrotum and contents (76870) |
$528.60 |
$881 |
5.0× |
| Us thyroid (76536) |
$399.60 |
$666 |
3.8× |
| Us transrectal (76872) |
$228.60 |
$381 |
2.2× |
| Vein X-Ray Chest (75827) |
$1,956 |
$3,260 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,006 |
$5,010 |
1.0× |
| Vein X-Ray Spleen/Liver (75810) |
$3,307.20 |
$5,512 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$3,006 |
$5,010 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,875.80 |
$4,793 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,640.40 |
$2,734 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,471.20 |
$2,452 |
0.9× |
| Venography Renal Bilateral (75833) |
$4,666.20 |
$7,777 |
1.5× |
| Venography Renal Unilateral (75831) |
$3,117.60 |
$5,196 |
1.0× |
| Venous sampling by catheter (75893) |
$5,919.60 |
$9,866 |
1.1× |
| Wrist 2 views (73100) |
$138 |
$230 |
1.6× |
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 4 matching MRF lines |
$114.60–$152.40 |
$191–$254 |
varies |
| X-ray antegrade pyelogram tube (74425) |
$410.40 |
$684 |
1.2× |
| X-Ray Aorta Leg Arteries (75630) |
$3,262.20 |
$5,437 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$174 |
$290 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$189 |
$315 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$689.40 |
$1,149 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$193.20 |
$322 |
2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$241.20 |
$402 |
2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$312 |
$520 |
3.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$117.60 |
$196 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$179.40 |
$299 |
2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$400.80 |
$668 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$220.20 |
$367 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$392.40 |
$654 |
3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$462 |
$770 |
4.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$394.20 |
$657 |
3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$249.60 |
$416 |
2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$640.80 |
$1,068 |
6.1× |
X-Ray Exam Unilat Ribs/Chest (71101)
range across 4 matching MRF lines |
$163.20–$217.20 |
$272–$362 |
varies |
| X-ray eye for foreign body (70030) |
$157.80 |
$263 |
1.8× |
| X-ray humerus (73060) |
$180 |
$300 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$537 |
$895 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$130.80 |
$218 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$183 |
$305 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$215.40 |
$359 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$128.40 |
$214 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$315.60 |
$526 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$178.20 |
$297 |
1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$126 |
$210 |
1.2× |
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 6 matching MRF lines |
$152.40–$202.80 |
$254–$338 |
varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$201 |
$335 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$291.60 |
$486 |
2.8× |
| X-Ray Stress View (77071) |
$226.80 |
$378 |
2.6× |
| X-ray thoracic spine 4 vw (72074) |
$334.20 |
$557 |
3.2× |
| X-Ray Tmj Unilat (70328) |
$142.80 |
$238 |
1.6× |
| X-Rays Bone Length Studies (77073) |
$192 |
$320 |
1.8× |
| X-Rays Bone Survey Complete (77075) |
$328.20 |
$547 |
3.1× |
| Xr c-spine 4 or 5 views (72050) |
$324 |
$540 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$118.80 |
$198 |
1.4× |
| Xr orbits complete 4 views (70200) |
$188.40 |
$314 |
1.8× |