| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,310.25 |
$4,537.10 |
2.6× |
| Abdomen 2 views (74019) |
$521.54 |
$548.99 |
4.2× |
| Acute gi blood loss imaging (78278) |
$1,860.46 |
$1,958.38 |
3.9× |
| Angiography extremity bilateral rs&i (75716) |
$10,386.58 |
$10,933.24 |
2.7× |
| Angiography extremity unilateral rs&i (75710) |
$4,748.81 |
$4,998.75 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$10,386.58 |
$10,933.24 |
2.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$17,314.37 |
$18,225.65 |
2.6× |
| Ankle 2 views (73600) |
$272.16 |
$286.48 |
2.6× |
| Arthrogram elbow (73085) |
$1,159.03 |
$1,220.03 |
2.8× |
| Arthrogram hip (73525) |
$1,196.40 |
$1,259.36 |
2.9× |
| Arthrogram knee (73580) |
$1,107.72 |
$1,166.02 |
2.6× |
| Arthrogram shoulder (73040) |
$1,637.60 |
$1,723.80 |
3.9× |
| Arthrogram wrist (73115) |
$1,324.38 |
$1,394.08 |
3.2× |
| Basic dosimetry (77300) |
$407.83 |
$429.29 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,321.63 |
$1,391.19 |
2.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,323.76 |
$1,393.43 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$2,002.36 |
$2,107.75 |
4.2× |
| Bone age studies (77072) |
$341.47 |
$359.44 |
2.7× |
| Bone Imaging 3 Phase (78315) |
$2,002.36 |
$2,107.75 |
4.2× |
| Bone Marrow Imaging Limited Area (78102) |
$1,384.52 |
$1,457.39 |
2.9× |
| Bone survey complete (77075) |
$584.19 |
$614.94 |
4.7× |
| Bowel imaging (78290) |
$1,353.37 |
$1,424.60 |
2.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,454.02 |
$1,530.55 |
2.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$3,916.16 |
$4,122.27 |
8.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,957.26 |
$2,060.27 |
4.7× |
| Cervical spine 2 or 3 views (72040) |
$468.42 |
$493.07 |
4.5× |
| Chest 1 view (71045) |
$278.82 |
$293.49 |
2.7× |
| Chest xray 3 views (71047) |
$278.82 |
$293.49 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$727.60 |
$765.89 |
3.5× |
| Clavicle complete (73000) |
$528.70 |
$556.52 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$332.60 |
$350.10 |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$508.06 |
$534.80 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,263.78 |
$4,488.18 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,879.74 |
$3,031.31 |
10.1× |
| CT abdomen w contrast (74160) |
$1,901.97 |
$2,002.07 |
9.0× |
| CT abdomen w wo contrast (74170) |
$2,219.96 |
$2,336.80 |
10.6× |
| CT abdomen w/o contrast (74150) |
$1,576.24 |
$1,659.20 |
12.6× |
| CT angio hrt w/3d image (75574) |
$784.20 |
$825.47 |
1.9× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,525.36 |
$1,605.64 |
7.3× |
| CT angiography upper extremity lt (73206) |
$1,664.58 |
$1,752.20 |
7.9× |
| CT c-spine w/contrast (72126) |
$1,891.58 |
$1,991.13 |
4.5× |
| CT c-spine w/o contrast (72125) |
$1,678.63 |
$1,766.98 |
13.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,210.93 |
$2,327.30 |
10.5× |
| CT chest w contrast (71260) |
$1,901.97 |
$2,002.07 |
9.0× |
| CT chest w/wo contrast (71270) |
$2,282.18 |
$2,402.30 |
10.9× |
| CT colonography screening (74263) |
$781.46 |
$822.58 |
2.7× |
| CT colonography w/o cntrst (74261) |
$792.24 |
$833.94 |
6.3× |
| CT head/brain with contrast (70460) |
$1,687.76 |
$1,776.60 |
8.0× |
| CT head/brain without and with contrast (70470) |
$1,999.36 |
$2,104.58 |
9.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,095.72 |
$1,153.40 |
2.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$205.53 |
$216.35 |
2.0× |
| CT hrt w/3d image congen (75573) |
$646.01 |
$680.01 |
1.5× |
| CT iac w contrast (70481) |
$1,540.03 |
$1,621.08 |
7.3× |
| CT limited/localized follow up study (76380) |
$646.67 |
$680.70 |
6.2× |
| CT lower ext w/o (73700) |
$1,289.18 |
$1,357.02 |
10.3× |
| CT lower extremity w wo contrast (73702) |
$1,796.71 |
$1,891.28 |
8.5× |
| CT lower extremity w/contrast material (73701) |
$1,649.64 |
$1,736.46 |
7.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,642.44 |
$2,781.51 |
12.6× |
| CT lumbar spine w/contrast (72132) |
$1,891.58 |
$1,991.13 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$1,665.40 |
$1,753.06 |
13.3× |
| CT maxillofacial w contrast (70487) |
$1,687.04 |
$1,775.82 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,900.66 |
$2,000.70 |
9.0× |
| CT maxillofacial wo contrast (70486) |
$1,267.63 |
$1,334.35 |
10.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,815.24 |
$1,910.78 |
8.6× |
| CT orbits w/o contrast (70480) |
$1,186.90 |
$1,249.37 |
9.5× |
| CT pelvis w/o contrast (72192) |
$1,289.18 |
$1,357.02 |
10.3× |
| CT pelvis w/wo contrast (72194) |
$2,148.14 |
$2,261.20 |
10.2× |
| CT scan of arm combo (73202) |
$1,960.78 |
$2,063.98 |
9.3× |
| CT soft tissue neck w contrast (70491) |
$2,184.36 |
$2,299.33 |
10.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,224.43 |
$2,341.50 |
10.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,948.28 |
$2,050.82 |
15.6× |
| CT thoracic spine w/contrast (72129) |
$1,891.58 |
$1,991.13 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,665.40 |
$1,753.06 |
13.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,261.20 |
$2,380.20 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,456.27 |
$1,532.92 |
11.6× |
| CT upper ext wo (73200) |
$1,289.18 |
$1,357.02 |
10.3× |
| CT upper extremity with contrast (73201) |
$1,649.64 |
$1,736.46 |
3.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,057.79 |
$3,218.72 |
14.5× |
| Cta Abdomen (74175) |
$1,870.36 |
$1,968.80 |
8.9× |
| CTA abdomen pelvis (74174) |
$3,668.82 |
$3,861.92 |
8.8× |
| CTA chest (71275) |
$1,922.78 |
$2,023.97 |
9.1× |
| Cta Head (70496) |
$2,179.86 |
$2,294.59 |
10.4× |
| Cta Neck (70498) |
$2,542.54 |
$2,676.36 |
12.1× |
| Cta Pelvis (72191) |
$1,834.70 |
$1,931.27 |
8.7× |
| Cystography minimum 3 views rs&i (74430) |
$365.38 |
$384.61 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$775.73 |
$816.56 |
6.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$290.18 |
$305.44 |
2.8× |
| Dxa bone density study axial skeleton (77085) |
$458.19 |
$482.30 |
3.7× |
| Esophagus (74220) |
$439.02 |
$462.14 |
2.1× |
| Facial bones min 3 views (70150) |
$419.12 |
$441.18 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,170.44 |
$1,232.04 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,492.70 |
$1,571.26 |
5.2× |
| Foot 2 views (73620) |
$272.75 |
$287.11 |
2.6× |
| Forearm 2 views (73090) |
$340.94 |
$358.88 |
3.3× |
| Hand 2 views (73120) |
$278.96 |
$293.64 |
2.2× |
| Heart Infarct Image (78466) |
$1,829.49 |
$1,925.78 |
3.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,422.72 |
$2,550.23 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,422.72 |
$2,550.23 |
5.1× |
| Hysterosalpingogram (74740) |
$998.11 |
$1,050.64 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,481.52 |
$3,664.76 |
5.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,481.26 |
$3,664.48 |
5.3× |
| Knee 3 views (73562) |
$407.62 |
$429.07 |
3.9× |
| Liver & spleen imaging static only (78215) |
$1,990.48 |
$2,095.24 |
4.2× |
| Lung perf&ventilat diferentl (78598) |
$2,398.40 |
$2,524.63 |
3.7× |
| Lung perfusion differential (78597) |
$1,415.31 |
$1,489.80 |
3.0× |
| Lung ventilation imaging (78579) |
$1,192.90 |
$1,255.68 |
2.5× |
| Lymphoscintigraphy (78195) |
$764.98 |
$805.24 |
1.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,560.22 |
$3,747.60 |
3.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,609.36 |
$3,799.32 |
8.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,889.99 |
$4,094.72 |
9.3× |
| Mammary ductogram or galactogram single (77053) |
$955.62 |
$1,005.91 |
3.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$560.56 |
$590.06 |
1.2× |
| Mr safety determination physician/other qhp (76016) |
$258.27 |
$271.86 |
2.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$71.83 |
$75.61 |
2.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$269.26 |
$283.43 |
2.4× |
| Mr safety implt pos&/immoblj (76019) |
$174.23 |
$183.40 |
2.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$709.04 |
$746.36 |
2.5× |
| MRA head w & w/o contrast (70546) |
$3,943.68 |
$4,151.24 |
9.4× |
| MRA head w/o contrast (70544) |
$2,887.54 |
$3,039.52 |
10.1× |
| MRA head with contrast (70545) |
$3,609.36 |
$3,799.32 |
8.6× |
| MRA neck w contrast (70548) |
$3,609.36 |
$3,799.32 |
8.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,943.68 |
$4,151.24 |
9.4× |
| MRA neck w/o contrast (70547) |
$2,887.54 |
$3,039.52 |
10.1× |
| MRI abdomen w contrast (74182) |
$3,560.22 |
$3,747.60 |
8.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,118.69 |
$4,335.46 |
9.9× |
| MRI abdomen w/o contrast (74181) |
$2,848.48 |
$2,998.40 |
10.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,609.36 |
$3,799.32 |
3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,943.68 |
$4,151.24 |
9.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,996.49 |
$2,101.57 |
7.0× |
| MRI breast wo contrast unilateral (77046) |
$1,996.49 |
$2,101.57 |
7.0× |
| MRI c-spine with contrast (72142) |
$2,887.54 |
$3,039.52 |
6.9× |
| MRI cardiac w/o contrast (75557) |
$1,160.44 |
$1,221.52 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$3,660.17 |
$3,852.81 |
12.8× |
| MRI chest w/o & w/contrast material (71552) |
$3,889.99 |
$4,094.72 |
9.3× |
| MRI chest w/o contrast (71550) |
$2,848.24 |
$2,998.14 |
10.0× |
| MRI fetal sngl/1st gestation (74712) |
$770.81 |
$811.38 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,609.36 |
$3,799.32 |
8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,943.68 |
$4,151.24 |
9.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,887.54 |
$3,039.52 |
10.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,887.54 |
$3,039.52 |
10.1× |
| MRI orbit face neck w contrast (70542) |
$3,609.36 |
$3,799.32 |
8.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,410.40 |
$3,589.90 |
8.2× |
| MRI pelvis w/contrast (72196) |
$3,239.06 |
$3,409.54 |
7.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,072.14 |
$3,233.83 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$2,887.54 |
$3,039.52 |
10.1× |
| MRI spectroscopy (76390) |
$3,805.26 |
$4,005.54 |
36.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,943.68 |
$4,151.24 |
9.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,560.22 |
$3,747.60 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,889.99 |
$4,094.72 |
9.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,560.22 |
$3,747.60 |
8.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,889.99 |
$4,094.72 |
9.3× |
| MRI temporomandibular joint (70336) |
$3,537.80 |
$3,724 |
12.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,848.24 |
$2,998.14 |
10.0× |
| MRI up ext w/o contrast (73218) |
$2,848.24 |
$2,998.14 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,848.24 |
$2,998.14 |
10.0× |
| MRI, joint upper extrem combo (73223) |
$3,943.68 |
$4,151.24 |
9.4× |
| Myocardial infarct spect (78469) |
$1,717.90 |
$1,808.32 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,954.99 |
$5,215.78 |
3.2× |
| Myocardial spect single study at rest or stress (78451) |
$4,053.34 |
$4,266.67 |
2.6× |
| Neck soft tissue (70360) |
$460.05 |
$484.26 |
4.4× |
| Nm adrenal scan (78075) |
$4,584.14 |
$4,825.41 |
3.0× |
| Nm cisternogram (78630) |
$1,440.07 |
$1,515.86 |
2.2× |
| Nm gastric emptying study (78264) |
$1,976.23 |
$2,080.24 |
4.1× |
| Nm gastroesophageal reflux study (78262) |
$1,363.27 |
$1,435.02 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,734.40 |
$3,930.95 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$1,692.62 |
$1,781.71 |
6.1× |
| Ob us nuchal meas 1 gest (76813) |
$629 |
$662.11 |
5.0× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$314.08 |
$330.62 |
2.5× |
| Osseous survey limited (77074) |
$763.28 |
$803.45 |
6.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,847.39 |
$1,944.62 |
2.8× |
| Parathyroid Planar Imaging (78070) |
$2,061.40 |
$2,169.89 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$295.88 |
$311.46 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,458.72 |
$1,535.49 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,398.40 |
$2,524.63 |
3.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,075.69 |
$1,132.30 |
1.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$359.65 |
$378.58 |
3.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$376 |
$395.80 |
3.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$362.65 |
$381.74 |
3.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$304.24 |
$320.26 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$376 |
$395.80 |
3.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$359.65 |
$378.58 |
3.4× |
| Radex Hand Minimum 3 Views (73130) |
$359.65 |
$378.58 |
3.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$298.82 |
$314.54 |
2.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$503.88 |
$530.40 |
4.0× |
| Radex Humerus Minimum 2 Views (73060) |
$429.74 |
$452.36 |
4.1× |
| Radex Kne 1/2 Views (73560) |
$359.65 |
$378.58 |
3.4× |
| Radex Kne Compl 4/More Views (73564) |
$433.70 |
$456.52 |
3.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$650.82 |
$685.07 |
5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$350.54 |
$368.98 |
3.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$415.04 |
$436.88 |
3.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$834.62 |
$878.55 |
8.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$268.25 |
$282.36 |
2.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$538.71 |
$567.06 |
4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$411.02 |
$432.66 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$386.56 |
$406.92 |
3.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$297.30 |
$312.94 |
2.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$659.21 |
$693.90 |
6.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$960.67 |
$1,011.23 |
7.7× |
| Radiation treatment delivery level 1 (77402) |
$584.95 |
$615.74 |
4.8× |
| Radiation treatment delivery level 2 (77407) |
$741.71 |
$780.75 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$919.16 |
$967.54 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$422.06 |
$444.28 |
4.0× |
| Radiologic exam chest 2 views (71046) |
$278.82 |
$293.49 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$1,323.34 |
$1,392.98 |
6.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,220.85 |
$1,285.10 |
5.8× |
| Radiologic examination femur 1 view (73551) |
$298.82 |
$314.54 |
2.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$340.94 |
$358.88 |
3.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$409.31 |
$430.86 |
3.3× |
| Radiologic examination, teeth; complete, full mouth Non-Facility (70320) |
$86.30 |
$90.84 |
0.3× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$262.84 |
$276.68 |
2.5× |
| Radiological examination surgical specimen (76098) |
$214.40 |
$225.68 |
0.3× |
| Ribs bilateral 3 views (71110) |
$834.62 |
$878.55 |
6.7× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,363.27 |
$1,435.02 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,198.24 |
$1,261.30 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,725.99 |
$4,974.73 |
7.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,895.99 |
$1,995.78 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,470.49 |
$5,758.41 |
3.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,822.64 |
$5,076.46 |
3.1× |
| Rp Therapy Intravenous Administration (79101) |
$663.74 |
$698.67 |
2.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$366.90 |
$386.21 |
1.3× |
| Scapula (73010) |
$630.07 |
$663.24 |
5.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$333.79 |
$351.36 |
14.3× |
| Shoulder 1 view (73020) |
$287.77 |
$302.92 |
2.8× |
| Sialogram (70390) |
$1,108.12 |
$1,166.44 |
3.9× |
| Small bowel series (74250) |
$830.20 |
$873.89 |
3.9× |
| Special dosimetry (77331) |
$479.07 |
$504.28 |
3.0× |
| Special Physics Consult (77370) |
$950.67 |
$1,000.70 |
5.9× |
| Special treatment procedure (77470) |
$1,625.47 |
$1,711.02 |
2.5× |
| Spine thoracic 3 views (72072) |
$502.92 |
$529.39 |
4.0× |
| Stereotactic Body Radiation Delivery (77373) |
$9,002.26 |
$9,476.06 |
4.2× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$292.52 |
$307.92 |
2.8× |
| Tbs technical calculation only (77091) |
$292.52 |
$307.92 |
2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$522.22 |
$549.70 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$522.22 |
$549.70 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,143.83 |
$2,256.66 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,081.82 |
$1,138.76 |
6.7× |
| Thoracolumbar 2 views (72080) |
$304.24 |
$320.26 |
2.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,873.32 |
$1,971.92 |
2.9× |
| Thyroid imaging w/blood flow (78013) |
$2,086.68 |
$2,196.50 |
4.4× |
| Thyroid uptake measurement (78012) |
$2,566.41 |
$2,701.48 |
5.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,566.43 |
$2,701.51 |
5.4× |
| Treatment device complex (77334) |
$1,031.86 |
$1,086.17 |
2.3× |
| Treatment device intermediate (77333) |
$805.55 |
$847.95 |
5.0× |
| Treatment devices simple (77332) |
$551.50 |
$580.53 |
3.4× |
| Ultrasound breast complete (76641) |
$440.86 |
$464.07 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$465.76 |
$490.28 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$744.23 |
$783.40 |
5.9× |
| Umbilical-artery Doppler (OB) (76820) |
$300.77 |
$316.60 |
2.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$336.40 |
$354.11 |
3.2× |
| Unlisted fluoroscopic procedure (76496) |
$323.35 |
$340.37 |
3.1× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$1,323.76 |
$1,393.43 |
2.8× |
| Unlisted ns dx nm (78699) |
$1,363.27 |
$1,435.02 |
2.8× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$1,323.76 |
$1,393.43 |
2.8× |
| Unlisted ultrasound procedure (76999) |
$126.54 |
$133.20 |
1.2× |
| Urethrocystogram voiding (74455) |
$998.11 |
$1,050.64 |
3.5× |
| Urethrocystography retrograde rs&i (74450) |
$1,237.84 |
$1,302.98 |
4.3× |
| Us breast unilateral limited (76642) |
$437.48 |
$460.51 |
4.2× |
| Us chest (76604) |
$662.82 |
$697.70 |
5.3× |
| Us compl joint r-t w/image documentation (76881) |
$73.15 |
$77 |
0.6× |
| Us encephalogram (76506) |
$1,614.45 |
$1,699.42 |
12.9× |
| Us hips infant static (76886) |
$245.78 |
$258.72 |
2.4× |
| Us infant hips w manipulation (76885) |
$331.10 |
$348.52 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$296.78 |
$312.40 |
2.4× |
| Us ob limited (76815) |
$220.26 |
$231.86 |
1.8× |
| Us ob transvaginal (76817) |
$636.01 |
$669.48 |
5.1× |
| Us pelvic non ob complete (76856) |
$780.32 |
$821.39 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$567.81 |
$597.69 |
4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$244.42 |
$257.28 |
2.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$572.30 |
$602.42 |
4.6× |
| Us retroperitoneal complete (76770) |
$892.80 |
$939.78 |
7.1× |
| Us retroperitoneal limited (76775) |
$750.55 |
$790.05 |
6.0× |
| Us scrotum and contents (76870) |
$484.53 |
$510.03 |
3.9× |
| Us soft tissue head/neck (76536) |
$366.56 |
$385.86 |
2.9× |
| Us spinal canal and contents (76800) |
$267.23 |
$281.30 |
2.1× |
| Us transrectal (76872) |
$159.60 |
$168 |
1.3× |
| Us, eye b-scan (76512) |
$242.55 |
$255.32 |
1.9× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,148.11 |
$1,208.54 |
9.2× |
| Venogram extremity bilateral (75822) |
$5,358.86 |
$5,640.91 |
2.8× |
| Venogram Extremity Unilateral (75820) |
$5,103.69 |
$5,372.30 |
2.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,377.08 |
$2,502.20 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$3,802.54 |
$4,002.67 |
2.0× |
| Vertebral fracture assessment via dxa (77086) |
$315.04 |
$331.62 |
3.0× |
| Wrist 2 views (73100) |
$361.28 |
$380.30 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$835.80 |
$879.78 |
6.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$340.46 |
$358.38 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,523.55 |
$1,603.74 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$304.30 |
$320.32 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$304.24 |
$320.26 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$358.42 |
$377.29 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$298.82 |
$314.54 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$811.16 |
$853.85 |
7.8× |
| X-ray IV pyelogram (ivp) (74400) |
$658.10 |
$692.74 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$417.25 |
$439.21 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$667.62 |
$702.76 |
6.4× |
| X-ray leg, infant (73592) |
$348.70 |
$367.04 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$493.05 |
$519 |
3.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$616.42 |
$648.86 |
4.9× |
| X-ray nose-rectum child f.b. (76010) |
$323.86 |
$340.90 |
3.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$436.25 |
$459.21 |
3.5× |
| X-ray retrograde pyelogram (74420) |
$599.96 |
$631.54 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$407.62 |
$429.07 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$112.77 |
$118.70 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$454.86 |
$478.80 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,216.72 |
$1,280.75 |
9.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$436.25 |
$459.21 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$411.02 |
$432.66 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$512.84 |
$539.83 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$307 |
$323.16 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$273.81 |
$288.22 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,169.55 |
$1,231.10 |
11.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$333.82 |
$351.38 |
3.2× |
| Xr bone length studies (77073) |
$308.28 |
$324.51 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$497.98 |
$524.19 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$581.87 |
$612.50 |
4.6× |
| Xr chest 4+ views (71048) |
$513.72 |
$540.76 |
4.1× |
| Xr urogram antegrade (74425) |
$704.01 |
$741.06 |
1.7× |