| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,159.60 |
$10,266 |
4.6× |
| Abdomen 1 View (74018) |
$388.20 |
$647 |
4.6× |
| Abdomen 2 views (74019) |
$327.60 |
$546 |
3.2× |
| Angiography extremity unilateral rs&i (75710) |
$2,265.60 |
$3,776 |
0.7× |
| Ankle 2 views (73600) |
$422.40 |
$704 |
5.0× |
| Arthrogram hip (73525) |
$640.80 |
$1,068 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$493.80 |
$823 |
3.8× |
| Bone age studies (77072) |
$250.20 |
$417 |
2.5× |
| Bone survey infant (77076) |
$405.60 |
$676 |
4.0× |
| Brachytx isodose complex (77318) |
$1,035.60 |
$1,726 |
2.8× |
| Brachytx Isodose Plan Simple (77316) |
$869.40 |
$1,449 |
2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,641.20 |
$4,402 |
1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$727.20 |
$1,212 |
2.1× |
| Chest 1 view (71045) |
$115.20 |
$192 |
1.4× |
| Chest 2 views (71046) |
$211.80 |
$353 |
2.5× |
| Chest 4 or more views (71048) |
$362.40 |
$604 |
3.6× |
| Clavicle complete (73000) |
$558 |
$930 |
6.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$265.20 |
$442 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$546.60 |
$911 |
4.2× |
| Contrast X-Ray Bladder (74430) |
$637.80 |
$1,063 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,374 |
$7,290 |
12.8× |
| CT abdomen and pelvis without contrast (74176) |
$4,530 |
$7,550 |
19.5× |
| CT abdomen w contrast (74160) |
$2,822.40 |
$4,704 |
16.5× |
| CT abdomen w wo contrast (74170) |
$3,406.80 |
$5,678 |
19.9× |
| CT abdomen w/o contrast (74150) |
$2,628.60 |
$4,381 |
25.8× |
| CT Angio Abdomen and Pelvis (74174) |
$4,444.80 |
$7,408 |
13.1× |
| CT Angio Chest (71275) |
$1,789.80 |
$2,983 |
10.5× |
| CT Angio Head (70496) |
$1,808.40 |
$3,014 |
10.6× |
| CT angio hrt w/3d image (75574) |
$1,811.40 |
$3,019 |
5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,710.60 |
$2,851 |
10.0× |
| CT Angio Neck (70498) |
$1,931.40 |
$3,219 |
11.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,998.60 |
$3,331 |
11.7× |
| CT cervical spine w/ contrast (72126) |
$1,870.20 |
$3,117 |
5.5× |
| CT cervical spine w/o contrast (72125) |
$2,520 |
$4,200 |
24.7× |
| CT chest w contrast (71260) |
$1,578.60 |
$2,631 |
9.2× |
| CT chest w/wo contrast (71270) |
$3,013.80 |
$5,023 |
17.6× |
| CT head/brain with contrast (70460) |
$1,986.60 |
$3,311 |
11.6× |
| CT head/brain without and with contrast (70470) |
$2,436 |
$4,060 |
14.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,623 |
$2,705 |
4.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$109 |
$109 |
1.3× |
| CT iac w contrast (70481) |
$1,360.80 |
$2,268 |
8.0× |
| CT lower ext w/o (73700) |
$1,849.80 |
$3,083 |
18.1× |
| CT lower extremity w/contrast material (73701) |
$2,310.60 |
$3,851 |
13.5× |
| CT lumbar spine w contrast (72132) |
$3,379.20 |
$5,632 |
9.9× |
| CT lumbar spine w/o contrast (72131) |
$2,187 |
$3,645 |
21.4× |
| CT maxillofacial w contrast (70487) |
$2,024.40 |
$3,374 |
11.8× |
| CT maxillofacial wo contrast (70486) |
$1,437 |
$2,395 |
14.1× |
| CT neck tissue combo (70492) |
$2,482.80 |
$4,138 |
14.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,104.80 |
$3,508 |
12.3× |
| CT orbits w/o contrast (70480) |
$1,834.20 |
$3,057 |
18.0× |
| CT pelvis w/o contrast (72192) |
$2,218.80 |
$3,698 |
21.8× |
| CT scan of leg combo (73702) |
$2,536.80 |
$4,228 |
14.8× |
| CT soft tissue neck w contrast (70491) |
$2,440.20 |
$4,067 |
14.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,773 |
$2,955 |
17.4× |
| CT thoracic spine w contrast (72129) |
$3,346.80 |
$5,578 |
19.6× |
| CT thoracic spine w/o contrast (72128) |
$3,122.40 |
$5,204 |
30.6× |
| CT thorax w/o contrast (71250) |
$1,256.40 |
$2,094 |
12.3× |
| CT upper ext wo (73200) |
$1,998 |
$3,330 |
19.6× |
| CT upper extremity with contrast (73201) |
$2,314.80 |
$3,858 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,210.60 |
$5,351 |
18.8× |
| Cta Abdomen (74175) |
$2,967.60 |
$4,946 |
17.3× |
| Discography Cerv/Thor Spine (72285) |
$3,745.80 |
$6,243 |
2.0× |
| Diskography lumbar (72295) |
$2,508 |
$4,180 |
1.3× |
| Dxa Bone Density Axial (77080) |
$649.20 |
$1,082 |
6.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$388.20 |
$647 |
4.6× |
| Esophagram (74220) |
$820.20 |
$1,367 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$529.20 |
$882 |
2.3× |
| Foot 2 views (73620) |
$384.60 |
$641 |
4.5× |
| Forearm 2 views (73090) |
$509.40 |
$849 |
6.0× |
| Hand 2 views (73120) |
$414.60 |
$691 |
4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,903.20 |
$8,172 |
7.2× |
| Knee 3 Views (73562) |
$467.40 |
$779 |
5.5× |
| Magnetic Image Jaw Joint (70336) |
$4,613.40 |
$7,689 |
19.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,626.60 |
$2,711 |
4.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,847.40 |
$8,079 |
14.2× |
| MRA head w/o contrast (70544) |
$3,268.80 |
$5,448 |
14.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,398 |
$7,330 |
12.9× |
| MRA neck w/o contrast (70547) |
$3,187.20 |
$5,312 |
13.7× |
| MRI abdomen w contrast (74182) |
$2,506.20 |
$4,177 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$4,209 |
$7,015 |
18.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,853.20 |
$6,422 |
5.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,818 |
$8,030 |
14.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,015.80 |
$6,693 |
5.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$4,628.40 |
$7,714 |
19.9× |
| MRI cardiac w/o contrast (75557) |
$463.20 |
$772 |
2.0× |
| MRI cervical spine w contrast (72142) |
$4,274.40 |
$7,124 |
12.6× |
| MRI cervical spine w/o cont (72141) |
$1,858.80 |
$3,098 |
8.0× |
| MRI chest wo w contrast (71552) |
$3,904.20 |
$6,507 |
11.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,808.60 |
$4,681 |
8.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,723.20 |
$7,872 |
13.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,046.40 |
$6,744 |
17.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$8,206.20 |
$13,677 |
24.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,419.60 |
$7,366 |
19.0× |
| MRI orbit face neck w contrast (70542) |
$3,032.40 |
$5,054 |
8.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,941.20 |
$9,902 |
17.5× |
| MRI pelvis w/o & w contrast (72197) |
$3,946.20 |
$6,577 |
11.6× |
| MRI pelvis w/o contrast (72195) |
$3,367.20 |
$5,612 |
14.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,602.40 |
$6,004 |
15.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,509.40 |
$5,849 |
15.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,680 |
$7,800 |
13.7× |
| MRI, abdomen, combo (74183) |
$6,756.60 |
$11,261 |
19.8× |
| MRI, dorsal spine combo (72157) |
$5,152.20 |
$8,587 |
15.1× |
| MRI, dorsal spine contrast (72147) |
$4,172.40 |
$6,954 |
12.3× |
| MRI, joint upper extrem (73221) |
$5,052.60 |
$8,421 |
21.7× |
| MRI, joint upper extrem combo (73223) |
$4,874.40 |
$8,124 |
14.3× |
| MRI, lumbar spine combo (72158) |
$4,103.40 |
$6,839 |
12.1× |
| Neck soft tissue (70360) |
$440.40 |
$734 |
5.2× |
| Nonvascular Shunt X-Ray (75809) |
$286.20 |
$477 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,123.20 |
$11,872 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$462.60 |
$771 |
4.5× |
| Pet Image W/Ct Lmtd (78814) |
$9,122.40 |
$15,204 |
6.5× |
| PET image w/CT, full body (78816) |
$9,579 |
$15,965 |
6.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,663.20 |
$12,772 |
5.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$708.60 |
$1,181 |
6.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$520.80 |
$868 |
6.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$480 |
$800 |
5.7× |
| Radex elbow complete minimum 3 views (73080) |
$633.60 |
$1,056 |
7.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$527.40 |
$879 |
5.2× |
| Radex fingr minimum 2 views (73140) |
$410.40 |
$684 |
4.8× |
| Radex foot complete minimum 3 views (73630) |
$492 |
$820 |
5.8× |
| Radex Hand Minimum 3 Views (73130) |
$480.60 |
$801 |
5.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$304.20 |
$507 |
3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$504 |
$840 |
5.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$330 |
$550 |
3.9× |
| Radex shoulder complete minimum 2 views (73030) |
$349.80 |
$583 |
4.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$500.40 |
$834 |
5.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$908.40 |
$1,514 |
5.3× |
| Radex Spine 1 View Specify Level (72020) |
$408 |
$680 |
4.8× |
| Radex Sternum Minimum 2 Views (71120) |
$410.40 |
$684 |
4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$538.80 |
$898 |
6.3× |
| Radex Toe Minimum 2 Views (73660) |
$389.40 |
$649 |
4.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$447.60 |
$746 |
5.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,245.80 |
$13,743 |
1.1× |
| Radiation treatment delivery level 2 (77407) |
$3,387.60 |
$5,646 |
9.0× |
| Radiation treatment delivery level 3 (77412) |
$3,387.60 |
$5,646 |
6.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$553.20 |
$922 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$871.20 |
$1,452 |
5.1× |
| Radiologic exam knee complete 4/more views (73564) |
$723 |
$1,205 |
7.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$568.80 |
$948 |
5.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$596.40 |
$994 |
3.5× |
| Radiologic exam swallow function contrast study (74230) |
$329.40 |
$549 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,009.80 |
$1,683 |
5.9× |
| Radiologic examination femur 1 view (73551) |
$343.20 |
$572 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$519 |
$865 |
6.1× |
| Radiologic examination knee 1/2 views (73560) |
$461.40 |
$769 |
5.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$223.20 |
$372 |
2.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$441 |
$735 |
5.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$493.80 |
$823 |
1.3× |
| Ribs bilateral 3 views (71110) |
$624.60 |
$1,041 |
6.1× |
| Scapula (73010) |
$519.60 |
$866 |
5.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$108.60 |
$181 |
4.6× |
| Shoulder 1 view (73020) |
$327.60 |
$546 |
3.9× |
| Skull less than 4 views (70250) |
$405.60 |
$676 |
4.0× |
| Special dosimetry (77331) |
$237 |
$395 |
1.8× |
| Special Physics Consult (77370) |
$846.60 |
$1,411 |
6.5× |
| Special teletherapy port plan (77321) |
$732.60 |
$1,221 |
2.0× |
| Special treatment procedure (77470) |
$2,596.80 |
$4,328 |
4.8× |
| Stereotactic Body Radiation Delivery (77373) |
$12,814.80 |
$21,358 |
7.3× |
| Sternoclavicular joints (71130) |
$240.60 |
$401 |
2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$655.20 |
$1,092 |
1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,434 |
$2,390 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$996.60 |
$1,661 |
7.6× |
| Thoracic spine 2 views (72070) |
$625.20 |
$1,042 |
6.1× |
| Thoracic spine 3 views (72072) |
$768 |
$1,280 |
7.5× |
| Thoracolumbar 2 views (72080) |
$516 |
$860 |
6.1× |
| Tx Devices Design & Construction Complex (77334) |
$1,099.20 |
$1,832 |
3.0× |
| Tx devices design & construction intermediate (77333) |
$243 |
$405 |
1.9× |
| Tx devices design & construction simple (77332) |
$583.80 |
$973 |
4.5× |
| Ultrasound Breast Limited (76642) |
$456.60 |
$761 |
5.4× |
| Ultrasound Elastography Parenchyma (76981) |
$455.40 |
$759 |
4.5× |
| Ultrasound Exam Aaa Screen (76706) |
$829.20 |
$1,382 |
8.1× |
| Ultrasound, abdomen limited (76705) |
$620.40 |
$1,034 |
6.1× |
| Unlisted magnetic resonance procedure (76498) |
$1,428 |
$2,380 |
16.8× |
| Unlisted us procedure (76999) |
$181.20 |
$302 |
2.1× |
| Upper gi w/o kub (74240) |
$918 |
$1,530 |
5.4× |
| Urethrocystography retrograde (74450) |
$665.40 |
$1,109 |
2.9× |
| Us chest (76604) |
$204 |
$340 |
2.0× |
| Us exam, pelvic, limited (76857) |
$334.80 |
$558 |
3.3× |
| Us kidney transplant (76776) |
$280.80 |
$468 |
2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$426 |
$710 |
4.2× |
| Us ob limited 1 or more fetuses (76815) |
$271.80 |
$453 |
2.7× |
| Us ob transvaginal (76817) |
$318 |
$530 |
3.1× |
| Us pelvic non ob complete (76856) |
$934.20 |
$1,557 |
9.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$399.60 |
$666 |
3.9× |
| Us retroperitoneal complete (76770) |
$637.80 |
$1,063 |
6.3× |
| Us retroperitoneal limited (76775) |
$523.80 |
$873 |
5.1× |
| Us scrotum and contents (76870) |
$743.40 |
$1,239 |
7.3× |
| Us thyroid (76536) |
$722.40 |
$1,204 |
7.1× |
| Wrist 2 views (73100) |
$407.40 |
$679 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$181.20 |
$302 |
2.1× |
| X-ray antegrade pyelogram tube (74425) |
$640.20 |
$1,067 |
1.9× |
| X-Ray Bend Only L-S Spine (72120) |
$436.20 |
$727 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$411 |
$685 |
4.8× |
| X-Ray Exam Breast Specimen (76098) |
$392.40 |
$654 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$385.20 |
$642 |
4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$580.80 |
$968 |
5.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$343.80 |
$573 |
4.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$281.40 |
$469 |
3.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$255.60 |
$426 |
2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$615.60 |
$1,026 |
6.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$615.60 |
$1,026 |
6.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,333.80 |
$2,223 |
13.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$803.40 |
$1,339 |
9.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,330.20 |
$2,217 |
13.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$411 |
$685 |
4.0× |
| X-ray eye for foreign body (70030) |
$546.60 |
$911 |
6.4× |
| X-ray humerus (73060) |
$476.40 |
$794 |
5.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$267 |
$445 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$413.40 |
$689 |
4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$848.40 |
$1,414 |
8.3× |
| X-ray nose-rectum child f.b. (76010) |
$181.20 |
$302 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$784.80 |
$1,308 |
7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$841.80 |
$1,403 |
8.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$583.80 |
$973 |
5.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$519 |
$865 |
6.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$898.80 |
$1,498 |
10.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$793.80 |
$1,323 |
7.8× |
| X-ray thoracic spine 4 vw (72074) |
$814.20 |
$1,357 |
8.0× |
| X-Ray Tmj Unilat (70328) |
$186.60 |
$311 |
2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$685.20 |
$1,142 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$584.40 |
$974 |
5.7× |
| X-Rays Bone Survey Complete (77075) |
$1,675.20 |
$2,792 |
16.4× |
| Xr c-spine 4 or 5 views (72050) |
$1,170 |
$1,950 |
11.5× |
| Xr facial bones less than 3 views (70140) |
$529.80 |
$883 |
6.2× |
| Xr orbits complete 4 views (70200) |
$517.80 |
$863 |
5.1× |