| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,366 |
$5,366 |
3.2× |
| Abdomen 2 views (74019) |
$485 |
$485 |
3.9× |
| Acute gi blood loss imaging (78278) |
$2,992 |
$2,992 |
6.2× |
| Angiography extremity bilateral rs&i (75716) |
$2,435 |
$2,435 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,360 |
$2,360 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$3,338 |
$3,338 |
0.9× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,912 |
$2,912 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,435 |
$2,435 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,391 |
$2,391 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$4,190 |
$4,190 |
0.6× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,590 |
$2,590 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,024 |
$1,024 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,714 |
$2,714 |
0.7× |
| Ankle 2 views (73600) |
$454 |
$454 |
4.4× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,309 |
$2,309 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,226 |
$2,226 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$2,101 |
$2,101 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$3,193 |
$3,193 |
0.8× |
| Arthrogram knee (73580) |
$2,861 |
$2,861 |
6.8× |
| Basic dosimetry (77300) |
$495.50 |
$495.50 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,949 |
$1,949 |
4.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,338 |
$2,338 |
4.9× |
| Bone &/joint imaging whole body (78306) |
$2,517 |
$2,517 |
5.3× |
| Bone age studies (77072) |
$311 |
$311 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$2,951 |
$2,951 |
6.2× |
| Bone survey complete (77075) |
$1,362 |
$1,362 |
10.9× |
| Bone survey infant (77076) |
$1,375 |
$1,375 |
11.0× |
| Bowel imaging (78290) |
$2,958 |
$2,958 |
6.2× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,941 |
$1,941 |
4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,977 |
$2,977 |
4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,709 |
$4,709 |
2.7× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$7,343 |
$7,343 |
7.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$6,129 |
$6,129 |
14.7× |
| Cervical spine 2 or 3 views (72040) |
$541 |
$541 |
5.2× |
| Chest 1 view (71045) |
$339 |
$339 |
3.3× |
| Chest xray 3 views (71047) |
$578 |
$578 |
5.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,524 |
$1,524 |
7.2× |
| Clavicle complete (73000) |
$460 |
$460 |
4.4× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$2,083 |
$2,083 |
20.0× |
| Continuing medical physics consltj pr wk (77336) |
$586 |
$586 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,864 |
$5,864 |
14.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,468 |
$2,468 |
8.6× |
| CT abdomen w contrast (74160) |
$4,111 |
$4,111 |
19.6× |
| CT abdomen w wo contrast (74170) |
$4,661 |
$4,661 |
22.2× |
| CT abdomen w/o contrast (74150) |
$1,949 |
$1,949 |
15.6× |
| CT angio hrt w/3d image (75574) |
$5,085 |
$5,085 |
12.2× |
| CT angio lwr extr w/o&w/dye (73706) |
$5,636 |
$5,636 |
26.8× |
| CT angiography upper extremity lt (73206) |
$5,125 |
$5,125 |
24.4× |
| CT c-spine w/contrast (72126) |
$2,688 |
$2,688 |
6.4× |
| CT c-spine w/o contrast (72125) |
$2,012 |
$2,012 |
16.1× |
| CT chest w contrast (71260) |
$3,191 |
$3,191 |
15.2× |
| CT chest w/wo contrast (71270) |
$3,969 |
$3,969 |
18.9× |
| CT head/brain with contrast (70460) |
$2,303 |
$2,303 |
11.0× |
| CT head/brain without and with contrast (70470) |
$2,743 |
$2,743 |
13.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,537 |
$3,537 |
8.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,761 |
$1,761 |
16.9× |
| CT hrt w/3d image congen (75573) |
$4,512 |
$4,512 |
10.8× |
| CT iac w contrast (70481) |
$3,065 |
$3,065 |
14.6× |
| CT limited/localized follow up study (76380) |
$2,075 |
$2,075 |
19.9× |
| CT lower ext w/o (73700) |
$2,004 |
$2,004 |
16.0× |
| CT lower extremity w/contrast material (73701) |
$2,704 |
$2,704 |
12.9× |
| CT lumbar spine w/contrast (72132) |
$2,704 |
$2,704 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$1,996 |
$1,996 |
15.9× |
| CT maxillofacial w contrast (70487) |
$2,389 |
$2,389 |
11.4× |
| CT maxillofacial w/wo contrast (70488) |
$3,003 |
$3,003 |
14.3× |
| CT maxillofacial wo contrast (70486) |
$2,114 |
$2,114 |
16.9× |
| CT orbits w/o contrast (70480) |
$2,382 |
$2,382 |
19.0× |
| CT pelvis w/o contrast (72192) |
$1,981 |
$1,981 |
15.8× |
| CT soft tissue neck w contrast (70491) |
$2,877 |
$2,877 |
13.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,498 |
$3,498 |
16.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,169 |
$2,169 |
17.3× |
| CT thoracic spine w/contrast (72129) |
$2,720 |
$2,720 |
12.9× |
| CT thoracic spine w/o contrast (72128) |
$2,004 |
$2,004 |
16.0× |
| CT thorax w/o contrast (71250) |
$2,429 |
$2,429 |
19.4× |
| CT upper ext wo (73200) |
$2,743 |
$2,743 |
21.9× |
| CT upper extremity with contrast (73201) |
$3,498 |
$3,498 |
8.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$7,208 |
$7,208 |
34.3× |
| Cta Abdomen (74175) |
$5,306 |
$5,306 |
25.2× |
| CTA abdomen pelvis (74174) |
$6,657 |
$6,657 |
15.9× |
| CTA chest (71275) |
$4,732 |
$4,732 |
22.5× |
| Cta Head (70496) |
$4,685 |
$4,685 |
22.3× |
| Cta Neck (70498) |
$4,677 |
$4,677 |
22.2× |
| Cta Pelvis (72191) |
$5,298 |
$5,298 |
25.2× |
| Cystography minimum 3 views rs&i (74430) |
$491 |
$491 |
1.2× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$1,195 |
$1,195 |
4.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$466 |
$466 |
3.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$865 |
$865 |
6.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$710 |
$710 |
5.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$774 |
$774 |
6.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$594 |
$594 |
5.7× |
| Dxa bone density study axial skeleton (77085) |
$1,422 |
$1,422 |
11.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,096 |
$1,096 |
3.8× |
| Esophageal motility (78258) |
$1,833 |
$1,833 |
3.8× |
| Esophagus (74220) |
$1,263 |
$1,263 |
6.0× |
| Facial bones min 3 views (70150) |
$641 |
$641 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$645 |
$645 |
5.1× |
| Fetal Echo (76825) |
$1,713 |
$1,713 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$522 |
$522 |
1.8× |
| Foot 2 views (73620) |
$392 |
$392 |
3.8× |
| Forearm 2 views (73090) |
$404 |
$404 |
3.9× |
| Functional MRI brain by phys/psych (70555) |
$4,285 |
$4,285 |
15.0× |
| Hand 2 views (73120) |
$435 |
$435 |
3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,423 |
$2,423 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,444 |
$2,444 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,901 |
$3,901 |
6.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,869 |
$2,869 |
6.0× |
| Hysterosalpingogram (74740) |
$2,676 |
$2,676 |
9.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$560 |
$560 |
4.5× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$905 |
$905 |
1.9× |
| Kidney imaging morphology (78700) |
$1,526 |
$1,526 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,892 |
$1,892 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,350 |
$1,350 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,999 |
$2,999 |
4.6× |
| Knee 3 views (73562) |
$591 |
$591 |
5.7× |
| Liver & spleen imaging static only (78215) |
$1,762 |
$1,762 |
3.7× |
| Lung perf&ventilat diferentl (78598) |
$2,588 |
$2,588 |
4.0× |
| Lung perfusion differential (78597) |
$1,661 |
$1,661 |
3.5× |
| Lung ventilation imaging (78579) |
$1,642 |
$1,642 |
3.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,477 |
$3,477 |
0.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,687 |
$3,687 |
1.0× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$3,452 |
$3,452 |
1.8× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$3,477 |
$3,477 |
4.6× |
| Lymphoscintigraphy (78195) |
$2,943 |
$2,943 |
4.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$5,136 |
$5,136 |
5.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70558) |
$8,901 |
$8,901 |
42.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70557) |
$6,031 |
$6,031 |
9.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70559) |
$10,143 |
$10,143 |
48.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$5,474 |
$5,474 |
13.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$6,856 |
$6,856 |
16.4× |
| Magnetic Resonance Elastography (76391) |
$2,962 |
$2,962 |
10.4× |
| Mr safety determination physician/other qhp (76016) |
$793 |
$793 |
7.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$192 |
$192 |
5.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$1,399 |
$1,399 |
12.3× |
| Mr safety implt pos&/immoblj (76019) |
$2,140 |
$2,140 |
30.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$3,335 |
$3,335 |
11.7× |
| MRA head w & w/o contrast (70546) |
$8,098 |
$8,098 |
19.4× |
| MRA head w/o contrast (70544) |
$5,288 |
$5,288 |
18.5× |
| MRA head with contrast (70545) |
$5,230 |
$5,230 |
12.5× |
| MRA neck w contrast (70548) |
$5,626 |
$5,626 |
13.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$8,156 |
$8,156 |
19.5× |
| MRA neck w/o contrast (70547) |
$5,317 |
$5,317 |
18.6× |
| MRI abdomen w contrast (74182) |
$6,139 |
$6,139 |
14.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,874 |
$6,874 |
16.4× |
| MRI abdomen w/o contrast (74181) |
$4,466 |
$4,466 |
15.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,218 |
$5,218 |
5.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,390 |
$6,390 |
15.3× |
| MRI c-spine with contrast (72142) |
$4,378 |
$4,378 |
10.5× |
| MRI cardiac w/o cont stress (75559) |
$6,310 |
$6,310 |
9.6× |
| MRI cardiac w/o contrast (75557) |
$4,273 |
$4,273 |
14.9× |
| MRI cervical spine w/o contrast (72141) |
$2,787 |
$2,787 |
9.7× |
| MRI chest w/o & w/contrast material (71552) |
$7,958 |
$7,958 |
19.0× |
| MRI chest w/o contrast (71550) |
$5,743 |
$5,743 |
20.1× |
| MRI chest with contrast (71551) |
$6,314 |
$6,314 |
6.7× |
| MRI fetal sngl/1st gestation (74712) |
$3,090 |
$3,090 |
10.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$5,457 |
$5,457 |
13.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$6,850 |
$6,850 |
16.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,049 |
$5,049 |
17.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,367 |
$4,367 |
15.3× |
| MRI orbit face neck w contrast (70542) |
$4,798 |
$4,798 |
11.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,748 |
$5,748 |
13.7× |
| MRI pelvis w/contrast (72196) |
$5,527 |
$5,527 |
13.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,862 |
$6,862 |
16.4× |
| MRI pelvis w/o contrast (72195) |
$5,113 |
$5,113 |
17.9× |
| MRI spectroscopy (76390) |
$6,151 |
$6,151 |
59.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,926 |
$4,926 |
11.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,308 |
$4,308 |
10.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,897 |
$4,897 |
11.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,338 |
$4,338 |
10.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,938 |
$4,938 |
11.8× |
| MRI temporomandibular joint (70336) |
$4,192 |
$4,192 |
14.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,793 |
$2,793 |
9.8× |
| MRI up ext w/o contrast (73218) |
$5,183 |
$5,183 |
18.1× |
| MRI upper ext joint w/o contrast (73221) |
$3,137 |
$3,137 |
11.0× |
| MRI, joint upper extrem combo (73223) |
$6,401 |
$6,401 |
15.3× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$3,216 |
$3,216 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,893 |
$3,893 |
2.5× |
| Myocardial spect single study at rest or stress (78451) |
$2,726 |
$2,726 |
1.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,641 |
$4,641 |
2.7× |
| Neck soft tissue (70360) |
$423 |
$423 |
4.1× |
| Nm cisternogram (78630) |
$3,029 |
$3,029 |
4.7× |
| Nm gastric emptying study (78264) |
$2,910 |
$2,910 |
6.1× |
| Nonvascular shunt X-ray (75809) |
$2,158 |
$2,158 |
17.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$17,137 |
$17,137 |
10.3× |
| Nuclear Rx Oral Admin (79005) |
$580 |
$580 |
2.1× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$637 |
$637 |
5.1× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$994 |
$994 |
7.9× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$1,107 |
$1,107 |
8.8× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$767 |
$767 |
4.8× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$96 |
$96 |
2.8× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$558 |
$558 |
4.5× |
| Orthopantogram (70355) |
$250 |
$250 |
2.4× |
| Osseous survey limited (77074) |
$833 |
$833 |
6.6× |
| Parathyroid Planar Imaging (78070) |
$2,551 |
$2,551 |
5.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,906 |
$2,906 |
6.1× |
| Pelvis 1 or 2 views (72170) |
$367 |
$367 |
2.9× |
| Perineogram (74775) |
$1,312 |
$1,312 |
4.6× |
| PET image w/CT, skull-thigh (78815) |
$5,883 |
$5,883 |
3.4× |
| PET imaging CT for attenuation limited area (78814) |
$4,282 |
$4,282 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$8,894 |
$8,894 |
5.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,877 |
$1,877 |
1.2× |
| PET whole body (78813) |
$6,646 |
$6,646 |
3.9× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$3,740 |
$3,740 |
2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,688 |
$2,688 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,688 |
$2,688 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$659 |
$659 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$522 |
$522 |
5.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$386 |
$386 |
3.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$454 |
$454 |
4.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$572 |
$572 |
5.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,033 |
$1,033 |
8.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,176 |
$1,176 |
9.4× |
| Radex fingr minimum 2 views (73140) |
$591 |
$591 |
5.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$485 |
$485 |
4.7× |
| Radex Hand Minimum 3 Views (73130) |
$541 |
$541 |
5.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$454 |
$454 |
4.4× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$883 |
$883 |
7.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$572 |
$572 |
4.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$877 |
$877 |
7.0× |
| Radex Humerus Minimum 2 Views (73060) |
$454 |
$454 |
4.4× |
| Radex Kne 1/2 Views (73560) |
$485 |
$485 |
4.7× |
| Radex Kne Compl 4/More Views (73564) |
$678 |
$678 |
5.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$591 |
$591 |
4.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$547 |
$547 |
5.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$560 |
$560 |
4.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$479 |
$479 |
4.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$448 |
$448 |
4.3× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$560 |
$560 |
4.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$778 |
$778 |
7.5× |
| Radex Toe Minimum 2 Views (73660) |
$423 |
$423 |
4.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$442 |
$442 |
3.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$616 |
$616 |
5.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,462 |
$1,462 |
11.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,600 |
$7,600 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$2,435 |
$2,435 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$398 |
$398 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$560 |
$560 |
4.5× |
| Radiologic exam chest 2 views (71046) |
$452 |
$452 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$1,910 |
$1,910 |
9.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,760 |
$1,760 |
8.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,543 |
$1,543 |
7.3× |
| Radiologic examination femur 1 view (73551) |
$404 |
$404 |
3.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$448 |
$448 |
4.3× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$1,636 |
$1,636 |
15.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,364 |
$2,364 |
4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,876 |
$5,876 |
9.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,674 |
$2,674 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,239 |
$3,239 |
5.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,156 |
$6,156 |
4.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,918 |
$7,918 |
4.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,024 |
$4,024 |
2.6× |
| Rp Therapy Intravenous Administration (79101) |
$602 |
$602 |
2.2× |
| Salivary gland function study (78232) |
$939 |
$939 |
2.0× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$935 |
$935 |
2.0× |
| Scapula (73010) |
$286 |
$286 |
2.3× |
| Shoulder 1 view (73020) |
$267 |
$267 |
2.6× |
| Simulation intermediate (77285) |
$2,007 |
$2,007 |
4.5× |
| Small bowel series (74250) |
$1,530 |
$1,530 |
7.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$985 |
$985 |
2.2× |
| Special Physics Consult (77370) |
$1,248.50 |
$1,248.50 |
7.8× |
| Special treatment procedure (77470) |
$2,851 |
$2,851 |
4.3× |
| Spine thoracic 3 views (72072) |
$535 |
$535 |
4.3× |
| Spleen imaging only (78185) |
$1,537 |
$1,537 |
3.2× |
| Stereotactic Body Radiation Delivery (77373) |
$3,463 |
$3,463 |
1.6× |
| Superior sagittal sinus venogram (75870) |
$3,494 |
$3,494 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,374 |
$1,374 |
3.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,435 |
$4,435 |
9.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,521 |
$1,521 |
9.4× |
| Thoracolumbar 2 views (72080) |
$460 |
$460 |
4.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,704 |
$2,704 |
4.2× |
| Thyroid uptake measurement (78012) |
$812 |
$812 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,139 |
$2,139 |
4.5× |
| Tmj unilateral (70328) |
$479 |
$479 |
4.6× |
| Treatment device complex (77334) |
$1,380 |
$1,380 |
3.1× |
| Treatment device intermediate (77333) |
$550 |
$550 |
3.4× |
| Treatment devices simple (77332) |
$666 |
$666 |
4.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,533 |
$1,533 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$766 |
$766 |
6.1× |
| Umbilical-artery Doppler (OB) (76820) |
$446 |
$446 |
3.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,012 |
$1,012 |
9.7× |
| Unlisted fluoroscopic procedure (76496) |
$1,843.50 |
$1,843.50 |
17.7× |
| Unlisted gastrointestinal px dx nuclear medicine (78299) |
$3,523 |
$3,523 |
7.4× |
| Unlisted magnetic resonance procedure (76498) |
$18,507 |
$18,507 |
177.5× |
| Unlisted ultrasound procedure (76999) |
$1,362 |
$1,362 |
13.1× |
| Ureteral reflux study (78740) |
$2,046 |
$2,046 |
4.3× |
| Urethrocystogram voiding (74455) |
$1,605 |
$1,605 |
5.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,605 |
$1,605 |
5.6× |
| Us breast unilateral limited (76642) |
$680 |
$680 |
6.5× |
| Us chest (76604) |
$701 |
$701 |
5.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$6,091 |
$6,091 |
23.5× |
| Us compl joint r-t w/image documentation (76881) |
$139 |
$139 |
1.1× |
| Us elastography parenchyma (76981) |
$1,005 |
$1,005 |
8.0× |
| Us encephalogram (76506) |
$1,031 |
$1,031 |
8.2× |
| Us hips infant static (76886) |
$905 |
$905 |
8.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$411 |
$411 |
3.3× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$195 |
$195 |
1.6× |
| Us ob detailed single fetus (76811) |
$1,147 |
$1,147 |
4.0× |
| Us ob limited (76815) |
$650 |
$650 |
5.2× |
| Us ob transvaginal (76817) |
$732 |
$732 |
5.8× |
| Us pelvic non ob complete (76856) |
$940 |
$940 |
7.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$446 |
$446 |
3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$905 |
$905 |
7.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$888 |
$888 |
7.1× |
| Us retroperitoneal complete (76770) |
$948 |
$948 |
7.6× |
| Us retroperitoneal limited (76775) |
$433 |
$433 |
3.5× |
| Us scrotum and contents (76870) |
$905 |
$905 |
7.2× |
| Us soft tissue head/neck (76536) |
$1,074 |
$1,074 |
8.6× |
| Us spinal canal and contents (76800) |
$1,533 |
$1,533 |
12.2× |
| Us transrectal (76872) |
$2,135 |
$2,135 |
17.0× |
| Us, eye b-scan (76512) |
$462 |
$462 |
3.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,433 |
$1,433 |
11.4× |
| Venogram extremity bilateral (75822) |
$2,247 |
$2,247 |
1.2× |
| Venogram Extremity Unilateral (75820) |
$2,110 |
$2,110 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$2,110 |
$2,110 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$2,266 |
$2,266 |
1.2× |
| Venography Renal Bilateral (75833) |
$2,558 |
$2,558 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,299 |
$2,299 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,485 |
$2,485 |
0.7× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,972 |
$2,972 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$909 |
$909 |
8.7× |
| Wrist 2 views (73100) |
$479 |
$479 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$647 |
$647 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$373 |
$373 |
3.6× |
| X-ray b.e. reductn intuss (74283) |
$2,979 |
$2,979 |
14.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$398 |
$398 |
3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$690 |
$690 |
6.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$746 |
$746 |
6.0× |
| X-ray exam of femur 2/> (73552) |
$504 |
$504 |
4.8× |
| X-ray eye for foreign body (70030) |
$454 |
$454 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$417 |
$417 |
4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$560 |
$560 |
5.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$591 |
$591 |
5.7× |
| X-ray leg, infant (73592) |
$442 |
$442 |
4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$541 |
$541 |
4.3× |
| X-ray nose-rectum child f.b. (76010) |
$386 |
$386 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$641 |
$641 |
5.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$485 |
$485 |
4.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$547 |
$547 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$690 |
$690 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$535 |
$535 |
4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$454 |
$454 |
4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$510 |
$510 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$585 |
$585 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$510 |
$510 |
4.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$311 |
$311 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$572 |
$572 |
5.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$448 |
$448 |
4.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$435 |
$435 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$616 |
$616 |
4.9× |
| Xr bone length studies (77073) |
$603 |
$603 |
4.8× |
| Xr c-spine 4 or 5 views (72050) |
$765 |
$765 |
6.1× |
| Xr c-spine 6 or more views (72052) |
$889 |
$889 |
7.1× |
| Xr chest 4+ views (71048) |
$597 |
$597 |
4.8× |
| Xr urogram antegrade (74425) |
$2,040 |
$2,040 |
4.9× |