| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,591.25 |
$13,701.78 |
6.8× |
| Acute gi blood loss imaging (78278) |
$1,906.25 |
$2,723.21 |
4.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,654.48 |
$6,649.25 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,199.17 |
$7,427.38 |
0.9× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$5,365.39 |
$7,664.83 |
1.7× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$4,569.33 |
$6,527.61 |
1.4× |
| Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736) |
$4,729.81 |
$6,756.87 |
0.8× |
| Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation Age Under 21 (75741) |
$1,279.68 |
$1,828.11 |
0.4× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,361.01 |
$1,944.29 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,514.64 |
$3,592.34 |
0.8× |
| Ankle 2 views (73600) |
$388.97 |
$555.66 |
4.4× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$5,814.13 |
$8,305.89 |
1.8× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$4,667.66 |
$6,668.08 |
1.4× |
| Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605) |
$3,153.70 |
$4,505.28 |
0.6× |
| Aortography, thoracic, without serialography, radiological supervision and interpretation Age Under 21 (75600) |
$3,307.09 |
$4,724.41 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$891.39 |
$1,273.41 |
6.5× |
| Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) |
$2,243.34 |
$3,204.77 |
4.0× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$7,919.51 |
$11,313.58 |
5.4× |
| Card MRI w/stress img & dye (75563) |
$2,563.26 |
$3,661.80 |
3.2× |
| Cardiac MRI morphology & function w/o contrast (75557) |
$990.62 |
$1,415.16 |
4.1× |
| Cardiac MRI w/stress img (75559) |
$1,827.51 |
$2,610.72 |
3.3× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$1,724.20 |
$2,463.14 |
4.8× |
| Clavicle complete (73000) |
$431.05 |
$615.78 |
4.8× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$5,112.12 |
$7,303.02 |
14.3× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$3,280.65 |
$4,686.63 |
18.3× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$3,361.51 |
$4,802.15 |
18.8× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$3,466.16 |
$4,951.65 |
19.3× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$3,624.75 |
$5,178.21 |
20.2× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$3,229.40 |
$4,613.42 |
18.0× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,768.83 |
$3,955.46 |
15.5× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,938.85 |
$4,198.35 |
16.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,899.59 |
$4,142.27 |
16.2× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$2,226.44 |
$3,180.62 |
20.8× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$3,216.15 |
$4,594.50 |
17.9× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$3,228.56 |
$4,612.22 |
18.0× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$2,786.84 |
$3,981.20 |
15.6× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$2,216.68 |
$3,166.68 |
20.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,653.32 |
$3,790.45 |
14.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$2,274.23 |
$3,248.89 |
21.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$3,284.79 |
$4,692.55 |
18.3× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$3,142.68 |
$4,489.53 |
17.5× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$3,250.93 |
$4,644.18 |
18.1× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$3,370.07 |
$4,814.38 |
18.8× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$1,232.91 |
$1,761.30 |
9.0× |
| Csf shunt evaluation (78645) |
$1,515.17 |
$2,164.52 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,934.70 |
$8,478.14 |
16.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,322.15 |
$6,174.50 |
17.7× |
| CT abdomen w & w/o contrast (74170) |
$3,543.85 |
$5,062.63 |
19.8× |
| CT abdomen w/contrast (74160) |
$2,962.93 |
$4,232.75 |
16.5× |
| CT abdomen w/o contrast (74150) |
$2,498.35 |
$3,569.06 |
23.4× |
| CT angio hrt w/3d image (75574) |
$2,533 |
$3,618.56 |
7.1× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$420 |
$600 |
2.3× |
| CT cervical spine w/contrast (72126) |
$2,960.42 |
$4,229.16 |
8.3× |
| CT cervical spine w/o contrast (72125) |
$2,679.32 |
$3,827.59 |
25.1× |
| CT chest w/contrast (71260) |
$2,887.78 |
$4,125.40 |
16.1× |
| CT extremity upper w & w/o contrast (73202) |
$2,894.03 |
$4,134.32 |
16.1× |
| CT extremity upper w/o contrast (73200) |
$2,214.71 |
$3,163.87 |
20.7× |
| CT head/brain with contrast (70460) |
$2,603.86 |
$3,719.80 |
14.5× |
| CT head/brain without and with contrast (70470) |
$3,071.88 |
$4,388.39 |
17.1× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$2,910.61 |
$4,158.01 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,812.02 |
$2,588.60 |
5.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$242.51 |
$346.44 |
2.7× |
| CT l-spine w/contrast (72132) |
$3,115 |
$4,449.99 |
8.7× |
| CT limited/localized follow up study (76380) |
$971.16 |
$1,387.37 |
10.9× |
| CT lower extremity w/dye (73701) |
$2,450.39 |
$3,500.55 |
13.7× |
| CT lumbar spine w/o contrast (72131) |
$2,699.18 |
$3,855.97 |
25.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,266.64 |
$4,666.62 |
18.2× |
| CT neck w/contrast (70491) |
$2,876.92 |
$4,109.88 |
16.1× |
| CT neck w/o contrast (70490) |
$2,268.42 |
$3,240.59 |
21.2× |
| CT pelvis w & w/o contrast (72194) |
$3,435.91 |
$4,908.43 |
19.2× |
| CT pelvis w/o contrast (72192) |
$2,327.95 |
$3,325.64 |
21.8× |
| CT thoracic spine w/contrast (72129) |
$2,746.48 |
$3,923.53 |
15.3× |
| CT thoracic spine w/o contrast (72128) |
$2,573.65 |
$3,676.63 |
24.1× |
| CT thorax lung cancer scr c- (71271) |
$231.82 |
$331.17 |
2.2× |
| CT thorax w/o contrast (71250) |
$2,206.20 |
$3,151.71 |
20.7× |
| CT upper extremity w/dye (73201) |
$2,657.20 |
$3,795.99 |
7.5× |
| CTA h&n c+ w/noncontrast img (70471) |
$4,550 |
$6,500 |
12.8× |
| CTA head w contrast (70496) |
$3,361.64 |
$4,802.32 |
18.8× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$658.95 |
$941.35 |
1.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Age Under 21 (70170) |
$478.96 |
$684.22 |
2.0× |
| Dilation ureters/urethra rs&i (74485) |
$1,783.64 |
$2,548.05 |
0.8× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$2,840.17 |
$4,057.38 |
1.4× |
| Diskography lumbar s&i (72295) |
$2,852.34 |
$4,074.76 |
1.4× |
| Doppler fetal mid cerebral artery (76821) |
$321.98 |
$459.97 |
3.0× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$528.66 |
$755.22 |
4.9× |
| Dxa bone density/peripheral (77081) |
$240.27 |
$343.24 |
2.7× |
| Fetal biophys profile w/o nst (76819) |
$733.01 |
$1,047.15 |
6.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$752.83 |
$1,075.46 |
3.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,092.24 |
$2,988.91 |
3.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$1,576.90 |
$2,252.71 |
3.9× |
| Gated heart planar single (78472) |
$1,941.26 |
$2,773.22 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,227.32 |
$7,467.59 |
7.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,225.86 |
$7,465.51 |
7.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,824.10 |
$6,891.56 |
6.8× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$2,581.46 |
$3,687.80 |
4.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,247.42 |
$3,210.60 |
5.5× |
| Ht muscle image spect sing (78451) |
$3,686.84 |
$5,266.91 |
2.8× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$559.59 |
$799.41 |
1.4× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$8,353.07 |
$11,932.95 |
5.9× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$5,978.82 |
$8,541.17 |
8.4× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,218.81 |
$1,741.15 |
3.0× |
| Intracavitary radiation source application - complex (77763) |
$2,293.49 |
$3,276.41 |
3.2× |
| Intracavitary radiation source application - intermediate (77762) |
$1,615.49 |
$2,307.84 |
2.9× |
| Intracavitary radiation source application - simple (77761) |
$1,089.49 |
$1,556.41 |
1.9× |
| Isodose brachytherapy complex 10+ sources (77318) |
$3,136.95 |
$4,481.35 |
8.2× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$2,442.68 |
$3,489.53 |
6.4× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$1,944.09 |
$2,777.27 |
5.1× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$4,784.70 |
$6,835.28 |
12.5× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$3,046.15 |
$4,351.64 |
8.0× |
| Kidney imaging morphol - nm kidney cortex (78700) |
$1,603.29 |
$2,290.41 |
3.9× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$2,180.38 |
$3,114.82 |
3.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$2,052.62 |
$2,932.31 |
3.7× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$2,346.50 |
$3,352.13 |
4.2× |
| Liver and spleen imaging (78215) |
$1,728.35 |
$2,469.06 |
4.2× |
| Liver imaging (78201) |
$1,483.09 |
$2,118.70 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$2,116.38 |
$3,023.39 |
3.8× |
| Lung perfusion imaging (78580) |
$1,611.66 |
$2,302.37 |
3.9× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$4,479.40 |
$6,399.13 |
12.6× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$3,441.79 |
$4,916.83 |
9.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$3,027.04 |
$4,324.34 |
12.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$4,358.50 |
$6,226.42 |
12.2× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$3,314.76 |
$4,735.36 |
9.3× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$3,147.68 |
$4,496.68 |
12.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$3,314.76 |
$4,735.36 |
9.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,207.05 |
$6,010.07 |
11.8× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$3,264.05 |
$4,662.92 |
9.2× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$4,184.35 |
$5,977.63 |
11.7× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$4,007.22 |
$5,724.59 |
11.2× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$625.69 |
$893.83 |
2.6× |
| Mammary ductogram single (77053) |
$526.76 |
$752.51 |
2.2× |
| Mandible min 4v (70110) |
$344.26 |
$491.79 |
3.2× |
| Mr safety determination physician/other qhp (76016) |
$154 |
$220 |
1.7× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$105 |
$150 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$55.13 |
$78.75 |
1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$161 |
$230 |
1.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$420 |
$600 |
1.7× |
| MRA head w/o contrast (70544) |
$3,017.66 |
$4,310.94 |
12.4× |
| MRA neck w/ contrast (70548) |
$3,333.80 |
$4,762.57 |
9.4× |
| MRA neck w/o contrast (70547) |
$3,010.41 |
$4,300.58 |
12.3× |
| MRI abdomen w/contrast (74182) |
$3,529.15 |
$5,041.64 |
9.9× |
| MRI abdomen w/o contrast (74181) |
$3,321.42 |
$4,744.88 |
13.6× |
| MRI abdomen w/wo contrast (74183) |
$4,657.17 |
$6,653.09 |
13.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,488.57 |
$4,983.66 |
4.4× |
| MRI breast c- bilateral (77047) |
$768.58 |
$1,097.96 |
3.2× |
| MRI breast without contrast material unilateral (77046) |
$768.58 |
$1,097.96 |
3.2× |
| MRI c-spine w&w/o cont (72156) |
$4,650.76 |
$6,643.93 |
13.0× |
| MRI cervical spine w/contrast (72142) |
$3,432.06 |
$4,902.93 |
9.6× |
| MRI chest w/contrast (71551) |
$1,960.29 |
$2,800.41 |
2.4× |
| MRI chest w/o contrast (71550) |
$2,117.97 |
$3,025.66 |
8.7× |
| MRI chest w/wo contrast (71552) |
$4,892.31 |
$6,989.01 |
13.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,207 |
$6,009.99 |
11.8× |
| MRI joint upr extrem w/dye (73222) |
$3,316.83 |
$4,738.32 |
4.1× |
| MRI joint upr extrem w/o dye (73221) |
$3,014.53 |
$4,306.46 |
12.4× |
| MRI lumbar spine w/contrast (72149) |
$3,606.39 |
$5,151.98 |
10.1× |
| MRI lumbar spine w/wo contrast (72158) |
$4,638.03 |
$6,625.75 |
13.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,869.65 |
$6,956.63 |
13.7× |
| MRI pelvis w & w/o contrast (72197) |
$4,904.86 |
$7,006.93 |
13.8× |
| MRI pelvis w/contrast (72196) |
$3,329.80 |
$4,756.85 |
9.3× |
| MRI pelvis w/o contrast (72195) |
$3,182.22 |
$4,546.02 |
13.1× |
| MRI spine cervical w/o contrast (72141) |
$3,131.05 |
$4,472.92 |
12.8× |
| MRI t-spine w&w/o cont (72157) |
$4,815.13 |
$6,878.75 |
13.5× |
| MRI thoracic spine w/contrast (72147) |
$3,500.42 |
$5,000.59 |
9.8× |
| MRI thoracic spine w/o contrst (72146) |
$3,171.80 |
$4,531.14 |
13.0× |
| MRI tmj (70336) |
$2,739.57 |
$3,913.66 |
11.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,757.51 |
$3,939.30 |
11.3× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$1,224.32 |
$1,749.02 |
3.2× |
| Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) |
$2,126.92 |
$3,038.45 |
2.7× |
| Myocardial spect multiple studies (78452) |
$5,392.42 |
$7,703.45 |
4.1× |
| Myocrd img PET 2rtracer CT (78433) |
$5,325.08 |
$7,607.25 |
2.4× |
| Myocrd img PET metab eval single study (78459) |
$5,432.63 |
$7,760.89 |
4.1× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,175.98 |
$5,965.68 |
2.9× |
| Myocrd img PET rst&strs CT (78431) |
$7,717.50 |
$11,025 |
3.4× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$1,558.20 |
$2,226 |
1.8× |
| Nm bone 3 phase (78315) |
$2,466.29 |
$3,523.27 |
6.0× |
| Nm bone imaging whole body (78306) |
$2,461.23 |
$3,516.04 |
6.0× |
| Nm bone marrow wb (78104) |
$975.89 |
$1,394.12 |
2.4× |
| Nm csf cisternogram (78630) |
$1,723.63 |
$2,462.32 |
3.1× |
| Nm gastric emptying (78264) |
$2,283.26 |
$3,261.79 |
5.6× |
| Nm lung ventilation imaging (78579) |
$1,352.72 |
$1,932.45 |
3.3× |
| Nm lymph system (78195) |
$2,079.78 |
$2,971.11 |
3.7× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,252.72 |
$1,789.59 |
3.1× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$1,734.35 |
$2,477.64 |
4.2× |
| Nuclear medicine study of salivary gland function (78232) |
$720.68 |
$1,029.54 |
1.8× |
| Ob us limited fetus(s) (76815) |
$365.08 |
$521.54 |
3.4× |
| Ob us nuchal meas 1 gest (76813) |
$270.12 |
$385.88 |
2.5× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$125.06 |
$178.65 |
1.2× |
| Panoramic X-ray of jaws (70355) |
$338.26 |
$483.22 |
3.8× |
| Parathyrd planar w/spect&CT (78072) |
$2,099.77 |
$2,999.66 |
3.8× |
| Parathyroid planar imaging (78070) |
$1,883.23 |
$2,690.32 |
4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,198.80 |
$11,712.56 |
5.6× |
| PET imaging CT for attenuation limited area (78814) |
$7,420.12 |
$10,600.16 |
5.1× |
| PET imaging for CT attenuation whole body (78816) |
$8,151.78 |
$11,645.39 |
5.6× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,226.59 |
$3,180.83 |
4.0× |
| Quan&char c athrosclrtc plaq (75577) |
$2,352 |
$3,360 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$665.59 |
$950.83 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$432.35 |
$617.64 |
4.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$761.80 |
$1,088.28 |
7.1× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$1,235.96 |
$1,765.65 |
11.6× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$1,235.96 |
$1,765.65 |
11.6× |
| Radex hip unilateral with pelvis 1 view (73501) |
$226.50 |
$323.56 |
2.5× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$277.93 |
$397.03 |
3.1× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$276.17 |
$394.52 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$320.23 |
$457.47 |
3.0× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$564.60 |
$806.56 |
5.3× |
| Radex spine cervical 2 or 3 views (72040) |
$510.53 |
$729.32 |
5.7× |
| Radex spine cervical 4 or 5 views (72050) |
$702.06 |
$1,002.93 |
6.6× |
| Radex spine cervical 6 or more views (72052) |
$780.24 |
$1,114.62 |
7.3× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$322.19 |
$460.27 |
3.6× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) |
$19,025.71 |
$27,179.58 |
2.5× |
| Radiation tx delivery lvl 1 (77402) |
$833.76 |
$1,191.08 |
8.0× |
| Radiation tx delivery lvl 2 (77407) |
$1,824.39 |
$2,606.26 |
4.6× |
| Radiation tx delivery lvl 3 (77412) |
$2,569.66 |
$3,670.94 |
4.6× |
| Radiologic exam abdomen 3+ views (74021) |
$423.45 |
$604.92 |
4.0× |
| Radiologic exam chest 3 views (71047) |
$409.68 |
$585.25 |
4.6× |
| Radiologic exam chest 4+ views (71048) |
$455.12 |
$650.17 |
4.3× |
| Radiologic exam colon double contrast study (74280) |
$1,186.22 |
$1,694.60 |
6.6× |
| Radiologic exam colon single contrast study (74270) |
$1,071.31 |
$1,530.43 |
6.0× |
| Radiologic exam esophagus double contrast study (74221) |
$682.11 |
$974.44 |
3.8× |
| Radiologic exam esophagus single contrast study (74220) |
$756.45 |
$1,080.64 |
4.2× |
| Radiologic exam small int single contrast study (74250) |
$864.53 |
$1,235.04 |
4.8× |
| Radiologic exam swallow function contrast study (74230) |
$647.96 |
$925.65 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$801.76 |
$1,145.36 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$954.92 |
$1,364.18 |
5.3× |
| Radiologic examination femur 1 view (73551) |
$209.73 |
$299.61 |
2.4× |
| Radiologic examination femur minimum 2 views (73552) |
$206.60 |
$295.13 |
2.3× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$256.22 |
$366.02 |
2.9× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$483.02 |
$690.02 |
5.4× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$662.73 |
$946.75 |
6.2× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$403.82 |
$576.88 |
4.5× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$494.01 |
$705.72 |
5.6× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$373.78 |
$533.96 |
4.2× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$454.65 |
$649.50 |
5.1× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$479.04 |
$684.33 |
5.4× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$276.15 |
$394.50 |
3.1× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$555.48 |
$793.54 |
5.2× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$421.65 |
$602.35 |
4.7× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$490.73 |
$701.03 |
5.5× |
| Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and… (74470) |
$895.22 |
$1,278.88 |
1.6× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$761.88 |
$1,088.40 |
7.1× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$574.03 |
$820.04 |
5.4× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$1,207.99 |
$1,725.69 |
3.4× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$484.81 |
$692.58 |
5.5× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$323.05 |
$461.49 |
3.6× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$479.11 |
$684.43 |
4.5× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$523.62 |
$748.02 |
4.9× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$867.53 |
$1,239.32 |
8.1× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$444.13 |
$634.46 |
4.2× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$453.99 |
$648.55 |
5.1× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$393.35 |
$561.92 |
4.4× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$339.97 |
$485.66 |
3.8× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$287.35 |
$410.50 |
3.2× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$504.03 |
$720.03 |
4.7× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Age Under 21 (70370) |
$496.47 |
$709.23 |
5.6× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$161.70 |
$231 |
1.8× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$363.13 |
$518.75 |
4.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$328.70 |
$469.56 |
3.1× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$3,034.16 |
$4,334.51 |
5.5× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$952.31 |
$1,360.44 |
4.0× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$1,103.12 |
$1,575.88 |
4.6× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$1,798.42 |
$2,569.16 |
7.5× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion (79403) |
$1,891.55 |
$2,702.21 |
7.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$707.95 |
$1,011.35 |
1.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$707.95 |
$1,011.35 |
1.8× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$1,018.18 |
$1,454.54 |
4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,629.49 |
$2,327.83 |
4.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,988.58 |
$2,840.82 |
4.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,982.36 |
$5,689.08 |
7.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,501.54 |
$3,573.62 |
4.5× |
| Rp loclzj tum spect 2 areas (78831) |
$2,501.54 |
$3,573.62 |
1.9× |
| Rp loclzj tum spect w/CT 1 (78830) |
$2,254.54 |
$3,220.76 |
1.7× |
| Rp loclzj tum spect w/CT 2 (78832) |
$2,543.63 |
$3,633.75 |
1.7× |
| Scapula complete (73010) |
$453.93 |
$648.46 |
4.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$640.19 |
$914.55 |
6.0× |
| Simulation intermediate (77285) |
$3,905.30 |
$5,578.99 |
10.2× |
| Special dosimetry (77331) |
$420.56 |
$600.80 |
3.1× |
| Special physics consult (77370) |
$1,336.74 |
$1,909.62 |
9.7× |
| Special teletherapy port plan (77321) |
$2,447.39 |
$3,496.26 |
6.4× |
| Special treatment procedure (77470) |
$6,506.13 |
$9,294.46 |
11.5× |
| Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) |
$11,728.68 |
$16,755.26 |
6.4× |
| Surface application of low dose rate radionuclide source (77789) |
$137.13 |
$195.90 |
1.3× |
| Testicular imaging with vascular flow Age Under 21 (78761) |
$1,329.30 |
$1,898.99 |
3.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,880.33 |
$5,543.32 |
10.1× |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$819.55 |
$1,170.78 |
4.6× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Age Under 21 (78015) |
$1,459.79 |
$2,085.41 |
3.6× |
| Thyroid imaging with vascular flow (78013) |
$693.75 |
$991.06 |
1.7× |
| Thyroid met imaging body (78018) |
$2,519.66 |
$3,599.51 |
4.5× |
| Thyroid uptake single/multiple quant measurement (78012) |
$802.22 |
$1,146.02 |
2.0× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,577.94 |
$2,254.20 |
3.9× |
| Tr simulation simple (77280) |
$2,695.64 |
$3,850.91 |
19.6× |
| Treatment device complex (77334) |
$1,763.16 |
$2,518.80 |
4.6× |
| Treatment device intermediate (77333) |
$951.67 |
$1,359.52 |
6.9× |
| Treatment device simple (77332) |
$795.37 |
$1,136.24 |
5.8× |
| Ultrasound breast limited (76642) |
$494.73 |
$706.75 |
5.6× |
| Ultrasound, abdomen limited (76705) |
$520.24 |
$743.20 |
4.9× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$355.84 |
$508.34 |
3.3× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$1,028.45 |
$1,469.21 |
9.6× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$823.32 |
$1,176.17 |
7.7× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$940.22 |
$1,343.16 |
8.8× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$824.67 |
$1,178.09 |
7.7× |
| Umbilical-artery Doppler (OB) (76820) |
$423.08 |
$604.40 |
4.0× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$2,462.02 |
$3,517.17 |
27.7× |
| Unlisted procedure, clinical brachytherapy (77799) |
$1,359.92 |
$1,942.73 |
13.0× |
| Ureteral reflux study (78740) |
$1,465.64 |
$2,093.77 |
3.6× |
| Urethrocystography retrograde rs&i (74450) |
$992.20 |
$1,417.42 |
4.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$1,254.36 |
$1,791.93 |
7.0× |
| Urography antegrade rs&i (74425) |
$1,014.40 |
$1,449.14 |
2.8× |
| Us abdominal aorta real time screen study aaa (76706) |
$316.08 |
$451.54 |
3.0× |
| Us breast uni real time with image complete (76641) |
$596.98 |
$852.82 |
5.6× |
| Us chest (76604) |
$393.16 |
$561.65 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$487.99 |
$697.12 |
4.6× |
| Us encephalogram (76506) |
$637.47 |
$910.67 |
6.0× |
| Us exam, pelvic, limited (76857) |
$371.54 |
$530.76 |
3.5× |
| Us guided compression repair (76936) |
$1,145.41 |
$1,636.30 |
5.2× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$652.75 |
$932.49 |
7.3× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$1,305.89 |
$1,865.55 |
14.7× |
| US OB Follow-Up/Repeat (76816) |
$560.56 |
$800.79 |
5.2× |
| Us ob transvaginal (76817) |
$424.53 |
$606.46 |
4.0× |
| Us retroperitoneal complete (76770) |
$1,026.53 |
$1,466.46 |
9.6× |
| Us retroperitoneal ltd (76775) |
$342.13 |
$488.75 |
3.2× |
| Us scrotum (76870) |
$536.55 |
$766.49 |
5.0× |
| Us soft tissue head/neck (76536) |
$511.36 |
$730.51 |
4.8× |
| Us spinal canal (76800) |
$668.63 |
$955.18 |
6.3× |
| Us transrectal (76872) |
$835.92 |
$1,194.17 |
7.8× |
| Venogram sinus/jugular (75860) |
$2,006.90 |
$2,866.99 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$3,617.70 |
$5,168.14 |
1.1× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$3,396.45 |
$4,852.06 |
1.1× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$3,144.31 |
$4,491.87 |
2.0× |
| Venography, epidural, radiological supervision and interpretation Age Under 21 (75872) |
$1,015.35 |
$1,450.50 |
1.6× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$2,407.38 |
$3,439.11 |
1.5× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$2,024.59 |
$2,892.26 |
1.3× |
| X-ray exam hips bi 3-4 views (73522) |
$291.58 |
$416.54 |
2.7× |
| X-ray exam of finger(s) (73140) |
$363.01 |
$518.58 |
4.1× |
| X-ray exam of knee 1 or 2 (73560) |
$396.92 |
$567.02 |
4.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,467.79 |
$2,096.84 |
8.2× |
| X-ray exam ribs bil 3 views (71110) |
$603.38 |
$861.97 |
5.6× |
| X-ray exam ribs uni 2 views (71100) |
$449.98 |
$642.82 |
5.1× |
| X-ray heel (73650) |
$386.50 |
$552.14 |
4.3× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$450.13 |
$643.04 |
4.2× |
| X-ray retrograde pyelogram (74420) |
$987.14 |
$1,410.19 |
2.8× |
| Xr abdomen 1 view (74018) |
$400.25 |
$571.78 |
4.5× |
| Xr abdomen 2 views (74019) |
$473.03 |
$675.75 |
4.4× |
| Xr arthrogram ankle (73615) |
$986.11 |
$1,408.72 |
2.8× |
| Xr arthrogram elbow (73085) |
$824.79 |
$1,178.27 |
2.3× |
| Xr arthrogram hip (73525) |
$1,152.12 |
$1,645.88 |
3.2× |
| Xr arthrogram knee (73580) |
$790.79 |
$1,129.70 |
2.2× |
| Xr arthrogram wrist (73115) |
$768.53 |
$1,097.89 |
2.2× |
| Xr bone age studies (77072) |
$436.70 |
$623.85 |
4.1× |
| Xr bone length study (77073) |
$539.37 |
$770.52 |
5.0× |
| Xr bone survey infant (77076) |
$529.61 |
$756.58 |
5.0× |
| Xr chest 1 view (71045) |
$288.98 |
$412.82 |
3.3× |
| Xr chest 2 views (71046) |
$452.11 |
$645.86 |
5.1× |
| Xr eye foreign body (70030) |
$341.86 |
$488.36 |
3.8× |
| Xr facial bones 3+ views (70150) |
$563.34 |
$804.77 |
5.3× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$373.10 |
$532.99 |
4.2× |
| Xr forearm 2 views (73090) |
$440.54 |
$629.33 |
5.0× |
| Xr hand 2v (73120) |
$409.71 |
$585.29 |
3.8× |
| Xr hysterosalpingogram (74740) |
$1,062.82 |
$1,518.31 |
4.4× |
| Xr myelogram c-spine (72240) |
$1,929.62 |
$2,756.59 |
2.4× |
| Xr myelogram l-spine (72265) |
$1,748.56 |
$2,497.94 |
2.2× |
| Xr myelogram t-spine (72255) |
$1,475.91 |
$2,108.44 |
1.8× |
| Xr neck soft tissue (70360) |
$424.77 |
$606.81 |
4.8× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$496.35 |
$709.06 |
5.6× |
| Xr osseous survey complete (77075) |
$1,049.12 |
$1,498.74 |
9.8× |
| Xr pelvis 1-2 views (72170) |
$423.35 |
$604.78 |
4.0× |
| Xr pelvis min 3 view (72190) |
$451.34 |
$644.76 |
4.2× |
| Xr peritoneogram (74190) |
$582.45 |
$832.06 |
1.0× |
| Xr sacrum/coccyx 2+ views (72220) |
$456.54 |
$652.19 |
5.1× |
| Xr shoulder 1 view (73020) |
$342.96 |
$489.94 |
3.9× |
| Xr sinuses 3+ views (70220) |
$589.35 |
$841.92 |
6.6× |
| Xr skull min 4 view (70260) |
$689.99 |
$985.69 |
6.5× |
| Xr spine 1 view (72020) |
$375.15 |
$535.92 |
4.2× |
| Xr spine thoracic 3v (72072) |
$510.54 |
$729.34 |
4.8× |
| Xr sternum 2+ views (71120) |
$406.47 |
$580.66 |
4.6× |
| Xr surgical specimen (76098) |
$611.50 |
$873.57 |
1.1× |
| Xr t-spine 2 views (72070) |
$457.51 |
$653.58 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$455.91 |
$651.29 |
5.1× |
| Xr tmj bilateral (70330) |
$467.81 |
$668.29 |
5.3× |
| Xr tmj unilateral (70328) |
$307.10 |
$438.71 |
3.5× |
| Xr venogram renal bilat (75833) |
$3,500.22 |
$5,000.31 |
1.1× |
| Xr wrist 2 views (73100) |
$392 |
$560 |
4.4× |