| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,402.14 |
$12,546 |
5.2× |
| Abdomen 2 views (74019) |
$402.97 |
$683 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,124.54 |
$1,906 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,171.79 |
$3,681 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,028.52 |
$6,828 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,357.40 |
$5,690.50 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,975.96 |
$5,044 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,641.38 |
$2,782 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,369.39 |
$2,321 |
0.4× |
| Angiography Spinal Selective Rs&I (75705) |
$2,931.12 |
$4,968 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,237.33 |
$5,487 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$961.70 |
$1,630 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,332.22 |
$2,258 |
0.4× |
| Ankle 2 views (73600) |
$263.73 |
$447 |
2.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$713.90 |
$1,210 |
2.0× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,619.01 |
$4,439 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,759.43 |
$4,677 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$3,275.09 |
$5,551 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,100.45 |
$5,255 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$1,641.38 |
$2,782 |
0.5× |
| Arthrogram elbow (73085) |
$571.12 |
$968 |
1.6× |
| Arthrogram hip (73525) |
$1,030.73 |
$1,747 |
2.8× |
| Arthrogram shoulder (73040) |
$886.77 |
$1,503 |
2.4× |
| Arthrogram wrist (73115) |
$853.73 |
$1,447 |
2.4× |
| Arthrography knee lt (73580) |
$854.32 |
$1,448 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$664.34 |
$1,126 |
4.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$824.82 |
$1,398 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$922.17 |
$1,563 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,617.19 |
$2,741 |
3.9× |
| Bone age studies (77072) |
$155.17 |
$263 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,827.82 |
$3,098 |
4.4× |
| Bone survey complete (77075) |
$933.97 |
$1,583 |
8.6× |
| Brachytx isodose complex (77318) |
$2,251.44 |
$3,816 |
5.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,500.37 |
$2,543 |
3.9× |
| Brain image w/flow 4 + views (78606) |
$788.24 |
$1,336 |
1.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$856.68 |
$1,452 |
2.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,103.30 |
$1,870 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,142.39 |
$7,021 |
2.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$539.85 |
$915 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,918.09 |
$3,251 |
5.3× |
| Cardiac shunt detection (78428) |
$489.70 |
$830 |
1.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$724.52 |
$1,228 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$369.93 |
$627 |
4.1× |
| Chest 1 view (71045) |
$202.37 |
$343 |
2.2× |
| Chest 3 views (71047) |
$283.79 |
$481 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$448.40 |
$760 |
2.5× |
| Cineradiography/videoradiography (76120) |
$470.23 |
$797 |
4.3× |
| Clavicle complete (73000) |
$302.08 |
$512 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,239 |
$2,100 |
11.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,008.90 |
$1,710 |
7.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,089.34 |
$8,626 |
14.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,704.56 |
$4,584 |
10.9× |
| CT abdomen w contrast (74160) |
$2,191.85 |
$3,715 |
12.0× |
| CT abdomen w wo contrast (74170) |
$2,449.68 |
$4,152 |
13.4× |
| CT abdomen w/o contrast (74150) |
$1,654.36 |
$2,804 |
15.2× |
| CT angio hrt w/3d image (75574) |
$238.36 |
$404 |
0.7× |
| CT angiography upper extremity lt (73206) |
$2,044.35 |
$3,465 |
11.2× |
| CT c-spine w/o contrast (72125) |
$1,581.79 |
$2,681 |
14.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,803.63 |
$3,057 |
9.9× |
| CT cervical spine with contrast (72126) |
$1,993.02 |
$3,378 |
5.5× |
| CT chest w/wo contrast (71270) |
$1,946.41 |
$3,299 |
10.7× |
| CT chest with contrast (71260) |
$2,211.91 |
$3,749 |
12.1× |
| CT colonography screening (74263) |
$2,793.06 |
$4,734 |
11.3× |
| CT colonography w/dye (74262) |
$1,643.74 |
$2,786 |
9.0× |
| CT colonography w/o cntrst (74261) |
$1,316.29 |
$2,231 |
12.1× |
| CT head/brain with contrast (70460) |
$1,610.70 |
$2,730 |
8.8× |
| CT head/brain without and with contrast (70470) |
$1,923.99 |
$3,261 |
10.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$214.76 |
$364 |
0.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$171.69 |
$291 |
1.9× |
| CT hrt w/3d image congen (75573) |
$214.76 |
$364 |
0.6× |
| CT iac w contrast (70481) |
$2,053.79 |
$3,481 |
11.3× |
| CT limited/localized follow up study (76380) |
$742.81 |
$1,259 |
8.2× |
| CT lower ext w/o (73700) |
$1,422.49 |
$2,411 |
13.1× |
| CT lower extremity w wo contrast (73702) |
$2,050.25 |
$3,475 |
11.3× |
| CT lower extremity with contrast (73701) |
$1,840.80 |
$3,120 |
10.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,011.90 |
$3,410 |
11.0× |
| CT lumbar spine w/o contrast (72131) |
$1,639.61 |
$2,779 |
15.1× |
| CT lumbar spine with contrast (72132) |
$1,910.42 |
$3,238 |
5.3× |
| CT maxillofacial w contrast (70487) |
$1,746.99 |
$2,961 |
9.6× |
| CT maxillofacial w/o contrast (70486) |
$1,370.57 |
$2,323 |
12.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,787.11 |
$3,029 |
9.8× |
| CT neck soft tissue w contrast (70491) |
$1,917.50 |
$3,250 |
10.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,431.98 |
$4,122 |
13.4× |
| CT orbits w/o contrast (70480) |
$1,837.85 |
$3,115 |
16.9× |
| CT pelvis w & w/o contrast (72194) |
$1,182.06 |
$2,003.50 |
6.5× |
| CT pelvis w/o contrast (72192) |
$1,452.58 |
$2,462 |
13.4× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$251.93 |
$427 |
2.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,349.97 |
$3,983 |
12.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,466.74 |
$2,486 |
13.5× |
| CT thoracic spine w/contrast (72129) |
$1,920.45 |
$3,255 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$1,674.42 |
$2,838 |
15.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,936.97 |
$3,283 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,172.33 |
$1,987 |
10.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,124.59 |
$3,601 |
11.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,515.12 |
$2,568 |
14.0× |
| CT upper extremity with contrast (73201) |
$1,767.64 |
$2,996 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,568.27 |
$4,353 |
14.1× |
| Cta Abdomen (74175) |
$3,111.66 |
$5,274 |
17.1× |
| CTA abdomen pelvis (74174) |
$2,614.88 |
$4,432 |
7.2× |
| CTA chest (71275) |
$2,439.65 |
$4,135 |
13.4× |
| Cta Head (70496) |
$1,967.65 |
$3,335 |
10.8× |
| CTA lwr ext w&w/o contrast (73706) |
$2,040.22 |
$3,458 |
11.2× |
| Cta Neck (70498) |
$2,139.93 |
$3,627 |
11.7× |
| Cta Pelvis (72191) |
$1,031.32 |
$1,748 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$538.67 |
$913 |
1.5× |
| Diskography lumbar (72295) |
$2,091.55 |
$3,545 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$367.57 |
$623 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$190.20 |
$322.37 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$425.39 |
$721 |
3.9× |
| Echoencephalography real time imaging (76506) |
$588.23 |
$997 |
5.4× |
| Esophagus (74220) |
$658.44 |
$1,116 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$502.09 |
$851 |
4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$415.36 |
$704 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$481.44 |
$816 |
1.9× |
| Foot 2 views (73620) |
$213.58 |
$362 |
2.4× |
| Forearm 2 views (73090) |
$275.53 |
$467 |
3.0× |
| Functional MRI brain by phys/psych (70555) |
$1,852.01 |
$3,139 |
7.5× |
| Functional MRI brain by tech (70554) |
$1,696.25 |
$2,875 |
6.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$463.15 |
$785 |
0.8× |
| Gated Heart Planar Single (78472) |
$1,581.79 |
$2,681 |
3.8× |
| Hand 2 views (73120) |
$312.70 |
$530 |
2.9× |
| Hand 3 views (73130) |
$359.31 |
$609 |
4.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,419.64 |
$5,796 |
4.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,886.28 |
$4,892 |
4.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,299.18 |
$2,202 |
1.8× |
| Heart Infarct Image (78466) |
$1,054.92 |
$1,788 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,604.80 |
$2,720 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,420.13 |
$2,407 |
3.4× |
| Ht muscle image spect sing (78451) |
$1,657.31 |
$2,809 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$394.12 |
$668 |
4.4× |
| Hysterosalpingogram (74740) |
$914.50 |
$1,550 |
3.7× |
| Interstitial radiation source applic complex (77778) |
$3,489.26 |
$5,914 |
4.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,307.44 |
$2,216 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,465.56 |
$2,484 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,250.21 |
$2,119 |
2.2× |
| Knee 3 views (73562) |
$405.33 |
$687 |
4.5× |
| Liver & spleen imaging static only (78215) |
$690.30 |
$1,170 |
1.7× |
| Liver imaging static only (78201) |
$610.65 |
$1,035 |
1.1× |
| Liver imaging w/vascular flow (78202) |
$849.01 |
$1,439 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$1,516.30 |
$2,570 |
2.7× |
| Lung perfusion differential (78597) |
$801.81 |
$1,359 |
1.9× |
| Lymphoscintigraphy (78195) |
$1,459.66 |
$2,474 |
2.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$153.40 |
$260 |
1.7× |
| Meckels Diverticulum (78290) |
$824.82 |
$1,398 |
2.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,543.54 |
$6,006 |
9.1× |
| Mr safety determination physician/other qhp (76016) |
$72.57 |
$123 |
0.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$48.97 |
$83 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$20.06 |
$34 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$76.11 |
$129 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$199.42 |
$338 |
0.8× |
| MRA head w & w/o contrast (70546) |
$3,655.64 |
$6,196 |
10.1× |
| MRA head w/o contrast (70544) |
$2,502.19 |
$4,241 |
10.1× |
| MRA head with contrast (70545) |
$2,575.94 |
$4,366 |
7.1× |
| MRA neck w contrast (70548) |
$2,112.20 |
$3,580 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,708.10 |
$4,590 |
7.5× |
| MRA neck w/o contrast (70547) |
$1,759.97 |
$2,983 |
7.1× |
| MRI abdomen w contrast (74182) |
$2,570.04 |
$4,356 |
7.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,134.08 |
$5,312 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$2,444.37 |
$4,143 |
9.9× |
| MRI any jnt lwr ext with con lt (73722) |
$3,168.89 |
$5,371 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,847.34 |
$4,826 |
3.5× |
| MRI breast w/o contrast bilateral (77047) |
$2,844.39 |
$4,821 |
11.5× |
| MRI breast w/o contrast unilat (77046) |
$1,952.31 |
$3,309 |
7.9× |
| MRI c-spine with contrast (72142) |
$3,185.41 |
$5,399 |
8.8× |
| MRI cardiac w/o contrast (75557) |
$824.23 |
$1,397 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$2,413.10 |
$4,090 |
9.7× |
| MRI chest w/o & w/contrast material (71552) |
$3,170.07 |
$5,373 |
8.8× |
| MRI chest w/o contrast (71550) |
$2,631.40 |
$4,460 |
10.6× |
| MRI chest with contrast (71551) |
$2,916.37 |
$4,943 |
3.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,279.17 |
$3,863 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,419.59 |
$4,101 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,263.24 |
$3,836 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,270.96 |
$5,544 |
13.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,594.28 |
$6,092 |
9.9× |
| MRI orbit/face/neck w/contrast (70542) |
$3,185.41 |
$5,399 |
8.8× |
| MRI pelvis w contrast (72196) |
$3,354.15 |
$5,685 |
9.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,456.22 |
$5,858 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,944.10 |
$4,990 |
11.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,050.30 |
$5,170 |
8.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,071.49 |
$3,511 |
2.5× |
| MRI scan of leg joint before and after contrast (73723) |
$3,372.44 |
$5,716 |
9.3× |
| MRI spectroscopy (76390) |
$830.13 |
$1,407 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,523.48 |
$5,972 |
9.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,871.53 |
$4,867 |
7.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,330.55 |
$5,645 |
9.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,443.19 |
$4,141 |
6.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,709.28 |
$4,592 |
7.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,419 |
$4,100 |
9.8× |
| MRI tmj (70336) |
$1,577.07 |
$2,673 |
6.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,406.61 |
$4,079 |
9.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,532.28 |
$4,292 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,126.95 |
$3,605 |
8.6× |
| Myelogram Cervical (72240) |
$935.15 |
$1,585 |
1.1× |
| Myelogram Lumbar (72265) |
$1,120.41 |
$1,899 |
1.4× |
| Myelogram thoracic (72255) |
$900.34 |
$1,526 |
1.1× |
| Myelography 2 or more regions (72270) |
$1,194.16 |
$2,024 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,142.39 |
$7,021 |
3.1× |
| Myocardial infarct spect (78469) |
$333.35 |
$565 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,217.86 |
$5,454 |
2.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,022.47 |
$1,733 |
1.1× |
| Neck soft tissue (70360) |
$279.07 |
$473 |
3.1× |
| Nm adrenal scan (78075) |
$1,627.22 |
$2,758 |
1.2× |
| Nm cisternogram (78630) |
$1,621.91 |
$2,749 |
2.9× |
| Nm gastric emptying study (78264) |
$1,591.82 |
$2,698 |
3.8× |
| Nm gastroesophageal reflux study (78262) |
$613.60 |
$1,040 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$533.36 |
$904 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,046.42 |
$13,638 |
5.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,080.93 |
$3,527 |
1.5× |
| Nuclear medicine of heart pumping function (78473) |
$2,047.30 |
$3,470 |
4.9× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$602.98 |
$1,022 |
1.5× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$372.88 |
$632 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$489.70 |
$830 |
1.2× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$421.85 |
$715 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$703.28 |
$1,192 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$388.81 |
$659 |
3.6× |
| Osseous survey infant (77076) |
$362.85 |
$615 |
3.3× |
| Osseous survey limited (77074) |
$232.46 |
$394 |
2.1× |
| Parathyrd planar w/spect&CT (78072) |
$800.04 |
$1,356 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,013.03 |
$1,717 |
2.4× |
| Parathyroid imaging (78070) |
$1,049.61 |
$1,779 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$294.41 |
$499 |
2.7× |
| Peritoneogram rs&i (74190) |
$918.04 |
$1,556 |
1.6× |
| PET image w/CT, skull-thigh (78815) |
$5,567.54 |
$9,436.50 |
3.7× |
| PET imaging CT for attenuation limited area (78814) |
$4,821.48 |
$8,172 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,280.50 |
$8,950 |
3.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,601.90 |
$4,410 |
7.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,211.86 |
$2,054 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,442.55 |
$2,445 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,097.99 |
$1,861 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$282.02 |
$478 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$358.13 |
$607 |
3.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$243.08 |
$412 |
2.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$237.18 |
$402 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$234.82 |
$398 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,042.64 |
$25,496 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,422.49 |
$2,411 |
2.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$443.68 |
$752 |
4.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$530.41 |
$899 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$354.59 |
$601 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$292.05 |
$495 |
3.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$316.83 |
$537 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$949.31 |
$1,609 |
5.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$658.44 |
$1,116 |
3.6× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$104.43 |
$177 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$684.99 |
$1,161 |
3.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$612.12 |
$1,037.50 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$233.64 |
$396 |
2.6× |
| Radiological examination surgical specimen (76098) |
$329.22 |
$558 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,560.55 |
$2,645 |
0.5× |
| Ribs bilateral 3 views (71110) |
$430.11 |
$729 |
4.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,329.27 |
$2,253 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,285.07 |
$3,873 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,746.99 |
$2,961 |
3.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$422.44 |
$716 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$569.35 |
$965 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$217.12 |
$368 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$247.21 |
$419 |
1.0× |
| Scanogram (77073) |
$266.68 |
$452 |
2.5× |
| Scapula complete (73010) |
$317.42 |
$538 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$41.30 |
$70 |
1.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$774.08 |
$1,312 |
7.1× |
| Sialogram (70390) |
$458.43 |
$777 |
1.9× |
| Simulation intermediate (77285) |
$1,473.23 |
$2,497 |
3.8× |
| Small bowel series (74250) |
$592.36 |
$1,004 |
3.3× |
| Spec medical radj physics consltj (77370) |
$1,298 |
$2,200 |
9.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,436.06 |
$2,434 |
3.7× |
| Special treatment procedure (77470) |
$2,770.64 |
$4,696 |
4.8× |
| Spine thoracic 3 views (72072) |
$434.83 |
$737 |
4.0× |
| Stereotactic body radiation delivery (77373) |
$10,762.19 |
$18,241 |
5.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,535.23 |
$4,297 |
6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,424.26 |
$2,414 |
3.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$445.45 |
$755 |
1.8× |
| Testicular Imaging With Vascular Flow (78761) |
$880.87 |
$1,493 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,241.41 |
$3,799 |
5.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,277.35 |
$2,165 |
9.2× |
| Thoracolumbar 2 views (72080) |
$276.12 |
$468 |
3.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,514.53 |
$2,567 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$576.43 |
$977 |
1.4× |
| Thyroid uptake measurement (78012) |
$315.06 |
$534 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$994.15 |
$1,685 |
2.4× |
| Tomogram (76100) |
$259.01 |
$439 |
2.4× |
| Treatment device intermediate (77333) |
$623.04 |
$1,056 |
4.5× |
| Treatment devices simple (77332) |
$545.16 |
$924 |
3.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,150.55 |
$3,645 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,299.18 |
$2,202 |
3.1× |
| Tx devices design & construction complex (77334) |
$1,298.59 |
$2,201 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$570.53 |
$967 |
5.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$36.58 |
$62 |
0.4× |
| Upper Extremity Infant (73092) |
$156.35 |
$265 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$770.54 |
$1,306 |
3.1× |
| Urethrocystography voiding (74455) |
$785.88 |
$1,332 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$849.01 |
$1,439 |
4.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,015.39 |
$1,721 |
5.6× |
| Us abdl aorta screen aaa (76706) |
$185.26 |
$314 |
1.7× |
| Us breast unilateral complete (76641) |
$485.57 |
$823 |
4.5× |
| Us breast unilateral limited (76642) |
$485.57 |
$823 |
5.4× |
| Us chest (76604) |
$401.20 |
$680 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$680.27 |
$1,153 |
6.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$343.97 |
$583 |
3.2× |
| Us guided compression repair (76936) |
$929.84 |
$1,576 |
4.1× |
| Us infant hips dynamic (76885) |
$415.36 |
$704 |
4.6× |
| Us infant hips limited static (76886) |
$415.36 |
$704 |
4.6× |
| Us kidney transplant (76776) |
$672.60 |
$1,140 |
6.2× |
| Us ob detailed single fetus (76811) |
$1,053.74 |
$1,786 |
4.3× |
| Us ob transvaginal (76817) |
$637.20 |
$1,080 |
5.9× |
| Us pelvic non ob complete (76856) |
$786.47 |
$1,333 |
7.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$408.87 |
$693 |
3.8× |
| Us pregnancy ltd (76815) |
$414.18 |
$702 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$679.68 |
$1,152 |
6.3× |
| Us retroperitoneal complete (76770) |
$793.55 |
$1,345 |
7.3× |
| Us retroperitoneal limited (76775) |
$521.56 |
$884 |
4.8× |
| Us scrotum and contents (76870) |
$709.77 |
$1,203 |
6.5× |
| Us soft tissue head/neck (76536) |
$604.16 |
$1,024 |
5.6× |
| Us spinal canal and contents (76800) |
$484.98 |
$822 |
4.5× |
| Us transrectal (76872) |
$463.15 |
$785 |
4.3× |
| Us xtr non-vasc lmtd (76882) |
$198.83 |
$337 |
1.8× |
| Venogram extremity bilateral (75822) |
$1,619.55 |
$2,745 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,534.05 |
$4,295 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,571.76 |
$2,664 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,315.11 |
$2,229 |
0.8× |
| Venography Renal Bilateral (75833) |
$2,230.20 |
$3,780 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,362.36 |
$4,004 |
0.7× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,686.22 |
$2,858 |
0.3× |
| Wrist 2 views (73100) |
$225.38 |
$382 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$527.46 |
$894 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$276.12 |
$468 |
3.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$346.92 |
$588 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,205.96 |
$2,044 |
6.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$291.46 |
$494 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$369.93 |
$627 |
4.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$223.02 |
$378 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$126.26 |
$214 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$133.93 |
$227 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$207.68 |
$352 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$329.81 |
$559 |
3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$394.12 |
$668 |
3.6× |
| X-ray exam of femur 1 (73551) |
$139.83 |
$237 |
1.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$480.26 |
$814 |
2.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$367.57 |
$623 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$87.32 |
$148 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$350.46 |
$594 |
3.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,253.75 |
$2,125 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$181.13 |
$307 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$170.51 |
$289 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$416.54 |
$706 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204.73 |
$347 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127.44 |
$216 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$450.76 |
$764 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$600.03 |
$1,017 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$550.47 |
$933 |
5.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$261.96 |
$444 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$284.97 |
$483 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$374.65 |
$635 |
3.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$329.81 |
$559 |
3.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$791.19 |
$1,341 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$793.55 |
$1,345 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$281.43 |
$477 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$380.55 |
$645 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$502.09 |
$851 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$454.30 |
$770 |
4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$272.58 |
$462 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$346.92 |
$588 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320.37 |
$543 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$236.59 |
$401 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$463.15 |
$785 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$323.91 |
$549 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$295.59 |
$501 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$197.06 |
$334 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$108.56 |
$184 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$292.05 |
$495 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$285.56 |
$484 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$259.60 |
$440 |
2.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$326.86 |
$554 |
3.6× |
| Xr arthrogram ankle (73615) |
$539.26 |
$914 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$695.61 |
$1,179 |
6.4× |
| Xr chest 4+ views (71048) |
$472 |
$800 |
4.3× |
| Xr finger(s) 2+ views (73140) |
$231.87 |
$393 |
2.6× |
| Xr shoulder 1 view (73020) |
$228.92 |
$388 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$510.35 |
$865 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$317.42 |
$538 |
3.5× |
| Xr tmj bilateral (70330) |
$1,040.76 |
$1,764 |
11.5× |
| Xray knee 1 or 2 views rt (73560) |
$378.78 |
$642 |
4.2× |