| 3-D radiotherapy plan dose-volume histograms (77295) |
$13,138.32 |
$13,138.32 |
8.8× |
| Abdomen 2 views (74019) |
$218.21 |
$218.21 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$807.91 |
$807.91 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$575.18 |
$575.18 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$475.60 |
$475.60 |
0.1× |
| Angiography internal mammary rs&i (75756) |
$489.22 |
$489.22 |
0.1× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$455.32 |
$455.32 |
0.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$470.35 |
$470.35 |
0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$379.50 |
$379.50 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$549.32 |
$549.32 |
0.1× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$463.36 |
$463.36 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$489.22 |
$489.22 |
0.1× |
| Ankle 2 views (73600) |
$113.21 |
$113.21 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$300.53 |
$300.53 |
0.8× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$423.53 |
$423.53 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$375.11 |
$375.11 |
0.1× |
| Aortography abdominal serialography rs&i (75625) |
$387.52 |
$387.52 |
0.1× |
| Artery X-Rays Adrenal Gland (75731) |
$459.52 |
$459.52 |
0.1× |
| Arthrogram elbow (73085) |
$649.26 |
$649.26 |
1.7× |
| Arthrogram hip (73525) |
$649.26 |
$649.26 |
1.7× |
| Arthrogram shoulder (73040) |
$649.26 |
$649.26 |
1.7× |
| Arthrogram wrist (73115) |
$490.62 |
$490.62 |
1.3× |
| Arthrography knee lt (73580) |
$810.72 |
$810.72 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$820.49 |
$820.49 |
5.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$768.77 |
$768.77 |
1.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$836.22 |
$836.22 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$836.22 |
$836.22 |
1.9× |
| Bone age studies (77072) |
$143.97 |
$143.97 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$869.76 |
$869.76 |
2.0× |
| Bone survey complete (77075) |
$387.17 |
$387.17 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,984.25 |
$2,984.25 |
7.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$597.56 |
$597.56 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,164.40 |
$5,164.40 |
3.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,344.65 |
$1,344.65 |
3.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$678.62 |
$678.62 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$166.33 |
$166.33 |
1.8× |
| Chest 1 view (71045) |
$131.39 |
$131.39 |
1.4× |
| Chest 3 views (71047) |
$201.27 |
$201.27 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$348.06 |
$348.06 |
1.8× |
| Clavicle complete (73000) |
$143.97 |
$143.97 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$297.73 |
$297.73 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$1,108.43 |
$1,108.43 |
7.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$320.09 |
$320.09 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,592.26 |
$3,592.26 |
9.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,951.29 |
$1,951.29 |
7.6× |
| CT abdomen w contrast (74160) |
$1,322.29 |
$1,322.29 |
7.0× |
| CT abdomen w wo contrast (74170) |
$2,366.41 |
$2,366.41 |
12.5× |
| CT abdomen w/o contrast (74150) |
$1,093.05 |
$1,093.05 |
9.7× |
| CT angio hrt w/3d image (75574) |
$417.93 |
$417.93 |
1.1× |
| CT angiography upper extremity lt (73206) |
$1,797.52 |
$1,797.52 |
9.5× |
| CT c-spine w/o contrast (72125) |
$1,140.58 |
$1,140.58 |
10.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$297.38 |
$297.38 |
1.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,620.02 |
$1,620.02 |
8.5× |
| CT cervical spine with contrast (72126) |
$1,365.62 |
$1,365.62 |
3.6× |
| CT chest w/wo contrast (71270) |
$1,702.47 |
$1,702.47 |
9.0× |
| CT chest with contrast (71260) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT colonography screening (74263) |
$1,093.05 |
$1,093.05 |
4.2× |
| CT colonography w/o cntrst (74261) |
$1,093.05 |
$1,093.05 |
9.7× |
| CT head/brain with contrast (70460) |
$1,093.05 |
$1,093.05 |
5.8× |
| CT head/brain without and with contrast (70470) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$306.82 |
$306.82 |
0.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$65 |
0.7× |
| CT hrt w/3d image congen (75573) |
$397.95 |
$397.95 |
1.1× |
| CT iac w contrast (70481) |
$1,093.05 |
$1,093.05 |
5.8× |
| CT limited/localized follow up study (76380) |
$677.91 |
$677.91 |
7.2× |
| CT lower ext w/o (73700) |
$1,002.21 |
$1,002.21 |
8.9× |
| CT lower extremity w wo contrast (73702) |
$1,209.76 |
$1,209.76 |
6.4× |
| CT lower extremity with contrast (73701) |
$1,140.58 |
$1,140.58 |
6.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,251 |
$1,251 |
6.6× |
| CT lumbar spine w/o contrast (72131) |
$1,140.58 |
$1,140.58 |
10.1× |
| CT lumbar spine with contrast (72132) |
$1,365.62 |
$1,365.62 |
3.6× |
| CT maxillofacial w contrast (70487) |
$1,093.05 |
$1,093.05 |
5.8× |
| CT maxillofacial w/o contrast (70486) |
$279.54 |
$279.54 |
2.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$1,093.05 |
$1,093.05 |
5.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT orbits w/o contrast (70480) |
$914.15 |
$914.15 |
8.1× |
| CT pelvis w & w/o contrast (72194) |
$1,632.59 |
$1,632.59 |
8.6× |
| CT pelvis w/o contrast (72192) |
$1,140.58 |
$1,140.58 |
10.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT soft tissue neck w/o contrast (70490) |
$914.15 |
$914.15 |
8.1× |
| CT thoracic spine w/contrast (72129) |
$1,365.62 |
$1,365.62 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,140.58 |
$1,140.58 |
10.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,702.47 |
$1,702.47 |
9.0× |
| CT thorax w/o contrast (71250) |
$1,140.58 |
$1,140.58 |
10.1× |
| CT unlisted procedure (76497) |
$706.59 |
$706.59 |
7.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,432.72 |
$1,432.72 |
7.6× |
| CT upper extremity w/o contrast rt (73200) |
$968.65 |
$968.65 |
8.6× |
| CT upper extremity with contrast (73201) |
$1,140.58 |
$1,140.58 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,038.84 |
$2,038.84 |
10.8× |
| Cta Abdomen (74175) |
$1,990.42 |
$1,990.42 |
10.5× |
| CTA abdomen pelvis (74174) |
$3,980.84 |
$3,980.84 |
10.6× |
| CTA chest (71275) |
$2,056.12 |
$2,056.12 |
10.8× |
| Cta Head (70496) |
$1,910.75 |
$1,910.75 |
10.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$592.78 |
$592.78 |
1.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,797.52 |
$1,797.52 |
9.5× |
| Cta Neck (70498) |
$1,910.75 |
$1,910.75 |
10.1× |
| Cta Pelvis (72191) |
$1,990.42 |
$1,990.42 |
10.5× |
| Diskography lumbar (72295) |
$262.08 |
$262.08 |
0.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$296.33 |
$296.33 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$141.18 |
$141.18 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$184.50 |
$184.50 |
1.6× |
| Echo exam of eye (76529) |
$148.16 |
$148.16 |
1.6× |
| Echoencephalography real time imaging (76506) |
$321.14 |
$321.14 |
2.8× |
| Esophagus (74220) |
$320.09 |
$320.09 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$176.05 |
$176.05 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$434.69 |
$434.69 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$400.47 |
$400.47 |
1.6× |
| Foot 2 views (73620) |
$139.77 |
$139.77 |
1.5× |
| Forearm 2 views (73090) |
$143.97 |
$143.97 |
1.5× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$788.35 |
$788.35 |
1.3× |
| Gated Heart Planar Single (78472) |
$1,766.09 |
$1,766.09 |
4.1× |
| Hand 2 views (73120) |
$128.94 |
$128.94 |
1.1× |
| Hand 3 views (73130) |
$146.77 |
$146.77 |
1.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,038.85 |
$4,038.85 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,038.85 |
$4,038.85 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,038.85 |
$4,038.85 |
5.4× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$698.19 |
$698.19 |
1.7× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$698.19 |
$698.19 |
1.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$381.26 |
$381.26 |
0.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,182.52 |
$1,182.52 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$633.18 |
$633.18 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,802.08 |
$1,802.08 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$159.35 |
$159.35 |
1.7× |
| Hysterosalpingogram (74740) |
$348.06 |
$348.06 |
1.3× |
| Image fusion (77399) |
$745.72 |
$745.72 |
5.1× |
| Interstitial radiation source applic complex (77778) |
$9,532.09 |
$9,532.09 |
12.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$411.65 |
$411.65 |
1.0× |
| Kidney imaging morphology (78700) |
$411.64 |
$411.64 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$813.84 |
$813.84 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,693.74 |
$1,693.74 |
2.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$364.12 |
$364.12 |
0.6× |
| Knee 3 views (73562) |
$159.35 |
$159.35 |
1.7× |
| Liver & spleen imaging static only (78215) |
$812.80 |
$812.80 |
1.9× |
| Liver imaging static only (78201) |
$196.40 |
$196.40 |
0.3× |
| Lung perf&ventilat diferentl (78598) |
$687.71 |
$687.71 |
1.2× |
| Lung perfusion differential (78597) |
$1,029.80 |
$1,029.80 |
2.4× |
| Lung Ventilation Imaging (78579) |
$681.92 |
$681.92 |
1.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$900.88 |
$900.88 |
0.3× |
| Lymphoscintigraphy (78195) |
$884.10 |
$884.10 |
1.5× |
| Meckels Diverticulum (78290) |
$761.78 |
$761.78 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,567.70 |
$2,567.70 |
6.3× |
| Mr elastography (76391) |
$533.71 |
$533.71 |
2.1× |
| MRA head w & w/o contrast (70546) |
$2,537.65 |
$2,537.65 |
6.7× |
| MRA head w/o contrast (70544) |
$1,353.74 |
$1,353.74 |
5.3× |
| MRA head with contrast (70545) |
$680.72 |
$680.72 |
1.8× |
| MRA neck w contrast (70548) |
$1,501.22 |
$1,501.22 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,126.22 |
$4,126.22 |
10.9× |
| MRA neck w/o contrast (70547) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI abdomen w contrast (74182) |
$2,496.41 |
$2,496.41 |
6.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,615.41 |
$4,615.41 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,496.41 |
$2,496.41 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,496.41 |
$2,496.41 |
2.9× |
| MRI breast w/o contrast bilateral (77047) |
$1,027.72 |
$1,027.72 |
4.0× |
| MRI breast w/o contrast unilat (77046) |
$373.21 |
$373.21 |
1.4× |
| MRI c-spine with contrast (72142) |
$2,525.76 |
$2,525.76 |
6.7× |
| MRI cardiac w/o cont stress (75559) |
$907.15 |
$907.15 |
1.5× |
| MRI cardiac w/o contrast (75557) |
$880.60 |
$880.60 |
3.4× |
| MRI cervical spine w/o contrast (72141) |
$2,101.20 |
$2,101.20 |
8.1× |
| MRI chest w/o & w/contrast material (71552) |
$4,586.06 |
$4,586.06 |
12.2× |
| MRI chest w/o contrast (71550) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI chest with contrast (71551) |
$2,347.35 |
$2,347.35 |
2.8× |
| MRI fetal sngl/1st gestation (74712) |
$624.12 |
$624.12 |
2.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,360.70 |
$2,360.70 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,810.11 |
$1,810.11 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,065.90 |
$2,065.90 |
8.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,615.41 |
$4,615.41 |
12.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,496.41 |
$2,496.41 |
6.6× |
| MRI pelvis w contrast (72196) |
$1,400.93 |
$1,400.93 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,564.19 |
$2,564.19 |
6.8× |
| MRI pelvis w/o contrast (72195) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI scan of arm joint before and after contrast (73223) |
$4,615.41 |
$4,615.41 |
12.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,213.62 |
$1,213.62 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$4,615.41 |
$4,615.41 |
12.2× |
| MRI spectroscopy (76390) |
$2,397.16 |
$2,397.16 |
25.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,356.39 |
$3,356.39 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,525.76 |
$2,525.76 |
6.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,709.08 |
$4,709.08 |
12.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,525.76 |
$2,525.76 |
6.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,709.08 |
$4,709.08 |
12.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,312.26 |
$2,312.26 |
9.0× |
| MRI tmj (70336) |
$2,127.40 |
$2,127.40 |
8.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,098.05 |
$2,098.05 |
8.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,001.82 |
$4,001.82 |
10.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,065.90 |
$2,065.90 |
8.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,451.59 |
$1,451.59 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,429.42 |
$3,429.42 |
2.5× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,662.60 |
$4,662.60 |
3.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,662.60 |
$4,662.60 |
3.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,662.60 |
$4,662.60 |
2.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$4,662.60 |
$4,662.60 |
2.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,178.70 |
$1,178.70 |
1.3× |
| Neck soft tissue (70360) |
$116.02 |
$116.02 |
1.2× |
| Nm bone marrow multiple (78103) |
$370.07 |
$370.07 |
0.9× |
| Nm bone marrow wb (78104) |
$804.76 |
$804.76 |
1.9× |
| Nm cisternogram (78630) |
$701 |
$701 |
1.2× |
| Nm csf leak detection (78650) |
$746.42 |
$746.42 |
0.5× |
| Nm gastric emptying study (78264) |
$782.40 |
$782.40 |
1.8× |
| Nm gastroesophageal reflux study (78262) |
$98.56 |
$98.56 |
0.2× |
| Nm peritoneal-venous shunt patency (78291) |
$355.03 |
$355.03 |
0.8× |
| Nm whole blood volume (78122) |
$810.36 |
$810.36 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,867.74 |
$11,867.74 |
7.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$589.85 |
$589.85 |
0.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,792.99 |
$1,792.99 |
1.3× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,451.59 |
$1,451.59 |
0.9× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$499.71 |
$499.71 |
0.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,733.23 |
$1,733.23 |
1.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$618.52 |
$618.52 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,666.50 |
$1,666.50 |
6.6× |
| Orthopantogram (70355) |
$53.83 |
$53.83 |
0.6× |
| Osseous survey limited (77074) |
$227.84 |
$227.84 |
2.0× |
| Parathyrd planar w/spect&CT (78072) |
$1,805.92 |
$1,805.92 |
3.1× |
| Parathyrd planar w/wo subtrj (78071) |
$1,423.98 |
$1,423.98 |
3.3× |
| Parathyroid imaging (78070) |
$692.58 |
$692.58 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$143.97 |
$143.97 |
1.3× |
| Perineogram (74775) |
$145.37 |
$145.37 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$5,674.58 |
$5,674.58 |
3.7× |
| PET imaging CT for attenuation limited area (78814) |
$1,782.15 |
$1,782.15 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,734.34 |
$5,734.34 |
3.7× |
| PET imaging limited area chest head/neck (78811) |
$1,451.59 |
$1,451.59 |
1.0× |
| PET whole body (78813) |
$1,451.59 |
$1,451.59 |
0.9× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,583.32 |
$1,583.32 |
1.1× |
| Pr heart first pass single,planar (78481) |
$415.15 |
$415.15 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,001.82 |
$4,001.82 |
10.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,242.90 |
$4,242.90 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$438.20 |
$438.20 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$665.69 |
$665.69 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$727.19 |
$727.19 |
1.2× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,298.95 |
$1,298.95 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$283.75 |
$283.75 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$87.72 |
$87.72 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$278.15 |
$278.15 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$184.50 |
$184.50 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$58.70 |
$58.70 |
0.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$290.74 |
$290.74 |
2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$36,457.28 |
$36,457.28 |
4.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$5,997.81 |
$5,997.81 |
10.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,846.45 |
$1,846.45 |
16.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$5,995.01 |
$5,995.01 |
14.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$173.32 |
$173.32 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$143.97 |
$143.97 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$173.32 |
$173.32 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$173.32 |
$173.32 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$459.86 |
$459.86 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$454.27 |
$454.27 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$402.56 |
$402.56 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$159.35 |
$159.35 |
1.7× |
| Radiological examination surgical specimen (76098) |
$116.02 |
$116.02 |
0.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$316.02 |
$316.02 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$381.26 |
$381.26 |
0.1× |
| Ribs bilateral 3 views (71110) |
$244.60 |
$244.60 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$874.66 |
$874.66 |
2.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$887.58 |
$887.58 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,664.49 |
$1,664.49 |
2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,646.58 |
$1,646.58 |
1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,683.62 |
$1,683.62 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,605.34 |
$1,605.34 |
1.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,035.76 |
$1,035.76 |
4.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$494.11 |
$494.11 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$1,065.80 |
$1,065.80 |
4.2× |
| Sacroiliac Joints < 3 Views (72200) |
$143.97 |
$143.97 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$470.07 |
$470.07 |
1.8× |
| Salivary gland function study (78232) |
$420.38 |
$420.38 |
1.0× |
| Scanogram (77073) |
$104.50 |
$104.50 |
0.9× |
| Scapula complete (73010) |
$143.97 |
$143.97 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$53.12 |
$53.12 |
2.3× |
| Sialogram (70390) |
$557.72 |
$557.72 |
2.2× |
| Simulation intermediate (77285) |
$1,711.58 |
$1,711.58 |
4.2× |
| Small bowel series (74250) |
$348.06 |
$348.06 |
1.8× |
| Spec medical radj physics consltj (77370) |
$1,924.73 |
$1,924.73 |
13.3× |
| Special dosimetry (77331) |
$745.72 |
$745.72 |
5.1× |
| Special treatment procedure (77470) |
$3,681.73 |
$3,681.73 |
6.2× |
| Spine thoracic 3 views (72072) |
$156.56 |
$156.56 |
1.4× |
| Splenoportograpy rs&i (75810) |
$431.23 |
$431.23 |
0.1× |
| Stereotactic body radiation delivery (77373) |
$32,602.58 |
$32,602.58 |
16.9× |
| Superior sagittal sinus venogram (75870) |
$369.72 |
$369.72 |
0.1× |
| Tbs Technical Calculation Only (77091) |
$98.01 |
$98.01 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,711.58 |
$1,711.58 |
4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$745.72 |
$745.72 |
1.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$176.57 |
$176.57 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$284.45 |
$284.45 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,427.32 |
$3,427.32 |
8.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,826.88 |
$1,826.88 |
12.6× |
| Thoracolumbar 2 views (72080) |
$190.81 |
$190.81 |
2.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$888.62 |
$888.62 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$774.71 |
$774.71 |
1.8× |
| Thyroid uptake measurement (78012) |
$313.10 |
$313.10 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$909.60 |
$909.60 |
2.1× |
| Tmj unilateral (70328) |
$234.45 |
$234.45 |
2.5× |
| Treatment devices simple (77332) |
$1,251 |
$1,251 |
8.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$475.25 |
$475.25 |
0.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$855.79 |
$855.79 |
2.0× |
| Tx devices design & construction complex (77334) |
$2,019.77 |
$2,019.77 |
5.0× |
| Ultrasound elastography first target lesion (76982) |
$92.96 |
$92.96 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$381.60 |
$381.60 |
3.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$92.69 |
$92.69 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$113.21 |
$113.21 |
1.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$355.03 |
$355.03 |
0.8× |
| Unlisted Ultrasound Procedure (76999) |
$136.99 |
$136.99 |
1.5× |
| Upper Extremity Infant (73092) |
$110.78 |
$110.78 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$122.32 |
$122.32 |
0.3× |
| Urethrocystography retrograde rs&i (74450) |
$453.23 |
$453.23 |
1.8× |
| Urethrocystography voiding (74455) |
$554.92 |
$554.92 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$111.82 |
$111.82 |
0.6× |
| Us abdl aorta screen aaa (76706) |
$71.61 |
$71.61 |
0.6× |
| Us breast unilateral complete (76641) |
$283.75 |
$283.75 |
2.5× |
| Us breast unilateral limited (76642) |
$212.46 |
$212.46 |
2.3× |
| Us chest (76604) |
$337.66 |
$337.66 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$197.44 |
$197.44 |
1.7× |
| Us elastography parenchyma (76981) |
$291.09 |
$291.09 |
2.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$275.35 |
$275.35 |
2.4× |
| Us guided compression repair (76936) |
$2,007.19 |
$2,007.19 |
8.6× |
| Us infant hips dynamic (76885) |
$423.18 |
$423.18 |
4.5× |
| Us infant hips limited static (76886) |
$130 |
$130 |
1.4× |
| Us kidney transplant (76776) |
$278.15 |
$278.15 |
2.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$122.93 |
$122.93 |
1.1× |
| Us ob transvaginal (76817) |
$555.95 |
$555.95 |
4.9× |
| Us pelvic non ob complete (76856) |
$410.94 |
$410.94 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$283.75 |
$283.75 |
2.5× |
| Us pregnancy ltd (76815) |
$305.42 |
$305.42 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$809.31 |
$809.31 |
7.2× |
| Us retroperitoneal complete (76770) |
$529.75 |
$529.75 |
4.7× |
| Us retroperitoneal limited (76775) |
$381.60 |
$381.60 |
3.4× |
| Us scrotum and contents (76870) |
$398.67 |
$398.67 |
3.5× |
| Us soft tissue head/neck (76536) |
$381.60 |
$381.60 |
3.4× |
| Us spinal canal and contents (76800) |
$254.39 |
$254.39 |
2.3× |
| Us transrectal (76872) |
$422.13 |
$422.13 |
3.7× |
| Us transrectal prostate volume (76873) |
$630.38 |
$630.38 |
5.6× |
| Us xtr non-vasc lmtd (76882) |
$110.43 |
$110.43 |
1.0× |
| Us, eye b-scan (76512) |
$479.44 |
$479.44 |
4.2× |
| Vascular flow imaging (78445) |
$199.88 |
$199.88 |
0.5× |
| Venogram extremity bilateral (75822) |
$403.62 |
$403.62 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$3,241.42 |
$3,241.42 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$438.20 |
$438.20 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$335.17 |
$335.17 |
0.2× |
| Venography Renal Bilateral (75833) |
$414.09 |
$414.09 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$381.26 |
$381.26 |
0.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$377.75 |
$377.75 |
0.1× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$373.20 |
$373.20 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$155.16 |
$155.16 |
1.6× |
| Wrist 2 views (73100) |
$122.99 |
$122.99 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$321.28 |
$321.28 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$184.50 |
$184.50 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$146.77 |
$146.77 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$599.65 |
$599.65 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$143.97 |
$143.97 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$159.35 |
$159.35 |
1.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$290.74 |
$290.74 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$131.39 |
$131.39 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$159.35 |
$159.35 |
1.7× |
| X-ray exam hip uni 4/> views (73503) |
$60.10 |
$60.10 |
0.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$130.34 |
$130.34 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$222.25 |
$222.25 |
2.0× |
| X-ray exam of femur 1 (73551) |
$128.59 |
$128.59 |
1.4× |
| X-ray eye for foreign body (70030) |
$94.82 |
$94.82 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$240.78 |
$240.78 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$236.10 |
$236.10 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$146.77 |
$146.77 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$108.68 |
$108.68 |
1.2× |
| X-ray IV pyelogram+drip infusn (74410) |
$110.43 |
$110.43 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$234.45 |
$234.45 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$173.32 |
$173.32 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$139.77 |
$139.77 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$110.08 |
$110.08 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$184.50 |
$184.50 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$320.09 |
$320.09 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$133.84 |
$133.84 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$143.97 |
$143.97 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$105.52 |
$105.52 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$173.32 |
$173.32 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$146.78 |
$146.78 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$82.47 |
$82.47 |
0.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$248.80 |
$248.80 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$292.13 |
$292.13 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$367.61 |
$367.61 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$173.32 |
$173.32 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$159.35 |
$159.35 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$159.35 |
$159.35 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$218.05 |
$218.05 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$233.90 |
$233.90 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$244.60 |
$244.60 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$173.32 |
$173.32 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$116.02 |
$116.02 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$151.32 |
$151.32 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$176.12 |
$176.12 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$176.12 |
$176.12 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$187.66 |
$187.66 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$116.02 |
$116.02 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$146.77 |
$146.77 |
1.6× |
| Xr arthrogram ankle (73615) |
$711.92 |
$711.92 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$306.10 |
$306.10 |
2.7× |
| Xr chest 4+ views (71048) |
$272.56 |
$272.56 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$116.02 |
$116.02 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$30.75 |
$30.75 |
0.3× |
| Xr shoulder 1 view (73020) |
$131.39 |
$131.39 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$246 |
$246 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$143.97 |
$143.97 |
1.5× |
| Xr tmj bilateral (70330) |
$184.50 |
$184.50 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$143.97 |
$143.97 |
1.5× |