| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,357.69 |
$9,355.92 |
1.7× |
| Abdomen 2 views (74019) |
$140.10 |
$555.94 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$602.56 |
$2,391.12 |
1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,653.88 |
$18,467.78 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,923.44 |
$7,632.69 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,282.29 |
$5,088.46 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,057.09 |
$8,163.05 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,143.23 |
$8,504.88 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,428.82 |
$5,669.92 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,245.86 |
$8,912.16 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,691.39 |
$6,711.87 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$810.50 |
$3,216.26 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$871.68 |
$3,459.04 |
0.3× |
| Ankle 2 views (73600) |
$116.08 |
$460.63 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$449.06 |
$1,782 |
1.3× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,647.01 |
$10,504 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,721.22 |
$6,830.22 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,324.53 |
$5,256.09 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$3,226.69 |
$12,804.32 |
1.0× |
| Arthrogram elbow (73085) |
$530.45 |
$2,104.96 |
1.5× |
| Arthrogram hip (73525) |
$409.16 |
$1,623.66 |
1.2× |
| Arthrogram shoulder (73040) |
$380.81 |
$1,511.16 |
1.1× |
| Arthrogram wrist (73115) |
$355.35 |
$1,410.13 |
1.0× |
| Arthrography knee lt (73580) |
$489.66 |
$1,943.09 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$260.27 |
$1,032.83 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$358.71 |
$1,423.44 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$450.99 |
$1,789.65 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$560.38 |
$2,223.73 |
1.4× |
| Bone age studies (77072) |
$133.57 |
$530.05 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$593.44 |
$2,354.91 |
1.5× |
| Bone Marrow Imaging Limited Area (78102) |
$274.61 |
$1,089.72 |
0.7× |
| Bone survey complete (77075) |
$287.53 |
$1,140.98 |
2.7× |
| Brachytx isodose complex (77318) |
$1,448.67 |
$5,748.70 |
3.9× |
| Brachytx isodose intermed (77317) |
$904.83 |
$3,590.58 |
2.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$844.95 |
$3,352.96 |
2.3× |
| Brain image w/flow 4 + views (78606) |
$603.75 |
$2,395.83 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$599.87 |
$2,380.42 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,735.18 |
$6,885.60 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$780.89 |
$3,098.78 |
2.2× |
| Cardiac shunt detection (78428) |
$511.35 |
$2,029.16 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$365.60 |
$1,450.80 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$136.28 |
$540.80 |
1.6× |
| Chest 1 view (71045) |
$96.69 |
$383.69 |
1.1× |
| Chest 3 views (71047) |
$131.04 |
$520 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$204.68 |
$812.21 |
1.2× |
| Clavicle complete (73000) |
$136 |
$539.67 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$237.76 |
$943.51 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$293.46 |
$1,164.51 |
2.2× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$224.71 |
$891.72 |
1.3× |
| Corpora cavernosography (74445) |
$251.56 |
$998.26 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,587.60 |
$6,300 |
4.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,231.06 |
$4,885.14 |
5.2× |
| CT abdomen w contrast (74160) |
$781.91 |
$3,102.82 |
4.5× |
| CT abdomen w wo contrast (74170) |
$925.89 |
$3,674.15 |
5.3× |
| CT abdomen w/o contrast (74150) |
$623.02 |
$2,472.31 |
5.9× |
| CT angio hrt w/3d image (75574) |
$596.34 |
$2,366.42 |
1.7× |
| CT angiography upper extremity lt (73206) |
$873.18 |
$3,465 |
5.0× |
| CT c-spine w/o contrast (72125) |
$722.77 |
$2,868.14 |
6.9× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$433.51 |
$1,720.28 |
2.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,390.11 |
$5,516.30 |
7.9× |
| CT cervical spine with contrast (72126) |
$795.94 |
$3,158.48 |
2.3× |
| CT chest w/wo contrast (71270) |
$845.27 |
$3,354.23 |
4.8× |
| CT chest with contrast (71260) |
$734.70 |
$2,915.46 |
4.2× |
| CT head/brain with contrast (70460) |
$762.46 |
$3,025.62 |
4.3× |
| CT head/brain without and with contrast (70470) |
$814.96 |
$3,233.98 |
4.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$487.57 |
$1,934.80 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$140.08 |
$555.89 |
1.6× |
| CT hrt w/3d image congen (75573) |
$587.35 |
$2,330.77 |
1.7× |
| CT iac w contrast (70481) |
$738.50 |
$2,930.55 |
4.2× |
| CT limited/localized follow up study (76380) |
$281.41 |
$1,116.72 |
3.2× |
| CT lower ext w/o (73700) |
$570.69 |
$2,264.66 |
5.5× |
| CT lower extremity w wo contrast (73702) |
$990.73 |
$3,931.45 |
5.6× |
| CT lower extremity with contrast (73701) |
$825.42 |
$3,275.45 |
4.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,005.06 |
$3,988.33 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$709.58 |
$2,815.80 |
6.8× |
| CT lumbar spine with contrast (72132) |
$800.99 |
$3,178.53 |
2.3× |
| CT maxillofacial w contrast (70487) |
$707.92 |
$2,809.22 |
4.0× |
| CT maxillofacial w/o contrast (70486) |
$599.91 |
$2,380.61 |
5.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,126.91 |
$4,471.88 |
6.4× |
| CT neck soft tissue w contrast (70491) |
$699.06 |
$2,774.05 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$949.47 |
$3,767.75 |
5.4× |
| CT orbits w/o contrast (70480) |
$618 |
$2,452.38 |
5.9× |
| CT pelvis w & w/o contrast (72194) |
$965.22 |
$3,830.22 |
5.5× |
| CT pelvis w/o contrast (72192) |
$637.04 |
$2,527.93 |
6.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$809.50 |
$3,212.32 |
4.6× |
| CT soft tissue neck w/o contrast (70490) |
$533.13 |
$2,115.59 |
5.1× |
| CT thoracic spine w/contrast (72129) |
$784.91 |
$3,114.72 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$731.77 |
$2,903.83 |
7.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,117.13 |
$4,433.07 |
6.4× |
| CT thorax w/o contrast (71250) |
$659.85 |
$2,618.44 |
6.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,030.50 |
$4,089.28 |
5.9× |
| CT upper extremity w/o contrast rt (73200) |
$565.82 |
$2,245.32 |
5.4× |
| CT upper extremity with contrast (73201) |
$806.10 |
$3,198.82 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,125.58 |
$4,466.60 |
6.4× |
| Cta Abdomen (74175) |
$928.98 |
$3,686.42 |
5.3× |
| CTA abdomen pelvis (74174) |
$1,671.20 |
$6,631.76 |
4.8× |
| CTA chest (71275) |
$871.58 |
$3,458.64 |
5.0× |
| Cta Head (70496) |
$955.36 |
$3,791.10 |
5.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,810.17 |
$7,183.23 |
5.2× |
| CTA lwr ext w&w/o contrast (73706) |
$887.45 |
$3,521.63 |
5.1× |
| Cta Neck (70498) |
$854.82 |
$3,392.13 |
4.9× |
| Cta Pelvis (72191) |
$1,110.53 |
$4,406.85 |
6.3× |
| Cystography minimum 3 views rs&i (74430) |
$266.54 |
$1,057.68 |
0.8× |
| Diskogram cervical (72285) |
$2,322.16 |
$9,214.91 |
1.2× |
| Diskography lumbar (72295) |
$1,967.71 |
$7,808.38 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$160.66 |
$637.52 |
1.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$146.78 |
$582.48 |
1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$84.34 |
$334.67 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$147.44 |
$585.09 |
1.4× |
| Echo exam of fetal heart (76825) |
$201.12 |
$798.08 |
0.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$251.56 |
$998.26 |
1.1× |
| Echoencephalography real time imaging (76506) |
$185.91 |
$737.74 |
1.8× |
| Esophagus (74220) |
$163.27 |
$647.88 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$138.98 |
$551.52 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$111.56 |
$442.66 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$227.70 |
$903.55 |
1.0× |
| Foot 2 views (73620) |
$114.17 |
$453.06 |
1.3× |
| Forearm 2 views (73090) |
$105.99 |
$420.60 |
1.2× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$43.03 |
$170.76 |
0.2× |
| Functional MRI brain by phys/psych (70555) |
$528.62 |
$2,097.68 |
2.2× |
| Functional MRI brain by tech (70554) |
$979.05 |
$3,885.11 |
4.1× |
| Gated Heart Planar Single (78472) |
$540.99 |
$2,146.78 |
1.4× |
| Hand 2 views (73120) |
$134.42 |
$533.40 |
1.3× |
| Hand 3 views (73130) |
$139.16 |
$552.21 |
1.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,660.66 |
$6,589.91 |
2.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,070.30 |
$8,215.46 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,970.51 |
$11,787.72 |
4.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$246.94 |
$979.91 |
0.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$314.37 |
$1,247.51 |
0.8× |
| Heart Infarct Image (78466) |
$329.75 |
$1,308.52 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,519.73 |
$6,030.68 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$730.56 |
$2,899.04 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$608.03 |
$2,412.83 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,310.06 |
$5,198.64 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$108.73 |
$431.45 |
1.2× |
| Hysterosalpingogram (74740) |
$291.10 |
$1,155.17 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$1,930.88 |
$7,662.21 |
2.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,560.85 |
$10,162.09 |
3.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,305.85 |
$9,150.21 |
4.2× |
| Intracavitary radiation source applic simple (77761) |
$1,611.98 |
$6,396.73 |
2.9× |
| Kidney imaging morphology (78700) |
$421.72 |
$1,673.49 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$545.40 |
$2,164.28 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$584.06 |
$2,317.68 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,060.28 |
$4,207.48 |
1.9× |
| Knee 3 views (73562) |
$130.18 |
$516.58 |
1.5× |
| Liver & spleen imaging static only (78215) |
$483.60 |
$1,919.03 |
1.2× |
| Liver imaging w/vascular flow (78202) |
$492.09 |
$1,952.73 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$666.65 |
$2,645.44 |
1.2× |
| Lung perfusion differential (78597) |
$489.77 |
$1,943.55 |
1.2× |
| Lung Ventilation Imaging (78579) |
$454.09 |
$1,801.95 |
1.1× |
| Lymphoscintigraphy (78195) |
$540.91 |
$2,146.46 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$347.52 |
$1,379.04 |
1.5× |
| Meckels Diverticulum (78290) |
$437.66 |
$1,736.75 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,428.92 |
$5,670.30 |
3.8× |
| MRA head w & w/o contrast (70546) |
$1,167.02 |
$4,631.04 |
3.3× |
| MRA head w/o contrast (70544) |
$770.74 |
$3,058.48 |
3.2× |
| MRA head with contrast (70545) |
$1,093.33 |
$4,338.60 |
3.1× |
| MRA neck w contrast (70548) |
$878.44 |
$3,485.88 |
2.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,125.58 |
$4,466.60 |
3.2× |
| MRA neck w/o contrast (70547) |
$789.81 |
$3,134.16 |
3.3× |
| MRI abdomen w contrast (74182) |
$1,137.91 |
$4,515.51 |
3.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,271.63 |
$5,046.17 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$867.87 |
$3,443.92 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$904.89 |
$3,590.84 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$969.37 |
$3,846.71 |
1.2× |
| MRI bone marrow blood supply (77084) |
$384.07 |
$1,524.10 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$1,121.90 |
$4,452 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$747.94 |
$2,968 |
3.1× |
| MRI c-spine with contrast (72142) |
$1,230.69 |
$4,883.71 |
3.5× |
| MRI cardiac w/o contrast (75557) |
$644.82 |
$2,558.79 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$879.07 |
$3,488.36 |
3.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,259.51 |
$4,998.07 |
3.6× |
| MRI chest w/o contrast (71550) |
$769.94 |
$3,055.32 |
3.2× |
| MRI chest with contrast (71551) |
$1,280.04 |
$5,079.54 |
1.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,582.01 |
$6,277.81 |
4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$998.42 |
$3,961.99 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$782.76 |
$3,106.20 |
3.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$844.40 |
$3,350.80 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,168.46 |
$4,636.76 |
3.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,152.33 |
$4,572.72 |
3.3× |
| MRI pelvis w contrast (72196) |
$1,160.47 |
$4,605.05 |
3.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,170.39 |
$4,644.39 |
3.3× |
| MRI pelvis w/o contrast (72195) |
$901.56 |
$3,577.60 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,144.77 |
$4,542.72 |
3.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,097.78 |
$4,356.28 |
3.1× |
| MRI spectroscopy (76390) |
$1,342.79 |
$5,328.55 |
15.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,292.23 |
$5,127.89 |
3.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,056.73 |
$4,193.36 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,161.04 |
$4,607.29 |
3.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,277.82 |
$5,070.72 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,405.60 |
$5,577.79 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$912.73 |
$3,621.94 |
3.8× |
| MRI tmj (70336) |
$981.95 |
$3,896.62 |
4.1× |
| MRI upper ext joint w/o contrast (73221) |
$835.19 |
$3,314.26 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,079.39 |
$4,283.28 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$814.89 |
$3,233.69 |
3.4× |
| Myelogram Cervical (72240) |
$827.72 |
$3,284.61 |
1.1× |
| Myelogram Lumbar (72265) |
$495.93 |
$1,967.97 |
0.6× |
| Myelogram thoracic (72255) |
$513.05 |
$2,035.93 |
0.7× |
| Myelography 2 or more regions (72270) |
$868.06 |
$3,444.69 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,683.04 |
$6,678.72 |
1.3× |
| Myocardial infarct spect (78469) |
$528.48 |
$2,097.13 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,419.60 |
$5,633.34 |
1.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,513.91 |
$6,007.59 |
1.8× |
| Neck soft tissue (70360) |
$102.21 |
$405.60 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$313.31 |
$1,243.30 |
0.8× |
| Nm adrenal scan (78075) |
$1,068.74 |
$4,241.02 |
0.8× |
| Nm bone marrow wb (78104) |
$448.14 |
$1,778.33 |
1.1× |
| Nm cisternogram (78630) |
$620.34 |
$2,461.66 |
1.1× |
| Nm csf leak detection (78650) |
$770.20 |
$3,056.35 |
0.6× |
| Nm gastric emptying study (78264) |
$522.92 |
$2,075.08 |
1.3× |
| Nm gastroesophageal reflux study (78262) |
$395.34 |
$1,568.81 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$345.69 |
$1,371.77 |
0.9× |
| Nm whole blood volume (78122) |
$249.23 |
$989 |
0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,556.05 |
$14,111.31 |
2.6× |
| Nuclear medicine of heart pumping function (78473) |
$805.88 |
$3,197.94 |
2.0× |
| Nuclear medicine study of digestive tracts (78299) |
$286.57 |
$1,137.20 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$620.51 |
$2,462.35 |
1.5× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$425.89 |
$1,690.03 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$220.67 |
$875.67 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$451.87 |
$1,793.13 |
1.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$133.02 |
$527.85 |
1.3× |
| Orthopantogram (70355) |
$103.57 |
$411.01 |
1.2× |
| Osseous survey infant (77076) |
$213.02 |
$845.31 |
2.0× |
| Osseous survey limited (77074) |
$220.85 |
$876.40 |
2.1× |
| Parathyrd planar w/spect&CT (78072) |
$541.31 |
$2,148.06 |
1.0× |
| Parathyroid imaging (78070) |
$443.99 |
$1,761.85 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$103.52 |
$410.79 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$2,006.77 |
$7,963.37 |
1.4× |
| PET imaging CT for attenuation limited area (78814) |
$1,702.68 |
$6,756.69 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$2,130.86 |
$8,455.76 |
1.5× |
| Pr csf ventriculography (78635) |
$280.99 |
$1,115.02 |
0.5× |
| Pr heart first pass single,planar (78481) |
$426.26 |
$1,691.50 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,150.93 |
$4,567.17 |
3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$429.01 |
$1,702.44 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$567.97 |
$2,253.85 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$281.08 |
$1,115.39 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$85.19 |
$338.04 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$150.01 |
$595.27 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$189.69 |
$752.72 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$47.38 |
$188 |
0.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$278.83 |
$1,106.48 |
2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,715.71 |
$26,649.64 |
0.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,076.42 |
$4,271.52 |
1.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$535.50 |
$2,125 |
5.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$919.72 |
$3,649.68 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$140.51 |
$557.56 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$102.20 |
$405.56 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$154.16 |
$611.75 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$117.75 |
$467.28 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$309.60 |
$1,228.58 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$225.74 |
$895.79 |
1.3× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$42.99 |
$170.60 |
0.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$242.16 |
$960.96 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$220.15 |
$873.60 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$118.49 |
$470.19 |
1.4× |
| Radiological examination surgical specimen (76098) |
$249.94 |
$991.83 |
0.5× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$223.78 |
$888 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,927.16 |
$11,615.70 |
0.9× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,589.38 |
$6,307.08 |
0.5× |
| Ribs bilateral 3 views (71110) |
$165.18 |
$655.49 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,240.23 |
$4,921.56 |
3.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,146.92 |
$4,551.29 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$826.82 |
$3,281.04 |
1.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$989.91 |
$3,928.20 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,743.59 |
$6,919 |
1.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,075.05 |
$4,266.08 |
0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$457.72 |
$1,816.33 |
2.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$329.17 |
$1,306.24 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$341.80 |
$1,356.33 |
1.5× |
| Sacroiliac Joints < 3 Views (72200) |
$112.51 |
$446.48 |
1.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$276.79 |
$1,098.36 |
1.2× |
| Salivary gland function study (78232) |
$444.27 |
$1,762.99 |
1.1× |
| Scanogram (77073) |
$163.29 |
$647.99 |
1.6× |
| Scapula complete (73010) |
$130.14 |
$516.44 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$31.82 |
$126.26 |
1.4× |
| Sella turcica (70240) |
$19.15 |
$76 |
0.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$178.62 |
$708.80 |
1.7× |
| Sialogram (70390) |
$238.03 |
$944.57 |
1.0× |
| Simulation intermediate (77285) |
$568.25 |
$2,254.95 |
1.5× |
| Small bowel series (74250) |
$207.95 |
$825.18 |
1.2× |
| Spec medical radj physics consltj (77370) |
$504.24 |
$2,000.96 |
3.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$449.34 |
$1,783.11 |
1.2× |
| Special dosimetry (77331) |
$281.83 |
$1,118.37 |
2.1× |
| Special treatment procedure (77470) |
$979.08 |
$3,885.24 |
1.8× |
| Spine thoracic 3 views (72072) |
$147.81 |
$586.53 |
1.4× |
| Stereotactic body radiation delivery (77373) |
$5,270.16 |
$20,913.32 |
2.9× |
| Tbs Technical Calculation Only (77091) |
$53.53 |
$212.43 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,307.90 |
$5,190.09 |
3.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$684.55 |
$2,716.46 |
1.8× |
| Testicular Imaging With Vascular Flow (78761) |
$596.54 |
$2,367.21 |
1.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$960.89 |
$3,813.05 |
2.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$360.34 |
$1,429.92 |
2.7× |
| Thoracolumbar 2 views (72080) |
$110.65 |
$439.09 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$630.17 |
$2,500.66 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$292.36 |
$1,160.17 |
0.7× |
| Thyroid uptake measurement (78012) |
$256.16 |
$1,016.50 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$414.64 |
$1,645.38 |
1.0× |
| Tomogram (76100) |
$454.62 |
$1,804.06 |
4.3× |
| Treatment device intermediate (77333) |
$320.74 |
$1,272.78 |
2.4× |
| Treatment devices simple (77332) |
$266.54 |
$1,057.71 |
2.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,170.29 |
$4,644 |
2.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$499.16 |
$1,980.82 |
1.2× |
| Tx devices design & construction complex (77334) |
$573.10 |
$2,274.22 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$249.70 |
$990.89 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$76.04 |
$301.77 |
0.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$230.01 |
$912.72 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$87.29 |
$346.37 |
1.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$257.61 |
$1,022.27 |
0.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$670.09 |
$2,659.10 |
6.6× |
| Unlisted Ultrasound Procedure (76999) |
$128.38 |
$509.45 |
1.5× |
| Upper Extremity Infant (73092) |
$139.01 |
$551.62 |
1.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$593.96 |
$2,357 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$330.95 |
$1,313.28 |
1.4× |
| Urethrocystography voiding (74455) |
$323.23 |
$1,282.66 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$415.23 |
$1,647.72 |
2.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$278.88 |
$1,106.68 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$142.17 |
$564.18 |
1.4× |
| Us breast unilateral complete (76641) |
$338.56 |
$1,343.50 |
3.2× |
| Us breast unilateral limited (76642) |
$221.48 |
$878.90 |
2.5× |
| Us chest (76604) |
$195.86 |
$777.24 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$163.32 |
$648.06 |
1.6× |
| Us elastography parenchyma (76981) |
$129.88 |
$515.38 |
1.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$100.73 |
$399.72 |
1.0× |
| Us guided compression repair (76936) |
$295.02 |
$1,170.70 |
1.4× |
| Us infant hips dynamic (76885) |
$126.86 |
$503.43 |
1.5× |
| Us infant hips limited static (76886) |
$204.12 |
$810 |
2.3× |
| Us ob detailed single fetus (76811) |
$213 |
$845.24 |
0.9× |
| Us ob transvaginal (76817) |
$131.68 |
$522.52 |
1.3× |
| Us pelvic non ob complete (76856) |
$301.74 |
$1,197.39 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$180.72 |
$717.13 |
1.7× |
| Us pregnancy ltd (76815) |
$63.30 |
$251.20 |
0.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$173.53 |
$688.62 |
1.7× |
| Us retroperitoneal complete (76770) |
$295.44 |
$1,172.40 |
2.8× |
| Us retroperitoneal limited (76775) |
$236.71 |
$939.32 |
2.3× |
| Us scrotum and contents (76870) |
$290.05 |
$1,150.98 |
2.8× |
| Us soft tissue head/neck (76536) |
$198 |
$785.70 |
1.9× |
| Us spinal canal and contents (76800) |
$233.97 |
$928.45 |
2.2× |
| Us transrectal (76872) |
$161.82 |
$642.14 |
1.5× |
| Us transrectal prostate volume (76873) |
$232.31 |
$921.85 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$160.62 |
$637.38 |
1.5× |
| Vascular flow imaging (78445) |
$243.45 |
$966.07 |
0.6× |
| Venogram extremity bilateral (75822) |
$961.92 |
$3,817.16 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,586.83 |
$6,296.94 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$857.76 |
$3,403.80 |
0.5× |
| Venography epidural rs&i (75872) |
$561.97 |
$2,230.02 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$641.28 |
$2,544.77 |
0.4× |
| Venography Renal Bilateral (75833) |
$2,822.41 |
$11,200.02 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$1,881.60 |
$7,466.68 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,207.66 |
$4,792.32 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,790.01 |
$7,103.20 |
0.3× |
| Wrist 2 views (73100) |
$100.81 |
$400.04 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$165.45 |
$656.53 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$120.75 |
$479.15 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$129.03 |
$512.04 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$317.53 |
$1,260.03 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$96.69 |
$383.71 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$126.06 |
$500.24 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$253.13 |
$1,004.47 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$84.70 |
$336.13 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$107.25 |
$425.61 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$155.98 |
$618.96 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$223.83 |
$888.21 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$228.14 |
$905.30 |
2.2× |
| X-ray exam of femur 1 (73551) |
$77.79 |
$308.70 |
0.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$200.07 |
$793.93 |
1.1× |
| X-ray eye for foreign body (70030) |
$83.01 |
$329.40 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$142.82 |
$566.76 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$94.84 |
$376.36 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$126.03 |
$500.10 |
1.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$857.02 |
$3,400.88 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$97.90 |
$388.49 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$89.95 |
$356.93 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$171.47 |
$680.44 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$121.01 |
$480.19 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$142.20 |
$564.30 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$140.19 |
$556.30 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$210.42 |
$835 |
2.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$129.52 |
$513.96 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$101.34 |
$402.15 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$117.48 |
$466.20 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$153.10 |
$607.55 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$145.65 |
$577.96 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$271.85 |
$1,078.77 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$280.67 |
$1,113.76 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$110.12 |
$436.99 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$142.53 |
$565.58 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$188.13 |
$746.55 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$115.37 |
$457.80 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$115.24 |
$457.32 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$122.77 |
$487.17 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$135.03 |
$535.82 |
1.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$76.04 |
$301.73 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$166.79 |
$661.88 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$134.38 |
$533.26 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$95.92 |
$380.63 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$97.03 |
$385.02 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$115.30 |
$457.52 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$118.20 |
$469.04 |
1.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$161.67 |
$641.55 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$91.80 |
$364.29 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.34 |
$489.46 |
1.4× |
| Xr arthrogram ankle (73615) |
$639 |
$2,535.71 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$220.37 |
$874.47 |
2.1× |
| Xr chest 4+ views (71048) |
$162.45 |
$644.63 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$87.88 |
$348.72 |
1.0× |
| Xr shoulder 1 view (73020) |
$91.72 |
$363.98 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$180.26 |
$715.33 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$115.15 |
$456.95 |
1.3× |
| Xr tmj bilateral (70330) |
$133.56 |
$530 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$111.37 |
$441.95 |
1.3× |