| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,962.80 |
$7,756 |
2.0× |
| Abdomen 2 views (74019) |
$326.61 |
$855 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,005.81 |
$2,633 |
2.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,138.82 |
$5,599 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$4,261.98 |
$11,157 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,719.54 |
$9,737 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,433.80 |
$8,989 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,724.58 |
$12,368 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,041.10 |
$21,050 |
2.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,020.55 |
$10,525 |
1.2× |
| Angiography Spinal Selective Rs&I (75705) |
$8,009.78 |
$20,968 |
1.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,240.74 |
$16,337 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,800.90 |
$9,950 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,859.73 |
$10,104 |
1.1× |
| Ankle 2 views (73600) |
$279.63 |
$732 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$473.68 |
$1,240 |
1.3× |
| Aortogram thoracic (75605) |
$3,865.46 |
$10,119 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,370.85 |
$11,442 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$4,370.85 |
$11,442 |
1.3× |
| Arthrogram hip (73525) |
$724.85 |
$1,897.50 |
1.9× |
| Arthrography knee lt (73580) |
$576.44 |
$1,509 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$350.30 |
$917 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$856.45 |
$2,242 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$1,206.36 |
$3,158 |
2.8× |
| Bone age studies (77072) |
$139.43 |
$365 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$1,254.49 |
$3,284 |
2.9× |
| Bone Marrow Imaging Limited Area (78102) |
$547.41 |
$1,433 |
1.3× |
| Bone survey complete (77075) |
$393.46 |
$1,030 |
3.5× |
| Brachytx isodose complex (77318) |
$1,975.33 |
$5,171 |
4.9× |
| Brachytx isodose intermed (77317) |
$1,362.98 |
$3,568 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,047.07 |
$2,741 |
2.6× |
| Brain image w/flow 4 + views (78606) |
$1,001.23 |
$2,621 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,007.57 |
$10,491 |
2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,289.64 |
$3,376 |
3.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$763.62 |
$1,999 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$333.11 |
$872 |
3.6× |
| Chest 1 view (71045) |
$215.07 |
$563 |
2.3× |
| Chest 3 views (71047) |
$294.91 |
$772 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$458.40 |
$1,200 |
2.4× |
| Cineradiography/videoradiography (76120) |
$665.45 |
$1,742 |
6.0× |
| Clavicle complete (73000) |
$314.77 |
$824 |
3.4× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$30,508.82 |
$79,866 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$767.82 |
$2,010 |
6.9× |
| Continuing medical physics consltj pr wk (77336) |
$420.20 |
$1,100 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,453.59 |
$6,423 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,332.42 |
$3,488 |
5.2× |
| CT abdomen w contrast (74160) |
$1,408.44 |
$3,687 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,618.92 |
$4,238 |
8.6× |
| CT abdomen w/o contrast (74150) |
$906.49 |
$2,373 |
8.1× |
| CT angio hrt w/3d image (75574) |
$1,151.35 |
$3,014 |
3.1× |
| CT angiography upper extremity lt (73206) |
$872.49 |
$2,284 |
4.7× |
| CT c-spine w/o contrast (72125) |
$1,828.64 |
$4,787 |
16.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,706.47 |
$7,085 |
14.5× |
| CT cervical spine with contrast (72126) |
$2,139.59 |
$5,601 |
5.7× |
| CT chest w/wo contrast (71270) |
$1,686.53 |
$4,415 |
9.0× |
| CT chest with contrast (71260) |
$1,505.85 |
$3,942 |
8.0× |
| CT colonography screening (74263) |
$591.34 |
$1,548 |
2.3× |
| CT colonography w/dye (74262) |
$1,052.03 |
$2,754 |
5.6× |
| CT colonography w/o cntrst (74261) |
$591.34 |
$1,548 |
5.3× |
| CT head/brain with contrast (70460) |
$1,699.90 |
$4,450 |
9.1× |
| CT head/brain without and with contrast (70470) |
$2,004.36 |
$5,247 |
10.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,151.35 |
$3,014 |
3.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$840.40 |
$2,200 |
9.1× |
| CT hrt w/3d image congen (75573) |
$1,151.35 |
$3,014 |
3.1× |
| CT iac w contrast (70481) |
$1,557.42 |
$4,077 |
8.3× |
| CT limited/localized follow up study (76380) |
$190.24 |
$498 |
2.0× |
| CT lower ext w/o (73700) |
$1,356.30 |
$3,550.50 |
12.2× |
| CT lower extremity w wo contrast (73702) |
$1,383.61 |
$3,622 |
7.4× |
| CT lower extremity with contrast (73701) |
$1,695.51 |
$4,438.50 |
9.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,646.88 |
$6,929 |
14.1× |
| CT lumbar spine w/o contrast (72131) |
$1,960.81 |
$5,133 |
17.6× |
| CT lumbar spine with contrast (72132) |
$2,274.43 |
$5,954 |
6.1× |
| CT maxillofacial w contrast (70487) |
$1,070.37 |
$2,802 |
5.7× |
| CT maxillofacial w/o contrast (70486) |
$884.33 |
$2,315 |
7.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,300.33 |
$3,404 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,391.63 |
$3,643 |
7.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,681.95 |
$4,403 |
9.0× |
| CT orbits w/o contrast (70480) |
$1,323.63 |
$3,465 |
11.9× |
| CT pelvis w & w/o contrast (72194) |
$1,791.20 |
$4,689 |
9.6× |
| CT pelvis w/o contrast (72192) |
$1,367.18 |
$3,579 |
12.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,697.99 |
$4,445 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,016.12 |
$2,660 |
9.1× |
| CT thoracic spine w/contrast (72129) |
$2,787.08 |
$7,296 |
14.9× |
| CT thoracic spine w/o contrast (72128) |
$1,858.05 |
$4,864 |
16.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,750.02 |
$7,199 |
14.7× |
| CT thorax w/o contrast (71250) |
$903.43 |
$2,365 |
8.1× |
| CT unlisted procedure (76497) |
$112.31 |
$294 |
1.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,402.71 |
$3,672 |
7.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,348.84 |
$3,531 |
12.1× |
| CT upper extremity with contrast (73201) |
$1,659.03 |
$4,343 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,014.60 |
$2,656 |
5.4× |
| Cta Abdomen (74175) |
$1,701.05 |
$4,453 |
9.1× |
| CTA abdomen pelvis (74174) |
$2,152.96 |
$5,636 |
5.8× |
| CTA chest (71275) |
$1,626.18 |
$4,257 |
8.7× |
| Cta Head (70496) |
$1,695.32 |
$4,438 |
9.1× |
| CTA lwr ext w&w/o contrast (73706) |
$988.42 |
$2,587.50 |
5.3× |
| Cta Neck (70498) |
$1,697.23 |
$4,443 |
9.1× |
| Cta Pelvis (72191) |
$498.13 |
$1,304 |
2.7× |
| Cystography minimum 3 views rs&i (74430) |
$459.55 |
$1,203 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$475.59 |
$1,245 |
4.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$166.17 |
$435 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$229.97 |
$602 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$229.97 |
$602 |
2.1× |
| Echo exam of fetal heart (76825) |
$843.84 |
$2,209 |
1.4× |
| Echoencephalography real time imaging (76506) |
$301.02 |
$788 |
2.7× |
| Esophagus (74220) |
$397.48 |
$1,040.50 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$291.47 |
$763 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$411.04 |
$1,076 |
1.6× |
| Foot 2 views (73620) |
$279.06 |
$730.50 |
3.0× |
| Forearm 2 views (73090) |
$338.46 |
$886 |
3.6× |
| Functional MRI brain by phys/psych (70555) |
$576.44 |
$1,509 |
2.3× |
| Gated Heart Planar Single (78472) |
$1,446.64 |
$3,787 |
3.4× |
| Hand 2 views (73120) |
$282.68 |
$740 |
2.5× |
| Hand 3 views (73130) |
$364.81 |
$955 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$917.95 |
$2,403 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$917.95 |
$2,403 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$917.95 |
$2,403 |
1.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$280.01 |
$733 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,691.88 |
$4,429 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,235.01 |
$3,233 |
2.9× |
| Ht muscle image spect sing (78451) |
$2,601.04 |
$6,809 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$294.91 |
$772 |
3.2× |
| Hysterosalpingogram (74740) |
$719.69 |
$1,884 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$3,381.85 |
$8,853 |
4.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,574.61 |
$4,122 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,175.04 |
$3,076 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,444.04 |
$6,398 |
4.2× |
| Knee 3 views (73562) |
$366.34 |
$959 |
3.9× |
| Liver & spleen imaging static only (78215) |
$560.78 |
$1,468 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,128.81 |
$2,955 |
2.6× |
| Liver imaging w/vascular flow (78202) |
$1,071.13 |
$2,804 |
1.8× |
| Lung perf&ventilat diferentl (78598) |
$1,153.26 |
$3,019 |
2.0× |
| Lung perfusion differential (78597) |
$748.72 |
$1,960 |
1.8× |
| Lung Ventilation Imaging (78579) |
$730.77 |
$1,913 |
1.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,265.57 |
$3,313 |
0.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$843.46 |
$2,208 |
0.3× |
| Lymphoscintigraphy (78195) |
$1,236.16 |
$3,236 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$362.90 |
$950 |
1.4× |
| Meckels Diverticulum (78290) |
$1,016.89 |
$2,662 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,807.25 |
$4,731 |
4.5× |
| Mr elastography (76391) |
$359.08 |
$940 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,428.38 |
$6,357 |
6.5× |
| MRA head w/o contrast (70544) |
$1,167.40 |
$3,056 |
4.6× |
| MRA head with contrast (70545) |
$1,715.95 |
$4,492 |
4.6× |
| MRA neck w contrast (70548) |
$1,502.79 |
$3,934 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,625.41 |
$4,255 |
4.4× |
| MRA neck w/o contrast (70547) |
$1,022.24 |
$2,676 |
4.0× |
| MRI abdomen w contrast (74182) |
$2,440.60 |
$6,389 |
6.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,773.32 |
$7,260 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$1,045.16 |
$2,736 |
4.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,576.52 |
$4,127 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,314.47 |
$3,441 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$1,949.35 |
$5,103 |
7.7× |
| MRI c-spine with contrast (72142) |
$1,795.02 |
$4,699 |
4.8× |
| MRI cardiac w/o contrast (75557) |
$1,121.94 |
$2,937 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,464.97 |
$3,835 |
5.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,282.38 |
$3,357 |
3.4× |
| MRI chest w/o contrast (71550) |
$769.35 |
$2,014 |
3.0× |
| MRI fetal sngl/1st gestation (74712) |
$350.68 |
$918 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,001.23 |
$2,621 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,630.38 |
$4,268 |
4.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,648.72 |
$4,316 |
6.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,273.21 |
$3,333 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,598.37 |
$6,802 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,740.78 |
$4,557 |
4.7× |
| MRI pelvis w contrast (72196) |
$1,516.93 |
$3,971 |
4.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,106.73 |
$5,515 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,306.44 |
$3,420 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,174.16 |
$5,691.50 |
5.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,950.57 |
$7,724 |
7.9× |
| MRI spectroscopy (76390) |
$371.31 |
$972 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,063.19 |
$5,401 |
5.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,917.26 |
$5,019 |
5.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,203.38 |
$5,768 |
5.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,917.26 |
$5,019 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,203.38 |
$5,768 |
5.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,564.68 |
$4,096 |
6.1× |
| MRI tmj (70336) |
$691.04 |
$1,809 |
2.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,842.78 |
$4,824 |
7.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,115.52 |
$5,538 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$803.73 |
$2,104 |
3.2× |
| Myelogram Cervical (72240) |
$1,629.23 |
$4,265 |
1.9× |
| Myelogram Lumbar (72265) |
$1,629.23 |
$4,265 |
1.9× |
| Myelogram thoracic (72255) |
$1,629.23 |
$4,265 |
1.9× |
| Myelography 2 or more regions (72270) |
$2,444.04 |
$6,398 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,133.93 |
$8,204 |
2.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,192.23 |
$3,121 |
1.3× |
| Neck soft tissue (70360) |
$269.31 |
$705 |
2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$361.38 |
$946 |
0.8× |
| Nm cisternogram (78630) |
$1,099.02 |
$2,877 |
1.9× |
| Nm csf leak detection (78650) |
$991.68 |
$2,596 |
0.7× |
| Nm gastric emptying study (78264) |
$1,245.32 |
$3,260 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,222.17 |
$8,435 |
2.2× |
| Nuclear medicine of heart pumping function (78473) |
$1,432.12 |
$3,749 |
3.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,456.95 |
$3,814 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$1,043.25 |
$2,731 |
4.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$399.19 |
$1,045 |
3.6× |
| Osseous survey infant (77076) |
$428.99 |
$1,123 |
3.8× |
| Osseous survey limited (77074) |
$287.27 |
$752 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$814.05 |
$2,131 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$708.23 |
$1,854 |
1.7× |
| Parathyroid imaging (78070) |
$667.74 |
$1,748 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$289.94 |
$759 |
2.6× |
| Perineogram (74775) |
$309.42 |
$810 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,988.47 |
$10,441 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$4,007.57 |
$10,491 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,083.97 |
$10,691 |
2.7× |
| PET imaging limited area chest head/neck (78811) |
$1,983.35 |
$5,192 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,747.92 |
$7,193.50 |
7.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,619.84 |
$9,476 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,619.84 |
$9,476 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,015.36 |
$2,658 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,431.36 |
$3,747 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$573.20 |
$1,500.50 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$139.05 |
$364 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$262.82 |
$688 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$543.21 |
$1,422 |
4.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$527.93 |
$1,382 |
4.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,377.80 |
$27,167 |
1.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$758.27 |
$1,985 |
1.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$361.76 |
$947 |
3.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$406.83 |
$1,065 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$187.95 |
$492 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$170.38 |
$446 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$254.03 |
$665 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$340.37 |
$891 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$347.62 |
$910 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$448.09 |
$1,173 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$441.60 |
$1,156 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$274.85 |
$719.50 |
3.0× |
| Radiological examination surgical specimen (76098) |
$715.87 |
$1,874 |
1.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,075.18 |
$10,668 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,728.32 |
$9,760 |
1.1× |
| Ribs bilateral 3 views (71110) |
$359.47 |
$941 |
3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,309.50 |
$3,428 |
3.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,275.50 |
$3,339 |
2.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,700.67 |
$4,452 |
2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,125.83 |
$5,565 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,363.82 |
$6,188 |
1.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,125.83 |
$5,565 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$473.68 |
$1,240 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$471.77 |
$1,235 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$254.42 |
$666 |
2.3× |
| Scanogram (77073) |
$131.03 |
$343 |
1.2× |
| Scapula complete (73010) |
$226.15 |
$592 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$67.81 |
$177.50 |
2.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$177.25 |
$464 |
1.6× |
| Small bowel series (74250) |
$314.39 |
$823 |
1.7× |
| Spec medical radj physics consltj (77370) |
$731.15 |
$1,914 |
5.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,093.67 |
$2,863 |
2.7× |
| Special dosimetry (77331) |
$241.05 |
$631 |
1.7× |
| Special treatment procedure (77470) |
$2,936.44 |
$7,687 |
5.0× |
| Spine thoracic 3 views (72072) |
$388.88 |
$1,018 |
3.5× |
| Stereotactic body radiation delivery (77373) |
$16,915.73 |
$44,282 |
8.9× |
| Superior sagittal sinus venogram (75870) |
$1,239.21 |
$3,244 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,688.83 |
$4,421 |
4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$861.03 |
$2,254 |
2.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,273.97 |
$3,335 |
3.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$471.39 |
$1,234 |
3.3× |
| Therapeutic Enema (74283) |
$529.46 |
$1,386 |
2.8× |
| Thoracolumbar 2 views (72080) |
$226.15 |
$592 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,054.71 |
$2,761 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$558.49 |
$1,462 |
1.3× |
| Tmj unilateral (70328) |
$106.58 |
$279 |
1.1× |
| Treatment device intermediate (77333) |
$357.56 |
$936 |
2.5× |
| Treatment devices simple (77332) |
$278.10 |
$728 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,840.17 |
$7,435 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$969.52 |
$2,538 |
2.3× |
| Tx devices design & construction complex (77334) |
$794.56 |
$2,080 |
2.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$393.85 |
$1,031 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$691.04 |
$1,809 |
6.2× |
| Umbilical-artery Doppler (OB) (76820) |
$137.14 |
$359 |
1.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$119.57 |
$313 |
1.3× |
| Unlisted fluoroscopic procedure (76496) |
$676.91 |
$1,772 |
7.3× |
| Unlisted magnetic resonance procedure (76498) |
$594.78 |
$1,557 |
6.4× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$472.16 |
$1,236 |
1.1× |
| Upper Extremity Infant (73092) |
$136.76 |
$358 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$367.87 |
$963 |
1.4× |
| Urethrocystography voiding (74455) |
$367.87 |
$963 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$205.90 |
$539 |
1.8× |
| Us breast unilateral complete (76641) |
$297.20 |
$778 |
2.7× |
| Us breast unilateral limited (76642) |
$223.86 |
$586 |
2.4× |
| Us chest (76604) |
$408.74 |
$1,070 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$339.22 |
$888 |
3.0× |
| Us elastography parenchyma (76981) |
$254.03 |
$665 |
2.3× |
| Us infant hips dynamic (76885) |
$369.78 |
$968 |
4.0× |
| Us kidney transplant (76776) |
$391.17 |
$1,024 |
3.5× |
| Us ob transvaginal (76817) |
$469.86 |
$1,230 |
4.2× |
| Us pelvic non ob complete (76856) |
$521.82 |
$1,366 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$354.88 |
$929 |
3.2× |
| Us pregnancy ltd (76815) |
$347.62 |
$910 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$581.03 |
$1,521 |
5.2× |
| Us retroperitoneal complete (76770) |
$418.68 |
$1,096 |
3.8× |
| Us retroperitoneal limited (76775) |
$359.85 |
$942 |
3.2× |
| Us scrotum and contents (76870) |
$511.12 |
$1,338 |
4.6× |
| Us soft tissue head/neck (76536) |
$336.16 |
$880 |
3.0× |
| Us spinal canal and contents (76800) |
$222.33 |
$582 |
2.0× |
| Us transrectal (76872) |
$313.63 |
$821 |
2.8× |
| Us transrectal prostate volume (76873) |
$238.37 |
$624 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$145.93 |
$382 |
1.3× |
| Venogram extremity bilateral (75822) |
$3,182.83 |
$8,332 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,619.84 |
$9,476 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,393.73 |
$3,648.50 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$1,427.73 |
$3,737.50 |
0.8× |
| Venography Renal Bilateral (75833) |
$6,112.77 |
$16,002 |
1.8× |
| Venography renal unilateral selective rs&i (75831) |
$4,075.18 |
$10,668 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,349.38 |
$8,768 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,748.72 |
$15,049 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$101.23 |
$265 |
1.1× |
| Wrist 2 views (73100) |
$264.16 |
$691.50 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$680.73 |
$1,782 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$197.50 |
$517 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$336.93 |
$882 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$469.86 |
$1,230 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$269.70 |
$706 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$317.06 |
$830 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$506.92 |
$1,327 |
4.5× |
| X-ray exam hip uni 1 view (73501) |
$219.27 |
$574 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$327.38 |
$857 |
3.5× |
| X-ray exam hip uni 4/> views (73503) |
$374.74 |
$981 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$654.75 |
$1,714 |
5.9× |
| X-ray exam of femur 1 (73551) |
$137.52 |
$360 |
1.5× |
| X-ray eye for foreign body (70030) |
$230.54 |
$603.50 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$232.26 |
$608 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$167.32 |
$438 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$318.97 |
$835 |
3.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,000.16 |
$5,236 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$146.50 |
$383.50 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$125.68 |
$329 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$421.35 |
$1,103 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$340.75 |
$892 |
3.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$134.85 |
$353 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$335.78 |
$879 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$527.16 |
$1,380 |
4.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$335.78 |
$879 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$163.50 |
$428 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$227.29 |
$595 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$406.07 |
$1,063 |
3.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$473.68 |
$1,240 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$302.17 |
$791 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$359.47 |
$941 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$442.36 |
$1,158 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$305.99 |
$801 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$263.97 |
$691 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$323.56 |
$847 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$208.58 |
$546 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$166.94 |
$437 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$285.74 |
$748 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$226.53 |
$593 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$221.56 |
$580 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$233.02 |
$610 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$203.61 |
$533 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$361.38 |
$946 |
3.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$435.48 |
$1,140 |
3.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$211.63 |
$554 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$322.41 |
$844 |
3.5× |
| Xr c-spine 6 or more views (72052) |
$526.40 |
$1,378 |
4.7× |
| Xr chest 4+ views (71048) |
$333.49 |
$873 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$215.64 |
$564.50 |
2.3× |
| Xr shoulder 1 view (73020) |
$254.80 |
$667 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$436.63 |
$1,143 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$349.34 |
$914.50 |
3.8× |
| Xr tmj bilateral (70330) |
$160.06 |
$419 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$311.33 |
$815 |
3.4× |