| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,018.40 |
$3,364 |
1.5× |
| Abdomen 2 views (74019) |
$459.90 |
$766.50 |
4.4× |
| Ankle 2 views (73600) |
$331.20 |
$552 |
3.8× |
| Arthrogram elbow (73085) |
$1,101.60 |
$1,836 |
3.2× |
| Arthrogram hip (73525) |
$1,358.40 |
$2,264 |
3.9× |
| Arthrogram shoulder (73040) |
$1,357.20 |
$2,262 |
3.9× |
| Arthrogram wrist (73115) |
$1,330.80 |
$2,218 |
3.8× |
| Arthrography knee lt (73580) |
$992.70 |
$1,654.50 |
2.8× |
| Basic radiation dosimetry calculation (77300) |
$215.40 |
$359 |
1.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$180.60 |
$301 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$384 |
$640 |
4.4× |
| Chest 1 view (71045) |
$408.60 |
$681 |
4.7× |
| Clavicle complete (73000) |
$358.80 |
$598 |
4.1× |
| Continuing medical physics consltj pr wk (77336) |
$215.40 |
$359 |
1.6× |
| Diskography lumbar (72295) |
$2,827.80 |
$4,713 |
1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$654.60 |
$1,091 |
6.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$398.70 |
$664.50 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$912.90 |
$1,521.50 |
8.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$660 |
$1,100 |
6.3× |
| Foot 2 views (73620) |
$301.80 |
$503 |
3.5× |
| Forearm 2 views (73090) |
$318 |
$530 |
3.6× |
| Hand 2 views (73120) |
$347.40 |
$579 |
3.3× |
| Hand 3 views (73130) |
$367.80 |
$613 |
4.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$927.60 |
$1,546 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$927.60 |
$1,546 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$927.60 |
$1,546 |
1.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$927.60 |
$1,546 |
2.4× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$927.60 |
$1,546 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$331.80 |
$553 |
3.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$183 |
$305 |
1.7× |
| Knee 3 views (73562) |
$384 |
$640 |
4.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$161.70 |
$269.50 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$424.80 |
$708 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,734.20 |
$4,557 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$568.20 |
$947 |
5.4× |
| Pelvis 1 or 2 views (72170) |
$321.60 |
$536 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$141.90 |
$236.50 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$344.70 |
$574.50 |
3.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$400.20 |
$667 |
3.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$887.40 |
$1,479 |
8.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,400.20 |
$20,667 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$374.40 |
$624 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$129.60 |
$216 |
1.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$129.60 |
$216 |
0.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$354.30 |
$590.50 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$312 |
$520 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$457.20 |
$762 |
5.2× |
| Ribs bilateral 3 views (71110) |
$515.10 |
$858.50 |
4.9× |
| Sacroiliac Joints < 3 Views (72200) |
$246.60 |
$411 |
2.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$253.20 |
$422 |
1.1× |
| Scanogram (77073) |
$396 |
$660 |
3.8× |
| Scapula complete (73010) |
$342.60 |
$571 |
3.3× |
| Simulation intermediate (77285) |
$418.80 |
$698 |
1.1× |
| Spec medical radj physics consltj (77370) |
$215.40 |
$359 |
1.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$401.40 |
$669 |
1.1× |
| Special dosimetry (77331) |
$145.80 |
$243 |
1.1× |
| Special treatment procedure (77470) |
$888 |
$1,480 |
1.6× |
| Spine thoracic 3 views (72072) |
$415.20 |
$692 |
4.0× |
| Stereotactic body radiation delivery (77373) |
$2,852.40 |
$4,754 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$211.20 |
$352 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$145.80 |
$243 |
0.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$646.80 |
$1,078 |
1.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$283.20 |
$472 |
2.1× |
| Thoracolumbar 2 views (72080) |
$108 |
$180 |
1.2× |
| Treatment device intermediate (77333) |
$275.40 |
$459 |
2.0× |
| Treatment devices simple (77332) |
$275.40 |
$459 |
2.0× |
| Tx devices design & construction complex (77334) |
$550.20 |
$917 |
1.5× |
| Umbilical-artery Doppler (OB) (76820) |
$468 |
$780 |
4.5× |
| Us chest (76604) |
$507 |
$845 |
4.8× |
| Us compl joint r-t w/image documentation (76881) |
$650.40 |
$1,084 |
6.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$442.80 |
$738 |
4.2× |
| Us ob detailed single fetus (76811) |
$1,068.90 |
$1,781.50 |
4.5× |
| Us ob transvaginal (76817) |
$555 |
$925 |
5.3× |
| Us pelvic non ob complete (76856) |
$763.50 |
$1,272.50 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$128.70 |
$214.50 |
1.2× |
| Us pregnancy ltd (76815) |
$483.60 |
$806 |
4.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$653.70 |
$1,089.50 |
6.2× |
| Us scrotum and contents (76870) |
$827.70 |
$1,379.50 |
7.9× |
| Us soft tissue head/neck (76536) |
$802.50 |
$1,337.50 |
7.7× |
| Us transrectal (76872) |
$265.50 |
$442.50 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$479.10 |
$798.50 |
4.6× |
| Wrist 2 views (73100) |
$324.60 |
$541 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$553.20 |
$922 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$109.80 |
$183 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$372.60 |
$621 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$299.40 |
$499 |
3.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$359.40 |
$599 |
4.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$231.30 |
$385.50 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$262.20 |
$437 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$312 |
$520 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$113.40 |
$189 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$942.60 |
$1,571 |
9.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$989.10 |
$1,648.50 |
9.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$365.40 |
$609 |
4.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$91.20 |
$152 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$471 |
$785 |
4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$268.20 |
$447 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$246.30 |
$410.50 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$402 |
$670 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$639.30 |
$1,065.50 |
6.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$157.20 |
$262 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$357.60 |
$596 |
4.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$477 |
$795 |
4.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$331.80 |
$553 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$478.50 |
$797.50 |
4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$570.90 |
$951.50 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$396.30 |
$660.50 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$352.80 |
$588 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$387.60 |
$646 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$340.80 |
$568 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$269.70 |
$449.50 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$427.50 |
$712.50 |
4.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$355.20 |
$592 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$225.30 |
$375.50 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$300 |
$500 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$363 |
$605 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$689.40 |
$1,149 |
6.6× |
| Xr finger(s) 2+ views (73140) |
$292.20 |
$487 |
3.4× |
| Xr shoulder 1 view (73020) |
$307.20 |
$512 |
3.5× |
| Xr spine cervical 4 or 5 views (72050) |
$548.40 |
$914 |
5.2× |
| Xr tibia/fibula 2 views (73590) |
$325.20 |
$542 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$349.80 |
$583 |
4.0× |