| 3-D radiotherapy plan dose-volume histograms (77295) |
$13,783 |
$13,783 |
9.8× |
| Abdomen 2 views (74019) |
$920 |
$920 |
8.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,343.98 |
$2,343.98 |
5.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,639 |
$6,639 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$8,800.55 |
$8,800.55 |
2.7× |
| Angiography extremity unilateral rs&i (75710) |
$9,062 |
$9,062 |
2.8× |
| Angiography internal mammary rs&i (75756) |
$8,740 |
$8,740 |
2.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$15,255.90 |
$15,255.90 |
2.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,428.85 |
$9,428.85 |
2.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,883.25 |
$7,883.25 |
2.5× |
| Angiography Spinal Selective Rs&I (75705) |
$15,255.90 |
$15,255.90 |
2.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$12,463 |
$12,463 |
2.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,025 |
$4,025 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,496 |
$3,496 |
1.1× |
| Ankle 2 views (73600) |
$784 |
$784 |
8.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,551 |
$1,551 |
4.4× |
| Aortogram thoracic (75605) |
$18,212 |
$18,212 |
3.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,787 |
$7,787 |
2.4× |
| Aortography abdominal serialography rs&i (75625) |
$6,578.17 |
$6,578.17 |
2.1× |
| Artery X-Rays Adrenal Gland (75731) |
$7,866 |
$7,866 |
2.5× |
| Arthrogram hip (73525) |
$1,275 |
$1,275 |
3.6× |
| Arthrogram shoulder (73040) |
$1,595 |
$1,595 |
4.5× |
| Arthrogram wrist (73115) |
$988 |
$988 |
2.8× |
| Basic radiation dosimetry calculation (77300) |
$1,255.80 |
$1,255.80 |
9.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,915 |
$1,915 |
4.7× |
| Bone &/joint imaging whole body (78306) |
$3,347.65 |
$3,347.65 |
8.2× |
| Bone age studies (77072) |
$510 |
$510 |
4.8× |
| Bone Imaging 3 Phase (78315) |
$3,234.95 |
$3,234.95 |
8.0× |
| Bone survey complete (77075) |
$2,145 |
$2,145 |
20.2× |
| Brachytx isodose complex (77318) |
$3,152 |
$3,152 |
8.3× |
| Brachytx isodose intermed (77317) |
$2,990 |
$2,990 |
7.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,813 |
$2,813 |
7.4× |
| Brain image w/flow 4 + views (78606) |
$2,805 |
$2,805 |
5.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,658 |
$8,658 |
6.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,065 |
$5,065 |
14.3× |
| Cervical spine 2 or 3 views (72040) |
$873 |
$873 |
9.9× |
| Chest 1 view (71045) |
$695 |
$695 |
7.9× |
| Chest 3 views (71047) |
$752 |
$752 |
8.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,378 |
$1,378 |
7.7× |
| Clavicle complete (73000) |
$848.70 |
$848.70 |
9.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,394 |
$2,394 |
22.5× |
| Continuing medical physics consltj pr wk (77336) |
$1,599 |
$1,599 |
11.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,888 |
$11,888 |
33.5× |
| CT abdomen and pelvis without contrast (74176) |
$7,437 |
$7,437 |
30.7× |
| CT abdomen w contrast (74160) |
$5,085 |
$5,085 |
28.5× |
| CT abdomen w wo contrast (74170) |
$5,831 |
$5,831 |
32.7× |
| CT abdomen w/o contrast (74150) |
$3,828 |
$3,828 |
36.0× |
| CT angio hrt w/3d image (75574) |
$3,955 |
$3,955 |
11.2× |
| CT angiography upper extremity lt (73206) |
$4,683.95 |
$4,683.95 |
26.3× |
| CT c-spine w/o contrast (72125) |
$7,208 |
$7,208 |
67.9× |
| CT cervical spine w&w/o contrast (72127) |
$10,974 |
$10,974 |
61.6× |
| CT cervical spine with contrast (72126) |
$9,771 |
$9,771 |
27.6× |
| CT chest w/wo contrast (71270) |
$5,903.25 |
$5,903.25 |
33.1× |
| CT chest with contrast (71260) |
$5,044 |
$5,044 |
28.3× |
| CT head/brain with contrast (70460) |
$4,594 |
$4,594 |
25.8× |
| CT head/brain without and with contrast (70470) |
$6,096.15 |
$6,096.15 |
34.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,374.75 |
$2,374.75 |
6.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$4,693 |
$4,693 |
53.1× |
| CT iac w contrast (70481) |
$5,027.80 |
$5,027.80 |
28.2× |
| CT limited/localized follow up study (76380) |
$2,036 |
$2,036 |
23.0× |
| CT lower ext w/o (73700) |
$3,290 |
$3,290 |
31.0× |
| CT lower extremity w wo contrast (73702) |
$4,800 |
$4,800 |
26.9× |
| CT lower extremity with contrast (73701) |
$4,148 |
$4,148 |
23.3× |
| CT lumbar spine w & w/o contrast (72133) |
$5,459 |
$5,459 |
30.6× |
| CT lumbar spine w/o contrast (72131) |
$4,538 |
$4,538 |
42.7× |
| CT lumbar spine with contrast (72132) |
$5,525.75 |
$5,525.75 |
15.6× |
| CT maxillofacial w contrast (70487) |
$6,480 |
$6,480 |
36.4× |
| CT maxillofacial w/o contrast (70486) |
$4,725 |
$4,725 |
44.5× |
| CT maxillofacial w/wo contrast (70488) |
$7,547 |
$7,547 |
42.4× |
| CT neck soft tissue w contrast (70491) |
$5,424 |
$5,424 |
30.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$4,991 |
$4,991 |
28.0× |
| CT orbits w/o contrast (70480) |
$4,489.60 |
$4,489.60 |
42.3× |
| CT pelvis w & w/o contrast (72194) |
$6,641 |
$6,641 |
37.3× |
| CT pelvis w/o contrast (72192) |
$4,157 |
$4,157 |
39.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$6,319 |
$6,319 |
35.5× |
| CT soft tissue neck w/o contrast (70490) |
$4,095 |
$4,095 |
38.6× |
| CT thoracic spine w/contrast (72129) |
$5,666.05 |
$5,666.05 |
31.8× |
| CT thoracic spine w/o contrast (72128) |
$4,444 |
$4,444 |
41.8× |
| CT thoracic spine w/wo contrast (72130) |
$5,730 |
$5,730 |
32.2× |
| CT thorax w/o contrast (71250) |
$4,341 |
$4,341 |
40.9× |
| CT unlisted procedure (76497) |
$1,400 |
$1,400 |
15.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,894 |
$3,894 |
21.9× |
| CT upper extremity w/o contrast rt (73200) |
$3,520 |
$3,520 |
33.1× |
| CT upper extremity with contrast (73201) |
$3,722 |
$3,722 |
10.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$9,707 |
$9,707 |
54.5× |
| Cta Abdomen (74175) |
$9,285 |
$9,285 |
52.1× |
| CTA abdomen pelvis (74174) |
$8,074 |
$8,074 |
22.8× |
| CTA chest (71275) |
$6,610 |
$6,610 |
37.1× |
| Cta Head (70496) |
$6,849 |
$6,849 |
38.4× |
| CTA lwr ext w&w/o contrast (73706) |
$5,233 |
$5,233 |
29.4× |
| Cta Neck (70498) |
$7,876.35 |
$7,876.35 |
44.2× |
| Cta Pelvis (72191) |
$5,003 |
$5,003 |
28.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,146 |
$1,146 |
3.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$835 |
$835 |
7.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$785 |
$785 |
7.4× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$542.50 |
$542.50 |
5.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,116.02 |
$1,116.02 |
10.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$558.90 |
$558.90 |
6.3× |
| Echo exam of fetal heart (76825) |
$1,867 |
$1,867 |
3.4× |
| Echoencephalography real time imaging (76506) |
$1,410 |
$1,410 |
13.3× |
| Esophagus (74220) |
$941 |
$941 |
5.3× |
| Fetal biophysical profile non-stress testing (76818) |
$1,407 |
$1,407 |
13.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,555.95 |
$1,555.95 |
14.7× |
| Fluoroscopy up to 1 hr (76000) |
$1,656 |
$1,656 |
6.8× |
| Foot 2 views (73620) |
$641 |
$641 |
7.3× |
| Forearm 2 views (73090) |
$792.35 |
$792.35 |
9.0× |
| Gated Heart Planar Single (78472) |
$3,654.25 |
$3,654.25 |
9.0× |
| Hand 2 views (73120) |
$637 |
$637 |
6.0× |
| Hand 3 views (73130) |
$1,106.88 |
$1,106.88 |
12.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$8,030 |
$8,030 |
11.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$9,960.15 |
$9,960.15 |
14.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$8,886 |
$8,886 |
12.6× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,026.95 |
$1,026.95 |
2.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$893 |
$893 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$3,296.50 |
$3,296.50 |
8.1× |
| Ht muscle image spect sing (78451) |
$7,649 |
$7,649 |
5.8× |
| Humerus Min 2 Views Left (73060) |
$986 |
$986 |
11.2× |
| Hysterosalpingogram (74740) |
$1,436 |
$1,436 |
5.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,248 |
$3,248 |
5.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,968 |
$3,968 |
7.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,408 |
$3,408 |
6.2× |
| Knee 3 views (73562) |
$775.53 |
$775.53 |
8.8× |
| Liver & spleen imaging static only (78215) |
$2,042 |
$2,042 |
5.0× |
| Lung perfusion differential (78597) |
$1,629 |
$1,629 |
4.0× |
| Lung Ventilation Imaging (78579) |
$1,629 |
$1,629 |
4.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$6,336.50 |
$6,336.50 |
2.0× |
| Lymphoscintigraphy (78195) |
$2,444 |
$2,444 |
4.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$433 |
$433 |
4.9× |
| Meckels Diverticulum (78290) |
$1,820 |
$1,820 |
4.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$9,895 |
$9,895 |
26.0× |
| MRA head w & w/o contrast (70546) |
$8,010 |
$8,010 |
22.6× |
| MRA head w/o contrast (70544) |
$4,456 |
$4,456 |
18.4× |
| MRA head with contrast (70545) |
$5,605 |
$5,605 |
15.8× |
| MRA neck w contrast (70548) |
$5,180 |
$5,180 |
14.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$7,165.50 |
$7,165.50 |
20.2× |
| MRA neck w/o contrast (70547) |
$4,449 |
$4,449 |
18.4× |
| MRI abdomen w contrast (74182) |
$5,491 |
$5,491 |
15.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,574 |
$6,574 |
18.6× |
| MRI abdomen w/o contrast (74181) |
$5,642 |
$5,642 |
23.3× |
| MRI any jnt lwr ext with con lt (73722) |
$5,950 |
$5,950 |
7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$6,698.75 |
$6,698.75 |
8.4× |
| MRI breast w/o contrast bilateral (77047) |
$4,311 |
$4,311 |
17.8× |
| MRI c-spine with contrast (72142) |
$5,419 |
$5,419 |
15.3× |
| MRI cardiac w/o contrast (75557) |
$4,510.30 |
$4,510.30 |
18.6× |
| MRI cervical spine w/o contrast (72141) |
$4,773 |
$4,773 |
19.7× |
| MRI chest w/o & w/contrast material (71552) |
$6,798 |
$6,798 |
19.2× |
| MRI chest w/o contrast (71550) |
$5,462.50 |
$5,462.50 |
22.5× |
| MRI chest with contrast (71551) |
$4,916 |
$4,916 |
6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$5,972 |
$5,972 |
16.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,635 |
$5,635 |
23.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,569.45 |
$5,569.45 |
23.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$8,010 |
$8,010 |
22.6× |
| MRI orbit/face/neck w/contrast (70542) |
$5,708 |
$5,708 |
16.1× |
| MRI pelvis w contrast (72196) |
$4,852 |
$4,852 |
13.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,779.25 |
$6,779.25 |
19.1× |
| MRI pelvis w/o contrast (72195) |
$4,901 |
$4,901 |
20.2× |
| MRI scan of arm joint before and after contrast (73223) |
$7,234.65 |
$7,234.65 |
20.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$5,251 |
$5,251 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$11,027 |
$11,027 |
31.1× |
| MRI spectroscopy (76390) |
$4,122 |
$4,122 |
46.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$8,124 |
$8,124 |
22.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,581 |
$5,581 |
15.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$7,167 |
$7,167 |
20.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,243.75 |
$6,243.75 |
17.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,830 |
$6,830 |
19.3× |
| MRI thoracic spine w/o contrast (72146) |
$4,778 |
$4,778 |
19.7× |
| MRI tmj (70336) |
$5,209.50 |
$5,209.50 |
21.5× |
| MRI upper ext joint w/o contrast (73221) |
$5,356.70 |
$5,356.70 |
22.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$8,249 |
$8,249 |
23.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,925 |
$5,925 |
24.4× |
| Myelogram Cervical (72240) |
$2,333 |
$2,333 |
2.9× |
| Myelogram Lumbar (72265) |
$2,058 |
$2,058 |
2.6× |
| Myelogram thoracic (72255) |
$1,976 |
$1,976 |
2.5× |
| Myelography 2 or more regions (72270) |
$1,898 |
$1,898 |
2.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$7,964 |
$7,964 |
6.1× |
| Myocardial Spect Multiple Studies (78452) |
$9,411 |
$9,411 |
7.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$7,226 |
$7,226 |
5.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$7,271 |
$7,271 |
5.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$8,129 |
$8,129 |
3.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,838.20 |
$2,838.20 |
3.3× |
| Neck soft tissue (70360) |
$617 |
$617 |
7.0× |
| Nm adrenal scan (78075) |
$3,673 |
$3,673 |
2.8× |
| Nm gastric emptying study (78264) |
$3,115 |
$3,115 |
7.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$14,432 |
$14,432 |
10.3× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$6,311 |
$6,311 |
4.3× |
| Nuclear Rx Oral Admin (79005) |
$3,401.70 |
$3,401.70 |
14.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,360 |
$1,360 |
12.8× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$338 |
$338 |
3.2× |
| Orthopantogram (70355) |
$664 |
$664 |
7.5× |
| Osseous survey infant (77076) |
$490 |
$490 |
4.6× |
| Osseous survey limited (77074) |
$645 |
$645 |
6.1× |
| Parathyrd planar w/spect&CT (78072) |
$4,422 |
$4,422 |
8.0× |
| Parathyroid imaging (78070) |
$2,308.05 |
$2,308.05 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$649 |
$649 |
6.1× |
| PET image w/CT, skull-thigh (78815) |
$10,477 |
$10,477 |
7.2× |
| PET imaging for CT attenuation whole body (78816) |
$10,477 |
$10,477 |
7.2× |
| PET imaging limited area chest head/neck (78811) |
$4,694 |
$4,694 |
3.6× |
| PET whole body (78813) |
$5,321 |
$5,321 |
3.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$9,499 |
$9,499 |
26.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$9,062 |
$9,062 |
2.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,603.45 |
$4,603.45 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,905 |
$2,905 |
7.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,854 |
$3,854 |
7.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,303.16 |
$1,303.16 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$606.05 |
$606.05 |
6.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$833 |
$833 |
7.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,036 |
$1,036 |
9.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$36,887.40 |
$36,887.40 |
4.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,222.95 |
$2,222.95 |
4.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,330 |
$1,330 |
12.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$664 |
$664 |
6.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$638 |
$638 |
7.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$787 |
$787 |
8.9× |
| Radiologic exam colon single contrast study (74270) |
$1,823.90 |
$1,823.90 |
10.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,720.40 |
$1,720.40 |
9.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,480 |
$1,480 |
8.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$826.10 |
$826.10 |
9.3× |
| Radiological examination surgical specimen (76098) |
$1,579 |
$1,579 |
2.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$6,342.25 |
$6,342.25 |
2.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$7,625 |
$7,625 |
2.4× |
| Ribs bilateral 3 views (71110) |
$888 |
$888 |
8.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,365.55 |
$2,365.55 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,726 |
$3,726 |
6.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,893 |
$4,893 |
3.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,321 |
$5,321 |
3.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,756 |
$3,756 |
2.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,900.95 |
$1,900.95 |
8.0× |
| Rp Therapy Intravenous Administration (79101) |
$933 |
$933 |
3.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,336 |
$1,336 |
5.5× |
| Scanogram (77073) |
$629 |
$629 |
5.9× |
| Scapula complete (73010) |
$734.85 |
$734.85 |
6.9× |
| Screening digital breast tomosynthesis (77063) |
$240.35 |
$240.35 |
10.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$783 |
$783 |
7.4× |
| Simulation intermediate (77285) |
$2,790 |
$2,790 |
7.3× |
| Small bowel series (74250) |
$1,290 |
$1,290 |
7.2× |
| Spec medical radj physics consltj (77370) |
$1,856 |
$1,856 |
13.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,950 |
$1,950 |
5.1× |
| Special dosimetry (77331) |
$942 |
$942 |
6.9× |
| Special treatment procedure (77470) |
$6,620 |
$6,620 |
11.8× |
| Stereotactic body radiation delivery (77373) |
$14,867.20 |
$14,867.20 |
8.2× |
| Superior sagittal sinus venogram (75870) |
$8,643.40 |
$8,643.40 |
2.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,242 |
$3,242 |
8.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,906 |
$2,906 |
7.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,913.45 |
$3,913.45 |
10.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,882 |
$1,882 |
13.8× |
| Thoracolumbar 2 views (72080) |
$939 |
$939 |
10.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,049.80 |
$3,049.80 |
5.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,315 |
$1,315 |
3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,141 |
$2,141 |
5.3× |
| Treatment devices simple (77332) |
$1,128 |
$1,128 |
8.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,750 |
$3,750 |
6.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,853.95 |
$1,853.95 |
4.6× |
| Tx devices design & construction complex (77334) |
$2,494.35 |
$2,494.35 |
6.6× |
| Ultrasound scan of cornea to determine thickness (76514) |
$287 |
$287 |
9.8× |
| Ultrasound scan to determine eye length and lens power (76519) |
$409 |
$409 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$1,382 |
$1,382 |
13.0× |
| Umbilical-artery Doppler (OB) (76820) |
$1,455.90 |
$1,455.90 |
13.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,331 |
$1,331 |
15.1× |
| Unlisted fluoroscopic procedure (76496) |
$710 |
$710 |
8.0× |
| Unlisted magnetic resonance procedure (76498) |
$3,374 |
$3,374 |
38.2× |
| Upper Extremity Infant (73092) |
$667 |
$667 |
6.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,695 |
$1,695 |
4.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,052 |
$1,052 |
4.3× |
| Urethrocystography voiding (74455) |
$1,762.95 |
$1,762.95 |
7.3× |
| Us abdl aorta screen aaa (76706) |
$790.05 |
$790.05 |
7.4× |
| Us breast unilateral complete (76641) |
$1,112 |
$1,112 |
10.5× |
| Us breast unilateral limited (76642) |
$1,055 |
$1,055 |
11.9× |
| Us chest (76604) |
$1,011 |
$1,011 |
9.5× |
| Us compl joint r-t w/image documentation (76881) |
$1,676.94 |
$1,676.94 |
15.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$742 |
$742 |
7.0× |
| Us ob detailed single fetus (76811) |
$1,397 |
$1,397 |
5.8× |
| Us ob transvaginal (76817) |
$991.30 |
$991.30 |
9.3× |
| Us pelvic non ob complete (76856) |
$1,760.07 |
$1,760.07 |
16.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,156.90 |
$1,156.90 |
10.9× |
| Us pregnancy ltd (76815) |
$1,412 |
$1,412 |
13.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,444 |
$1,444 |
13.6× |
| Us retroperitoneal complete (76770) |
$1,655 |
$1,655 |
15.6× |
| Us retroperitoneal limited (76775) |
$1,417.95 |
$1,417.95 |
13.4× |
| Us scrotum and contents (76870) |
$1,540 |
$1,540 |
14.5× |
| Us soft tissue head/neck (76536) |
$1,712.35 |
$1,712.35 |
16.1× |
| Us transrectal (76872) |
$1,594 |
$1,594 |
15.0× |
| Us xtr non-vasc lmtd (76882) |
$1,224 |
$1,224 |
11.5× |
| Us, eye b-scan (76512) |
$615 |
$615 |
5.8× |
| Venogram extremity bilateral (75822) |
$4,551 |
$4,551 |
2.8× |
| Venography caval inferior serialography rs&i (75825) |
$9,062 |
$9,062 |
2.8× |
| Venography caval superior serialography rs&i (75827) |
$4,404.50 |
$4,404.50 |
2.8× |
| Venography epidural rs&i (75872) |
$2,783 |
$2,783 |
4.4× |
| Venography extremity unilateral rs&i (75820) |
$3,231.36 |
$3,231.36 |
2.0× |
| Venography renal unilateral selective rs&i (75831) |
$9,062 |
$9,062 |
2.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$9,641.60 |
$9,641.60 |
3.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$8,625 |
$8,625 |
1.5× |
| Wrist 2 views (73100) |
$580 |
$580 |
6.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,265 |
$1,265 |
11.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$864 |
$864 |
9.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$953 |
$953 |
10.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,860 |
$1,860 |
10.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$734.85 |
$734.85 |
8.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$803.85 |
$803.85 |
9.1× |
| X-ray exam hip uni 1 view (73501) |
$458 |
$458 |
5.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$518 |
$518 |
5.9× |
| X-ray exam hip uni 4/> views (73503) |
$726 |
$726 |
6.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,194 |
$1,194 |
11.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,350 |
$1,350 |
12.7× |
| X-ray exam of femur 1 (73551) |
$477 |
$477 |
5.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,048.50 |
$1,048.50 |
11.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$616 |
$616 |
7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$467 |
$467 |
5.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$889.81 |
$889.81 |
8.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$592 |
$592 |
6.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,031 |
$1,031 |
9.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,592 |
$1,592 |
15.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$632 |
$632 |
7.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$708 |
$708 |
6.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,097.10 |
$1,097.10 |
10.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$710 |
$710 |
6.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$768 |
$768 |
8.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,134 |
$1,134 |
12.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$741 |
$741 |
7.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$642.85 |
$642.85 |
7.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,378 |
$1,378 |
15.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$828 |
$828 |
9.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$927 |
$927 |
8.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$481.85 |
$481.85 |
5.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$723.35 |
$723.35 |
8.2× |
| Xr c-spine 6 or more views (72052) |
$1,317 |
$1,317 |
12.4× |
| Xr chest 4+ views (71048) |
$857 |
$857 |
8.1× |
| Xr finger(s) 2+ views (73140) |
$575 |
$575 |
6.5× |
| Xr shoulder 1 view (73020) |
$1,134 |
$1,134 |
12.8× |
| Xr spine cervical 4 or 5 views (72050) |
$1,461 |
$1,461 |
13.8× |
| Xr tibia/fibula 2 views (73590) |
$1,056 |
$1,056 |
11.9× |
| Xr tmj bilateral (70330) |
$857 |
$857 |
9.7× |
| Xray knee 1 or 2 views rt (73560) |
$668 |
$668 |
7.6× |