| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,656.50 |
$9,313 |
3.2× |
| Abdomen 1 View (74018) |
$83.50 |
$167 |
0.9× |
| Abdomen 2 views (74019) |
$153 |
$306 |
1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$860.50 |
$1,721 |
2.1× |
| Angio internal mammary (75756) |
$2,204 |
$4,408 |
0.7× |
| Angio pulmonary bilat (75743) |
$2,151.50 |
$4,303 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,204 |
$4,408 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,878.50 |
$5,757 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,689 |
$5,378 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,151.50 |
$4,303 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,151.50 |
$4,303 |
0.7× |
| Ankle 2 views (73600) |
$1,175.50 |
$2,351 |
12.9× |
| Aortography thoracic serialography rs&i (75605) |
$5,119 |
$10,238 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$4,582 |
$9,164 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,694 |
$5,388 |
0.8× |
| Artery X-Rays Pelvis (75736) |
$3,012 |
$6,024 |
0.5× |
| Artery X-Rays Spine (75705) |
$3,526 |
$7,052 |
0.6× |
| Arthrogram hip (73525) |
$1,045 |
$2,090 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$658.50 |
$1,317 |
4.7× |
| Bone age studies (77072) |
$115.50 |
$231 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$5,041 |
$10,082 |
12.1× |
| Bone Imaging Limited Area (78300) |
$3,332 |
$6,664 |
8.0× |
| Bone Imaging Whole Body (78306) |
$4,383.50 |
$8,767 |
10.5× |
| Bone marrow imaging; whole body (78104) |
$697.50 |
$1,395 |
1.7× |
| Brachytx isodose complex (77318) |
$2,260 |
$4,520 |
5.8× |
| Brachytx isodose intermed (77317) |
$1,784.50 |
$3,569 |
4.6× |
| Brachytx Isodose Plan Simple (77316) |
$1,538.50 |
$3,077 |
3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,108 |
$4,216 |
5.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,108 |
$4,216 |
2.6× |
| Cat Scan Follow-Up Study (76380) |
$184 |
$368 |
2.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,156.50 |
$2,313 |
2.0× |
| Chest 1 view (71045) |
$115.50 |
$231 |
1.3× |
| Chest 2 views (71046) |
$145.50 |
$291 |
1.6× |
| Chest 3 views (71047) |
$152.50 |
$305 |
1.7× |
| Chest 4 or more views (71048) |
$165.50 |
$331 |
1.5× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$624 |
$1,248 |
5.7× |
| Clavicle complete (73000) |
$386.50 |
$773 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$136.50 |
$273 |
1.3× |
| Continuing medical physics consltj pr wk (77336) |
$683 |
$1,366 |
4.9× |
| Contrast Exam Abdominl Aorta (75625) |
$2,757.50 |
$5,515 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$1,219 |
$2,438 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,888.50 |
$13,777 |
18.9× |
| CT abdomen and pelvis without contrast (74176) |
$4,174 |
$8,348 |
16.8× |
| CT abdomen w contrast (74160) |
$4,135 |
$8,270 |
22.6× |
| CT abdomen w wo contrast (74170) |
$5,632 |
$11,264 |
30.7× |
| CT abdomen w/o contrast (74150) |
$2,591 |
$5,182 |
23.7× |
| CT Angio Abdomen and Pelvis (74174) |
$8,188 |
$16,376 |
22.5× |
| CT Angio Chest (71275) |
$3,084.50 |
$6,169 |
16.8× |
| CT Angio Head (70496) |
$3,984 |
$7,968 |
21.8× |
| CT angio hrt w/3d image (75574) |
$2,378 |
$4,756 |
6.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,668 |
$3,336 |
9.1× |
| CT Angio Neck (70498) |
$4,882 |
$9,764 |
26.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,102 |
$6,204 |
16.9× |
| CT bone density (77078) |
$178 |
$356 |
2.0× |
| CT cervical spine w/ contrast (72126) |
$3,188.50 |
$6,377 |
8.8× |
| CT cervical spine w/o contrast (72125) |
$1,594.50 |
$3,189 |
14.6× |
| CT cervical spine w/wo cont (72127) |
$3,572.50 |
$7,145 |
19.5× |
| CT chest w contrast (71260) |
$2,635.50 |
$5,271 |
14.4× |
| CT chest w/wo contrast (71270) |
$2,759.50 |
$5,519 |
15.1× |
| CT colonography screening (74263) |
$484 |
$968 |
1.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$819 |
$1,638 |
4.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$819 |
$1,638 |
7.5× |
| CT head/brain with contrast (70460) |
$3,547 |
$7,094 |
19.4× |
| CT head/brain without and with contrast (70470) |
$3,855.50 |
$7,711 |
21.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,584.50 |
$3,169 |
4.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$361 |
$722 |
4.0× |
| CT hrt w/3d image congen (75573) |
$2,188.50 |
$4,377 |
6.0× |
| CT iac w contrast (70481) |
$3,011 |
$6,022 |
16.4× |
| CT l-spine w&w/o contrast (72133) |
$1,094 |
$2,188 |
6.0× |
| CT lower ext w/o (73700) |
$966.50 |
$1,933 |
8.9× |
| CT lower extremity w/contrast material (73701) |
$1,062 |
$2,124 |
5.8× |
| CT lumbar spine w contrast (72132) |
$927 |
$1,854 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$831.50 |
$1,663 |
7.6× |
| CT maxillofacial w contrast (70487) |
$5,331.50 |
$10,663 |
29.1× |
| CT maxillofacial wo contrast (70486) |
$4,201 |
$8,402 |
38.5× |
| CT neck tissue combo (70492) |
$2,270.50 |
$4,541 |
12.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,281.50 |
$6,563 |
17.9× |
| CT orbits w/o contrast (70480) |
$2,528.50 |
$5,057 |
23.2× |
| CT pelvis w&w/o contrast (72194) |
$2,290 |
$4,580 |
12.5× |
| CT pelvis w/o contrast (72192) |
$1,416 |
$2,832 |
13.0× |
| CT scans face/jaw combo (70488) |
$6,487.50 |
$12,975 |
35.4× |
| CT soft tissue neck w contrast (70491) |
$4,236 |
$8,472 |
23.1× |
| CT soft tissue neck w/o contrast (70490) |
$3,628.50 |
$7,257 |
33.2× |
| CT thoracic spine w contrast (72129) |
$1,109 |
$2,218 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$621 |
$1,242 |
5.7× |
| CT thoracic spine w/wo cont (72130) |
$1,109 |
$2,218 |
6.1× |
| CT thorax w/o contrast (71250) |
$2,135 |
$4,270 |
19.6× |
| CT unlisted procedure (76497) |
$896.50 |
$1,793 |
9.9× |
| CT upper ext wo (73200) |
$1,688.50 |
$3,377 |
15.5× |
| CT upper extremity with contrast (73201) |
$2,110.50 |
$4,221 |
5.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,498.50 |
$4,997 |
13.6× |
| Cta Abdomen (74175) |
$5,772.50 |
$11,545 |
31.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$5,018 |
$10,036 |
13.8× |
| CTA pelvis (72191) |
$2,234 |
$4,468 |
12.2× |
| Dilation ureters/urethra rs&i (74485) |
$1,192 |
$2,384 |
0.5× |
| Dxa Bone Density Axial (77080) |
$612 |
$1,224 |
5.6× |
| Dxa bone density study (77085) |
$636 |
$1,272 |
5.8× |
| Echo Guide For Artery Repair (76936) |
$1,253 |
$2,506 |
5.6× |
| Echograp Trans R Pros Study (76873) |
$1,682.50 |
$3,365 |
15.4× |
| Esophagram (74220) |
$712.50 |
$1,425 |
3.9× |
| Fluoroscopy up to 1 hr (76000) |
$774 |
$1,548 |
3.1× |
| Follow-Up Angiography (75898) |
$527.50 |
$1,055 |
0.2× |
| Foot 2 views (73620) |
$704.50 |
$1,409 |
7.8× |
| Forearm 2 views (73090) |
$340.50 |
$681 |
3.7× |
| Gastric emptying imaging study (78264) |
$3,680.50 |
$7,361 |
8.8× |
| Gated Heart Planar Single (78472) |
$2,776.50 |
$5,553 |
6.7× |
| Hand 2 views (73120) |
$1,086 |
$2,172 |
9.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,000.50 |
$4,001 |
2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,320.50 |
$2,641 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$724.50 |
$1,449 |
1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,150.50 |
$8,301 |
1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,192 |
$8,384 |
1.3× |
| Hepatobil Syst Image W/Drug (78227) |
$1,794.50 |
$3,589 |
3.2× |
| Hepatobiliary System Imaging (78226) |
$1,310 |
$2,620 |
3.1× |
| Interstitial radiation source applic complex (77778) |
$3,397.50 |
$6,795 |
4.7× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$7,232.50 |
$14,465 |
0.9× |
| K Flow/Funct Image Multiple (78709) |
$1,372.50 |
$2,745 |
2.4× |
| K Flow/Funct Image W/Drug (78708) |
$659 |
$1,318 |
1.2× |
| K Flow/Funct Image W/O Drug (78707) |
$865 |
$1,730 |
1.5× |
| Knee 3 Views (73562) |
$910 |
$1,820 |
10.0× |
| Leveen/Shunt Patency Exam (78291) |
$433.50 |
$867 |
1.0× |
| Liver & Spleen Imaging Static Only (78215) |
$2,179.50 |
$4,359 |
5.2× |
| Liver imaging static only (78201) |
$1,433.50 |
$2,867 |
2.5× |
| Liver imaging w/vascular flow (78202) |
$820.50 |
$1,641 |
1.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$577 |
$1,154 |
1.0× |
| Lung perfusion differential (78597) |
$374.50 |
$749 |
0.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,376 |
$2,752 |
2.4× |
| Lung Ventilation Imaging (78579) |
$771.50 |
$1,543 |
1.8× |
| Lymph System Imaging (78195) |
$1,892.50 |
$3,785 |
3.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$822.50 |
$1,645 |
0.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$583.50 |
$1,167 |
0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,151.50 |
$4,303 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$730 |
$1,460 |
0.2× |
| Magnetic Resonance Elastography (76391) |
$1,653.50 |
$3,307 |
6.6× |
| Mammary ductogram or galactogram multiple (77054) |
$666.50 |
$1,333 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$493 |
$986 |
2.0× |
| Meckels Divert Exam (78290) |
$509.50 |
$1,019 |
1.2× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$640.50 |
$1,281 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,228 |
$2,456 |
3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$257 |
$514 |
8.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$699.50 |
$1,399 |
7.0× |
| Mr safety implt pos&/immoblj (76019) |
$699.50 |
$1,399 |
11.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$699.50 |
$1,399 |
2.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,116.50 |
$8,233 |
11.3× |
| MRA head w/o contrast (70544) |
$2,465 |
$4,930 |
9.9× |
| MRA head with contrast (70545) |
$4,116.50 |
$8,233 |
11.3× |
| MRA neck w contrast (70548) |
$2,311.50 |
$4,623 |
6.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,719 |
$5,438 |
7.5× |
| MRA neck w/o contrast (70547) |
$1,631.50 |
$3,263 |
6.5× |
| MRI abdomen w contrast (74182) |
$4,645 |
$9,290 |
12.7× |
| MRI abdomen w/o contrast (74181) |
$2,947 |
$5,894 |
11.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,326.50 |
$6,653 |
4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,912.50 |
$7,825 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,223 |
$6,446 |
3.9× |
| MRI brain functional w/o physician admnistration (70554) |
$3,625.50 |
$7,251 |
14.6× |
| MRI brain functional w/physician admnistration (70555) |
$2,819 |
$5,638 |
11.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,595.50 |
$3,191 |
6.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,917.50 |
$3,835 |
7.7× |
| MRI cardiac w/o cont stress (75559) |
$1,833 |
$3,666 |
3.2× |
| MRI cardiac w/o contrast (75557) |
$1,833 |
$3,666 |
7.4× |
| MRI cervical spine w contrast (72142) |
$3,130 |
$6,260 |
8.6× |
| MRI cervical spine w/o cont (72141) |
$2,208.50 |
$4,417 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,232 |
$4,464 |
9.0× |
| MRI chest with contrast (71551) |
$6,656 |
$13,312 |
8.1× |
| MRI chest wo w contrast (71552) |
$3,719 |
$7,438 |
10.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,395 |
$6,790 |
9.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,994 |
$7,988 |
11.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,397 |
$4,794 |
9.6× |
| MRI lumbar spine w contrast (72149) |
$2,897 |
$5,794 |
8.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,682 |
$7,364 |
10.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,095.50 |
$4,191 |
8.4× |
| MRI orbit face neck w contrast (70542) |
$2,968 |
$5,936 |
8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,492.50 |
$6,985 |
9.6× |
| MRI pelvis w contrast (72196) |
$4,498 |
$8,996 |
12.3× |
| MRI pelvis w/o & w contrast (72197) |
$4,418 |
$8,836 |
12.1× |
| MRI pelvis w/o contrast (72195) |
$2,775 |
$5,550 |
11.1× |
| MRI spectroscopy (76390) |
$2,415 |
$4,830 |
26.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,357.50 |
$4,715 |
9.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,127 |
$6,254 |
8.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,097 |
$4,194 |
8.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,552 |
$7,104 |
9.7× |
| MRI, abdomen, combo (74183) |
$4,441.50 |
$8,883 |
12.2× |
| MRI, dorsal spine combo (72157) |
$3,927.50 |
$7,855 |
10.8× |
| MRI, dorsal spine contrast (72147) |
$3,338 |
$6,676 |
9.2× |
| MRI, joint upper extrem (73221) |
$2,162 |
$4,324 |
8.7× |
| MRI, joint upper extrem combo (73223) |
$3,664 |
$7,328 |
10.1× |
| MRI, lumbar spine combo (72158) |
$3,408 |
$6,816 |
9.4× |
| Myelogram cervical (72240) |
$963 |
$1,926 |
1.2× |
| Myelogram Lumbar (72265) |
$1,284 |
$2,568 |
1.6× |
| Myelography thoracic (72255) |
$963 |
$1,926 |
1.2× |
| Myelograpy 2/more regions rs&i (72270) |
$3,447.50 |
$6,895 |
4.2× |
| N-invas est c ffr sw aly CTA (75580) |
$347 |
$694 |
0.4× |
| Neck soft tissue (70360) |
$193.50 |
$387 |
2.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$331 |
$662 |
0.8× |
| Nonvascular Shunt X-Ray (75809) |
$296.50 |
$593 |
2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,770.50 |
$13,541 |
4.7× |
| Nuclear Rx Intra-Arterial (79445) |
$386.50 |
$773 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$2,970.50 |
$5,941 |
12.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,310 |
$4,620 |
4.1× |
| Parathyroid Planar Imaging (78070) |
$1,083.50 |
$2,167 |
2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,119.50 |
$4,239 |
5.1× |
| Pelvis 1 or 2 views (72170) |
$572.50 |
$1,145 |
5.2× |
| Perineogram (74775) |
$333.50 |
$667 |
1.3× |
| Peritoneogram Rs&I (74190) |
$278.50 |
$557 |
0.5× |
| Pet Image W/Ct Lmtd (78814) |
$4,923.50 |
$9,847 |
3.3× |
| PET image w/CT, full body (78816) |
$5,580.50 |
$11,161 |
3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,471.50 |
$10,943 |
3.7× |
| Proton trmt simple w/comp (77522) |
$6,056 |
$12,112 |
4.6× |
| Proton tx delivery complex (77525) |
$5,887 |
$11,774 |
4.5× |
| Proton tx delivery intermediate (77523) |
$4,302.50 |
$8,605 |
3.3× |
| Proton tx delivery simple w/o compensation (77520) |
$2,216 |
$4,432 |
3.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,331 |
$10,662 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$977.50 |
$1,955 |
2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$153 |
$306 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$614 |
$1,228 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$1,051.50 |
$2,103 |
11.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$423.50 |
$847 |
4.7× |
| Radex elbow complete minimum 3 views (73080) |
$301 |
$602 |
3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$484.50 |
$969 |
4.4× |
| Radex fingr minimum 2 views (73140) |
$758.50 |
$1,517 |
8.3× |
| Radex foot complete minimum 3 views (73630) |
$682.50 |
$1,365 |
7.5× |
| Radex Hand Minimum 3 Views (73130) |
$1,038 |
$2,076 |
11.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$484 |
$968 |
5.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$513.50 |
$1,027 |
5.7× |
| Radex shoulder complete minimum 2 views (73030) |
$1,221.50 |
$2,443 |
13.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$695.50 |
$1,391 |
7.7× |
| Radex Sternum Minimum 2 Views (71120) |
$436.50 |
$873 |
4.8× |
| Radex Toe Minimum 2 Views (73660) |
$162 |
$324 |
1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$851.50 |
$1,703 |
9.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$394.50 |
$789 |
3.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,723 |
$37,446 |
2.4× |
| Radiation treatment delivery level 1 (77402) |
$185 |
$370 |
1.7× |
| Radiation treatment delivery level 2 (77407) |
$2,532 |
$5,064 |
6.3× |
| Radiation treatment delivery level 3 (77412) |
$3,627.50 |
$7,255 |
6.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$169.50 |
$339 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$153 |
$306 |
1.4× |
| Radiologic exam colon double contrast study (74280) |
$579 |
$1,158 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$413 |
$826 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$1,021 |
$2,042 |
9.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$826 |
$1,652 |
7.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$883.50 |
$1,767 |
4.8× |
| Radiologic exam swallow function contrast study (74230) |
$975.50 |
$1,951 |
5.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$330 |
$660 |
1.8× |
| Radiologic examination femur 1 view (73551) |
$721 |
$1,442 |
7.9× |
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines |
$848–$1,697 |
$1,696–$3,394 |
varies |
| Radiologic examination knee 1/2 views (73560) |
$791 |
$1,582 |
8.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$786.50 |
$1,573 |
8.7× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$824.50 |
$1,649 |
3.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,221.50 |
$2,443 |
3.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$798 |
$1,596 |
2.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$841 |
$1,682 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,508.50 |
$3,017 |
3.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,742.50 |
$5,485 |
4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,467 |
$4,934 |
1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,320.50 |
$2,641 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,558 |
$3,116 |
6.4× |
| Rp Therapy Intravenous Administration (79101) |
$165.50 |
$331 |
0.7× |
| Salivary Gland Imaging Serial Images (78231) |
$415 |
$830 |
1.0× |
| Scapula (73010) |
$753 |
$1,506 |
6.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$94 |
$188 |
4.0× |
| Shoulder Arthrography (73040) |
$776.50 |
$1,553 |
2.1× |
| Skull less than 4 views (70250) |
$877.50 |
$1,755 |
8.0× |
| Special dosimetry (77331) |
$577.50 |
$1,155 |
4.1× |
| Special Physics Consult (77370) |
$1,037.50 |
$2,075 |
7.4× |
| Special teletherapy port plan (77321) |
$803 |
$1,606 |
2.1× |
| Special treatment procedure (77470) |
$2,264.50 |
$4,529 |
3.9× |
| Speech evaluation, complex (70371) |
$123.50 |
$247 |
0.5× |
| Stereotactic Body Radiation Delivery (77373) |
$3,268 |
$6,536 |
1.8× |
| Sternoclavicular joints (71130) |
$516.50 |
$1,033 |
5.7× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$247.50 |
$495 |
2.7× |
| Tbs technical calculation only (77091) |
$202 |
$404 |
2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,292 |
$2,584 |
3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$659 |
$1,318 |
1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,569.50 |
$3,139 |
4.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,319 |
$2,638 |
3.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$833.50 |
$1,667 |
5.9× |
| Thoracic spine 2 views (72070) |
$382.50 |
$765 |
3.5× |
| Thoracic spine 3 views (72072) |
$485.50 |
$971 |
4.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,128 |
$2,256 |
2.7× |
| Thyroid Met Imaging Body (78018) |
$2,315.50 |
$4,631 |
4.1× |
| Thyroid Uptake Measurement (78012) |
$2,632 |
$5,264 |
6.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,409 |
$2,818 |
3.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,216 |
$2,432 |
3.1× |
| Tx devices design & construction intermediate (77333) |
$426 |
$852 |
3.0× |
| Tx devices design & construction simple (77332) |
$657 |
$1,314 |
4.7× |
Ultrasound Breast Limited (76642)
range across 5 matching MRF lines |
$643.50–$1,287 |
$1,287–$2,574 |
varies |
| Ultrasound elastography first target lesion (76982) |
$651.50 |
$1,303 |
6.0× |
| Ultrasound Elastography Parenchyma (76981) |
$651.50 |
$1,303 |
6.0× |
| Ultrasound Exam Aaa Screen (76706) |
$530 |
$1,060 |
4.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,009 |
$2,018 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$1,351 |
$2,702 |
12.4× |
| Unlisted Dx Radiographic Procedure (76499) |
$830.50 |
$1,661 |
9.1× |
| Unlisted fluoroscopic procedure (76496) |
$135.50 |
$271 |
1.5× |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$347.50–$63,239 |
$695–$126,478 |
varies |
| Upper gi w/o kub (74240) |
$518 |
$1,036 |
2.8× |
| Urethrocystogram voiding (74455) |
$1,016 |
$2,032 |
4.1× |
| Urethrocystography retrograde (74450) |
$1,016 |
$2,032 |
4.1× |
Us breast unilateral complete (76641)
range across 5 matching MRF lines |
$944.50–$1,888.50 |
$1,889–$3,777 |
varies |
| Us chest (76604) |
$720.50 |
$1,441 |
6.6× |
| Us complete joint (76881) |
$2,529 |
$5,058 |
23.2× |
| Us exam, pelvic, limited (76857) |
$890 |
$1,780 |
8.2× |
| Us kidney transplant (76776) |
$827 |
$1,654 |
7.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,346 |
$2,692 |
12.3× |
| Us pelvic non ob complete (76856) |
$2,023.50 |
$4,047 |
18.5× |
| Us retroperitoneal complete (76770) |
$986 |
$1,972 |
9.0× |
| Us retroperitoneal limited (76775) |
$570 |
$1,140 |
5.2× |
| Us scrotum and contents (76870) |
$1,336 |
$2,672 |
12.2× |
| Us thyroid (76536) |
$1,024 |
$2,048 |
9.4× |
| Us transrectal (76872) |
$1,036.50 |
$2,073 |
9.5× |
| Vein X-Ray Chest (75827) |
$1,083 |
$2,166 |
0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,202.50 |
$4,405 |
0.7× |
| Vein X-Ray Spleen/Liver (75810) |
$2,344 |
$4,688 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$2,151.50 |
$4,303 |
0.7× |
| Venography Adrenal Unilateral (75840) |
$2,151.50 |
$4,303 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$4,707 |
$9,414 |
1.4× |
| Venography extremity bilateral rs&i (75822) |
$1,563 |
$3,126 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,335.50 |
$2,671 |
0.8× |
| Venography Renal Bilateral (75833) |
$4,150.50 |
$8,301 |
1.3× |
| Venography Renal Unilateral (75831) |
$3,652.50 |
$7,305 |
1.1× |
| Venous sampling by catheter (75893) |
$3,526 |
$7,052 |
0.6× |
| Wrist 2 views (73100) |
$890.50 |
$1,781 |
9.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$166.50 |
$333 |
1.8× |
| X-ray antegrade pyelogram tube (74425) |
$463.50 |
$927 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$3,323 |
$6,646 |
1.0× |
| X-Ray Exam Breast Specimen (76098) |
$844 |
$1,688 |
1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$177.50 |
$355 |
2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$286 |
$572 |
2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$338 |
$676 |
3.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$406 |
$812 |
4.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$562 |
$1,124 |
6.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$703.50 |
$1,407 |
6.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$500.50 |
$1,001 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$652 |
$1,304 |
6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$764.50 |
$1,529 |
7.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$829.50 |
$1,659 |
7.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$949 |
$1,898 |
10.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$685 |
$1,370 |
6.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$586 |
$1,172 |
5.4× |
| X-ray eye for foreign body (70030) |
$270 |
$540 |
3.0× |
| X-ray humerus (73060) |
$759.50 |
$1,519 |
8.4× |
| X-ray IV pyelogram (ivp) (74400) |
$927 |
$1,854 |
5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$145.50 |
$291 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$910 |
$1,820 |
10.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$522 |
$1,044 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$733 |
$1,466 |
6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$388.50 |
$777 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$340.50 |
$681 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$879.50 |
$1,759 |
9.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,096.50 |
$2,193 |
10.0× |
| X-ray thoracic spine 4 vw (72074) |
$537 |
$1,074 |
4.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$463.50 |
$927 |
1.3× |
| X-Rays Bone Length Studies (77073) |
$267.50 |
$535 |
2.5× |
| X-Rays Bone Survey Complete (77075) |
$2,328.50 |
$4,657 |
21.3× |
| Xr c-spine 4 or 5 views (72050) |
$1,308.50 |
$2,617 |
12.0× |
| Xr facial bones less than 3 views (70140) |
$339.50 |
$679 |
3.7× |
| Xr orbits complete 4 views (70200) |
$781 |
$1,562 |
7.2× |