| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$13,693 |
$13,693 |
9.5× |
| Acute gi blood loss imaging (78278) |
$2,961 |
$2,961 |
7.1× |
| Angio adrenal bilat select (75733) |
$18,229 |
$18,229 |
5.5× |
| Angio adrenal unilat select (75731) |
$18,229 |
$18,229 |
5.5× |
| Angio extremity unilateral (75710) |
$18,229 |
$18,229 |
5.5× |
| Angio pulmonary unilateral (75741) |
$18,229 |
$18,229 |
5.5× |
| Angiogram extremity bilateral (75716) |
$18,229 |
$18,229 |
5.5× |
| Angiogram pelvic (75736) |
$18,229 |
$18,229 |
3.1× |
| Angiography internal mammary rs&i (75756) |
$5,886 |
$5,886 |
1.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$16,911.50 |
$16,911.50 |
5.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$18,229 |
$18,229 |
3.1× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$5,142 |
$5,142 |
1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$10,849 |
$10,849 |
3.3× |
| Ankle 2 views (73600) |
$671 |
$671 |
7.4× |
| Arthrography knee lt (73580) |
$2,462 |
$2,462 |
6.8× |
| Arthrography wrist lt (73115) |
$2,462 |
$2,462 |
6.8× |
| Barium enema (74270) |
$4,186 |
$4,186 |
22.9× |
| Basic dosimetry (77300) |
$2,108 |
$2,108 |
15.0× |
| Bilat selctv renal venogram (75833) |
$18,229 |
$18,229 |
5.5× |
| Bone age studies (77072) |
$1,318 |
$1,318 |
12.1× |
| Bone imaging limited area (78300) |
$15,313 |
$15,313 |
36.7× |
| Bone survey complete (77075) |
$5,719 |
$5,719 |
52.4× |
| Bowel imaging (78290) |
$7,529 |
$7,529 |
18.0× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$5,201 |
$5,201 |
13.3× |
| Brain image w/flow 4 + views (78606) |
$3,799 |
$3,799 |
6.7× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$3,230 |
$3,230 |
7.7× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$4,515 |
$4,515 |
10.8× |
| Cardiac shunt detection (78428) |
$2,637 |
$2,637 |
6.3× |
| Cerebrospinal fluid leakage (78650) |
$4,504 |
$4,504 |
3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$3,376 |
$3,376 |
18.4× |
| Cisternogram (78630) |
$2,900 |
$2,900 |
5.1× |
| Clavicle complete (73000) |
$1,372 |
$1,372 |
15.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$15,801 |
$15,801 |
86.3× |
| Continuing medical physics consltj pr wk (77336) |
$1,441 |
$1,441 |
10.3× |
| Contrast exam abdominl aorta (75625) |
$18,229 |
$18,229 |
5.5× |
| Contrast exam thoracic aorta (75605) |
$18,229 |
$18,229 |
3.1× |
| Csf shunt evaluation (78645) |
$2,472 |
$2,472 |
4.4× |
| CT - st neck w&wo contr (70492) |
$15,515 |
$15,515 |
84.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$28,567 |
$28,567 |
78.4× |
| CT abdomen and pelvis without contrast (74176) |
$25,352 |
$25,352 |
101.7× |
| CT abdomen w wo contrast (74170) |
$16,435 |
$16,435 |
89.7× |
| CT abdomen w/contrast (74160) |
$14,761 |
$14,761 |
80.6× |
| CT abdomen w/o contrast (74150) |
$13,646 |
$13,646 |
125.0× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$19,148 |
$19,148 |
52.6× |
| CT angio abdom w/o & w/dye (74175) |
$16,232 |
$16,232 |
88.6× |
| CT angio abdominal arteries (75635) |
$4,618 |
$4,618 |
25.2× |
| CT angio hrt w/3d image (75574) |
$14,411 |
$14,411 |
39.6× |
| CT angiograph pelv w/o&w/dye (72191) |
$14,418 |
$14,418 |
78.7× |
| CT cervical spine w/contrast (72126) |
$13,235 |
$13,235 |
36.3× |
| CT cervical spine w/o contrast (72125) |
$12,133 |
$12,133 |
111.1× |
| CT chest w/contrast (71260) |
$13,458 |
$13,458 |
73.5× |
| CT extremity upper w & w/o contrast (73202) |
$18,290 |
$18,290 |
99.9× |
| CT head/brain with contrast (70460) |
$13,387 |
$13,387 |
73.1× |
| CT head/brain without and with contrast (70470) |
$19,140 |
$19,140 |
104.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,448 |
$3,448 |
9.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$3,448 |
$3,448 |
37.9× |
| CT hrt w/3d image congen (75573) |
$3,448 |
$3,448 |
9.5× |
| CT limited/localized follow up study (76380) |
$10,941 |
$10,941 |
120.4× |
| CT lower ext w/wo contrast (73702) |
$18,290 |
$18,290 |
99.9× |
| CT lower extremity w contrast (73701) |
$13,985 |
$13,985 |
76.3× |
| CT lower extremity w/o contrast unilateral (73700) |
$13,056 |
$13,056 |
119.6× |
| CT lumbar spine w/contrast (72132) |
$13,235 |
$13,235 |
36.3× |
| CT lumbar spine w/o contrast (72131) |
$12,133 |
$12,133 |
111.1× |
| CT lumbar spine w/o then w/ con (72133) |
$14,245 |
$14,245 |
77.8× |
| CT maxillofacial area w/o contrast (70486) |
$10,937 |
$10,937 |
100.2× |
| CT maxillofacial w/contrast (70487) |
$14,545 |
$14,545 |
79.4× |
| CT maxillofacial w/o then w/ con (70488) |
$15,515 |
$15,515 |
84.7× |
| CT orbit sella ear w/o con (70480) |
$9,220 |
$9,220 |
84.5× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$25,004 |
$25,004 |
136.5× |
| CT pelvis w & w/o contrast (72194) |
$13,111 |
$13,111 |
71.6× |
| CT pelvis w/o contrast (72192) |
$11,721 |
$11,721 |
107.4× |
| CT soft tissue neck w/contrast (70491) |
$12,754 |
$12,754 |
69.6× |
| CT soft tissue neck w/o contrast (70490) |
$11,701 |
$11,701 |
107.2× |
| CT spine cervical w/wo contrast (72127) |
$14,245 |
$14,245 |
77.8× |
| CT thoracic spine w/contrast (72129) |
$12,335 |
$12,335 |
67.3× |
| CT thoracic spine w/o contrast (72128) |
$10,456 |
$10,456 |
95.8× |
| CT thoracic spine w/o then w/ con (72130) |
$17,434 |
$17,434 |
95.2× |
| CT thorax lung cancer scr c- (71271) |
$12,174 |
$12,174 |
111.5× |
| CT thorax w/o contrast (71250) |
$12,174 |
$12,174 |
111.5× |
| CT thorax w/o then w/ contrast (71270) |
$16,371 |
$16,371 |
89.4× |
| CT upper extremity w/dye (73201) |
$13,985 |
$13,985 |
38.4× |
| CT upper extremity w/o contrast rt (73200) |
$12,868 |
$12,868 |
117.9× |
| CTA chest w/wo contrast (71275) |
$17,813 |
$17,813 |
97.2× |
| CTA head w contrast (70496) |
$21,046 |
$21,046 |
114.9× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$2,312 |
$2,312 |
12.6× |
| Cta Neck (70498) |
$5,490 |
$5,490 |
30.0× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$10,770 |
$10,770 |
58.8× |
| Dilation ureters/urethra rs&i (74485) |
$9,299 |
$9,299 |
4.3× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$14,215 |
$14,215 |
7.0× |
| Diskography lumbar (72295) |
$14,215 |
$14,215 |
7.0× |
| Doppler echo fetal spectral display complete (76827) |
$1,647 |
$1,647 |
15.1× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$1,102 |
$1,102 |
10.1× |
| Doppler fetal mid cerebral artery (76821) |
$2,203 |
$2,203 |
20.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,753 |
$1,753 |
7.0× |
| Esophogram (74220) |
$2,280 |
$2,280 |
12.4× |
| Fetal biophysical profile non-stress testing (76818) |
$5,029 |
$5,029 |
46.1× |
| Fetal biophysical profile w/o nst (76819) |
$3,789 |
$3,789 |
34.7× |
| Fetal echo complete (76825) |
$11,267 |
$11,267 |
19.7× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$1,884 |
$1,884 |
7.6× |
| Gastric emptying study (78264) |
$7,237 |
$7,237 |
17.3× |
| Gastroesophageal reflux study (78262) |
$3,559 |
$3,559 |
8.5× |
| Gated heart planar single (78472) |
$7,673 |
$7,673 |
18.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,065 |
$4,065 |
5.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,065 |
$4,065 |
5.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,065 |
$4,065 |
5.6× |
| Heart infarct image (78466) |
$4,897 |
$4,897 |
11.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$18,229 |
$18,229 |
5.5× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$18,229 |
$18,229 |
5.5× |
| Hepatobil syst image w/drug (78227) |
$5,351 |
$5,351 |
9.4× |
| Hepatobiliary system imaging (78226) |
$5,351 |
$5,351 |
12.8× |
| Humerus min 2 views (73060) |
$1,667 |
$1,667 |
18.3× |
| Hysterosalpingography (74740) |
$2,875 |
$2,875 |
11.5× |
| Imrt planning (77301) |
$9,675 |
$9,675 |
6.7× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$12,391 |
$12,391 |
17.0× |
| Intracavitary radiation source applic complex (77763) |
$2,646 |
$2,646 |
3.6× |
| Intracavitary radiation source applic intermed (77762) |
$2,646 |
$2,646 |
4.6× |
| Intracavitary radiation source applic simple (77761) |
$2,646 |
$2,646 |
4.6× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$5,178 |
$5,178 |
13.2× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$2,258 |
$2,258 |
5.8× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$4,469 |
$4,469 |
11.4× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$2,823 |
$2,823 |
7.2× |
| Ivp (74400) |
$3,727 |
$3,727 |
20.3× |
| Ivp w tomography (74415) |
$5,159 |
$5,159 |
28.2× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$2,680 |
$2,680 |
4.7× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$4,537 |
$4,537 |
8.0× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$4,769 |
$4,769 |
8.4× |
| Kidney w vascular flow (78701) |
$4,097 |
$4,097 |
9.8× |
| Liver & spleen; static only (78215) |
$6,161 |
$6,161 |
14.8× |
| Liver & spleen; w vasc flow (78216) |
$2,385 |
$2,385 |
5.7× |
| Liver imaging w/vascular flow (78202) |
$10,464 |
$10,464 |
18.5× |
| Lung perf&ventilat diferentl (78598) |
$7,684 |
$7,684 |
13.6× |
| Lung perfusion differential (78597) |
$6,590 |
$6,590 |
15.8× |
| Lung ventilat&perfus imaging (78582) |
$9,603 |
$9,603 |
16.9× |
| Lung ventilation imaging (78579) |
$7,650 |
$7,650 |
18.3× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) |
$1,892 |
$1,892 |
2.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$9,595 |
$9,595 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$13,491 |
$13,491 |
37.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$13,491 |
$13,491 |
37.0× |
| Mammary ductogram multiple ducts (77054) |
$2,109 |
$2,109 |
8.5× |
| Mammary ductogram single (77053) |
$2,200 |
$2,200 |
8.8× |
| Mlc device(s) for imrt (77338) |
$4,854 |
$4,854 |
12.4× |
| MRA head w & w/o contrast (70546) |
$8,239 |
$8,239 |
22.6× |
| MRA head w/contrast (70545) |
$5,494 |
$5,494 |
15.1× |
| MRA head w/o contrast (70544) |
$5,152 |
$5,152 |
20.7× |
| MRA neck w/contrast (70548) |
$5,494 |
$5,494 |
15.1× |
| MRA neck w/o contrast (70547) |
$5,152 |
$5,152 |
20.7× |
| MRA neck w/wo contrast (70549) |
$8,239 |
$8,239 |
22.6× |
| MRI abdomen w/contrast (74182) |
$15,170 |
$15,170 |
41.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$16,188 |
$16,188 |
44.4× |
| MRI abdomen w/o contrast (74181) |
$5,339 |
$5,339 |
21.4× |
| MRI any jnt lwr ext with con lt (73722) |
$14,811 |
$14,811 |
18.1× |
| MRI breast without contrast bilateral (77047) |
$2,622 |
$2,622 |
10.5× |
| MRI breast without contrast material unilateral (77046) |
$2,622 |
$2,622 |
10.5× |
| MRI cervical spine w/o contrast (72141) |
$7,840 |
$7,840 |
31.5× |
| MRI cervical spine with contrast (72142) |
$14,450 |
$14,450 |
39.7× |
| MRI chest w & w/o contrast (71552) |
$13,368 |
$13,368 |
36.7× |
| MRI chest w/contrast (71551) |
$10,787 |
$10,787 |
13.2× |
| MRI chest w/o contrast (71550) |
$9,216 |
$9,216 |
37.0× |
| MRI fetal sngl/1st gestation (74712) |
$9,522 |
$9,522 |
38.2× |
| MRI joint upper ext w/contrast (73222) |
$14,811 |
$14,811 |
18.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$13,491 |
$13,491 |
37.0× |
| MRI joint upr extrem w/o dye (73221) |
$8,428 |
$8,428 |
33.8× |
| Mri Lower Extremity W/O Dye (73718) |
$8,428 |
$8,428 |
33.8× |
| MRI lumbar spine with contrast (72149) |
$14,370 |
$14,370 |
39.4× |
| MRI lumbar w/wo contrast (72158) |
$20,150 |
$20,150 |
55.3× |
| MRI orbit/face/neck w/contrast (70542) |
$5,339 |
$5,339 |
14.7× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$16,188 |
$16,188 |
44.4× |
| MRI orbit/face/neck w/o contrast (70540) |
$5,276 |
$5,276 |
21.2× |
| MRI pelvis w/ contrast (72196) |
$11,902 |
$11,902 |
32.7× |
| MRI pelvis w/o contrast (72195) |
$9,523 |
$9,523 |
38.2× |
| MRI pelvis w/wo contrast (72197) |
$16,188 |
$16,188 |
44.4× |
| MRI spectroscopy (76390) |
$2,064 |
$2,064 |
22.7× |
| MRI spine cervical wo/w contrast (72156) |
$20,270 |
$20,270 |
55.6× |
| MRI spine thoracic w/contrast (72147) |
$14,925 |
$14,925 |
41.0× |
| MRI thoracic spine w wo contrast (72157) |
$20,944 |
$20,944 |
57.5× |
| MRI thoracic spine w/o contrast (72146) |
$7,121 |
$7,121 |
28.6× |
| MRI tmj (70336) |
$13,816 |
$13,816 |
55.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$8,428 |
$8,428 |
33.8× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$13,491 |
$13,491 |
37.0× |
| Myelogram thoracic (72255) |
$5,744 |
$5,744 |
7.0× |
| Myelography 2 or more regions (72270) |
$2,308 |
$2,308 |
2.8× |
| Myelography lumbosacral (72265) |
$5,744 |
$5,744 |
7.0× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$9,492 |
$9,492 |
7.0× |
| Myocardial spect single study at rest or stress (78451) |
$1,427 |
$1,427 |
1.1× |
| Myocrd img PET metab eval single study (78459) |
$4,795 |
$4,795 |
3.5× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$3,378 |
$3,378 |
3.8× |
| Nm bone 3 phase (78315) |
$5,948 |
$5,948 |
14.2× |
| Nm bone imaging whole body (78306) |
$7,951 |
$7,951 |
19.0× |
| Nm bone marrow scan multiple (78103) |
$6,339 |
$6,339 |
15.2× |
| Nm bone multi (78305) |
$4,078 |
$4,078 |
9.8× |
| Nm heart perfusion spect stress rest (78452) |
$14,560 |
$14,560 |
10.8× |
| Nm kidney function (78725) |
$1,061 |
$1,061 |
2.5× |
| Nm kidney imaging morphology (78700) |
$3,421 |
$3,421 |
8.2× |
| Nm liver image static only (78201) |
$4,602 |
$4,602 |
8.1× |
| Nm lymph system (78195) |
$5,938 |
$5,938 |
10.5× |
| Nm myocard infarct spect (78469) |
$3,084 |
$3,084 |
5.4× |
| Nm thyroid ca mets limited (78015) |
$9,237 |
$9,237 |
22.1× |
| Nm thyroid imaging only (78013) |
$4,581 |
$4,581 |
11.0× |
| Nose to rectum for fb child (76010) |
$725 |
$725 |
8.0× |
| Nuclear medicine study of brain, less than 4 static views (78600) |
$5,494 |
$5,494 |
13.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$3,846 |
$3,846 |
9.2× |
| Nuclear rx IV admin (79101) |
$6,049 |
$6,049 |
24.8× |
| Ob us < 14 wks single fetus (76801) |
$5,370 |
$5,370 |
49.2× |
| Ob us nuchal meas 1 gest (76813) |
$757 |
$757 |
6.9× |
| Oral radiopharm rx (79005) |
$7,398 |
$7,398 |
30.4× |
| Parathyroid imaging (78070) |
$3,312 |
$3,312 |
7.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,681 |
$1,681 |
4.0× |
| Peritoneal-venous shunt patency test (78291) |
$5,459 |
$5,459 |
13.1× |
| PET brain metabolic eval (78608) |
$9,461 |
$9,461 |
6.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$9,464 |
$9,464 |
6.3× |
| PET imaging for CT attenuation whole body (78816) |
$9,464 |
$9,464 |
6.3× |
| PET imaging limited area chest head/neck (78811) |
$61,388 |
$61,388 |
45.4× |
| PET imaging whole body (78813) |
$9,464 |
$9,464 |
6.3× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$9,464 |
$9,464 |
6.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$5,886 |
$5,886 |
1.8× |
| Pulmonary perfusion imaging particulate (78580) |
$6,658 |
$6,658 |
15.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,109 |
$2,109 |
3.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,892 |
$1,892 |
20.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,966 |
$1,966 |
18.0× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$2,014 |
$2,014 |
18.4× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$2,061 |
$2,061 |
18.9× |
| Radex hip unilateral with pelvis 1 view (73501) |
$357 |
$357 |
3.9× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$1,756 |
$1,756 |
19.3× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$1,867 |
$1,867 |
17.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,754 |
$1,754 |
16.1× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$1,906 |
$1,906 |
17.5× |
| Radex spine cervical 2 or 3 views (72040) |
$2,048 |
$2,048 |
22.5× |
| Radex spine cervical 4 or 5 views (72050) |
$2,440 |
$2,440 |
22.4× |
| Radex spine cervical 6 or more views (72052) |
$2,597 |
$2,597 |
23.8× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$1,553 |
$1,553 |
17.1× |
| Radiation delivery stereotactic cranial linear (77372) |
$24,767 |
$24,767 |
3.2× |
| Radiation tx delivery lvl 1 (77402) |
$2,191 |
$2,191 |
20.6× |
| Radiation tx delivery lvl 2 (77407) |
$2,308 |
$2,308 |
5.7× |
| Radiation tx delivery lvl 3 (77412) |
$4,000 |
$4,000 |
6.9× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$3,238 |
$3,238 |
29.7× |
| Radiologic exam phrnx&/crv esoph contrast study (74210) |
$1,570 |
$1,570 |
8.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$3,401 |
$3,401 |
18.6× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$1,510 |
$1,510 |
16.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,700 |
$1,700 |
18.7× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$2,801 |
$2,801 |
25.7× |
| Radiologic examination, salivary gland for calculus Other Diagnostic Radiology FS (70380) |
$725 |
$725 |
8.0× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$2,671 |
$2,671 |
24.5× |
| Red cell volume determination (separate procedure); single sampling Age Under 21 (78120) |
$13,292 |
$13,292 |
31.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,132 |
$1,132 |
2.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,132 |
$1,132 |
2.8× |
| Renal cyst study (74470) |
$2,109 |
$2,109 |
3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$5,392 |
$5,392 |
12.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$7,893 |
$7,893 |
18.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$8,013 |
$8,013 |
14.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$9,974 |
$9,974 |
17.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$7,893 |
$7,893 |
13.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,394 |
$1,394 |
5.7× |
| Saline infused sonohysterogram (76831) |
$1,299 |
$1,299 |
5.2× |
| Salivary gland funct study (78232) |
$1,388 |
$1,388 |
3.3× |
| Salivary gland imaging (78230) |
$1,281 |
$1,281 |
3.1× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$131 |
$131 |
5.6× |
| Selective spinal angiogram (75705) |
$18,229 |
$18,229 |
3.1× |
| Shoulder arthrogram (73040) |
$2,462 |
$2,462 |
6.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,135 |
$1,135 |
10.4× |
| Simulation complex (77290) |
$4,520 |
$4,520 |
11.6× |
| Simulation intermediate (77285) |
$4,047 |
$4,047 |
10.4× |
| Simulation simple (77280) |
$2,501 |
$2,501 |
17.8× |
| Small bowel series (74250) |
$2,727 |
$2,727 |
14.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$3,956 |
$3,956 |
10.1× |
| Special dosimetry (77331) |
$3,439 |
$3,439 |
24.5× |
| Special physics consult (77370) |
$2,307 |
$2,307 |
16.4× |
| Special treatment procedure (77470) |
$6,071.50 |
$6,071.50 |
10.5× |
| Spleen imaging only (78185) |
$2,514 |
$2,514 |
6.0× |
| Splenoportography (75810) |
$18,229 |
$18,229 |
5.5× |
| Stereotactic body radiation delivery (77373) |
$13,254 |
$13,254 |
7.1× |
| Superior sagittal sinus venogram (75870) |
$17,694 |
$17,694 |
5.4× |
| Testicular imaging w/flow (78761) |
$5,699 |
$5,699 |
13.7× |
| Therapeutic enema barium or air (74283) |
$2,527 |
$2,527 |
13.8× |
| Thyroid met imaging body (78018) |
$8,416 |
$8,416 |
14.8× |
| Thyroid uptake single/multiple quant measurement (78012) |
$2,725 |
$2,725 |
6.5× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$12,506 |
$12,506 |
30.0× |
| Treatment device intermediate (77333) |
$5,513 |
$5,513 |
39.3× |
| Treatment devices complex (77334) |
$4,854 |
$4,854 |
12.4× |
| Treatment devices simple (77332) |
$3,012 |
$3,012 |
21.5× |
| Ultrasound breast limited (76642) |
$4,605 |
$4,605 |
50.7× |
| Ultrasound, abdomen limited (76705) |
$2,230 |
$2,230 |
20.4× |
| Umbilical-artery Doppler (OB) (76820) |
$2,203 |
$2,203 |
20.2× |
| Ureteral reflux study (78740) |
$5,537 |
$5,537 |
13.3× |
| Urethrocystography retrograde rs&i (74450) |
$2,383 |
$2,383 |
9.6× |
| Urethrocystography voiding (74455) |
$3,226 |
$3,226 |
12.9× |
| Urography antegrade (74425) |
$1,027 |
$1,027 |
2.8× |
| Urography retrograde w/wo kub (74420) |
$3,919 |
$3,919 |
10.8× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) |
$2,512 |
$2,512 |
13.7× |
| Us abdominal aorta real time screen study aaa (76706) |
$3,124 |
$3,124 |
28.6× |
| Us breast uni real time with image complete (76641) |
$2,040.50 |
$2,040.50 |
18.7× |
| Us chest (76604) |
$1,110 |
$1,110 |
10.2× |
| Us compl joint r-t w/image documentation (76881) |
$902 |
$902 |
8.3× |
| Us encephalogram (76506) |
$1,647 |
$1,647 |
15.1× |
| Us guided compression repair (76936) |
$1,034 |
$1,034 |
4.6× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$3,390 |
$3,390 |
37.3× |
| Us kidney transplanted (76776) |
$2,464 |
$2,464 |
22.6× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$902 |
$902 |
8.3× |
| Us ob detailed single fetus (76811) |
$2,512 |
$2,512 |
10.1× |
| Us ob followup per fetus (76816) |
$2,027 |
$2,027 |
18.6× |
| Us ob limited 1 or more fetuses (76815) |
$2,410 |
$2,410 |
22.1× |
| Us obstetric transvaginal (76817) |
$1,567 |
$1,567 |
14.4× |
| Us pelvic limited or f/u non-ob (76857) |
$2,957.50 |
$2,957.50 |
27.1× |
| Us pelvis complete (76856) |
$2,957.50 |
$2,957.50 |
27.1× |
| Us retroperitoneal complete (76770) |
$5,969 |
$5,969 |
54.7× |
| Us retroperitoneal limited (76775) |
$3,204 |
$3,204 |
29.3× |
| Us scrotum (76870) |
$3,353 |
$3,353 |
30.7× |
| Us soft tissue head/neck (76536) |
$3,335 |
$3,335 |
30.5× |
| Us spinal canal (76800) |
$3,793 |
$3,793 |
34.7× |
| Us transrectal (76872) |
$1,665 |
$1,665 |
15.3× |
| Us transrectal prostate volume (76873) |
$3,819 |
$3,819 |
35.0× |
| Vascular flow imaging (78445) |
$3,940 |
$3,940 |
9.4× |
| Vein X-ray liver w/hemodynam (75885) |
$18,229 |
$18,229 |
5.5× |
| Venogram extremity bilateral (75822) |
$4,769.50 |
$4,769.50 |
2.9× |
| Venogram ivc w serialography (75825) |
$18,229 |
$18,229 |
5.5× |
| Venogram svc w serialography (75827) |
$9,271 |
$9,271 |
5.6× |
| Venography adrenal unilateral selective rs&i (75840) |
$18,229 |
$18,229 |
5.5× |
| Venography ext unilateral (75820) |
$5,885 |
$5,885 |
3.6× |
| Venography renal unilateral selective rs&i (75831) |
$18,229 |
$18,229 |
5.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,886 |
$5,886 |
1.8× |
| Venous sampling by catheter (75893) |
$18,229 |
$18,229 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$2,008 |
$2,008 |
22.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,299 |
$1,299 |
14.3× |
| X-ray aorta leg arteries (75630) |
$18,229 |
$18,229 |
5.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$4,438 |
$4,438 |
24.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,700 |
$1,700 |
18.7× |
| X-ray exam hips bi 3-4 views (73522) |
$1,832 |
$1,832 |
16.8× |
| X-ray exam of finger(s) (73140) |
$1,552 |
$1,552 |
17.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$2,111 |
$2,111 |
11.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$725 |
$725 |
8.0× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$725 |
$725 |
8.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,700 |
$1,700 |
18.7× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$725 |
$725 |
6.6× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$1,618 |
$1,618 |
17.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,700 |
$1,700 |
18.7× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$1,445 |
$1,445 |
15.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$3,496 |
$3,496 |
32.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$506 |
$506 |
5.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,814 |
$2,814 |
25.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$3,105 |
$3,105 |
28.4× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$986 |
$986 |
9.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$725 |
$725 |
8.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$3,337 |
$3,337 |
30.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,486 |
$1,486 |
13.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,896 |
$1,896 |
20.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,806 |
$1,806 |
19.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,472 |
$2,472 |
27.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$2,814 |
$2,814 |
25.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,595 |
$1,595 |
14.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,796 |
$1,796 |
19.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$1,700 |
$1,700 |
18.7× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$459 |
$459 |
5.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,699 |
$1,699 |
18.7× |
| Xr abdomen 1 view (74018) |
$1,949 |
$1,949 |
21.4× |
| Xr abdomen 2 views (74019) |
$2,706 |
$2,706 |
24.8× |
| Xr abdomen 3 views (74021) |
$3,049 |
$3,049 |
27.9× |
| Xr arthrogram ankle (73615) |
$2,462 |
$2,462 |
6.8× |
| Xr arthrogram elbow (73085) |
$2,462 |
$2,462 |
6.8× |
| Xr arthrogram hip (73525) |
$2,462 |
$2,462 |
6.8× |
| Xr bone density axial (77080) |
$2,457 |
$2,457 |
22.5× |
| Xr bone length study (77073) |
$2,213 |
$2,213 |
20.3× |
| Xr bone survey infant (77076) |
$21,805 |
$21,805 |
199.7× |
| Xr bone survey limited (77074) |
$4,661 |
$4,661 |
42.7× |
| Xr chest 1 view (71045) |
$905 |
$905 |
10.0× |
| Xr chest 2 views (71046) |
$1,886 |
$1,886 |
20.8× |
| Xr chest 3 views (71047) |
$2,597 |
$2,597 |
28.6× |
| Xr cystogram 3+ views (74430) |
$2,512 |
$2,512 |
6.9× |
| Xr eye foreign body (70030) |
$1,504 |
$1,504 |
16.5× |
| Xr facial bones 3 views (70150) |
$2,663 |
$2,663 |
24.4× |
| Xr joint survey 1 view (77077) |
$749 |
$749 |
6.9× |
| Xr lower extremity 2 views infant (73592) |
$1,716 |
$1,716 |
18.9× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$2,226 |
$2,226 |
20.4× |
| Xr mandible 4 views (70110) |
$2,424 |
$2,424 |
22.2× |
| Xr myelogram c-spine (72240) |
$6,500 |
$6,500 |
7.9× |
| Xr nasal bones (70160) |
$1,779 |
$1,779 |
19.6× |
| Xr pelvis 3 views (72190) |
$2,061 |
$2,061 |
18.9× |
| Xr sella turcica (70240) |
$537 |
$537 |
5.9× |
| Xr sialogram (70390) |
$3,124 |
$3,124 |
12.5× |
| Xr spine 1 view (72020) |
$1,482 |
$1,482 |
16.3× |
| Xr sternum 2 views (71120) |
$2,021 |
$2,021 |
22.2× |
| Xr stress view joint (77071) |
$385 |
$385 |
4.2× |
| Xr surgical specimen (76098) |
$2,655 |
$2,655 |
4.7× |
| Xr upper extremity 2 views infant (73092) |
$538 |
$538 |
4.9× |
| Xray elbow 2 views (73070) |
$725 |
$725 |
8.0× |
| Xray forearm 2 views (73090) |
$1,700 |
$1,700 |
18.7× |
| Xray knee 1 or 2 views rt (73560) |
$725 |
$725 |
8.0× |
| Xray neck soft tissue (70360) |
$1,585 |
$1,585 |
17.4× |
| Xray optic foramina (70190) |
$560 |
$560 |
6.2× |
| Xray orbits complete min 4 views (70200) |
$2,546 |
$2,546 |
23.3× |
| Xray pelvis 1 or 2 views (72170) |
$1,774 |
$1,774 |
16.2× |
| Xray ribs bilateral 3 views (71110) |
$927 |
$927 |
8.5× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$2,214 |
$2,214 |
20.3× |
| Xray scapula complete (73010) |
$1,570 |
$1,570 |
14.4× |
| Xray shoulder 1 view (73020) |
$1,667 |
$1,667 |
18.3× |
| Xray sinuses paranasal <3 views (70210) |
$694 |
$694 |
7.6× |
| Xray spine thoracic 2 views (72070) |
$2,028 |
$2,028 |
18.6× |
| Xray tibia-fibula 2 views bil (73590) |
$1,700 |
$1,700 |
18.7× |
| Xray tmj open - closed unilat (70328) |
$725 |
$725 |
8.0× |
| Xray tmj's bilateral open-clsc (70330) |
$2,198 |
$2,198 |
24.2× |