| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,992.25 |
$9,120.31 |
2.3× |
| Abdomen 2 views (74019) |
$250.80 |
$764.45 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,663.72 |
$5,070.96 |
4.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$7,079.50 |
$21,578.16 |
2.3× |
| Angiography extremity bilateral rs&i (75716) |
$5,236.90 |
$15,961.94 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$6,731.56 |
$20,648.95 |
2.2× |
| Angiography internal mammary rs&i (75756) |
$2,473.44 |
$7,539 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,588.90 |
$13,986.86 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,079.50 |
$21,578.16 |
2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,712.63 |
$14,364 |
1.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,588.90 |
$13,986.86 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$644.97 |
$1,965.86 |
0.2× |
| Ankle 2 views (73600) |
$195.59 |
$592.69 |
2.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$610.12 |
$1,859.66 |
1.8× |
| Aortogram thoracic (75605) |
$4,588.90 |
$13,986.86 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,588.90 |
$13,986.86 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$4,588.90 |
$13,986.86 |
1.5× |
| Artery X-Rays Adrenal Gland (75731) |
$7,079.50 |
$21,578.16 |
2.3× |
| Arthrogram elbow (73085) |
$654.45 |
$2,007.51 |
2.0× |
| Arthrogram hip (73525) |
$696.52 |
$2,136.55 |
2.1× |
| Arthrogram shoulder (73040) |
$677.72 |
$2,078.91 |
2.0× |
| Arthrogram wrist (73115) |
$548.96 |
$1,675.83 |
1.6× |
| Arthrography knee lt (73580) |
$669.67 |
$2,054.20 |
2.0× |
| Basic radiation dosimetry calculation (77300) |
$403.04 |
$1,221.33 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$748.54 |
$2,281.53 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$728.76 |
$2,221.22 |
1.9× |
| Bone age studies (77072) |
$240.09 |
$731.80 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$748.54 |
$2,281.53 |
2.0× |
| Bone Marrow Imaging Limited Area (78102) |
$919.90 |
$2,803.84 |
2.4× |
| Bone survey complete (77075) |
$240.09 |
$731.80 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$839.07 |
$2,557.47 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$553.43 |
$1,686.85 |
1.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$553.43 |
$1,686.85 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$370.44 |
$1,122.55 |
4.4× |
| Chest 1 view (71045) |
$173.69 |
$532.79 |
2.1× |
| Chest 3 views (71047) |
$132.76 |
$404.62 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$461.36 |
$1,406.22 |
2.7× |
| Clavicle complete (73000) |
$218.44 |
$665.81 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$108.20 |
$329.80 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$365.28 |
$1,120.49 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,518.53 |
$13,772.39 |
13.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,117.78 |
$9,502.92 |
13.6× |
| CT abdomen w contrast (74160) |
$1,594.04 |
$4,858.60 |
9.5× |
| CT abdomen w wo contrast (74170) |
$2,282.31 |
$6,956.43 |
13.6× |
| CT abdomen w/o contrast (74150) |
$1,523.42 |
$4,643.36 |
15.2× |
| CT angio hrt w/3d image (75574) |
$1,854.07 |
$5,687.34 |
5.5× |
| CT angiography upper extremity lt (73206) |
$2,174.08 |
$6,640.20 |
12.9× |
| CT c-spine w/o contrast (72125) |
$1,511.18 |
$4,606.04 |
15.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,546.03 |
$4,712.27 |
9.2× |
| CT cervical spine with contrast (72126) |
$1,011.22 |
$3,082.18 |
3.0× |
| CT chest w/wo contrast (71270) |
$2,238.06 |
$6,821.57 |
13.3× |
| CT chest with contrast (71260) |
$1,695.72 |
$5,168.50 |
10.1× |
| CT head/brain with contrast (70460) |
$1,288.98 |
$3,928.79 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,990.42 |
$6,066.76 |
11.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$489.77 |
$1,492.80 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$177.01 |
$539.54 |
2.1× |
| CT iac w contrast (70481) |
$1,286.15 |
$3,920.17 |
7.6× |
| CT limited/localized follow up study (76380) |
$1,067.72 |
$3,254.37 |
12.8× |
| CT lower ext w/o (73700) |
$1,357.72 |
$4,138.28 |
13.5× |
| CT lower extremity w wo contrast (73702) |
$2,174.08 |
$6,640.20 |
12.9× |
| CT lower extremity with contrast (73701) |
$1,429.28 |
$4,356.40 |
8.5× |
| CT lumbar spine w & w/o contrast (72133) |
$2,449.90 |
$7,467.24 |
14.6× |
| CT lumbar spine w/o contrast (72131) |
$2,125.08 |
$6,477.20 |
21.2× |
| CT lumbar spine with contrast (72132) |
$2,125.08 |
$6,477.20 |
6.3× |
| CT maxillofacial w contrast (70487) |
$1,288.98 |
$3,928.79 |
7.7× |
| CT maxillofacial w/o contrast (70486) |
$1,175.04 |
$3,581.51 |
11.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,001.75 |
$6,101.28 |
11.9× |
| CT neck soft tissue w contrast (70491) |
$1,425.50 |
$4,344.90 |
8.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,288.98 |
$3,928.79 |
7.7× |
| CT orbits w/o contrast (70480) |
$1,241.92 |
$3,785.32 |
12.4× |
| CT pelvis w & w/o contrast (72194) |
$2,507.35 |
$7,642.36 |
14.9× |
| CT pelvis w/o contrast (72192) |
$1,746.58 |
$5,323.52 |
17.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,425.50 |
$4,344.90 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,425.50 |
$4,344.90 |
14.2× |
| CT thoracic spine w/contrast (72129) |
$1,049.84 |
$3,199.90 |
6.2× |
| CT thoracic spine w/o contrast (72128) |
$2,153.32 |
$6,563.27 |
21.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,329.46 |
$4,052.18 |
7.9× |
| CT thorax w/o contrast (71250) |
$1,044.81 |
$3,199.64 |
10.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,107.39 |
$6,436.53 |
12.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,334.18 |
$4,066.56 |
13.3× |
| CT upper extremity with contrast (73201) |
$1,405.74 |
$4,284.64 |
4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,330.32 |
$7,102.79 |
13.8× |
| Cta Abdomen (74175) |
$2,219.23 |
$6,764.16 |
13.2× |
| CTA abdomen pelvis (74174) |
$4,041.48 |
$12,318.34 |
12.1× |
| CTA chest (71275) |
$2,541.24 |
$7,745.66 |
15.1× |
| Cta Head (70496) |
$2,645.75 |
$8,064.20 |
15.7× |
| CTA lwr ext w&w/o contrast (73706) |
$2,174.08 |
$6,640.20 |
12.9× |
| Cta Neck (70498) |
$1,425.50 |
$4,344.90 |
8.5× |
| Cta Pelvis (72191) |
$2,024.34 |
$6,170.14 |
12.0× |
| Cystography minimum 3 views rs&i (74430) |
$466.08 |
$1,420.62 |
1.4× |
| Diskogram cervical (72285) |
$5,448.74 |
$16,607.65 |
2.9× |
| Diskography lumbar (72295) |
$5,448.74 |
$16,607.65 |
2.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$193.02 |
$588.34 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$193.02 |
$588.34 |
1.9× |
| Echoencephalography real time imaging (76506) |
$436.45 |
$1,338.81 |
4.4× |
| Esophagus (74220) |
$440.64 |
$1,343.04 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$333.89 |
$1,011.79 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$366.28 |
$1,116.40 |
1.6× |
| Foot 2 views (73620) |
$247.85 |
$751.05 |
3.0× |
| Forearm 2 views (73090) |
$114.88 |
$350.15 |
1.4× |
| Gated Heart Planar Single (78472) |
$1,492.36 |
$4,548.66 |
3.9× |
| Hand 2 views (73120) |
$203.80 |
$621.24 |
2.0× |
| Hand 3 views (73130) |
$278.70 |
$849.47 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$796.28 |
$2,427.06 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$796.28 |
$2,427.06 |
2.1× |
| Ht muscle image spect sing (78451) |
$3,343.84 |
$10,257.19 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$237.27 |
$723.19 |
2.8× |
| Hysterosalpingogram (74740) |
$627.08 |
$1,911.32 |
2.7× |
| Image fusion (77399) |
$426.53 |
$1,300.06 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$7,701.86 |
$23,475.11 |
11.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,600.64 |
$4,878.72 |
2.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,600.64 |
$4,878.72 |
3.0× |
| Intracavitary radiation source applic simple (77761) |
$1,600.64 |
$4,878.72 |
3.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$161.94 |
$493.60 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,493.30 |
$4,551.54 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,029.11 |
$3,136.70 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,017.74 |
$6,150.02 |
3.9× |
| Knee 3 views (73562) |
$200.54 |
$611.25 |
2.4× |
| Liver & spleen imaging static only (78215) |
$796.55 |
$2,427.86 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$1,236.58 |
$3,769.06 |
2.4× |
| Lung perfusion differential (78597) |
$1,236.58 |
$3,769.06 |
3.2× |
| Lung Ventilation Imaging (78579) |
$542.51 |
$1,653.56 |
1.4× |
| Lymphoscintigraphy (78195) |
$983.93 |
$2,999 |
1.9× |
| Mammary ductogram or galactogram multiple (77054) |
$723.10 |
$2,204.01 |
3.2× |
| Mammary ductogram or galactogram single (77053) |
$543.70 |
$1,657.19 |
2.4× |
| Meckels Diverticulum (78290) |
$683.56 |
$2,083.50 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$806.90 |
$2,459.42 |
2.2× |
| Mr safety determination physician/other qhp (76016) |
$120.76 |
$368.05 |
1.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$81.46 |
$248.29 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$31.93 |
$97.96 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$125.88 |
$383.68 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$331.50 |
$1,010.39 |
1.4× |
| MRA head w & w/o contrast (70546) |
$3,277.59 |
$10,053.97 |
9.8× |
| MRA head w/o contrast (70544) |
$2,954.74 |
$9,008.78 |
12.9× |
| MRA head with contrast (70545) |
$1,007.68 |
$3,072.34 |
3.0× |
| MRA neck w contrast (70548) |
$1,355.44 |
$4,157.80 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,143.31 |
$9,642.04 |
9.4× |
| MRA neck w/o contrast (70547) |
$1,385.88 |
$4,251.18 |
6.1× |
| MRI abdomen w contrast (74182) |
$1,119.09 |
$3,432.79 |
3.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,504.52 |
$7,633.74 |
7.5× |
| MRI abdomen w/o contrast (74181) |
$2,170.14 |
$6,656.87 |
9.5× |
| MRI any jnt lwr ext with con lt (73722) |
$1,534.52 |
$4,681.72 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,749.84 |
$5,342.19 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,975.07 |
$6,019.96 |
8.6× |
| MRI breast w/o contrast unilat (77046) |
$1,558.80 |
$4,751.18 |
6.8× |
| MRI c-spine with contrast (72142) |
$1,421.69 |
$4,361.02 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$2,214.02 |
$6,791.46 |
9.7× |
| MRI chest w/o & w/contrast material (71552) |
$2,972.31 |
$9,117.53 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,664.33 |
$8,172.80 |
11.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,272.46 |
$9,916.54 |
9.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,268.29 |
$3,874.94 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,624.68 |
$4,953.74 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,892.60 |
$5,805.51 |
8.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,652.68 |
$8,137.05 |
7.9× |
| MRI orbit/face/neck w/contrast (70542) |
$2,007.20 |
$6,157.07 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,668.81 |
$11,254.03 |
11.0× |
| MRI pelvis w/o contrast (72195) |
$2,889.94 |
$8,864.86 |
12.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,920.80 |
$8,905.74 |
8.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,514.16 |
$7,618.68 |
7.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,351.03 |
$10,279.23 |
10.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,468.26 |
$4,503.85 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,966.05 |
$9,098.30 |
8.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,433.33 |
$4,396.71 |
4.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,123.61 |
$9,581.63 |
9.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,309.81 |
$7,085.31 |
10.1× |
| MRI tmj (70336) |
$1,202.24 |
$3,673.16 |
5.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,054.67 |
$6,302.66 |
9.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,173.96 |
$12,648.36 |
12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,446.24 |
$7,412.86 |
10.7× |
| Myelogram Cervical (72240) |
$1,273.92 |
$3,882.88 |
1.7× |
| Myelogram Lumbar (72265) |
$1,273.92 |
$3,882.88 |
1.7× |
| Myelogram thoracic (72255) |
$1,273.92 |
$3,882.88 |
1.7× |
| Myelography 2 or more regions (72270) |
$2,005.48 |
$6,112.68 |
2.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,578.42 |
$10,976.74 |
2.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,395.25 |
$4,252.69 |
1.7× |
| Neck soft tissue (70360) |
$284.36 |
$866.70 |
3.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$564.94 |
$1,721.93 |
1.5× |
| Nm cisternogram (78630) |
$1,669.36 |
$5,088.19 |
3.2× |
| Nm gastric emptying study (78264) |
$1,340.76 |
$4,086.63 |
3.5× |
| Nm gastroesophageal reflux study (78262) |
$623.32 |
$1,899.86 |
1.6× |
| Nm peritoneal-venous shunt patency (78291) |
$560.38 |
$1,708.04 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,992.25 |
$9,120.31 |
2.3× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$621.42 |
$1,894.10 |
1.6× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$654.40 |
$1,994.58 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$1,052.64 |
$3,208.46 |
4.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$144.68 |
$440.99 |
1.4× |
| Osseous survey infant (77076) |
$240.09 |
$731.80 |
2.4× |
| Osseous survey limited (77074) |
$240.09 |
$731.80 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$683.69 |
$2,083.88 |
1.8× |
| Parathyroid imaging (78070) |
$1,034.78 |
$3,153.98 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$228.80 |
$697.37 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$8,307.51 |
$25,483.16 |
6.1× |
| PET imaging CT for attenuation limited area (78814) |
$8,307.51 |
$25,483.16 |
6.1× |
| PET imaging for CT attenuation whole body (78816) |
$8,016.84 |
$24,293.45 |
5.8× |
| Platelet survival study (78191) |
$843.64 |
$2,571.38 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,357.96 |
$7,189.60 |
7.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$806.90 |
$2,459.42 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$920.94 |
$2,807 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$519.95 |
$1,584.80 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$141.60 |
$431.58 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$234.50 |
$714.74 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$234.50 |
$714.74 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$161.94 |
$493.60 |
1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,975.02 |
$45,935.65 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$336.85 |
$1,033.27 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$174.53 |
$535.37 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$174.53 |
$535.37 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$521.62 |
$1,589.90 |
5.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$251.38 |
$766.22 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$250.80 |
$764.45 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$247.99 |
$760.71 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$456.66 |
$1,391.89 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$464.94 |
$1,417.14 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$603.66 |
$1,851.71 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$603.66 |
$1,851.71 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$148.56 |
$450.17 |
1.8× |
| Radiological examination surgical specimen (76098) |
$1,050.58 |
$3,204.39 |
2.0× |
| Ribs bilateral 3 views (71110) |
$290.94 |
$886.78 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,207.47 |
$6,728.32 |
4.2× |
| Rp Therapy Intravenous Administration (79101) |
$800.32 |
$2,439.34 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$145.21 |
$440.03 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,504.58 |
$4,585.94 |
6.6× |
| Scanogram (77073) |
$238.37 |
$722.34 |
2.4× |
| Scapula complete (73010) |
$218.44 |
$665.81 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$13.27 |
$40.45 |
0.6× |
| Sialogram (70390) |
$519.95 |
$1,584.80 |
2.3× |
| Simulation intermediate (77285) |
$760.77 |
$2,318.80 |
2.1× |
| Small bowel series (74250) |
$417.10 |
$1,271.32 |
2.5× |
| Spec medical radj physics consltj (77370) |
$365.28 |
$1,120.49 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$856.80 |
$2,611.52 |
2.4× |
| Special dosimetry (77331) |
$403.04 |
$1,221.33 |
3.1× |
| Special treatment procedure (77470) |
$1,250.37 |
$3,811.10 |
2.4× |
| Spine thoracic 3 views (72072) |
$319.18 |
$972.86 |
3.2× |
| Stereotactic body radiation delivery (77373) |
$3,316.54 |
$10,173.45 |
1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$856.80 |
$2,611.52 |
2.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$384.16 |
$1,170.91 |
1.1× |
| Testicular Imaging With Vascular Flow (78761) |
$1,152.46 |
$3,512.68 |
3.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$856.80 |
$2,611.52 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$384.16 |
$1,170.91 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,995.16 |
$6,081.20 |
3.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$318.52 |
$970.87 |
0.8× |
| Thyroid uptake measurement (78012) |
$242.08 |
$737.86 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$494.52 |
$1,507.30 |
1.3× |
| Tmj unilateral (70328) |
$169.21 |
$519.06 |
2.0× |
| Tomogram (76100) |
$269.28 |
$820.78 |
2.7× |
| Treatment device intermediate (77333) |
$630.84 |
$1,922.80 |
4.9× |
| Treatment devices simple (77332) |
$560.22 |
$1,707.53 |
4.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,263.60 |
$6,899.40 |
4.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,047.95 |
$3,194.12 |
2.7× |
| Tx devices design & construction complex (77334) |
$691.49 |
$2,095.42 |
1.9× |
| Ultrasound elastography first target lesion (76982) |
$158.02 |
$481.64 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$555.07 |
$1,702.68 |
5.5× |
| Umbilical-artery Doppler (OB) (76820) |
$205.19 |
$629.41 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$108.88 |
$331.87 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$159.76 |
$487.08 |
1.9× |
| Unlisted Ultrasound Procedure (76999) |
$934.78 |
$2,849.18 |
11.2× |
| Upper Extremity Infant (73092) |
$176.42 |
$538.85 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$980.16 |
$2,987.51 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$466.08 |
$1,420.62 |
2.0× |
| Urethrocystography voiding (74455) |
$466.08 |
$1,420.62 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$610.12 |
$1,859.66 |
3.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$629.90 |
$1,919.94 |
3.7× |
| Us abdl aorta screen aaa (76706) |
$199.81 |
$609.02 |
2.0× |
| Us breast unilateral complete (76641) |
$176.36 |
$534.43 |
1.8× |
| Us breast unilateral limited (76642) |
$176.36 |
$534.43 |
2.1× |
| Us chest (76604) |
$414.30 |
$1,262.77 |
4.1× |
| Us compl joint r-t w/image documentation (76881) |
$425.92 |
$1,300.89 |
4.2× |
| Us elastography parenchyma (76981) |
$158.02 |
$481.64 |
1.6× |
| Us guided compression repair (76936) |
$241.91 |
$733.06 |
1.2× |
| Us infant hips dynamic (76885) |
$203.38 |
$619.88 |
2.4× |
| Us infant hips limited static (76886) |
$182.66 |
$556.76 |
2.2× |
| Us ob transvaginal (76817) |
$905.78 |
$2,760.82 |
9.0× |
| Us pelvic non ob complete (76856) |
$608.80 |
$1,867.47 |
6.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$285.29 |
$869.56 |
2.8× |
| Us pregnancy ltd (76815) |
$427.46 |
$1,302.88 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$318.25 |
$970.02 |
3.2× |
| Us retroperitoneal complete (76770) |
$610.12 |
$1,859.66 |
6.1× |
| Us retroperitoneal limited (76775) |
$302.61 |
$928.25 |
3.0× |
| Us scrotum and contents (76870) |
$302.61 |
$928.25 |
3.0× |
| Us soft tissue head/neck (76536) |
$453.90 |
$1,392.34 |
4.5× |
| Us spinal canal and contents (76800) |
$249.52 |
$760.55 |
2.5× |
| Us transrectal (76872) |
$318.25 |
$970.02 |
3.2× |
| Us transrectal prostate volume (76873) |
$318.25 |
$970.02 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$179.40 |
$547.02 |
1.8× |
| Venogram extremity bilateral (75822) |
$2,473.44 |
$7,539 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$7,079.50 |
$21,578.16 |
2.3× |
| Venography caval superior serialography rs&i (75827) |
$2,473.44 |
$7,539 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$1,450.33 |
$4,420.58 |
1.0× |
| Wrist 2 views (73100) |
$268.34 |
$817.91 |
3.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$489.60 |
$1,492.31 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$244.81 |
$746.17 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$299.40 |
$912.58 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$940.60 |
$2,866.94 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$221.06 |
$673.82 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$236.34 |
$720.34 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$141.60 |
$431.58 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$141.60 |
$431.58 |
1.7× |
| X-ray exam hip uni 4/> views (73503) |
$234.50 |
$714.74 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$234.50 |
$714.74 |
2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$447.05 |
$1,362.60 |
4.5× |
| X-ray exam of femur 1 (73551) |
$148.56 |
$450.17 |
1.8× |
| X-ray eye for foreign body (70030) |
$238.94 |
$729.80 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$425.58 |
$1,297.17 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$286.23 |
$872.43 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$254.22 |
$774.84 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$236.34 |
$720.34 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$303.19 |
$924.12 |
3.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$429.36 |
$1,308.66 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$604.55 |
$1,831.96 |
7.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$265.33 |
$810.39 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$480.20 |
$1,463.64 |
4.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$495.26 |
$1,509.54 |
4.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$457.32 |
$1,393.90 |
4.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$396.40 |
$1,208.22 |
4.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$161.94 |
$493.60 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$253.28 |
$772 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$249.92 |
$757.34 |
2.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$725.17 |
$2,224.44 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$213.97 |
$656.34 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$276.64 |
$848.60 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$399.23 |
$1,216.85 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$276.82 |
$843.72 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$272.12 |
$829.40 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$237.27 |
$723.19 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$429.36 |
$1,308.66 |
5.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$267.39 |
$815 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$470.78 |
$1,434.92 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$308.82 |
$941.30 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$199.61 |
$608.42 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$131.61 |
$403.70 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$119.58 |
$364.46 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$104.51 |
$318.54 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$374.38 |
$1,134.49 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$220.33 |
$671.56 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$273.05 |
$832.24 |
3.3× |
| Xr arthrogram ankle (73615) |
$780.10 |
$2,377.72 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$483.02 |
$1,472.24 |
4.8× |
| Xr chest 4+ views (71048) |
$263.13 |
$797.37 |
2.6× |
| Xr Cholecystography Oral Contrast (74290) |
$318.25 |
$970.02 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$218.44 |
$665.81 |
2.6× |
| Xr shoulder 1 view (73020) |
$224.08 |
$682.99 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$468.90 |
$1,429.18 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$297.54 |
$906.88 |
3.6× |
| Xr tmj bilateral (70330) |
$562.12 |
$1,713.32 |
6.7× |
| Xray knee 1 or 2 views rt (73560) |
$191.13 |
$582.56 |
2.3× |