| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,442.50 |
$16,885 |
6.1× |
| Abdomen 2 views (74019) |
$449 |
$898 |
4.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,112 |
$4,224 |
5.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,297.50 |
$2,595 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,302 |
$2,604 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$765.50 |
$1,531 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,376 |
$2,752 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,292 |
$4,584 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,482 |
$2,964 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,917 |
$3,834 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,794 |
$3,588 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$477.50 |
$955 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$964 |
$1,928 |
0.3× |
| Ankle 2 views (73600) |
$201 |
$402 |
2.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,864 |
$3,728 |
5.3× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$875 |
$1,750 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,468.50 |
$2,937 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,446.50 |
$2,893 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$2,927.50 |
$5,855 |
0.9× |
| Arthrogram elbow (73085) |
$245 |
$490 |
0.7× |
| Arthrogram hip (73525) |
$338 |
$676 |
1.0× |
| Arthrogram shoulder (73040) |
$299.50 |
$599 |
0.9× |
| Arthrogram wrist (73115) |
$535.50 |
$1,071 |
1.5× |
| Arthrography knee lt (73580) |
$501.50 |
$1,003 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$2,185 |
$4,370 |
16.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,350 |
$2,700 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$2,464.50 |
$4,929 |
6.1× |
| Bone age studies (77072) |
$237 |
$474 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$2,822.50 |
$5,645 |
7.0× |
| Bone Marrow Imaging Limited Area (78102) |
$804.50 |
$1,609 |
2.0× |
| Bone survey complete (77075) |
$646 |
$1,292 |
6.2× |
| Brachytx isodose complex (77318) |
$2,103.50 |
$4,207 |
5.6× |
| Brachytx isodose intermed (77317) |
$1,708 |
$3,416 |
4.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,487.50 |
$2,975 |
4.0× |
| Brain image w/flow 4 + views (78606) |
$2,097.50 |
$4,195 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,314 |
$14,628 |
5.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,048.50 |
$2,097 |
3.0× |
| Cardiac shunt detection (78428) |
$1,766 |
$3,532 |
4.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,962.50 |
$3,925 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$272 |
$544 |
3.1× |
| Chest 1 view (71045) |
$460 |
$920 |
5.3× |
| Chest 3 views (71047) |
$666 |
$1,332 |
7.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,248 |
$2,496 |
7.1× |
| Clavicle complete (73000) |
$405 |
$810 |
4.6× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$57,044 |
$114,088 |
7.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,188 |
$2,376 |
11.3× |
| Continuing medical physics consltj pr wk (77336) |
$819 |
$1,638 |
6.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,840.50 |
$5,681 |
8.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,147 |
$4,294 |
9.0× |
| CT abdomen w contrast (74160) |
$1,340 |
$2,680 |
7.6× |
| CT abdomen w wo contrast (74170) |
$1,474 |
$2,948 |
8.4× |
| CT abdomen w/o contrast (74150) |
$1,218 |
$2,436 |
11.6× |
| CT angio hrt w/3d image (75574) |
$1,030 |
$2,060 |
2.9× |
| CT angiography upper extremity lt (73206) |
$1,243.50 |
$2,487 |
7.1× |
| CT c-spine w/o contrast (72125) |
$1,291 |
$2,582 |
12.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$1,040 |
$2,080 |
5.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,669.50 |
$3,339 |
9.5× |
| CT cervical spine with contrast (72126) |
$1,517.50 |
$3,035 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,317 |
$2,634 |
7.5× |
| CT chest with contrast (71260) |
$1,197.50 |
$2,395 |
6.8× |
| CT head/brain with contrast (70460) |
$1,375 |
$2,750 |
7.8× |
| CT head/brain without and with contrast (70470) |
$1,639 |
$3,278 |
9.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$899.50 |
$1,799 |
2.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$189.50 |
$379 |
2.2× |
| CT hrt w/3d image congen (75573) |
$1,412 |
$2,824 |
4.0× |
| CT iac w contrast (70481) |
$1,313 |
$2,626 |
7.5× |
| CT limited/localized follow up study (76380) |
$415.50 |
$831 |
4.8× |
| CT lower ext w/o (73700) |
$875.50 |
$1,751 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,134 |
$2,268 |
6.4× |
| CT lower extremity with contrast (73701) |
$952.50 |
$1,905 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,481.50 |
$2,963 |
8.4× |
| CT lumbar spine w/o contrast (72131) |
$1,224.50 |
$2,449 |
11.7× |
| CT lumbar spine with contrast (72132) |
$1,347 |
$2,694 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,430.50 |
$2,861 |
8.1× |
| CT maxillofacial w/o contrast (70486) |
$1,300.50 |
$2,601 |
12.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,573 |
$3,146 |
8.9× |
| CT neck soft tissue w contrast (70491) |
$1,443 |
$2,886 |
8.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,444 |
$2,888 |
8.2× |
| CT orbits w/o contrast (70480) |
$1,193.50 |
$2,387 |
11.4× |
| CT pelvis w & w/o contrast (72194) |
$1,236.50 |
$2,473 |
7.0× |
| CT pelvis w/o contrast (72192) |
$1,022 |
$2,044 |
9.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,587 |
$3,174 |
9.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,312 |
$2,624 |
12.5× |
| CT thoracic spine w/contrast (72129) |
$1,190.50 |
$2,381 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,082 |
$2,164 |
10.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,309 |
$2,618 |
7.4× |
| CT thorax w/o contrast (71250) |
$1,088.50 |
$2,177 |
10.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,206 |
$2,412 |
6.8× |
| CT upper extremity w/o contrast rt (73200) |
$991.50 |
$1,983 |
9.4× |
| CT upper extremity with contrast (73201) |
$1,083 |
$2,166 |
3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,421.50 |
$2,843 |
8.1× |
| Cta Abdomen (74175) |
$1,912 |
$3,824 |
10.9× |
| CTA abdomen pelvis (74174) |
$2,336.50 |
$4,673 |
6.7× |
| CTA chest (71275) |
$1,141 |
$2,282 |
6.5× |
| Cta Head (70496) |
$1,397 |
$2,794 |
7.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,040 |
$2,080 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,100 |
$2,200 |
6.2× |
| Cta Neck (70498) |
$1,504 |
$3,008 |
8.5× |
| Cta Pelvis (72191) |
$1,317.50 |
$2,635 |
7.5× |
| Cystography minimum 3 views rs&i (74430) |
$1,223.50 |
$2,447 |
3.5× |
| Diskography lumbar (72295) |
$1,797 |
$3,594 |
0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$788 |
$1,576 |
7.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$340 |
$680 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$350.50 |
$701 |
4.0× |
| Echoencephalography real time imaging (76506) |
$715 |
$1,430 |
6.8× |
| Esophagus (74220) |
$722 |
$1,444 |
4.1× |
| Fetal biophysical profile non-stress testing (76818) |
$960 |
$1,920 |
9.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$574 |
$1,148 |
5.5× |
| Fluoroscopy up to 1 hr (76000) |
$240.50 |
$481 |
1.0× |
| Foot 2 views (73620) |
$346 |
$692 |
4.0× |
| Forearm 2 views (73090) |
$521.50 |
$1,043 |
6.0× |
| Functional MRI brain by phys/psych (70555) |
$437.50 |
$875 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,896 |
$3,792 |
4.7× |
| Hand 2 views (73120) |
$248.50 |
$497 |
2.4× |
| Hand 3 views (73130) |
$586 |
$1,172 |
6.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,129 |
$4,258 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,688 |
$7,376 |
5.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,823.50 |
$11,647 |
8.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,439.50 |
$2,879 |
3.7× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,439.50 |
$2,879 |
3.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$875 |
$1,750 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,557.50 |
$5,115 |
4.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,557.50 |
$5,115 |
6.4× |
| Ht muscle image spect sing (78451) |
$6,524.50 |
$13,049 |
5.0× |
| Humerus Min 2 Views Left (73060) |
$542 |
$1,084 |
6.2× |
| Hysterosalpingogram (74740) |
$687.50 |
$1,375 |
2.9× |
| Image fusion (77399) |
$934 |
$1,868 |
6.9× |
| Interstitial radiation source applic complex (77778) |
$7,283.50 |
$14,567 |
10.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$7,587.50 |
$15,175 |
13.7× |
| Intracavitary radiation source applic simple (77761) |
$6,481.50 |
$12,963 |
11.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$1,235.50 |
$2,471 |
3.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,830 |
$3,660 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,011.50 |
$4,023 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,429 |
$4,858 |
4.5× |
| Knee 3 views (73562) |
$507.50 |
$1,015 |
5.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,606.50 |
$5,213 |
6.5× |
| Lung perf&ventilat diferentl (78598) |
$2,078.50 |
$4,157 |
3.8× |
| Lung perfusion differential (78597) |
$2,352.50 |
$4,705 |
5.9× |
| Lung Ventilation Imaging (78579) |
$1,227.50 |
$2,455 |
3.1× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$843.50 |
$1,687 |
0.3× |
| Lymphoscintigraphy (78195) |
$2,490 |
$4,980 |
4.6× |
| Mammary ductogram or galactogram multiple (77054) |
$234 |
$468 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$658.50 |
$1,317 |
2.7× |
| Meckels Diverticulum (78290) |
$1,708 |
$3,416 |
4.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,031.50 |
$4,063 |
5.4× |
| Mr elastography (76391) |
$1,422.50 |
$2,845 |
5.9× |
| Mr safety determination physician/other qhp (76016) |
$119 |
$238 |
1.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$80.50 |
$161 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$33 |
$66 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$124 |
$248 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$326.50 |
$653 |
1.4× |
| MRA head w & w/o contrast (70546) |
$4,518 |
$9,036 |
12.9× |
| MRA head w/o contrast (70544) |
$1,130.50 |
$2,261 |
4.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,134.50 |
$2,269 |
3.2× |
| MRA neck w/o contrast (70547) |
$938 |
$1,876 |
3.9× |
| MRI abdomen w contrast (74182) |
$1,114 |
$2,228 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,225 |
$2,450 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$1,012.50 |
$2,025 |
4.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,389 |
$2,778 |
1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,131 |
$2,262 |
1.4× |
| MRI bone marrow blood supply (77084) |
$771.50 |
$1,543 |
3.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,109 |
$2,218 |
4.6× |
| MRI breast w/o contrast unilat (77046) |
$1,019 |
$2,038 |
4.3× |
| MRI c-spine with contrast (72142) |
$1,548 |
$3,096 |
4.4× |
| MRI cardiac w/o contrast (75557) |
$1,161.50 |
$2,323 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,407.50 |
$2,815 |
5.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,251 |
$2,502 |
3.6× |
| MRI chest w/o contrast (71550) |
$1,034 |
$2,068 |
4.3× |
| MRI chest with contrast (71551) |
$1,137 |
$2,274 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$984.50 |
$1,969 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$899 |
$1,798 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$936.50 |
$1,873 |
3.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,634 |
$3,268 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,201 |
$4,402 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,797 |
$3,594 |
5.1× |
| MRI pelvis w contrast (72196) |
$1,372.50 |
$2,745 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,509 |
$3,018 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$967.50 |
$1,935 |
4.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,248.50 |
$2,497 |
3.6× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,154 |
$2,308 |
1.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,499 |
$2,998 |
4.3× |
| MRI spectroscopy (76390) |
$1,024.50 |
$2,049 |
11.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,703 |
$3,406 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,161.50 |
$2,323 |
3.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,278 |
$2,556 |
3.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,041 |
$2,082 |
3.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,144.50 |
$2,289 |
3.3× |
| MRI thoracic spine w/o contrast (72146) |
$946.50 |
$1,893 |
3.9× |
| MRI tmj (70336) |
$798 |
$1,596 |
3.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,031 |
$2,062 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,046.50 |
$2,093 |
3.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$892.50 |
$1,785 |
3.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$7,338 |
$14,676 |
5.6× |
| Myocardial Spect Multiple Studies (78452) |
$6,875.50 |
$13,751 |
5.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$7,107 |
$14,214 |
4.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,022 |
$10,044 |
2.3× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$5,798.50 |
$11,597 |
2.6× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$4,835 |
$9,670 |
3.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$6,058.50 |
$12,117 |
7.0× |
| Neck soft tissue (70360) |
$402.50 |
$805 |
4.6× |
| Nm cisternogram (78630) |
$2,974 |
$5,948 |
5.5× |
| Nm csf leak detection (78650) |
$838.50 |
$1,677 |
0.6× |
| Nm gastric emptying study (78264) |
$2,342.50 |
$4,685 |
5.8× |
| Nm peritoneal-venous shunt patency (78291) |
$1,744 |
$3,488 |
4.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,009 |
$18,018 |
6.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$5,751.50 |
$11,503 |
4.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$5,572 |
$11,144 |
4.3× |
| Nuclear medicine of heart pumping function (78473) |
$2,308 |
$4,616 |
5.7× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$5,112 |
$10,224 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$2,118.50 |
$4,237 |
9.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$706.50 |
$1,413 |
6.7× |
| Orthopantogram (70355) |
$192.50 |
$385 |
2.2× |
| Osseous survey infant (77076) |
$509 |
$1,018 |
4.8× |
| Parathyrd planar w/spect&CT (78072) |
$4,573.50 |
$9,147 |
8.4× |
| Parathyrd planar w/wo subtrj (78071) |
$4,573.50 |
$9,147 |
11.4× |
| Parathyroid imaging (78070) |
$2,111.50 |
$4,223 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$247 |
$494 |
2.4× |
| Perineogram (74775) |
$1,267.50 |
$2,535 |
5.3× |
| Peritoneogram rs&i (74190) |
$1,503.50 |
$3,007 |
2.7× |
| PET image w/CT, skull-thigh (78815) |
$4,760 |
$9,520 |
3.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,493 |
$6,986 |
2.4× |
| PET imaging for CT attenuation whole body (78816) |
$4,900.50 |
$9,801 |
3.4× |
| Pr MRI brain w/o & w/ dye (70559) |
$530 |
$1,060 |
3.0× |
| Pr MRI brain w/o dye (70557) |
$2,060 |
$4,120 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,111 |
$2,222 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$972 |
$1,944 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$961 |
$1,922 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,699 |
$3,398 |
4.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,403.50 |
$4,807 |
4.4× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,103 |
$2,206 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,442 |
$2,884 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$310.50 |
$621 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$377.50 |
$755 |
3.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$501 |
$1,002 |
4.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$509 |
$1,018 |
4.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$623.50 |
$1,247 |
5.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$24,762 |
$49,524 |
3.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$999.50 |
$1,999 |
1.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$893 |
$1,786 |
8.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$965 |
$1,930 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$560 |
$1,120 |
5.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$384.50 |
$769 |
4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$695 |
$1,390 |
6.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$625 |
$1,250 |
7.1× |
| Radiologic exam colon single contrast study (74270) |
$1,260 |
$2,520 |
7.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,225.50 |
$2,451 |
7.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,191.50 |
$2,383 |
6.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$872.50 |
$1,745 |
5.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$323 |
$646 |
3.7× |
| Radiological examination surgical specimen (76098) |
$572.50 |
$1,145 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,160 |
$6,320 |
1.0× |
| Ribs bilateral 3 views (71110) |
$354 |
$708 |
3.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,970.50 |
$3,941 |
4.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,019 |
$6,038 |
5.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,929 |
$5,858 |
5.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,809.50 |
$13,619 |
5.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,181 |
$2,362 |
5.0× |
| Rp Therapy Intravenous Administration (79101) |
$4,641 |
$9,282 |
19.8× |
| Scanogram (77073) |
$228 |
$456 |
2.2× |
| Scapula complete (73010) |
$269.50 |
$539 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$29 |
$58 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$792.50 |
$1,585 |
7.5× |
| Sialogram (70390) |
$584 |
$1,168 |
2.4× |
| Simulation intermediate (77285) |
$1,464 |
$2,928 |
3.9× |
| Small bowel series (74250) |
$932 |
$1,864 |
5.3× |
| Spec medical radj physics consltj (77370) |
$2,693.50 |
$5,387 |
19.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,036 |
$4,072 |
5.4× |
| Special dosimetry (77331) |
$1,011 |
$2,022 |
7.5× |
| Special treatment procedure (77470) |
$3,329.50 |
$6,659 |
6.0× |
| Spine thoracic 3 views (72072) |
$341.50 |
$683 |
3.3× |
| Splenoportograpy rs&i (75810) |
$2,979 |
$5,958 |
0.9× |
| Stereotactic body radiation delivery (77373) |
$19,213 |
$38,426 |
10.7× |
| Superior sagittal sinus venogram (75870) |
$416.50 |
$833 |
0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$693.50 |
$1,387 |
6.8× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$156.50 |
$313 |
1.5× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$57 |
$114 |
1.5× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$156.50 |
$313 |
1.5× |
| Tbs Technical Calculation Only (77091) |
$413 |
$826 |
4.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,165.50 |
$4,331 |
5.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,051 |
$2,102 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,284 |
$4,568 |
6.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,273.50 |
$2,547 |
9.4× |
| Thoracolumbar 2 views (72080) |
$314 |
$628 |
3.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,320.50 |
$4,641 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,183.50 |
$2,367 |
2.9× |
| Thyroid uptake measurement (78012) |
$1,269.50 |
$2,539 |
3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,468.50 |
$2,937 |
3.7× |
| Tomogram (76100) |
$441.50 |
$883 |
4.2× |
| Treatment device intermediate (77333) |
$1,203 |
$2,406 |
8.9× |
| Treatment devices simple (77332) |
$1,120.50 |
$2,241 |
8.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,019 |
$6,038 |
5.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,778 |
$3,556 |
4.4× |
| Tx devices design & construction complex (77334) |
$2,031.50 |
$4,063 |
5.4× |
| Ultrasound elastography first target lesion (76982) |
$397 |
$794 |
3.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,383 |
$2,766 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$1,129 |
$2,258 |
10.8× |
| Unlisted fluoroscopic procedure (76496) |
$240.50 |
$481 |
2.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,676.50 |
$3,353 |
19.2× |
| Upper Extremity Infant (73092) |
$181 |
$362 |
1.7× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$1,411.50 |
$2,823 |
15.0× |
| Urethrocystography retrograde rs&i (74450) |
$1,027 |
$2,054 |
4.3× |
| Urethrocystography voiding (74455) |
$938.50 |
$1,877 |
3.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,107 |
$2,214 |
6.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,212.50 |
$2,425 |
6.9× |
| Us abdl aorta screen aaa (76706) |
$634 |
$1,268 |
6.0× |
| Us breast unilateral complete (76641) |
$562.50 |
$1,125 |
5.4× |
| Us breast unilateral limited (76642) |
$562.50 |
$1,125 |
6.4× |
| Us chest (76604) |
$588 |
$1,176 |
5.6× |
| Us compl joint r-t w/image documentation (76881) |
$941.50 |
$1,883 |
9.0× |
| Us elastography parenchyma (76981) |
$397 |
$794 |
3.8× |
| Us guided compression repair (76936) |
$465 |
$930 |
2.1× |
| Us infant hips dynamic (76885) |
$667 |
$1,334 |
7.6× |
| Us kidney transplant (76776) |
$832 |
$1,664 |
7.9× |
| Us ob transvaginal (76817) |
$653 |
$1,306 |
6.2× |
| Us pelvic non ob complete (76856) |
$996 |
$1,992 |
9.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$662.50 |
$1,325 |
6.3× |
| Us pregnancy ltd (76815) |
$508.50 |
$1,017 |
4.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$806.50 |
$1,613 |
7.7× |
| Us retroperitoneal complete (76770) |
$990 |
$1,980 |
9.4× |
| Us retroperitoneal limited (76775) |
$832 |
$1,664 |
7.9× |
| Us scrotum and contents (76870) |
$878 |
$1,756 |
8.4× |
| Us soft tissue head/neck (76536) |
$879.50 |
$1,759 |
8.4× |
| Us spinal canal and contents (76800) |
$595.50 |
$1,191 |
5.7× |
| Us transrectal (76872) |
$958 |
$1,916 |
9.1× |
| Us transrectal prostate volume (76873) |
$680.50 |
$1,361 |
6.5× |
| Us xtr non-vasc lmtd (76882) |
$941.50 |
$1,883 |
9.0× |
| Venogram extremity bilateral (75822) |
$562 |
$1,124 |
0.4× |
| Venogram orbital (75880) |
$1,111.50 |
$2,223 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$5,050.50 |
$10,101 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$1,079 |
$2,158 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$454.50 |
$909 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,741.50 |
$3,483 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$958.50 |
$1,917 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$688.50 |
$1,377 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,523 |
$3,046 |
0.3× |
| Wrist 2 views (73100) |
$229 |
$458 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$856 |
$1,712 |
8.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$274.50 |
$549 |
3.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$568 |
$1,136 |
6.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,269 |
$2,538 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$234 |
$468 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$633.50 |
$1,267 |
7.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$577.50 |
$1,155 |
5.5× |
| X-ray exam hip uni 1 view (73501) |
$233.50 |
$467 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$381.50 |
$763 |
4.4× |
| X-ray exam hip uni 4/> views (73503) |
$185 |
$370 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$625.50 |
$1,251 |
6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$775 |
$1,550 |
7.4× |
| X-ray exam of femur 1 (73551) |
$325.50 |
$651 |
3.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$386.50 |
$773 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$304 |
$608 |
3.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$598 |
$1,196 |
6.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,682.50 |
$3,365 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$316.50 |
$633 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$233.50 |
$467 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$378.50 |
$757 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$200.50 |
$401 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$284.50 |
$569 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$351 |
$702 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$485.50 |
$971 |
4.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$245 |
$490 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$447.50 |
$895 |
5.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$281 |
$562 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$316 |
$632 |
3.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,111.50 |
$2,223 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$332 |
$664 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$368 |
$736 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$482.50 |
$965 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$288 |
$576 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$316.50 |
$633 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$591 |
$1,182 |
6.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$322.50 |
$645 |
3.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$209 |
$418 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402 |
$804 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$283 |
$566 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$265 |
$530 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$229 |
$458 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$214 |
$428 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$290.50 |
$581 |
2.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$397.50 |
$795 |
3.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$274.50 |
$549 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$461.50 |
$923 |
5.3× |
| Xr arthrogram ankle (73615) |
$447 |
$894 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$560 |
$1,120 |
5.3× |
| Xr chest 4+ views (71048) |
$698 |
$1,396 |
6.6× |
| Xr finger(s) 2+ views (73140) |
$248.50 |
$497 |
2.8× |
| Xr shoulder 1 view (73020) |
$198.50 |
$397 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$633 |
$1,266 |
6.0× |
| Xr tibia/fibula 2 views (73590) |
$587.50 |
$1,175 |
6.7× |
| Xr tmj bilateral (70330) |
$260 |
$520 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$445 |
$890 |
5.1× |