| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,442.50 |
$16,885 |
6.1× |
| Abdomen 1 View (74018) |
$384.50 |
$769 |
4.4× |
| Abdomen 2 views (74019) |
$449 |
$898 |
4.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,112 |
$4,224 |
5.3× |
| Angio internal mammary (75756) |
$765.50 |
$1,531 |
0.2× |
| Angio pulmonary bilat (75743) |
$2,292 |
$4,584 |
0.7× |
| 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 pulmonary unilateral slctv rs&i (75741) |
$1,482 |
$2,964 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$964 |
$1,928 |
0.3× |
| Ankle 2 views (73600) |
$201 |
$402 |
2.3× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$875 |
$1,750 |
0.2× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,794 |
$3,588 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$2,927.50 |
$5,855 |
0.9× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,376 |
$2,752 |
0.2× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$1,917 |
$3,834 |
0.3× |
| Arthrogram ankle (73615) |
$447 |
$894 |
1.3× |
| Arthrogram hip (73525) |
$338 |
$676 |
1.0× |
| Arthrogram Wrist (73115) |
$535.50 |
$1,071 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$2,185 |
$4,370 |
16.2× |
| Bone age studies (77072) |
$237 |
$474 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$2,822.50 |
$5,645 |
7.0× |
| Bone Imaging Limited Area (78300) |
$1,350 |
$2,700 |
3.4× |
| Bone Imaging Whole Body (78306) |
$2,464.50 |
$4,929 |
6.1× |
| Bone marrow imaging limited area (78102) |
$804.50 |
$1,609 |
2.0× |
| Bone survey infant (77076) |
$509 |
$1,018 |
4.8× |
| Brachytx isodose complex (77318) |
$2,103.50 |
$4,207 |
5.6× |
| Brachytx isodose intermed (77317) |
$1,708 |
$3,416 |
4.5× |
| Brachytx Isodose Plan Simple (77316) |
$1,487.50 |
$2,975 |
4.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (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 MRI w/w/o contrast w/stress (75563) |
$1,154 |
$2,308 |
1.5× |
| Cardiac Shunt Detection (78428) |
$1,766 |
$3,532 |
4.4× |
| Cat Scan Follow-Up Study (76380) |
$415.50 |
$831 |
4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,962.50 |
$3,925 |
3.6× |
| Cerebrospinal Fluid Scan (78630) |
$2,974 |
$5,948 |
5.5× |
| Chest 1 view (71045) |
$460 |
$920 |
5.3× |
| Chest 2 views (71046) |
$625 |
$1,250 |
7.1× |
| Chest 3 views (71047) |
$666 |
$1,332 |
7.6× |
| Chest 4 or more views (71048) |
$698 |
$1,396 |
6.6× |
| Clavicle complete (73000) |
$405 |
$810 |
4.6× |
| 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× |
| Contrast Exam Abdominl Aorta (75625) |
$1,446.50 |
$2,893 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$1,223.50 |
$2,447 |
3.5× |
| Contrast X-Ray Of Elbow (73085) |
$245 |
$490 |
0.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$501.50 |
$1,003 |
1.4× |
| 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 Abdomen and Pelvis (74174) |
$2,336.50 |
$4,673 |
6.7× |
| CT Angio Chest (71275) |
$1,141 |
$2,282 |
6.5× |
| CT Angio Head (70496) |
$1,397 |
$2,794 |
7.9× |
| CT angio hrt w/3d image (75574) |
$1,030 |
$2,060 |
2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,100 |
$2,200 |
6.2× |
| CT Angio Neck (70498) |
$1,504 |
$3,008 |
8.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,243.50 |
$2,487 |
7.1× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,040 |
$2,080 |
5.9× |
| CT cervical spine w/ contrast (72126) |
$1,517.50 |
$3,035 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$1,291 |
$2,582 |
12.3× |
| CT cervical spine w/wo cont (72127) |
$1,669.50 |
$3,339 |
9.5× |
| CT chest w contrast (71260) |
$1,197.50 |
$2,395 |
6.8× |
| CT chest w/wo contrast (71270) |
$1,317 |
$2,634 |
7.5× |
| 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 l-spine w&w/o contrast (72133) |
$1,481.50 |
$2,963 |
8.4× |
| CT lower ext w/o (73700) |
$875.50 |
$1,751 |
8.3× |
| CT lower extremity w/contrast material (73701) |
$952.50 |
$1,905 |
5.4× |
| CT lumbar spine w contrast (72132) |
$1,347 |
$2,694 |
3.8× |
| CT lumbar spine w/o contrast (72131) |
$1,224.50 |
$2,449 |
11.7× |
| CT maxillofacial w contrast (70487) |
$1,430.50 |
$2,861 |
8.1× |
| CT maxillofacial wo contrast (70486) |
$1,300.50 |
$2,601 |
12.4× |
| CT neck tissue combo (70492) |
$1,587 |
$3,174 |
9.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) |
$1,134 |
$2,268 |
6.4× |
| CT scans face/jaw combo (70488) |
$1,573 |
$3,146 |
8.9× |
| CT soft tissue neck w contrast (70491) |
$1,443 |
$2,886 |
8.2× |
| 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 cont (72130) |
$1,309 |
$2,618 |
7.4× |
| CT thorax w/o contrast (71250) |
$1,088.50 |
$2,177 |
10.4× |
| CT upper ext wo (73200) |
$991.50 |
$1,983 |
9.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,206 |
$2,412 |
6.8× |
| 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 head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,040 |
$2,080 |
3.0× |
| CTA pelvis (72191) |
$1,317.50 |
$2,635 |
7.5× |
| Dilation ureters/urethra rs&i (74485) |
$1,682.50 |
$3,365 |
0.8× |
| Diskography lumbar (72295) |
$1,797 |
$3,594 |
0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$788 |
$1,576 |
7.5× |
| Dxa Bone Density Axial (77080) |
$340 |
$680 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$350.50 |
$701 |
4.0× |
| Echo Guide For Artery Repair (76936) |
$465 |
$930 |
2.1× |
| Echograp Trans R Pros Study (76873) |
$680.50 |
$1,361 |
6.5× |
| Esophagram (74220) |
$722 |
$1,444 |
4.1× |
| Fetal Biophys Profile W/Nst (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× |
| Follow-Up Angiography (75898) |
$477.50 |
$955 |
0.2× |
| Foot 2 views (73620) |
$346 |
$692 |
4.0× |
| Forearm 2 views (73090) |
$521.50 |
$1,043 |
6.0× |
| Gastric emptying imaging study (78264) |
$2,342.50 |
$4,685 |
5.8× |
| Gated Heart Planar Single (78472) |
$1,896 |
$3,792 |
4.7× |
| Gated Heart, Multiple (78473) |
$2,308 |
$4,616 |
5.7× |
| Hand 2 views (73120) |
$248.50 |
$497 |
2.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$5,823.50 |
$11,647 |
8.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,688 |
$7,376 |
5.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,129 |
$4,258 |
3.0× |
| Heart Image (Pet) Multiple (78492) |
$5,751.50 |
$11,503 |
4.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,160 |
$6,320 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$875 |
$1,750 |
0.3× |
| Hepatobil Syst Image W/Drug (78227) |
$2,557.50 |
$5,115 |
4.7× |
| Hepatobiliary System Imaging (78226) |
$2,557.50 |
$5,115 |
6.4× |
| Ht Musc Image Planar Mult (78454) |
$5,572 |
$11,144 |
4.3× |
| Ht Muscle Image Spect Sing (78451) |
$6,524.50 |
$13,049 |
5.0× |
| Hysterosalpingogram (74740) |
$687.50 |
$1,375 |
2.9× |
| Image fusion (77399) |
$934 |
$1,868 |
6.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$667 |
$1,334 |
7.6× |
| 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× |
| K Flow/Funct Image Multiple (78709) |
$2,429 |
$4,858 |
4.5× |
| K Flow/Funct Image W/Drug (78708) |
$2,011.50 |
$4,023 |
3.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,830 |
$3,660 |
3.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,235.50 |
$2,471 |
3.1× |
| Knee 3 Views (73562) |
$507.50 |
$1,015 |
5.8× |
| Leveen/Shunt Patency Exam (78291) |
$1,744 |
$3,488 |
4.3× |
| 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 Ventilat&Perfus Imaging (78582) |
$2,403.50 |
$4,807 |
4.4× |
| Lung Ventilation Imaging (78579) |
$1,227.50 |
$2,455 |
3.1× |
| Lymph System Imaging (78195) |
$2,490 |
$4,980 |
4.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$843.50 |
$1,687 |
0.3× |
| Magnetic Image Jaw Joint (70336) |
$798 |
$1,596 |
3.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$2,060 |
$4,120 |
3.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$530 |
$1,060 |
3.0× |
| Magnetic Resonance Elastography (76391) |
$1,422.50 |
$2,845 |
5.9× |
| Mammary ductogram or galactogram multiple (77054) |
$234 |
$468 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$658.50 |
$1,317 |
2.7× |
| Meckels Divert Exam (78290) |
$1,708 |
$3,416 |
4.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,031.50 |
$4,063 |
5.4× |
| Mr safety determination physician/other qhp (76016) |
$119 |
$238 |
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 implt pos&/immoblj (76019) |
$80.50 |
$161 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$326.50 |
$653 |
1.4× |
| Mra Head W/O & W/Contrast Material (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 contrast (74181) |
$1,012.50 |
$2,025 |
4.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,389 |
$2,778 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,499 |
$2,998 |
4.3× |
| 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 brain functional w/physician admnistration (70555) |
$437.50 |
$875 |
1.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,109 |
$2,218 |
4.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,019 |
$2,038 |
4.3× |
| MRI cardiac w/o contrast (75557) |
$1,161.50 |
$2,323 |
4.8× |
| MRI cervical spine w contrast (72142) |
$1,548 |
$3,096 |
4.4× |
| MRI cervical spine w/o cont (72141) |
$1,407.50 |
$2,815 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,034 |
$2,068 |
4.3× |
| MRI chest with contrast (71551) |
$1,137 |
$2,274 |
1.4× |
| MRI chest wo w contrast (71552) |
$1,251 |
$2,502 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$899 |
$1,798 |
2.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,111 |
$2,222 |
3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$936.50 |
$1,873 |
3.9× |
| MRI lumbar spine w contrast (72149) |
$1,161.50 |
$2,323 |
3.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,703 |
$3,406 |
4.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,634 |
$3,268 |
6.8× |
| MRI orbit face neck w contrast (70542) |
$1,797 |
$3,594 |
5.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,201 |
$4,402 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,372.50 |
$2,745 |
3.9× |
| MRI pelvis w/o & w contrast (72197) |
$1,509 |
$3,018 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$967.50 |
$1,935 |
4.0× |
| MRI spectroscopy (76390) |
$1,024.50 |
$2,049 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$946.50 |
$1,893 |
3.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$984.50 |
$1,969 |
2.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$892.50 |
$1,785 |
3.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,046.50 |
$2,093 |
3.0× |
| MRI, abdomen, combo (74183) |
$1,225 |
$2,450 |
3.5× |
| MRI, dorsal spine combo (72157) |
$1,144.50 |
$2,289 |
3.3× |
| MRI, dorsal spine contrast (72147) |
$1,041 |
$2,082 |
3.0× |
| MRI, joint upper extrem (73221) |
$1,031 |
$2,062 |
4.3× |
| MRI, joint upper extrem combo (73223) |
$1,248.50 |
$2,497 |
3.6× |
| MRI, lumbar spine combo (72158) |
$1,278 |
$2,556 |
3.6× |
| 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 sw aly CTA (75580) |
$6,058.50 |
$12,117 |
7.0× |
| Neck soft tissue (70360) |
$402.50 |
$805 |
4.6× |
| Nm csf leak detection (78650) |
$838.50 |
$1,677 |
0.6× |
| Nonvascular Shunt X-Ray (75809) |
$792.50 |
$1,585 |
7.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,009 |
$18,018 |
6.5× |
| Nuclear Rx Intra-Arterial (79445) |
$1,181 |
$2,362 |
5.0× |
| Nuclear Rx Oral Admin (79005) |
$2,118.50 |
$4,237 |
9.0× |
| Panoramic X-ray of jaws (70355) |
$192.50 |
$385 |
2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$4,573.50 |
$9,147 |
8.4× |
| Parathyroid Planar Imaging (78070) |
$2,111.50 |
$4,223 |
5.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$4,573.50 |
$9,147 |
11.4× |
| 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 Lmtd (78814) |
$3,493 |
$6,986 |
2.4× |
| PET image w/CT, full body (78816) |
$4,900.50 |
$9,801 |
3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,760 |
$9,520 |
3.3× |
| Pet Myocardial Sngl Study (78491) |
$5,112 |
$10,224 |
3.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$972 |
$1,944 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,699 |
$3,398 |
4.2× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,103 |
$2,206 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$856 |
$1,712 |
8.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,442 |
$2,884 |
2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$568 |
$1,136 |
6.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$316.50 |
$633 |
3.6× |
| Radex elbow complete minimum 3 views (73080) |
$633.50 |
$1,267 |
7.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$386.50 |
$773 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$248.50 |
$497 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$598 |
$1,196 |
6.8× |
| Radex Hand Minimum 3 Views (73130) |
$586 |
$1,172 |
6.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$284.50 |
$569 |
3.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$509 |
$1,018 |
4.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$245 |
$490 |
2.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$332 |
$664 |
3.8× |
| Radex shoulder complete minimum 2 views (73030) |
$591 |
$1,182 |
6.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$209 |
$418 |
2.4× |
| Radex Spine 1 View Specify Level (72020) |
$265 |
$530 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$214 |
$428 |
2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$260 |
$520 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$274.50 |
$549 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$181 |
$362 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$461.50 |
$923 |
5.3× |
| 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 level 1 (77402) |
$893 |
$1,786 |
8.7× |
| Radiation treatment delivery level 2 (77407) |
$965 |
$1,930 |
2.5× |
| Radiation treatment delivery level 3 (77412) |
$999.50 |
$1,999 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$560 |
$1,120 |
5.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$695 |
$1,390 |
6.6× |
| Radiologic exam colon double contrast study (74280) |
$1,269 |
$2,538 |
7.2× |
| 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 knee complete 4/more views (73564) |
$378.50 |
$757 |
3.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$316 |
$632 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$932 |
$1,864 |
5.3× |
| Radiologic exam swallow function contrast study (74230) |
$1,248 |
$2,496 |
7.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,191.50 |
$2,383 |
6.8× |
| Radiologic examination femur 1 view (73551) |
$325.50 |
$651 |
3.7× |
| Radiologic examination femur minimum 2 views (73552) |
$323 |
$646 |
3.7× |
| Radiologic examination knee 1/2 views (73560) |
$445 |
$890 |
5.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$587.50 |
$1,175 |
6.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,439.50 |
$2,879 |
3.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,439.50 |
$2,879 |
3.7× |
| Ribs bilateral 3 views (71110) |
$354 |
$708 |
3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,778 |
$3,556 |
4.4× |
| 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 2+ Days Imaging (78804) |
$3,019 |
$6,038 |
5.5× |
| 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/acquisj 1day img (78830) |
$6,809.50 |
$13,619 |
5.2× |
| Rp Therapy Intravenous Administration (79101) |
$4,641 |
$9,282 |
19.8× |
| Scapula (73010) |
$269.50 |
$539 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$29 |
$58 |
1.2× |
| Shoulder 1 view (73020) |
$198.50 |
$397 |
2.3× |
| Shoulder Arthrography (73040) |
$299.50 |
$599 |
0.9× |
| Sialogram (70390) |
$584 |
$1,168 |
2.4× |
| Skull less than 4 views (70250) |
$283 |
$566 |
2.7× |
| Special dosimetry (77331) |
$1,011 |
$2,022 |
7.5× |
| Special Physics Consult (77370) |
$2,693.50 |
$5,387 |
19.9× |
| Special teletherapy port plan (77321) |
$2,036 |
$4,072 |
5.4× |
| Special treatment procedure (77470) |
$3,329.50 |
$6,659 |
6.0× |
| Srs Multisource (77371) |
$57,044 |
$114,088 |
7.7× |
| Stereotactic Body Radiation Delivery (77373) |
$19,213 |
$38,426 |
10.7× |
| Sternoclavicular joints (71130) |
$229 |
$458 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$416.50 |
$833 |
0.1× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$156.50 |
$313 |
1.5× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$156.50 |
$313 |
1.5× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$57 |
$114 |
1.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$693.50 |
$1,387 |
6.8× |
| 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 Intermed (77285) |
$1,464 |
$2,928 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,273.50 |
$2,547 |
9.4× |
| Thoracic spine 2 views (72070) |
$290.50 |
$581 |
2.8× |
| Thoracic spine 3 views (72072) |
$341.50 |
$683 |
3.3× |
| Thoracolumbar 2 views (72080) |
$314 |
$628 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,183.50 |
$2,367 |
2.9× |
| Thyroid Met Imaging Body (78018) |
$2,320.50 |
$4,641 |
4.3× |
| 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× |
| Tx Devices Design & Construction Complex (77334) |
$2,031.50 |
$4,063 |
5.4× |
| Tx devices design & construction intermediate (77333) |
$1,203 |
$2,406 |
8.9× |
| Tx devices design & construction simple (77332) |
$1,120.50 |
$2,241 |
8.3× |
| Ultrasound Breast Limited (76642) |
$562.50 |
$1,125 |
6.4× |
| Ultrasound elastography first target lesion (76982) |
$397 |
$794 |
3.8× |
| Ultrasound Elastography Parenchyma (76981) |
$397 |
$794 |
3.8× |
| Ultrasound Exam Aaa Screen (76706) |
$634 |
$1,268 |
6.0× |
| 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)
range across 3 matching MRF lines |
$702.50–$2,359.50 |
$1,405–$4,719 |
varies |
| Upper gi w/o kub (74240) |
$872.50 |
$1,745 |
5.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$1,411.50 |
$2,823 |
15.0× |
| Urethrocystogram voiding (74455) |
$938.50 |
$1,877 |
3.9× |
| Urethrocystography retrograde (74450) |
$1,027 |
$2,054 |
4.3× |
| Us breast unilateral complete (76641) |
$562.50 |
$1,125 |
5.4× |
| Us chest (76604) |
$588 |
$1,176 |
5.6× |
| Us complete joint (76881) |
$941.50 |
$1,883 |
9.0× |
| Us exam, pelvic, limited (76857) |
$662.50 |
$1,325 |
6.3× |
| Us head (76506) |
$715 |
$1,430 |
6.8× |
| Us kidney transplant (76776) |
$832 |
$1,664 |
7.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$941.50 |
$1,883 |
9.0× |
| Us ob limited 1 or more fetuses (76815) |
$508.50 |
$1,017 |
4.8× |
| Us ob transvaginal (76817) |
$653 |
$1,306 |
6.2× |
| Us pelvic non ob complete (76856) |
$996 |
$1,992 |
9.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$806.50 |
$1,613 |
7.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$706.50 |
$1,413 |
6.7× |
| 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 spinal canal and contents (76800) |
$595.50 |
$1,191 |
5.7× |
| Us thyroid (76536) |
$879.50 |
$1,759 |
8.4× |
| Us transrectal (76872) |
$958 |
$1,916 |
9.1× |
| Vein X-Ray Chest (75827) |
$1,079 |
$2,158 |
0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$961 |
$1,922 |
0.3× |
| Vein X-Ray Spleen/Liver (75810) |
$2,979 |
$5,958 |
0.9× |
| Venogram Sinus/Jugular (75860) |
$688.50 |
$1,377 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$5,050.50 |
$10,101 |
1.6× |
| Venography extremity bilateral rs&i (75822) |
$562 |
$1,124 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$454.50 |
$909 |
0.3× |
| Venography Orbital Rs&I (75880) |
$1,111.50 |
$2,223 |
1.8× |
| Venography Renal Bilateral (75833) |
$1,741.50 |
$3,483 |
0.5× |
| Venography Renal Unilateral (75831) |
$958.50 |
$1,917 |
0.3× |
Venous sampling by catheter (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 Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$274.50 |
$549 |
3.1× |
| X-ray antegrade pyelogram tube (74425) |
$1,864 |
$3,728 |
5.3× |
| X-Ray Aorta Leg Arteries (75630) |
$1,468.50 |
$2,937 |
0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$234 |
$468 |
2.7× |
| X-Ray Exam Breast Specimen (76098) |
$572.50 |
$1,145 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$310.50 |
$621 |
3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$377.50 |
$755 |
3.6× |
| 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 2 Views (73521) |
$501 |
$1,002 |
4.8× |
| 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 L-S Spine Bending (72114) |
$485.50 |
$971 |
4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$272 |
$544 |
3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$560 |
$1,120 |
5.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$368 |
$736 |
3.5× |
| X-ray humerus (73060) |
$542 |
$1,084 |
6.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,107 |
$2,214 |
6.3× |
| X-ray IV pyelogram+tomography (74415) |
$1,212.50 |
$2,425 |
6.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$233.50 |
$467 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$200.50 |
$401 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$351 |
$702 |
3.3× |
| X-ray nose-rectum child f.b. (76010) |
$447.50 |
$895 |
5.1× |
| 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 Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$322.50 |
$645 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402 |
$804 |
3.8× |
| X-ray thoracic spine 4 vw (72074) |
$397.50 |
$795 |
3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,111.50 |
$2,223 |
3.2× |
| X-Rays Bone Length Studies (77073) |
$228 |
$456 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$646 |
$1,292 |
6.2× |
| Xr c-spine 4 or 5 views (72050) |
$633 |
$1,266 |
6.0× |
| Xr facial bones less than 3 views (70140) |
$304 |
$608 |
3.5× |
| Xr orbits complete 4 views (70200) |
$281 |
$562 |
2.7× |
| Xr Tomogram Single Plane (76100) |
$441.50 |
$883 |
4.2× |