| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,856.50 |
$23,713 |
8.5× |
| Abdomen 2 views (74019) |
$690.50 |
$1,381 |
6.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,211.50 |
$4,423 |
5.5× |
| Angiography extremity bilateral rs&i (75716) |
$5,552 |
$11,104 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$5,535 |
$11,070 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$4,301 |
$8,602 |
1.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,011 |
$14,022 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,846 |
$11,692 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,032 |
$8,064 |
1.3× |
| Angiography Spinal Selective Rs&I (75705) |
$6,943 |
$13,886 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,129 |
$12,258 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,056.50 |
$2,113 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,647.50 |
$5,295 |
0.8× |
| Ankle 2 views (73600) |
$473.50 |
$947 |
5.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$984.50 |
$1,969 |
2.8× |
| Aortogram thoracic (75605) |
$3,098 |
$6,196 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,778 |
$11,556 |
1.8× |
| Aortography abdominal serialography rs&i (75625) |
$4,681.50 |
$9,363 |
1.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,621.50 |
$5,243 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$7,479 |
$14,958 |
2.4× |
| Arthrogram elbow (73085) |
$1,131 |
$2,262 |
3.2× |
| Arthrogram hip (73525) |
$1,061 |
$2,122 |
3.0× |
| Arthrogram shoulder (73040) |
$1,465.50 |
$2,931 |
4.2× |
| Arthrogram wrist (73115) |
$885 |
$1,770 |
2.5× |
| Arthrography knee lt (73580) |
$1,257.50 |
$2,515 |
3.6× |
| Basic radiation dosimetry calculation (77300) |
$942 |
$1,884 |
7.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,382.50 |
$4,765 |
5.9× |
| Bone &/joint imaging whole body (78306) |
$2,838 |
$5,676 |
7.1× |
| Bone age studies (77072) |
$374.50 |
$749 |
3.6× |
| Bone Imaging 3 Phase (78315) |
$2,779 |
$5,558 |
6.9× |
| Bone Marrow Imaging Limited Area (78102) |
$817 |
$1,634 |
2.0× |
| Bone survey complete (77075) |
$1,555 |
$3,110 |
14.8× |
| Brachytx isodose complex (77318) |
$2,495.50 |
$4,991 |
6.6× |
| Brachytx isodose intermed (77317) |
$1,108.50 |
$2,217 |
2.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,311.50 |
$2,623 |
3.5× |
| Brain image w/flow 4 + views (78606) |
$1,623 |
$3,246 |
3.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,245 |
$2,490 |
2.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,919.50 |
$15,839 |
5.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,048.50 |
$2,097 |
3.0× |
| Cardiac shunt detection (78428) |
$1,533 |
$3,066 |
3.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,550 |
$3,100 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$640.50 |
$1,281 |
7.3× |
| Chest 1 view (71045) |
$944.50 |
$1,889 |
10.8× |
| Chest 3 views (71047) |
$1,019.50 |
$2,039 |
11.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,176 |
$2,352 |
6.7× |
| Clavicle complete (73000) |
$636 |
$1,272 |
7.3× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$69,805 |
$139,610 |
9.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,188 |
$2,376 |
11.3× |
| Continuing medical physics consltj pr wk (77336) |
$1,137.50 |
$2,275 |
8.4× |
| 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 hrt w/3d image (75574) |
$1,030 |
$2,060 |
2.9× |
| CT angiography upper extremity lt (73206) |
$1,302 |
$2,604 |
7.4× |
| 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 colonography screening (74263) |
$969.50 |
$1,939 |
4.0× |
| CT colonography w/o cntrst (74261) |
$575.50 |
$1,151 |
5.5× |
| 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 limited/localized follow up study (76380) |
$454.50 |
$909 |
5.2× |
| CT lower ext w/o (73700) |
$876.50 |
$1,753 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,014 |
$2,028 |
5.8× |
| CT lower extremity with contrast (73701) |
$972 |
$1,944 |
5.5× |
| 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) |
$1,199 |
$2,398 |
6.8× |
| CT upper extremity w/o contrast rt (73200) |
$993.50 |
$1,987 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,099.50 |
$2,199 |
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) |
$1,205.50 |
$2,411 |
6.8× |
| 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) |
$1,281.50 |
$2,563 |
3.7× |
| Diskogram cervical (72285) |
$3,273.50 |
$6,547 |
1.7× |
| Diskography lumbar (72295) |
$1,966.50 |
$3,933 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,257.50 |
$2,515 |
12.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$638 |
$1,276 |
6.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$541.50 |
$1,083 |
6.2× |
| Dxa bone density study axial skeleton (77085) |
$874.50 |
$1,749 |
8.3× |
| Echoencephalography real time imaging (76506) |
$1,088 |
$2,176 |
10.4× |
| Esophagus (74220) |
$1,249 |
$2,498 |
7.1× |
| Fetal biophysical profile non-stress testing (76818) |
$1,730.50 |
$3,461 |
16.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,816 |
$3,632 |
17.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,032.50 |
$2,065 |
4.3× |
| Foot 2 views (73620) |
$636 |
$1,272 |
7.3× |
| Forearm 2 views (73090) |
$631 |
$1,262 |
7.2× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$3,508 |
$7,016 |
6.4× |
| Gated Heart Planar Single (78472) |
$2,671.50 |
$5,343 |
6.7× |
| Hand 2 views (73120) |
$477 |
$954 |
4.5× |
| Hand 3 views (73130) |
$695 |
$1,390 |
8.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,385 |
$6,770 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,125 |
$12,250 |
8.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$7,360 |
$14,720 |
10.5× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,586.50 |
$5,173 |
6.7× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,586.50 |
$5,173 |
6.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,227.50 |
$8,455 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,853 |
$5,706 |
5.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,686.50 |
$5,373 |
6.7× |
| Ht muscle image spect sing (78451) |
$5,340.50 |
$10,681 |
4.1× |
| Humerus Min 2 Views Left (73060) |
$632.50 |
$1,265 |
7.2× |
| Hysterosalpingogram (74740) |
$1,441 |
$2,882 |
6.0× |
| Image fusion (77399) |
$1,696 |
$3,392 |
12.6× |
| Interstitial radiation source applic complex (77778) |
$2,361 |
$4,722 |
3.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$712 |
$1,424 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$5,172 |
$10,344 |
9.3× |
| Kidney funcj study non-img radioisotopic study (78725) |
$968.50 |
$1,937 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,255.50 |
$4,511 |
4.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,314.50 |
$4,629 |
4.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,675.50 |
$3,351 |
3.1× |
| Knee 3 views (73562) |
$732 |
$1,464 |
8.4× |
| Liver & spleen imaging static only (78215) |
$1,933.50 |
$3,867 |
4.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,816 |
$3,632 |
4.5× |
| Lung perf&ventilat diferentl (78598) |
$2,126.50 |
$4,253 |
3.9× |
| Lung perfusion differential (78597) |
$1,569.50 |
$3,139 |
3.9× |
| Lung Ventilation Imaging (78579) |
$2,076.50 |
$4,153 |
5.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,549.50 |
$7,099 |
1.1× |
| Lymphoscintigraphy (78195) |
$2,239 |
$4,478 |
4.1× |
| Mammary ductogram or galactogram multiple (77054) |
$1,200 |
$2,400 |
5.0× |
| Mammary ductogram or galactogram single (77053) |
$993.50 |
$1,987 |
4.1× |
| Meckels Diverticulum (78290) |
$2,666 |
$5,332 |
6.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,593 |
$7,186 |
9.6× |
| 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 head with contrast (70545) |
$1,244 |
$2,488 |
3.5× |
| MRA neck w contrast (70548) |
$1,032.50 |
$2,065 |
2.9× |
| 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) |
$1,367.50 |
$2,735 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,136 |
$2,272 |
1.4× |
| MRI bone marrow blood supply (77084) |
$771.50 |
$1,543 |
3.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,121 |
$2,242 |
4.7× |
| 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) |
$1,030 |
$2,060 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$936 |
$1,872 |
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) |
$1,977 |
$3,954 |
5.6× |
| 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) |
$1,250 |
$2,500 |
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) |
$1,504 |
$3,008 |
4.3× |
| MRI spectroscopy (76390) |
$802 |
$1,604 |
9.2× |
| 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) |
$1,033 |
$2,066 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,082 |
$2,164 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$895 |
$1,790 |
3.7× |
| Myelogram Cervical (72240) |
$2,655.50 |
$5,311 |
3.4× |
| Myelogram Lumbar (72265) |
$2,720.50 |
$5,441 |
3.5× |
| Myelogram thoracic (72255) |
$2,805 |
$5,610 |
3.6× |
| Myelography 2 or more regions (72270) |
$3,094 |
$6,188 |
3.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,352 |
$12,704 |
4.9× |
| Myocardial Spect Multiple Studies (78452) |
$8,153 |
$16,306 |
6.3× |
| 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) |
$594.50 |
$1,189 |
6.8× |
| Nm bone marrow multiple (78103) |
$1,321 |
$2,642 |
3.3× |
| Nm bone marrow wb (78104) |
$1,485.50 |
$2,971 |
3.7× |
| Nm cisternogram (78630) |
$2,120.50 |
$4,241 |
3.9× |
| Nm csf leak detection (78650) |
$1,927 |
$3,854 |
1.5× |
| Nm gastric emptying study (78264) |
$2,198 |
$4,396 |
5.5× |
| Nm peritoneal-venous shunt patency (78291) |
$1,579.50 |
$3,159 |
3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,983 |
$27,966 |
10.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$4,719.50 |
$9,439 |
3.6× |
| Nuclear medicine of heart pumping function (78473) |
$3,197 |
$6,394 |
8.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$2,808 |
$5,616 |
7.0× |
| Nuclear Rx Oral Admin (79005) |
$2,373 |
$4,746 |
10.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,216 |
$2,432 |
11.6× |
| Orthopantogram (70355) |
$319 |
$638 |
3.6× |
| Osseous survey infant (77076) |
$874 |
$1,748 |
8.3× |
| Parathyrd planar w/spect&CT (78072) |
$5,156.50 |
$10,313 |
9.5× |
| Parathyrd planar w/wo subtrj (78071) |
$4,556 |
$9,112 |
11.3× |
| Parathyroid imaging (78070) |
$2,198 |
$4,396 |
5.5× |
| Pelvis 1 or 2 views (72170) |
$596 |
$1,192 |
5.7× |
| Perineogram (74775) |
$907.50 |
$1,815 |
3.8× |
| Peritoneogram rs&i (74190) |
$698.50 |
$1,397 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$4,707 |
$9,414 |
3.3× |
| PET imaging CT for attenuation limited area (78814) |
$7,144.50 |
$14,289 |
5.0× |
| PET imaging for CT attenuation whole body (78816) |
$6,407.50 |
$12,815 |
4.5× |
| 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) |
$1,132.50 |
$2,265 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,919 |
$13,838 |
2.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,243 |
$4,486 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,140 |
$4,280 |
5.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,616.50 |
$5,233 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,200.50 |
$2,401 |
2.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$695 |
$1,390 |
8.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$927.50 |
$1,855 |
8.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$902.50 |
$1,805 |
8.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$508.50 |
$1,017 |
4.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,487 |
$2,974 |
14.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$31,217 |
$62,434 |
4.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,677.50 |
$3,355 |
3.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,074 |
$2,148 |
10.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,182 |
$2,364 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$855.50 |
$1,711 |
8.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$706 |
$1,412 |
8.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$904.50 |
$1,809 |
8.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$998 |
$1,996 |
11.4× |
| Radiologic exam colon single contrast study (74270) |
$1,754.50 |
$3,509 |
10.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,660 |
$3,320 |
9.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,732 |
$3,464 |
9.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,502.50 |
$3,005 |
8.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$612 |
$1,224 |
7.0× |
| Radiological examination surgical specimen (76098) |
$1,450 |
$2,900 |
2.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,730 |
$9,460 |
1.5× |
| Ribs bilateral 3 views (71110) |
$939.50 |
$1,879 |
8.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,248.50 |
$4,497 |
5.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,969 |
$5,938 |
5.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,879 |
$5,758 |
5.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$7,771 |
$15,542 |
6.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$582 |
$1,164 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,985 |
$3,970 |
8.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,824 |
$5,648 |
11.8× |
| Scanogram (77073) |
$521.50 |
$1,043 |
5.0× |
| Scapula complete (73010) |
$671 |
$1,342 |
6.4× |
| Screening digital breast tomosynthesis (77063) |
$63 |
$126 |
2.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,119.50 |
$2,239 |
10.7× |
| Sialogram (70390) |
$916.50 |
$1,833 |
3.8× |
| Simulation intermediate (77285) |
$1,944.50 |
$3,889 |
5.2× |
| Small bowel series (74250) |
$1,522 |
$3,044 |
8.6× |
| Spec medical radj physics consltj (77370) |
$4,074 |
$8,148 |
30.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,283.50 |
$4,567 |
6.1× |
| Special dosimetry (77331) |
$1,038 |
$2,076 |
7.7× |
| Special treatment procedure (77470) |
$4,819 |
$9,638 |
8.7× |
| Spine thoracic 3 views (72072) |
$899.50 |
$1,799 |
8.6× |
| Splenoportograpy rs&i (75810) |
$3,434 |
$6,868 |
1.1× |
| Stereotactic body radiation delivery (77373) |
$21,496.50 |
$42,993 |
12.0× |
| Superior sagittal sinus venogram (75870) |
$1,325.50 |
$2,651 |
0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$206.50 |
$413 |
2.0× |
| 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) |
$677 |
$1,354 |
7.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,393 |
$4,786 |
6.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,191 |
$2,382 |
3.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,825.50 |
$9,651 |
12.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,442.50 |
$2,885 |
10.7× |
| Thoracolumbar 2 views (72080) |
$615.50 |
$1,231 |
7.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,347.50 |
$4,695 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,330.50 |
$2,661 |
3.3× |
| Thyroid uptake measurement (78012) |
$867.50 |
$1,735 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,154.50 |
$4,309 |
5.4× |
| Tomogram (76100) |
$641 |
$1,282 |
6.1× |
| Treatment device intermediate (77333) |
$1,449.50 |
$2,899 |
10.7× |
| Treatment devices simple (77332) |
$1,369 |
$2,738 |
10.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,911.50 |
$5,823 |
5.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,806.50 |
$3,613 |
4.5× |
| Tx devices design & construction complex (77334) |
$2,745.50 |
$5,491 |
7.3× |
| Ultrasound elastography first target lesion (76982) |
$768 |
$1,536 |
7.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$2,727.50 |
$5,455 |
7.8× |
| Ultrasound, abdomen limited (76705) |
$1,980.50 |
$3,961 |
18.9× |
| Umbilical-artery Doppler (OB) (76820) |
$493 |
$986 |
4.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$440 |
$880 |
5.0× |
| Unlisted fluoroscopic procedure (76496) |
$517 |
$1,034 |
5.9× |
| Unlisted magnetic resonance procedure (76498) |
$2,359.50 |
$4,719 |
27.0× |
| Upper Extremity Infant (73092) |
$461.50 |
$923 |
4.4× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$1,600 |
$3,200 |
16.9× |
| Urethrocystography retrograde rs&i (74450) |
$1,008.50 |
$2,017 |
4.2× |
| Urethrocystography voiding (74455) |
$1,417 |
$2,834 |
5.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,097 |
$4,194 |
11.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,523 |
$3,046 |
8.6× |
| Us abdl aorta screen aaa (76706) |
$1,579.50 |
$3,159 |
15.0× |
| Us breast unilateral complete (76641) |
$1,499.50 |
$2,999 |
14.3× |
| Us breast unilateral limited (76642) |
$1,458 |
$2,916 |
16.7× |
| Us chest (76604) |
$1,206 |
$2,412 |
11.5× |
| Us compl joint r-t w/image documentation (76881) |
$2,285.50 |
$4,571 |
21.8× |
| Us elastography parenchyma (76981) |
$2,147.50 |
$4,295 |
20.4× |
| Us guided compression repair (76936) |
$2,019.50 |
$4,039 |
9.3× |
| Us infant hips dynamic (76885) |
$761 |
$1,522 |
8.7× |
| Us kidney transplant (76776) |
$1,470.50 |
$2,941 |
14.0× |
| Us ob detailed single fetus (76811) |
$1,759.50 |
$3,519 |
7.3× |
| Us ob transvaginal (76817) |
$1,387 |
$2,774 |
13.2× |
| Us pelvic non ob complete (76856) |
$2,034 |
$4,068 |
19.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$981.50 |
$1,963 |
9.3× |
| Us pregnancy ltd (76815) |
$1,394 |
$2,788 |
13.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,704 |
$3,408 |
16.2× |
| Us retroperitoneal complete (76770) |
$2,295.50 |
$4,591 |
21.9× |
| Us retroperitoneal limited (76775) |
$1,550.50 |
$3,101 |
14.8× |
| Us scrotum and contents (76870) |
$1,750 |
$3,500 |
16.7× |
| Us soft tissue head/neck (76536) |
$1,710 |
$3,420 |
16.3× |
| Us spinal canal and contents (76800) |
$1,102 |
$2,204 |
10.5× |
| Us transrectal (76872) |
$2,349.50 |
$4,699 |
22.4× |
| Us xtr non-vasc lmtd (76882) |
$2,166 |
$4,332 |
20.6× |
| Venogram extremity bilateral (75822) |
$1,852 |
$3,704 |
1.2× |
| Venogram orbital (75880) |
$2,310 |
$4,620 |
3.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,181 |
$6,362 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$4,002.50 |
$8,005 |
2.5× |
| Venography extremity unilateral rs&i (75820) |
$1,697.50 |
$3,395 |
1.1× |
| Venography Renal Bilateral (75833) |
$6,037.50 |
$12,075 |
1.9× |
| Venography renal unilateral selective rs&i (75831) |
$5,113 |
$10,226 |
1.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,302 |
$2,604 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,068.50 |
$8,137 |
0.7× |
| Wrist 2 views (73100) |
$484 |
$968 |
5.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,087 |
$2,174 |
10.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$540.50 |
$1,081 |
6.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$736.50 |
$1,473 |
8.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,860.50 |
$5,721 |
16.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$543 |
$1,086 |
6.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$773.50 |
$1,547 |
8.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,226 |
$2,452 |
11.7× |
| X-ray exam hip uni 1 view (73501) |
$435.50 |
$871 |
5.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$654.50 |
$1,309 |
7.5× |
| X-ray exam hip uni 4/> views (73503) |
$602.50 |
$1,205 |
5.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,187.50 |
$2,375 |
11.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,374.50 |
$2,749 |
13.1× |
| X-ray exam of femur 1 (73551) |
$495 |
$990 |
5.7× |
| X-ray eye for foreign body (70030) |
$429.50 |
$859 |
4.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$858 |
$1,716 |
8.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$484.50 |
$969 |
5.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$763.50 |
$1,527 |
8.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$6,600.50 |
$13,201 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$615.50 |
$1,231 |
7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$673.50 |
$1,347 |
7.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$904.50 |
$1,809 |
8.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$708.50 |
$1,417 |
8.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$338 |
$676 |
3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$732 |
$1,464 |
7.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,180 |
$2,360 |
11.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$497 |
$994 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$522.50 |
$1,045 |
6.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$532 |
$1,064 |
6.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$789 |
$1,578 |
7.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$733.50 |
$1,467 |
7.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,952.50 |
$3,905 |
5.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$651.50 |
$1,303 |
7.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$770.50 |
$1,541 |
7.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$894 |
$1,788 |
8.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$657.50 |
$1,315 |
6.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$583.50 |
$1,167 |
6.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$798 |
$1,596 |
9.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$761.50 |
$1,523 |
8.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$442.50 |
$885 |
5.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,153.50 |
$2,307 |
11.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$729.50 |
$1,459 |
6.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$535.50 |
$1,071 |
6.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$370 |
$740 |
4.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$572.50 |
$1,145 |
6.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$726.50 |
$1,453 |
6.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$858 |
$1,716 |
8.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$468 |
$936 |
5.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$714 |
$1,428 |
8.2× |
| Xr arthrogram ankle (73615) |
$790 |
$1,580 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$1,123.50 |
$2,247 |
10.7× |
| Xr chest 4+ views (71048) |
$1,196.50 |
$2,393 |
11.4× |
| Xr finger(s) 2+ views (73140) |
$497.50 |
$995 |
5.7× |
| Xr shoulder 1 view (73020) |
$492.50 |
$985 |
5.6× |
| Xr spine cervical 4 or 5 views (72050) |
$1,003 |
$2,006 |
9.6× |
| Xr tibia/fibula 2 views (73590) |
$782.50 |
$1,565 |
9.0× |
| Xr tmj bilateral (70330) |
$839.50 |
$1,679 |
9.6× |
| Xray knee 1 or 2 views rt (73560) |
$598 |
$1,196 |
6.8× |