| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,392.93 |
$5,159 |
1.0× |
| Abdomen 2 views (74019) |
$105.03 |
$389 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$265.14 |
$982 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,572.48 |
$5,824 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$9,179.19 |
$33,997 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$1,535.49 |
$5,687 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$505.44 |
$1,872 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,520.37 |
$5,631 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,572.48 |
$5,824 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,550.02 |
$5,740.80 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,308.50 |
$8,550 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,490.40 |
$5,520 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$144.61 |
$535.60 |
0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$505.44 |
$1,872 |
0.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$115.83 |
$429 |
0.3× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,512 |
$5,600 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,542.24 |
$5,712 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,557.90 |
$3,002 |
0.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,490.40 |
$5,520 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,550.02 |
$5,740.80 |
0.5× |
| Arthrogram elbow (73085) |
$406.32 |
$1,504.89 |
1.2× |
| Arthrogram hip (73525) |
$121.50 |
$450 |
0.4× |
| Arthrogram shoulder (73040) |
$121.50 |
$450 |
0.4× |
| Arthrogram wrist (73115) |
$41.76 |
$154.68 |
0.1× |
| Arthrography knee lt (73580) |
$121.50 |
$450 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$122.04 |
$452 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$161.77 |
$599.15 |
0.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$449.44 |
$1,664.60 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$463.05 |
$1,715 |
1.2× |
| Bone age studies (77072) |
$96.12 |
$356 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$462.51 |
$1,713 |
1.2× |
| Bone survey complete (77075) |
$185.76 |
$688 |
1.8× |
| Brachytx isodose complex (77318) |
$428.72 |
$1,587.87 |
1.2× |
| Brain image w/flow 4 + views (78606) |
$324.31 |
$1,201.15 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$985.53 |
$3,650.10 |
0.7× |
| Brain Imaging Vascular Flow Only (78610) |
$135.89 |
$503.30 |
0.3× |
| Cervical spine 2 or 3 views (72040) |
$74.25 |
$275 |
0.9× |
| Chest 1 view (71045) |
$74.52 |
$276 |
0.9× |
| Chest 3 views (71047) |
$88.29 |
$327 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$125.55 |
$465 |
0.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$721.18 |
$2,671.04 |
0.9× |
| Clavicle complete (73000) |
$91.80 |
$340 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$151.20 |
$560 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$208.17 |
$771 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,346.49 |
$4,987 |
4.0× |
| CT abdomen and pelvis without contrast (74176) |
$706.41 |
$2,616.34 |
3.0× |
| CT abdomen w contrast (74160) |
$611.01 |
$2,263 |
3.6× |
| CT abdomen w wo contrast (74170) |
$673.11 |
$2,493 |
3.9× |
| CT abdomen w/o contrast (74150) |
$307.53 |
$1,139 |
3.0× |
| CT angio hrt w/3d image (75574) |
$765.18 |
$2,834 |
2.3× |
| CT angiography upper extremity lt (73206) |
$666.44 |
$2,468.30 |
3.9× |
| CT c-spine w/o contrast (72125) |
$675 |
$2,500 |
6.6× |
| CT cervical spine w&w/o contrast (72127) |
$706.60 |
$2,617.05 |
4.1× |
| CT cervical spine with contrast (72126) |
$758.16 |
$2,808 |
2.2× |
| CT chest w/wo contrast (71270) |
$815.50 |
$3,020.35 |
4.8× |
| CT chest with contrast (71260) |
$800.55 |
$2,965 |
4.7× |
| CT head/brain with contrast (70460) |
$647.19 |
$2,397 |
3.8× |
| CT head/brain without and with contrast (70470) |
$925.83 |
$3,429 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$118.53 |
$439 |
1.4× |
| CT iac w contrast (70481) |
$717.66 |
$2,658 |
4.2× |
| CT limited/localized follow up study (76380) |
$76.94 |
$284.95 |
0.9× |
| CT lower ext w/o (73700) |
$264.87 |
$981 |
2.6× |
| CT lower extremity w wo contrast (73702) |
$331.30 |
$1,227.05 |
1.9× |
| CT lower extremity with contrast (73701) |
$303.62 |
$1,124.50 |
1.8× |
| CT lumbar spine w & w/o contrast (72133) |
$803.36 |
$2,975.40 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$591.57 |
$2,191 |
5.8× |
| CT lumbar spine with contrast (72132) |
$758.16 |
$2,808 |
2.2× |
| CT maxillofacial w contrast (70487) |
$646.92 |
$2,396 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$509.49 |
$1,887 |
5.0× |
| CT maxillofacial w/wo contrast (70488) |
$789.16 |
$2,922.80 |
4.6× |
| CT neck soft tissue w contrast (70491) |
$647.19 |
$2,397 |
3.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$820.53 |
$3,039 |
4.8× |
| CT orbits w/o contrast (70480) |
$616.41 |
$2,283 |
6.1× |
| CT pelvis w & w/o contrast (72194) |
$439.72 |
$1,628.60 |
2.6× |
| CT pelvis w/o contrast (72192) |
$284.81 |
$1,054.85 |
2.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$682.83 |
$2,529 |
4.0× |
| CT soft tissue neck w/o contrast (70490) |
$477.09 |
$1,767 |
4.7× |
| CT thoracic spine w/contrast (72129) |
$758.16 |
$2,808 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$591.57 |
$2,191 |
5.8× |
| CT thoracic spine w/wo contrast (72130) |
$713.67 |
$2,643.22 |
4.2× |
| CT thorax w/o contrast (71250) |
$225.60 |
$835.55 |
2.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$331.30 |
$1,227.05 |
1.9× |
| CT upper extremity w/o contrast rt (73200) |
$232.47 |
$861 |
2.3× |
| CT upper extremity with contrast (73201) |
$302.13 |
$1,119 |
0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$877.50 |
$3,250 |
5.1× |
| Cta Abdomen (74175) |
$679.86 |
$2,518 |
4.0× |
| CTA abdomen pelvis (74174) |
$832.95 |
$3,085 |
2.5× |
| CTA chest (71275) |
$810 |
$3,000 |
4.8× |
| Cta Head (70496) |
$946.08 |
$3,504 |
5.6× |
| CTA lwr ext w&w/o contrast (73706) |
$828.13 |
$3,067.14 |
4.9× |
| Cta Neck (70498) |
$821.07 |
$3,041 |
4.8× |
| Cystography minimum 3 views rs&i (74430) |
$64.26 |
$238 |
0.2× |
| Diskography lumbar (72295) |
$1,700.89 |
$6,299.60 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$139.32 |
$516 |
1.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86.67 |
$321 |
1.0× |
| Echo exam of eye (76529) |
$64.95 |
$240.56 |
0.8× |
| Esophagus (74220) |
$81.27 |
$301 |
0.5× |
| Fetal biophysical profile non-stress testing (76818) |
$80.73 |
$299 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$84.44 |
$312.72 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$70.70 |
$261.82 |
0.3× |
| Forearm 2 views (73090) |
$89.91 |
$333 |
1.1× |
| Gated Heart Planar Single (78472) |
$476.01 |
$1,763 |
1.2× |
| Hand 3 views (73130) |
$89.64 |
$332 |
1.1× |
| Heart Infarct Image (78466) |
$283.56 |
$1,050.22 |
0.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,572.48 |
$5,824 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$438.75 |
$1,625 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$376.92 |
$1,396 |
1.0× |
| Ht muscle image spect sing (78451) |
$481.22 |
$1,782.30 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$83.70 |
$310 |
1.0× |
| Hysterosalpingogram (74740) |
$91.26 |
$338 |
0.4× |
| Interstitial radiation source applic complex (77778) |
$962.21 |
$3,563.73 |
1.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$697.94 |
$2,584.95 |
1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$523.56 |
$1,939.10 |
1.0× |
| Intracavitary radiation source applic simple (77761) |
$349.15 |
$1,293.15 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$461.66 |
$1,709.87 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$579.15 |
$2,145 |
1.1× |
| Knee 3 views (73562) |
$101.79 |
$377 |
1.2× |
| Liver imaging static only (78201) |
$305.98 |
$1,133.25 |
0.6× |
| Liver imaging w/vascular flow (78202) |
$427.86 |
$1,584.65 |
0.8× |
| Lung Ventilation Imaging (78579) |
$389.48 |
$1,442.50 |
1.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$287.82 |
$1,066 |
0.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$287.82 |
$1,066 |
0.5× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$287.82 |
$1,066 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$287.82 |
$1,066 |
0.1× |
| Lymphoscintigraphy (78195) |
$140.67 |
$521 |
0.3× |
| Meckels Diverticulum (78290) |
$269.74 |
$999.04 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,709.10 |
$6,330 |
4.7× |
| MRA head w & w/o contrast (70546) |
$965.52 |
$3,576 |
2.8× |
| MRA head w/o contrast (70544) |
$547.29 |
$2,027 |
2.4× |
| MRA head with contrast (70545) |
$644.22 |
$2,386 |
1.9× |
| MRA neck w contrast (70548) |
$644.22 |
$2,386 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$761.13 |
$2,819 |
2.2× |
| MRA neck w/o contrast (70547) |
$547.29 |
$2,027 |
2.4× |
| MRI abdomen w contrast (74182) |
$835.38 |
$3,094 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,110.51 |
$4,113 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$777.06 |
$2,878 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$863.90 |
$3,199.62 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$830.85 |
$3,077.22 |
1.1× |
| MRI breast w/o contrast bilateral (77047) |
$550.40 |
$2,038.52 |
2.4× |
| MRI breast w/o contrast unilat (77046) |
$520.29 |
$1,927 |
2.2× |
| MRI c-spine with contrast (72142) |
$769.50 |
$2,850 |
2.3× |
| MRI cervical spine w/o contrast (72141) |
$653.94 |
$2,422 |
2.8× |
| MRI chest w/o & w/contrast material (71552) |
$866.43 |
$3,209 |
2.6× |
| MRI chest w/o contrast (71550) |
$652.86 |
$2,418 |
2.8× |
| MRI chest with contrast (71551) |
$841.01 |
$3,114.85 |
1.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$859.13 |
$3,181.95 |
2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$757.48 |
$2,805.50 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$653.94 |
$2,422 |
2.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$647.46 |
$2,398 |
2.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$867.78 |
$3,214 |
2.6× |
| MRI orbit/face/neck w/contrast (70542) |
$842.31 |
$3,119.65 |
2.5× |
| MRI pelvis w contrast (72196) |
$842.31 |
$3,119.65 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,031.13 |
$3,819 |
3.0× |
| MRI pelvis w/o contrast (72195) |
$777.06 |
$2,878 |
3.4× |
| MRI scan of arm joint before and after contrast (73223) |
$867.78 |
$3,214 |
2.6× |
| MRI scan of leg joint before and after contrast (73723) |
$867.78 |
$3,214 |
2.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$953.10 |
$3,530 |
2.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$792.99 |
$2,937 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,066.50 |
$3,950 |
3.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$792.99 |
$2,937 |
2.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,066.50 |
$3,950 |
3.1× |
| MRI thoracic spine w/o contrast (72146) |
$653.94 |
$2,422 |
2.8× |
| MRI tmj (70336) |
$738.71 |
$2,735.95 |
3.2× |
| MRI upper ext joint w/o contrast (73221) |
$653.94 |
$2,422 |
2.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$983.50 |
$3,642.58 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$653.94 |
$2,422 |
2.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$698.09 |
$2,585.50 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$888.30 |
$3,290 |
0.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$366.27 |
$1,356.56 |
0.3× |
| Neck soft tissue (70360) |
$64.26 |
$238 |
0.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$101.09 |
$374.40 |
0.3× |
| Nm cisternogram (78630) |
$194.21 |
$719.30 |
0.4× |
| Nm csf leak detection (78650) |
$618.65 |
$2,291.30 |
0.5× |
| Nm gastric emptying study (78264) |
$341.82 |
$1,266 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$300.50 |
$1,112.96 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,376 |
$8,800 |
1.8× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$673.10 |
$2,492.98 |
0.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$333.18 |
$1,234 |
0.3× |
| Nuclear Rx Oral Admin (79005) |
$189.57 |
$702.10 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$89.84 |
$332.75 |
0.9× |
| Osseous survey infant (77076) |
$127.71 |
$473 |
1.3× |
| Parathyroid imaging (78070) |
$187.65 |
$695 |
0.5× |
| Pelvis 1 or 2 views (72170) |
$91.26 |
$338 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$1,499.85 |
$5,555 |
1.1× |
| PET imaging CT for attenuation limited area (78814) |
$691.17 |
$2,559.90 |
0.5× |
| PET imaging for CT attenuation whole body (78816) |
$1,390.77 |
$5,151 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$867.78 |
$3,214 |
2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,550.02 |
$5,740.80 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$395.28 |
$1,464 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$713.61 |
$2,643 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$140.38 |
$519.90 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$164.16 |
$608 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$216.68 |
$802.50 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$103.68 |
$384 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$117.30 |
$434.43 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$528.93 |
$1,959 |
5.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$289.98 |
$1,074 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$139.32 |
$516 |
1.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$151.20 |
$560 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$86.94 |
$322 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$105.03 |
$389 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$86.36 |
$319.87 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$191.70 |
$710 |
1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$184.99 |
$685.16 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$244.68 |
$906.24 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$686.61 |
$2,543 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$182.52 |
$676 |
2.2× |
| Radiological examination surgical specimen (76098) |
$90.13 |
$333.81 |
0.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,550.02 |
$5,740.80 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,550.02 |
$5,740.80 |
0.5× |
| Ribs bilateral 3 views (71110) |
$76.41 |
$283 |
0.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,330.56 |
$4,928 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$989.88 |
$3,666.20 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$160.46 |
$594.28 |
0.7× |
| Scapula complete (73010) |
$90.99 |
$337 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$27 |
$100 |
1.2× |
| Simulation intermediate (77285) |
$223.28 |
$826.95 |
0.6× |
| Small bowel series (74250) |
$130.68 |
$484 |
0.8× |
| Spec medical radj physics consltj (77370) |
$183.06 |
$678 |
1.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$248.42 |
$920.10 |
0.7× |
| Special dosimetry (77331) |
$118.05 |
$437.23 |
0.9× |
| Special treatment procedure (77470) |
$594.27 |
$2,201 |
1.1× |
| Splenoportograpy rs&i (75810) |
$1,550.02 |
$5,740.80 |
0.5× |
| Stereotactic body radiation delivery (77373) |
$1,939.95 |
$7,185 |
1.1× |
| Superior sagittal sinus venogram (75870) |
$520.44 |
$1,927.55 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$786.78 |
$2,914 |
2.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$467.37 |
$1,731 |
1.3× |
| Testicular Imaging With Vascular Flow (78761) |
$355.16 |
$1,315.40 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$372.60 |
$1,380 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$206.15 |
$763.52 |
1.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$430.23 |
$1,593.45 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$148.93 |
$551.60 |
0.4× |
| Thyroid uptake measurement (78012) |
$93.58 |
$346.60 |
0.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$261.63 |
$969 |
0.7× |
| Tomogram (76100) |
$142.60 |
$528.15 |
1.4× |
| Treatment device intermediate (77333) |
$225.72 |
$836 |
1.7× |
| Treatment devices simple (77332) |
$173.61 |
$643 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,304.43 |
$4,831.23 |
2.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$373.71 |
$1,384.12 |
1.0× |
| Tx devices design & construction complex (77334) |
$341.82 |
$1,266 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$271.62 |
$1,006 |
2.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$555.06 |
$2,055.78 |
5.6× |
| Unlisted Ultrasound Procedure (76999) |
$66.96 |
$248 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$74.18 |
$274.72 |
0.3× |
| Urethrocystography voiding (74455) |
$89.24 |
$330.50 |
0.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$353.93 |
$1,310.85 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$127.17 |
$471 |
1.3× |
| Us breast unilateral complete (76641) |
$75.06 |
$278 |
0.7× |
| Us breast unilateral limited (76642) |
$75.06 |
$278 |
0.9× |
| Us chest (76604) |
$277.29 |
$1,027 |
2.7× |
| Us guided compression repair (76936) |
$272.97 |
$1,011 |
1.3× |
| Us infant hips dynamic (76885) |
$233.55 |
$865 |
2.8× |
| Us infant hips limited static (76886) |
$271.62 |
$1,006 |
3.2× |
| Us ob transvaginal (76817) |
$188.11 |
$696.70 |
1.9× |
| Us pelvic non ob complete (76856) |
$275.80 |
$1,021.50 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$54.23 |
$200.86 |
0.5× |
| Us pregnancy ltd (76815) |
$135.81 |
$503 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$163.89 |
$607 |
1.6× |
| Us retroperitoneal complete (76770) |
$101.25 |
$375 |
1.0× |
| Us retroperitoneal limited (76775) |
$277.29 |
$1,027 |
2.7× |
| Us scrotum and contents (76870) |
$275.26 |
$1,019.48 |
2.7× |
| Us soft tissue head/neck (76536) |
$279.99 |
$1,037 |
2.8× |
| Us transrectal prostate volume (76873) |
$206.28 |
$764 |
2.0× |
| Us xtr non-vasc lmtd (76882) |
$140.40 |
$520 |
1.4× |
| Us, eye b-scan (76512) |
$120.96 |
$448 |
1.2× |
| Venogram extremity bilateral (75822) |
$502.63 |
$1,861.60 |
0.3× |
| Venogram orbital (75880) |
$505.44 |
$1,872 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$1,520.37 |
$5,631 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$486 |
$1,800 |
0.3× |
| Venography epidural rs&i (75872) |
$505.44 |
$1,872 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$329.97 |
$1,222.10 |
0.2× |
| Venography Renal Bilateral (75833) |
$1,572.48 |
$5,824 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$1,550.02 |
$5,740.80 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$486 |
$1,800 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,550.02 |
$5,740.80 |
0.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$126.09 |
$467 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$89.04 |
$329.77 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$95.31 |
$353 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$247.71 |
$917.45 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$92.61 |
$343 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$518.32 |
$1,919.70 |
5.1× |
| X-ray exam hip uni 1 view (73501) |
$166.72 |
$617.50 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$164.16 |
$608 |
1.9× |
| X-ray exam hip uni 4/> views (73503) |
$274.58 |
$1,016.97 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$280.26 |
$1,038 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$534.06 |
$1,978 |
5.3× |
| X-ray exam of femur 1 (73551) |
$165.80 |
$614.08 |
2.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$217.80 |
$806.65 |
1.3× |
| X-ray eye for foreign body (70030) |
$74.52 |
$276 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$86.94 |
$322 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$90.99 |
$337 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.99 |
$337 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$70.47 |
$261 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$110.70 |
$410 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$144.72 |
$536 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$62.10 |
$230 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$79.11 |
$293 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$87.75 |
$325 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$92.07 |
$341 |
0.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$61.29 |
$227 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$86.67 |
$321 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$115.83 |
$429 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$73.17 |
$271 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$74.25 |
$275 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$90.99 |
$337 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86.94 |
$322 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$134.13 |
$496.78 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$88.61 |
$328.20 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$76.21 |
$282.25 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$66.42 |
$246 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$84.51 |
$313 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$88.56 |
$328 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$68.85 |
$255 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$86.94 |
$322 |
1.0× |
| Xr arthrogram ankle (73615) |
$41.56 |
$153.92 |
0.1× |
| Xr c-spine 6 or more views (72052) |
$143.10 |
$530 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$78.30 |
$290 |
0.9× |
| Xr shoulder 1 view (73020) |
$53.46 |
$198 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$120.15 |
$445 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$90.99 |
$337 |
1.1× |
| Xr tmj bilateral (70330) |
$85.23 |
$315.68 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$82.89 |
$307 |
1.0× |