| 3-D radiotherapy plan dose-volume histograms (77295) |
$510 |
$510 |
0.4× |
| Abdomen 2 views (74019) |
$57.50 |
$57.50 |
0.6× |
| Acute venous thrombus image (78456) |
$104 |
$104 |
0.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$137 |
$137 |
0.0× |
| Angiography extremity bilateral rs&i (75716) |
$476.25 |
$476.25 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$396 |
$396 |
0.1× |
| Angiography internal mammary rs&i (75756) |
$130 |
$130 |
0.0× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$385.50 |
$385.50 |
0.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$174 |
$174 |
0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$138 |
$138 |
0.0× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$231 |
$231 |
0.0× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$121 |
$121 |
0.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$182.25 |
$182.25 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$122 |
$122 |
0.0× |
| Ankle 2 views (73600) |
$66 |
$66 |
0.8× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$120 |
$120 |
0.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$413.25 |
$413.25 |
0.1× |
| Aortography abdominal serialography rs&i (75625) |
$347.25 |
$347.25 |
0.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$50 |
$50 |
0.0× |
| Artery X-Rays Adrenal Gland (75731) |
$120 |
$120 |
0.0× |
| Arthrogram hip (73525) |
$120 |
$120 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$74 |
$74 |
0.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$124 |
$124 |
0.3× |
| Cardiac shunt detection (78428) |
$80 |
$80 |
0.2× |
| Cervical spine 2 or 3 views (72040) |
$74 |
$74 |
0.9× |
| Chest 1 view (71045) |
$65 |
$65 |
0.8× |
| Chest 3 views (71047) |
$50 |
$50 |
0.6× |
| Clavicle complete (73000) |
$60 |
$60 |
0.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$254 |
$254 |
1.6× |
| Cystography minimum 3 views rs&i (74430) |
$33 |
$33 |
0.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$67.23 |
$67.23 |
0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$52.09 |
$52.09 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$347 |
$347 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$255 |
$255 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$121.94 |
$121.94 |
0.5× |
| Foot 2 views (73620) |
$56 |
$56 |
0.7× |
| Forearm 2 views (73090) |
$57 |
$57 |
0.7× |
| Gated Heart Planar Single (78472) |
$102 |
$102 |
0.3× |
| Hand 2 views (73120) |
$60 |
$60 |
0.6× |
| Hand 3 views (73130) |
$72 |
$72 |
0.9× |
| Heart Infarct Image (78466) |
$75 |
$75 |
0.2× |
| Heart infarct image w ef (78468) |
$84 |
$84 |
0.2× |
| Ht muscle image spect sing (78451) |
$144 |
$144 |
0.1× |
| Humerus Min 2 Views Left (73060) |
$65 |
$65 |
0.8× |
| Hysterosalpingogram (74740) |
$246 |
$246 |
1.1× |
| Interstitial radiation source applic complex (77778) |
$1,141 |
$1,141 |
1.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,030 |
$1,030 |
1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$729 |
$729 |
1.4× |
| Intracavitary radiation source applic simple (77761) |
$458 |
$458 |
0.9× |
| Knee 3 views (73562) |
$81 |
$81 |
1.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$93 |
$93 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$509 |
$509 |
1.5× |
| Myelogram Lumbar (72265) |
$199 |
$199 |
0.3× |
| Myelogram thoracic (72255) |
$58 |
$58 |
0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$155 |
$155 |
0.1× |
| Myocardial infarct spect (78469) |
$98 |
$98 |
0.2× |
| Myocardial Spect Multiple Studies (78452) |
$169 |
$169 |
0.1× |
| Neck soft tissue (70360) |
$37.46 |
$37.46 |
0.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$593 |
$593 |
1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$949 |
$949 |
0.7× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$196 |
$196 |
0.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$140 |
$140 |
0.1× |
| Nuclear medicine of heart pumping function (78473) |
$153 |
$153 |
0.4× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$154 |
$154 |
0.3× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$158 |
$158 |
0.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$105 |
$105 |
0.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$89 |
$89 |
0.2× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$81 |
$81 |
0.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$325 |
$325 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$51.50 |
$51.50 |
0.5× |
| Pr heart first pass single,planar (78481) |
$102 |
$102 |
0.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$61.14 |
$61.14 |
0.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$100.50 |
$100.50 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$50 |
$50 |
0.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$54.50 |
$54.50 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$94 |
$94 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$73.50 |
$73.50 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$58 |
$58 |
0.7× |
| Radiological examination surgical specimen (76098) |
$39.75 |
$39.75 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$135 |
$135 |
0.0× |
| Ribs bilateral 3 views (71110) |
$56.50 |
$56.50 |
0.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$169 |
$169 |
0.3× |
| Sacroiliac Joints < 3 Views (72200) |
$50 |
$50 |
0.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$252 |
$252 |
1.1× |
| Scapula complete (73010) |
$66 |
$66 |
0.7× |
| Simulation intermediate (77285) |
$128 |
$128 |
0.4× |
| Spec medical radj physics consltj (77370) |
$246 |
$246 |
2.0× |
| Special dosimetry (77331) |
$104 |
$104 |
0.8× |
| Special treatment procedure (77470) |
$241 |
$241 |
0.5× |
| Spine thoracic 3 views (72072) |
$50 |
$50 |
0.5× |
| Superior sagittal sinus venogram (75870) |
$122 |
$122 |
0.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$136 |
$136 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$344 |
$344 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$167 |
$167 |
0.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$186 |
$186 |
0.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$85 |
$85 |
0.7× |
| Thoracolumbar 2 views (72080) |
$63 |
$63 |
0.8× |
| Treatment device intermediate (77333) |
$89 |
$89 |
0.7× |
| Treatment devices simple (77332) |
$54 |
$54 |
0.4× |
| Tx devices design & construction complex (77334) |
$137 |
$137 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$243 |
$243 |
2.5× |
| Umbilical-artery Doppler (OB) (76820) |
$138 |
$138 |
1.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$50 |
$50 |
0.6× |
| Us abdl aorta screen aaa (76706) |
$63 |
$63 |
0.6× |
| Us breast unilateral limited (76642) |
$187 |
$187 |
2.3× |
| Us chest (76604) |
$189 |
$189 |
1.9× |
| Us guided compression repair (76936) |
$644.25 |
$644.25 |
3.2× |
| Us ob transvaginal (76817) |
$275 |
$275 |
2.8× |
| Us pelvic non ob complete (76856) |
$471.38 |
$471.38 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$306.19 |
$306.19 |
3.1× |
| Us pregnancy ltd (76815) |
$240 |
$240 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$349 |
$349 |
3.6× |
| Us retroperitoneal complete (76770) |
$239.06 |
$239.06 |
2.5× |
| Us scrotum and contents (76870) |
$222.62 |
$222.62 |
2.3× |
| Us soft tissue head/neck (76536) |
$274.50 |
$274.50 |
2.8× |
| Us transrectal (76872) |
$358.58 |
$358.58 |
3.7× |
| Us transrectal prostate volume (76873) |
$178 |
$178 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$78 |
$78 |
0.8× |
| Vascular flow imaging (78445) |
$49 |
$49 |
0.1× |
| Venogram extremity bilateral (75822) |
$112 |
$112 |
0.1× |
| Venography caval inferior serialography rs&i (75825) |
$335.25 |
$335.25 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$343.50 |
$343.50 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$281.25 |
$281.25 |
0.2× |
| Venography Renal Bilateral (75833) |
$152 |
$152 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$132 |
$132 |
0.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$342.75 |
$342.75 |
0.1× |
| Wrist 2 views (73100) |
$69 |
$69 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$63.50 |
$63.50 |
0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$80 |
$80 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$72 |
$72 |
0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$55 |
$55 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$50 |
$50 |
0.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$78 |
$78 |
0.8× |
| X-ray exam hip uni 1 view (73501) |
$57 |
$57 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$96 |
$96 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$73.24 |
$73.24 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$68.59 |
$68.59 |
0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$77.44 |
$77.44 |
0.8× |
| X-ray exam of femur 1 (73551) |
$37.48 |
$37.48 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$50 |
$50 |
0.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$50 |
$50 |
0.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$67 |
$67 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$55 |
$55 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$50 |
$50 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$91 |
$91 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$74 |
$74 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$50 |
$50 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$50 |
$50 |
0.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$84 |
$84 |
0.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$63 |
$63 |
0.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$68 |
$68 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$49.27 |
$49.27 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$70.52 |
$70.52 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$50 |
$50 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$63 |
$63 |
0.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$60 |
$60 |
0.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$56 |
$56 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$50 |
$50 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$50 |
$50 |
0.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$54 |
$54 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$33.98 |
$33.98 |
0.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$61 |
$61 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$67 |
$67 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$64 |
$64 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$81 |
$81 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$50 |
$50 |
0.5× |
| Xr finger(s) 2+ views (73140) |
$78 |
$78 |
1.0× |
| Xr shoulder 1 view (73020) |
$46 |
$46 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$101 |
$101 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$64 |
$64 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$72 |
$72 |
0.9× |