| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,443 |
$5,443 |
3.8× |
| Abdomen 2 views (74019) |
$677 |
$677 |
6.2× |
| Acute gi blood loss imaging (78278) |
$1,386 |
$1,386 |
3.3× |
| Angio Adrenal Bilat Select (75733) |
$4,843.50 |
$4,843.50 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,757 |
$3,757 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,757 |
$3,757 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,292 |
$5,292 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,133 |
$5,133 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,930 |
$8,930 |
2.7× |
| Angiography Spinal Selective Rs&I (75705) |
$6,092 |
$6,092 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,292 |
$5,292 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,041 |
$4,041 |
1.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,025 |
$4,025 |
1.2× |
| Ankle 2 views (73600) |
$390 |
$390 |
4.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,240 |
$3,240 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,240 |
$3,240 |
1.0× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$15,797 |
$15,797 |
4.8× |
| Artery X-Rays Adrenal Gland (75731) |
$4,025 |
$4,025 |
1.2× |
| Arthrogram ankle (73615) |
$556 |
$556 |
1.5× |
| Arthrogram elbow (73085) |
$496 |
$496 |
1.4× |
| Arthrogram hip (73525) |
$463 |
$463 |
1.3× |
| Arthrogram knee (73580) |
$556 |
$556 |
1.5× |
| Arthrogram shoulder (73040) |
$556 |
$556 |
1.5× |
| Arthrogram wrist (73115) |
$463 |
$463 |
1.3× |
| Basic dosimetry (77300) |
$1,209 |
$1,209 |
8.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,593 |
$1,593 |
3.8× |
| Bone &/joint imaging whole body (78306) |
$2,463 |
$2,463 |
5.9× |
| Bone age studies (77072) |
$495 |
$495 |
4.5× |
| Bone Imaging 3 Phase (78315) |
$1,556 |
$1,556 |
3.7× |
| Bone survey complete (77075) |
$501 |
$501 |
4.6× |
| Bone survey infant (77076) |
$501 |
$501 |
4.6× |
| Bowel imaging (78290) |
$1,338 |
$1,338 |
3.2× |
| Brachytx isodose complex (77318) |
$2,537 |
$2,537 |
6.5× |
| Brachytx isodose intermed (77317) |
$2,108 |
$2,108 |
5.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,497 |
$1,497 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,472 |
$4,472 |
3.0× |
| Brain Imaging Vascular Flow Only (78610) |
$1,101 |
$1,101 |
1.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,198 |
$2,198 |
5.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,666 |
$3,666 |
10.1× |
| Cervical spine 2 or 3 views (72040) |
$501 |
$501 |
5.5× |
| Chest 1 view (71045) |
$943.50 |
$943.50 |
10.4× |
| Chest xray 3 views (71047) |
$1,003 |
$1,003 |
11.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$501 |
$501 |
2.7× |
| Cineradiography/videoradiography (76120) |
$486 |
$486 |
4.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$12,631 |
$12,631 |
15.4× |
| Clavicle complete (73000) |
$535 |
$535 |
5.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,510 |
$1,510 |
13.8× |
| Continuing medical physics consltj pr wk (77336) |
$1,449 |
$1,449 |
10.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,242 |
$1,242 |
3.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,242 |
$1,242 |
5.0× |
| CT abdomen w contrast (74160) |
$1,242 |
$1,242 |
6.8× |
| CT abdomen w wo contrast (74170) |
$1,242 |
$1,242 |
6.8× |
| CT abdomen w/o contrast (74150) |
$1,242 |
$1,242 |
11.4× |
| CT angio hrt w/3d image (75574) |
$1,639 |
$1,639 |
4.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,863 |
$1,863 |
10.2× |
| CT angiography upper extremity lt (73206) |
$1,242 |
$1,242 |
6.8× |
| CT c-spine w/contrast (72126) |
$1,242 |
$1,242 |
3.4× |
| CT c-spine w/o contrast (72125) |
$1,242 |
$1,242 |
11.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,242 |
$1,242 |
6.8× |
| CT chest w contrast (71260) |
$1,242 |
$1,242 |
6.8× |
| CT chest w/wo contrast (71270) |
$1,242 |
$1,242 |
6.8× |
| CT colonography screening (74263) |
$935 |
$935 |
3.8× |
| CT colonography w/o cntrst (74261) |
$935 |
$935 |
8.6× |
| CT head/brain with contrast (70460) |
$1,242 |
$1,242 |
6.8× |
| CT head/brain without and with contrast (70470) |
$1,242 |
$1,242 |
6.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,639 |
$1,639 |
4.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,480 |
$1,480 |
16.3× |
| CT iac w contrast (70481) |
$1,242 |
$1,242 |
6.8× |
| CT lower ext w/o (73700) |
$1,242 |
$1,242 |
11.4× |
| CT lower extremity w/contrast material (73701) |
$1,242 |
$1,242 |
6.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,242 |
$1,242 |
6.8× |
| CT lumbar spine w/contrast (72132) |
$1,242 |
$1,242 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$1,242 |
$1,242 |
11.4× |
| CT maxillofacial w contrast (70487) |
$1,196 |
$1,196 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$1,196 |
$1,196 |
11.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,150 |
$1,150 |
6.3× |
| CT orbits w/o contrast (70480) |
$1,196 |
$1,196 |
11.0× |
| CT pelvis w/o contrast (72192) |
$1,242 |
$1,242 |
11.4× |
| CT pelvis w/wo contrast (72194) |
$1,242 |
$1,242 |
6.8× |
| CT soft tissue neck w contrast (70491) |
$1,242 |
$1,242 |
6.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,242 |
$1,242 |
6.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,242 |
$1,242 |
11.4× |
| CT thoracic spine w/contrast (72129) |
$1,242 |
$1,242 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,242 |
$1,242 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,242 |
$1,242 |
11.4× |
| CT unlisted procedure (76497) |
$1,610 |
$1,610 |
17.7× |
| CT upper ext wo (73200) |
$1,242 |
$1,242 |
11.4× |
| CT upper extremity with contrast (73201) |
$1,242 |
$1,242 |
3.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,242 |
$1,242 |
6.8× |
| Cta Abdomen (74175) |
$1,242 |
$1,242 |
6.8× |
| CTA abdomen pelvis (74174) |
$1,242 |
$1,242 |
3.4× |
| CTA chest (71275) |
$1,242 |
$1,242 |
6.8× |
| Cta Head (70496) |
$1,242 |
$1,242 |
6.8× |
| Cta Neck (70498) |
$1,242 |
$1,242 |
6.8× |
| Cta Pelvis (72191) |
$1,242 |
$1,242 |
6.8× |
| Cystography minimum 3 views rs&i (74430) |
$748 |
$748 |
2.1× |
| Diskography lumbar (72295) |
$2,054 |
$2,054 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$617 |
$617 |
5.7× |
| Dxa bone density study axial skeleton (77085) |
$486 |
$486 |
4.5× |
| Esophagus (74220) |
$613 |
$613 |
3.3× |
| Facial bones min 3 views (70150) |
$763 |
$763 |
7.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,920 |
$1,920 |
17.6× |
| Fluoroscopy up to 1 hr (76000) |
$643 |
$643 |
2.6× |
| Foot 2 views (73620) |
$508 |
$508 |
5.6× |
| Forearm 2 views (73090) |
$501 |
$501 |
5.5× |
| Hand 2 views (73120) |
$501 |
$501 |
4.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$7,673 |
$7,673 |
10.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$7,794 |
$7,794 |
10.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$7,916 |
$7,916 |
10.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,307 |
$3,307 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,308 |
$4,308 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,128.50 |
$1,128.50 |
2.0× |
| Hysterosalpingogram (74740) |
$1,672 |
$1,672 |
6.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$13,581.40 |
$13,581.40 |
18.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$21,588.70 |
$21,588.70 |
37.4× |
| Intracavitary Radiation Source Applic Simple (77761) |
$23,494.05 |
$23,494.05 |
40.7× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$21,887 |
$21,887 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,507 |
$1,507 |
2.7× |
| Knee 3 views (73562) |
$501 |
$501 |
5.5× |
| Liver & spleen imaging static only (78215) |
$1,820 |
$1,820 |
4.4× |
| Liver imaging static only (78201) |
$3,986 |
$3,986 |
7.0× |
| Lung perf&ventilat diferentl (78598) |
$1,108 |
$1,108 |
2.0× |
| Lung perfusion differential (78597) |
$730 |
$730 |
1.7× |
| Lymphoscintigraphy (78195) |
$666 |
$666 |
1.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,476 |
$1,476 |
1.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,419 |
$1,419 |
3.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,533 |
$1,533 |
4.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$632 |
$632 |
1.6× |
| Mr safety determination physician/other qhp (76016) |
$354 |
$354 |
3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$98 |
$98 |
3.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$369 |
$369 |
3.7× |
| Mr safety implt pos&/immoblj (76019) |
$238 |
$238 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$971 |
$971 |
3.9× |
| MRA head w & w/o contrast (70546) |
$1,533 |
$1,533 |
4.2× |
| MRA head w/o contrast (70544) |
$1,533 |
$1,533 |
6.2× |
| MRA head with contrast (70545) |
$1,533 |
$1,533 |
4.2× |
| MRA neck w contrast (70548) |
$1,533 |
$1,533 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,533 |
$1,533 |
4.2× |
| MRA neck w/o contrast (70547) |
$1,533 |
$1,533 |
6.2× |
| MRI abdomen w contrast (74182) |
$1,533 |
$1,533 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,533 |
$1,533 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,533 |
$1,533 |
6.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,419 |
$1,419 |
1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,300 |
$2,300 |
6.3× |
| MRI breast w/o contrast bilateral (77047) |
$2,300 |
$2,300 |
9.2× |
| MRI breast wo contrast unilateral (77046) |
$1,533 |
$1,533 |
6.2× |
| MRI c-spine with contrast (72142) |
$1,533 |
$1,533 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$4,024 |
$4,024 |
16.1× |
| MRI cervical spine w/o contrast (72141) |
$1,533 |
$1,533 |
6.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,533 |
$1,533 |
4.2× |
| MRI chest w/o contrast (71550) |
$1,533 |
$1,533 |
6.2× |
| MRI chest with contrast (71551) |
$1,419 |
$1,419 |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,419 |
$1,419 |
3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,300 |
$2,300 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,300 |
$2,300 |
9.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,476 |
$1,476 |
5.9× |
| MRI orbit face neck w contrast (70542) |
$1,533 |
$1,533 |
4.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,476 |
$1,476 |
4.1× |
| MRI pelvis w/contrast (72196) |
$1,533 |
$1,533 |
4.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,533 |
$1,533 |
4.2× |
| MRI pelvis w/o contrast (72195) |
$1,533 |
$1,533 |
6.2× |
| MRI spectroscopy (76390) |
$5,470 |
$5,470 |
60.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,533 |
$1,533 |
4.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,533 |
$1,533 |
4.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,533 |
$1,533 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,533 |
$1,533 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,533 |
$1,533 |
4.2× |
| MRI temporomandibular joint (70336) |
$1,533 |
$1,533 |
6.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,533 |
$1,533 |
6.2× |
| MRI up ext w/o contrast (73218) |
$1,533 |
$1,533 |
6.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,300 |
$2,300 |
9.2× |
| MRI, joint upper extrem combo (73223) |
$1,533 |
$1,533 |
4.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,556 |
$1,556 |
1.2× |
| Myocardial spect single study at rest or stress (78451) |
$6,525 |
$6,525 |
4.8× |
| N-invas est c ffr sw aly CTA (75580) |
$2,152 |
$2,152 |
2.4× |
| Neck soft tissue (70360) |
$519 |
$519 |
5.7× |
| Nm cisternogram (78630) |
$1,616 |
$1,616 |
2.9× |
| Nm gastric emptying study (78264) |
$1,654 |
$1,654 |
4.0× |
| Nm kidney scan w/flow (78701) |
$8,027 |
$8,027 |
19.2× |
| Nonvascular shunt X-ray (75809) |
$626 |
$626 |
5.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,139 |
$5,139 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$1,788 |
$1,788 |
7.3× |
| Osseous survey limited (77074) |
$1,308 |
$1,308 |
12.0× |
| Parathyroid Planar Imaging (78070) |
$1,398 |
$1,398 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$501 |
$501 |
4.6× |
| PET image w/CT, skull-thigh (78815) |
$4,644 |
$4,644 |
3.1× |
| PET imaging CT for attenuation limited area (78814) |
$4,644 |
$4,644 |
3.1× |
| PET imaging for CT attenuation whole body (78816) |
$4,644 |
$4,644 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,307 |
$3,307 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,025 |
$4,025 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,791 |
$1,791 |
4.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$948 |
$948 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$796 |
$796 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$501 |
$501 |
5.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$518 |
$518 |
5.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$501 |
$501 |
5.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$722 |
$722 |
7.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$722 |
$722 |
6.6× |
| Radex fingr minimum 2 views (73140) |
$502 |
$502 |
5.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$532 |
$532 |
5.9× |
| Radex Hand Minimum 3 Views (73130) |
$501 |
$501 |
5.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$501 |
$501 |
5.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$751 |
$751 |
6.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$750 |
$750 |
6.9× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,125 |
$1,125 |
10.3× |
| Radex Humerus Minimum 2 Views (73060) |
$550 |
$550 |
6.1× |
| Radex Kne 1/2 Views (73560) |
$501 |
$501 |
5.5× |
| Radex Kne Compl 4/More Views (73564) |
$501 |
$501 |
4.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$501 |
$501 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$646 |
$646 |
7.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$501 |
$501 |
4.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$603 |
$603 |
6.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$430 |
$430 |
4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,280 |
$1,280 |
14.1× |
| Radex Toe Minimum 2 Views (73660) |
$498 |
$498 |
5.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$360 |
$360 |
3.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$645 |
$645 |
7.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,778 |
$20,778 |
2.7× |
| Radiation treatment delivery level 1 (77402) |
$922 |
$922 |
8.7× |
| Radiation treatment delivery level 2 (77407) |
$1,156 |
$1,156 |
2.9× |
| Radiation treatment delivery level 3 (77412) |
$4,088 |
$4,088 |
7.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$468 |
$468 |
5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$599 |
$599 |
5.5× |
| Radiologic exam chest 2 views (71046) |
$601.50 |
$601.50 |
6.6× |
| Radiologic exam colon single contrast study (74270) |
$501 |
$501 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$501 |
$501 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$501 |
$501 |
2.7× |
| Radiologic examination femur 1 view (73551) |
$501 |
$501 |
5.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$501 |
$501 |
5.5× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$859 |
$859 |
7.9× |
| Radiological examination surgical specimen (76098) |
$648 |
$648 |
1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,421 |
$1,421 |
3.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$997 |
$997 |
2.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,295 |
$1,295 |
3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,217 |
$2,217 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,024 |
$3,024 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,024 |
$3,024 |
5.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$589 |
$589 |
2.4× |
| Scapula (73010) |
$681 |
$681 |
6.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$87 |
$87 |
3.7× |
| Shoulder 1 view (73020) |
$490 |
$490 |
5.4× |
| Simulation intermediate (77285) |
$1,029 |
$1,029 |
2.6× |
| Small bowel series (74250) |
$501 |
$501 |
2.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,023 |
$1,023 |
2.6× |
| Special dosimetry (77331) |
$476 |
$476 |
3.4× |
| Special Physics Consult (77370) |
$816 |
$816 |
5.8× |
| Special treatment procedure (77470) |
$3,984 |
$3,984 |
6.9× |
| Spine thoracic 3 views (72072) |
$501 |
$501 |
4.6× |
| Stereotactic Body Radiation Delivery (77373) |
$18,778 |
$18,778 |
10.1× |
| Tbs technical calculation only (77091) |
$278 |
$278 |
3.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,448 |
$2,448 |
6.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,730 |
$4,730 |
12.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,866 |
$2,866 |
20.4× |
| Thoracolumbar 2 views (72080) |
$501 |
$501 |
5.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,221 |
$1,221 |
2.2× |
| Thyroid uptake measurement (78012) |
$685 |
$685 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,104 |
$1,104 |
2.6× |
| Treatment device complex (77334) |
$3,639 |
$3,639 |
9.3× |
| Treatment device intermediate (77333) |
$753 |
$753 |
5.4× |
| Treatment devices simple (77332) |
$551 |
$551 |
3.9× |
| Ultrasound breast complete (76641) |
$765 |
$765 |
7.0× |
| Ultrasound Exam Aaa Screen (76706) |
$535 |
$535 |
4.9× |
| Ultrasound, abdomen limited (76705) |
$1,096 |
$1,096 |
10.0× |
| Umbilical-artery Doppler (OB) (76820) |
$297 |
$297 |
2.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$139 |
$139 |
1.5× |
| Unlisted magnetic resonance procedure (76498) |
$2,312 |
$2,312 |
25.4× |
| Unlisted ultrasound procedure (76999) |
$367 |
$367 |
4.0× |
| Urethrocystogram voiding (74455) |
$1,257 |
$1,257 |
5.0× |
| Urethrocystography retrograde rs&i (74450) |
$501 |
$501 |
2.0× |
| Us breast unilateral limited (76642) |
$730 |
$730 |
8.0× |
| Us chest (76604) |
$656 |
$656 |
6.0× |
| Us compl joint r-t w/image documentation (76881) |
$663 |
$663 |
6.1× |
| Us elastography parenchyma (76981) |
$234 |
$234 |
2.1× |
| Us encephalogram (76506) |
$818 |
$818 |
7.5× |
| Us hips infant static (76886) |
$486 |
$486 |
5.3× |
| Us infant hips w manipulation (76885) |
$947 |
$947 |
10.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$730 |
$730 |
6.7× |
| Us ob detailed single fetus (76811) |
$972 |
$972 |
3.9× |
| Us ob limited (76815) |
$547 |
$547 |
5.0× |
| Us ob transvaginal (76817) |
$953 |
$953 |
8.7× |
| Us pelvic non ob complete (76856) |
$601 |
$601 |
5.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$730 |
$730 |
6.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$601 |
$601 |
5.5× |
| Us retroperitoneal complete (76770) |
$865.50 |
$865.50 |
7.9× |
| Us retroperitoneal limited (76775) |
$898 |
$898 |
8.2× |
| Us scrotum and contents (76870) |
$877 |
$877 |
8.0× |
| Us soft tissue head/neck (76536) |
$735 |
$735 |
6.7× |
| Us spinal canal and contents (76800) |
$803 |
$803 |
7.4× |
| Us transrectal (76872) |
$948 |
$948 |
8.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$776 |
$776 |
7.1× |
| Venogram extremity bilateral (75822) |
$2,647 |
$2,647 |
1.6× |
| Venogram Extremity Unilateral (75820) |
$1,779 |
$1,779 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,024 |
$3,024 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$1,779 |
$1,779 |
1.1× |
| Venography Renal Bilateral (75833) |
$4,107 |
$4,107 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$4,107 |
$4,107 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,024 |
$3,024 |
0.9× |
| Venous sampling by catheter (75893) |
$6,506 |
$6,506 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$175 |
$175 |
1.9× |
| Wrist 2 views (73100) |
$695 |
$695 |
7.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$668 |
$668 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$341 |
$341 |
3.8× |
| X-ray b.e. reductn intuss (74283) |
$501 |
$501 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$501 |
$501 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$501 |
$501 |
5.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$501 |
$501 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$751 |
$751 |
6.9× |
| X-ray exam of femur 2/> (73552) |
$501 |
$501 |
5.5× |
| X-ray eye for foreign body (70030) |
$1,046 |
$1,046 |
11.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$574 |
$574 |
6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$396 |
$396 |
4.4× |
| X-ray leg, infant (73592) |
$363 |
$363 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$501 |
$501 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$501 |
$501 |
4.6× |
| X-ray nose-rectum child f.b. (76010) |
$296.50 |
$296.50 |
3.3× |
| X-ray optic foramen (70190) |
$185 |
$185 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$501 |
$501 |
4.6× |
| X-ray retrograde pyelogram (74420) |
$660 |
$660 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$524 |
$524 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$594 |
$594 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$613 |
$613 |
5.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$667 |
$667 |
7.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$598 |
$598 |
6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$501 |
$501 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$623 |
$623 |
5.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$501 |
$501 |
5.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$369 |
$369 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$596 |
$596 |
6.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$501 |
$501 |
4.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$501 |
$501 |
4.6× |
| Xr bone length studies (77073) |
$539 |
$539 |
4.9× |
| Xr c-spine 4 or 5 views (72050) |
$501 |
$501 |
4.6× |
| Xr c-spine 6 or more views (72052) |
$501 |
$501 |
4.6× |
| Xr chest 4+ views (71048) |
$1,117 |
$1,117 |
10.2× |