| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,926.58 |
$5,504.50 |
1.3× |
| Abdomen 2 views (74019) |
$57.75 |
$165 |
0.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$842.10 |
$2,406 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$195.30 |
$533 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,031.58 |
$454.50 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$3,010.35 |
$4,412.50 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,871.35 |
$11,061 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,052 |
$4,504.50 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,262.75 |
$3,347.50 |
0.7× |
| Angiography Spinal Selective Rs&I (75705) |
$5,806.85 |
$8,482 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,477.55 |
$12,793 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,787.40 |
$4,082.50 |
0.8× |
| Ankle 2 views (73600) |
$66.85 |
$191 |
0.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$768.08 |
$2,194.50 |
2.1× |
| Aortogram thoracic (75605) |
$4,659.90 |
$13,314 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,445.98 |
$474.50 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,382.35 |
$390.50 |
1.3× |
| Arthrogram elbow (73085) |
$300.12 |
$857.50 |
0.8× |
| Arthrogram hip (73525) |
$489.30 |
$1,398 |
1.3× |
| Arthrogram shoulder (73040) |
$468.48 |
$1,338.50 |
1.3× |
| Arthrogram wrist (73115) |
$697.20 |
$1,992 |
1.9× |
| Arthrography knee lt (73580) |
$443.80 |
$1,268 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$214.02 |
$611.50 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$661.32 |
$1,889.50 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$1,183.52 |
$3,381.50 |
2.8× |
| Bone age studies (77072) |
$44.80 |
$128 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$1,161.65 |
$3,319 |
2.7× |
| Bone Marrow Imaging Limited Area (78102) |
$316.22 |
$903.50 |
0.7× |
| Bone survey complete (77075) |
$540.92 |
$1,545.50 |
4.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$543.02 |
$1,551.50 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$107.45 |
$307 |
0.1× |
| Brain Imaging Vascular Flow Only (78610) |
$350.35 |
$1,001 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$166.25 |
$475 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$44.80 |
$128 |
0.5× |
| Chest 1 view (71045) |
$20.65 |
$59 |
0.2× |
| Chest 3 views (71047) |
$234.68 |
$670.50 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$445.20 |
$1,272 |
2.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$611.62 |
$1,747.50 |
0.7× |
| Clavicle complete (73000) |
$66.32 |
$189.50 |
0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$94.32 |
$269.50 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$443.10 |
$1,266 |
3.1× |
| Corpora cavernosography (74445) |
$717.85 |
$2,051 |
6.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,576.88 |
$7,362.50 |
6.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,951.95 |
$5,577 |
7.7× |
| CT abdomen w contrast (74160) |
$1,423.45 |
$4,067 |
7.6× |
| CT abdomen w wo contrast (74170) |
$1,579.72 |
$4,513.50 |
8.4× |
| CT abdomen w/o contrast (74150) |
$821.98 |
$2,348.50 |
7.4× |
| CT angio hrt w/3d image (75574) |
$920.32 |
$2,629.50 |
2.5× |
| CT angiography upper extremity lt (73206) |
$1,092.52 |
$3,121.50 |
5.8× |
| CT c-spine w/o contrast (72125) |
$1,401.75 |
$4,005 |
12.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,517.42 |
$4,335.50 |
8.1× |
| CT cervical spine with contrast (72126) |
$1,456.88 |
$4,162.50 |
3.9× |
| CT chest w/wo contrast (71270) |
$1,400.52 |
$4,001.50 |
7.5× |
| CT chest with contrast (71260) |
$1,308.48 |
$3,738.50 |
7.0× |
| CT colonography w/o cntrst (74261) |
$343.88 |
$982.50 |
3.1× |
| CT head/brain with contrast (70460) |
$1,262.62 |
$3,607.50 |
6.7× |
| CT head/brain without and with contrast (70470) |
$1,331.92 |
$3,805.50 |
7.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$479.85 |
$1,371 |
1.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$120.05 |
$343 |
1.3× |
| CT hrt w/3d image congen (75573) |
$353.15 |
$1,009 |
0.9× |
| CT iac w contrast (70481) |
$1,149.58 |
$3,284.50 |
6.1× |
| CT lower ext w/o (73700) |
$1,242.15 |
$3,549 |
11.1× |
| CT lower extremity w wo contrast (73702) |
$1,422.40 |
$4,064 |
7.6× |
| CT lower extremity with contrast (73701) |
$1,216.08 |
$3,474.50 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,542.45 |
$4,407 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$1,428.35 |
$4,081 |
12.8× |
| CT lumbar spine with contrast (72132) |
$1,465.45 |
$4,187 |
3.9× |
| CT maxillofacial w contrast (70487) |
$1,030.22 |
$2,943.50 |
5.5× |
| CT maxillofacial w/o contrast (70486) |
$723.62 |
$2,067.50 |
6.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,091.82 |
$3,119.50 |
5.8× |
| CT neck soft tissue w contrast (70491) |
$1,260.88 |
$3,602.50 |
6.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,186.32 |
$3,389.50 |
6.3× |
| CT orbits w/o contrast (70480) |
$1,087.62 |
$3,107.50 |
9.7× |
| CT pelvis w & w/o contrast (72194) |
$1,539.12 |
$4,397.50 |
8.2× |
| CT pelvis w/o contrast (72192) |
$1,281.52 |
$3,661.50 |
11.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,325.80 |
$3,788 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,189.65 |
$3,399 |
10.7× |
| CT thoracic spine w/contrast (72129) |
$1,456.88 |
$4,162.50 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$1,426.25 |
$4,075 |
12.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,517.42 |
$4,335.50 |
8.1× |
| CT thorax w/o contrast (71250) |
$1,164.45 |
$3,327 |
10.4× |
| CT unlisted procedure (76497) |
$116.90 |
$334 |
1.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,420.48 |
$4,058.50 |
7.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,200.15 |
$3,429 |
10.8× |
| CT upper extremity with contrast (73201) |
$1,355.38 |
$3,872.50 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,334.02 |
$3,811.50 |
7.1× |
| Cta Abdomen (74175) |
$1,161.82 |
$3,319.50 |
6.2× |
| CTA abdomen pelvis (74174) |
$2,059.75 |
$5,885 |
5.5× |
| CTA chest (71275) |
$1,207.68 |
$3,450.50 |
6.5× |
| Cta Head (70496) |
$1,399.48 |
$3,998.50 |
7.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$256.72 |
$733.50 |
0.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,305.32 |
$3,729.50 |
7.0× |
| Cta Neck (70498) |
$1,495.20 |
$4,272 |
8.0× |
| Cta Pelvis (72191) |
$1,062.42 |
$3,035.50 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$295.05 |
$843 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$80.85 |
$231 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$192.68 |
$550.50 |
1.7× |
| Dxa bone density study axial skeleton (77085) |
$99.40 |
$284 |
0.9× |
| Esophagus (74220) |
$490.70 |
$1,402 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$120.40 |
$344 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$99.92 |
$285.50 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$305.38 |
$38 |
1.2× |
| Foot 2 views (73620) |
$37.10 |
$106 |
0.4× |
| Forearm 2 views (73090) |
$58.62 |
$167.50 |
0.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$494.90 |
$1,414 |
0.9× |
| Gated Heart Planar Single (78472) |
$962.85 |
$2,751 |
2.3× |
| Hand 2 views (73120) |
$26.60 |
$76 |
0.2× |
| Hand 3 views (73130) |
$44.10 |
$126 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$843.85 |
$2,411 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$874.12 |
$2,497.50 |
2.0× |
| Ht muscle image spect sing (78451) |
$2,120.65 |
$6,059 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$41.30 |
$118 |
0.4× |
| Hysterosalpingogram (74740) |
$447.65 |
$1,279 |
1.8× |
| Image fusion (77399) |
$124.60 |
$356 |
0.9× |
| Kidney funcj study non-img radioisotopic study (78725) |
$294 |
$840 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$847.18 |
$2,420.50 |
1.5× |
| Knee 3 views (73562) |
$42.70 |
$122 |
0.5× |
| Liver & spleen imaging static only (78215) |
$700.18 |
$2,000.50 |
1.6× |
| Lung perf&ventilat diferentl (78598) |
$313.25 |
$895 |
0.5× |
| Lung perfusion differential (78597) |
$266.35 |
$761 |
0.6× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$514.85 |
$1,471 |
0.8× |
| Lymphoscintigraphy (78195) |
$851.55 |
$2,433 |
1.5× |
| Meckels Diverticulum (78290) |
$418.42 |
$1,195.50 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$570.50 |
$1,630 |
1.4× |
| Mr elastography (76391) |
$176.05 |
$503 |
0.7× |
| MRA head w & w/o contrast (70546) |
$1,554.35 |
$4,441 |
4.2× |
| MRA head w/o contrast (70544) |
$1,319.15 |
$3,769 |
5.2× |
| MRA head with contrast (70545) |
$1,438.50 |
$4,110 |
3.9× |
| MRA neck w contrast (70548) |
$1,230.60 |
$3,516 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,370.95 |
$3,917 |
3.7× |
| MRA neck w/o contrast (70547) |
$1,107.40 |
$3,164 |
4.3× |
| MRI abdomen w contrast (74182) |
$1,385.48 |
$3,958.50 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,760.50 |
$5,030 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,226.22 |
$3,503.50 |
4.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,232 |
$3,520 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,148.35 |
$3,281 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$800.28 |
$2,286.50 |
3.1× |
| MRI breast w/o contrast unilat (77046) |
$137.90 |
$394 |
0.5× |
| MRI c-spine with contrast (72142) |
$1,643.78 |
$4,696.50 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,545.08 |
$4,414.50 |
6.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,139.25 |
$3,255 |
3.1× |
| MRI chest w/o contrast (71550) |
$650.12 |
$1,857.50 |
2.6× |
| MRI chest with contrast (71551) |
$825.48 |
$2,358.50 |
1.0× |
| MRI fetal sngl/1st gestation (74712) |
$236.78 |
$676.50 |
0.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,098.82 |
$3,139.50 |
3.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,034.95 |
$2,957 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,013.42 |
$2,895.50 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$913.15 |
$2,609 |
3.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,576.92 |
$4,505.50 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,161.82 |
$3,319.50 |
3.1× |
| MRI pelvis w contrast (72196) |
$1,378.82 |
$3,939.50 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,731.62 |
$4,947.50 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,093.22 |
$3,123.50 |
4.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,330 |
$3,800 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,495.72 |
$4,273.50 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,822.45 |
$5,207 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,638.88 |
$4,682.50 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,839.95 |
$5,257 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,643.78 |
$4,696.50 |
4.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,808.28 |
$5,166.50 |
4.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,536.50 |
$4,390 |
6.0× |
| MRI tmj (70336) |
$1,087.62 |
$3,107.50 |
4.3× |
| MRI upper ext joint w/o contrast (73221) |
$851.20 |
$2,432 |
3.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,406.30 |
$4,018 |
3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$919.45 |
$2,627 |
3.6× |
| Myocardial Spect Multiple Studies (78452) |
$527.98 |
$1,508.50 |
0.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$120.05 |
$343 |
0.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$114.10 |
$326 |
0.1× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,105.82 |
$3,159.50 |
0.5× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,447.78 |
$4,136.50 |
0.6× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$982.10 |
$2,806 |
0.6× |
| Neck soft tissue (70360) |
$44.10 |
$126 |
0.5× |
| Nm bone marrow multiple (78103) |
$255.32 |
$729.50 |
0.6× |
| Nm cisternogram (78630) |
$903.52 |
$2,581.50 |
1.6× |
| Nm gastric emptying study (78264) |
$936.25 |
$2,675 |
2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,310.88 |
$6,602.50 |
1.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$488.42 |
$1,395.50 |
0.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$325.85 |
$931 |
0.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$495.25 |
$1,415 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$674.10 |
$1,926 |
2.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$68.08 |
$194.50 |
0.6× |
| Osseous survey infant (77076) |
$396.72 |
$1,133.50 |
3.6× |
| Osseous survey limited (77074) |
$184.10 |
$526 |
1.7× |
| Parathyrd planar w/wo subtrj (78071) |
$467.42 |
$1,335.50 |
1.1× |
| Parathyroid imaging (78070) |
$648.02 |
$1,851.50 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$43.75 |
$125 |
0.4× |
| Peritoneogram rs&i (74190) |
$320.95 |
$917 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$2,109.98 |
$6,028.50 |
1.4× |
| PET imaging CT for attenuation limited area (78814) |
$1,248.28 |
$3,566.50 |
0.8× |
| PET imaging for CT attenuation whole body (78816) |
$1,999.38 |
$5,712.50 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,161.12 |
$3,317.50 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,216.15 |
$4,720 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$614.25 |
$1,755 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$579.25 |
$1,655 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,163.22 |
$3,323.50 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$366.98 |
$1,048.50 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$86.10 |
$246 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$118.65 |
$339 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$226.80 |
$648 |
2.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$61.25 |
$175 |
0.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$256.72 |
$733.50 |
2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,759.10 |
$25,026 |
1.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$588.35 |
$1,681 |
1.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$533.75 |
$1,525 |
4.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$489.65 |
$1,399 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$44.45 |
$127 |
0.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$41.65 |
$119 |
0.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$66.85 |
$191 |
0.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$36.40 |
$104 |
0.4× |
| Radiologic exam colon single contrast study (74270) |
$495.25 |
$1,415 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$490.70 |
$1,402 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$466.72 |
$1,333.50 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$175.70 |
$502 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$75.08 |
$214.50 |
0.8× |
| Radiological examination surgical specimen (76098) |
$265.82 |
$759.50 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,733.80 |
$5,432 |
1.1× |
| Ribs bilateral 3 views (71110) |
$286.48 |
$818.50 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,089.38 |
$3,112.50 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,094.10 |
$3,126 |
1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$126.35 |
$361 |
0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$147 |
$420 |
0.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$626.15 |
$1,789 |
0.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$126 |
$360 |
0.5× |
| Rp Therapy Intravenous Administration (79101) |
$289.62 |
$827.50 |
1.2× |
| Scanogram (77073) |
$199.32 |
$569.50 |
1.8× |
| Scapula complete (73010) |
$54.25 |
$155 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$30.28 |
$86.50 |
1.3× |
| Sella turcica (70240) |
$131.08 |
$374.50 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$30.80 |
$88 |
0.3× |
| Simulation intermediate (77285) |
$403.20 |
$1,152 |
1.0× |
| Small bowel series (74250) |
$423.15 |
$1,209 |
2.3× |
| Spec medical radj physics consltj (77370) |
$774.20 |
$2,212 |
5.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$441.35 |
$1,261 |
1.1× |
| Special dosimetry (77331) |
$119 |
$340 |
0.8× |
| Special treatment procedure (77470) |
$1,070.12 |
$3,057.50 |
1.8× |
| Spine thoracic 3 views (72072) |
$31.85 |
$91 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$2,931.25 |
$8,375 |
1.5× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$76.30 |
$218 |
0.7× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$43.75 |
$125 |
1.1× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$76.30 |
$218 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$546.52 |
$1,561.50 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$316.05 |
$903 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$713.30 |
$2,038 |
1.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$318.50 |
$910 |
2.2× |
| Thoracolumbar 2 views (72080) |
$242.02 |
$691.50 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$676.02 |
$1,931.50 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$432.95 |
$1,237 |
1.0× |
| Thyroid uptake measurement (78012) |
$321.30 |
$918 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$315.52 |
$901.50 |
0.7× |
| Tmj unilateral (70328) |
$114.98 |
$328.50 |
1.2× |
| Treatment device intermediate (77333) |
$320.08 |
$914.50 |
2.2× |
| Treatment devices simple (77332) |
$252.88 |
$722.50 |
1.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,089.20 |
$3,112 |
1.9× |
| Tx devices design & construction complex (77334) |
$448 |
$1,280 |
1.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$172.55 |
$493 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$301 |
$860 |
2.7× |
| Umbilical-artery Doppler (OB) (76820) |
$51.62 |
$147.50 |
0.5× |
| Unlisted fluoroscopic procedure (76496) |
$111.30 |
$318 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$551.25 |
$1,575 |
5.9× |
| Upper Extremity Infant (73092) |
$33.08 |
$94.50 |
0.3× |
| Urethrocystography retrograde rs&i (74450) |
$259 |
$740 |
1.0× |
| Urethrocystography voiding (74455) |
$416.15 |
$1,189 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$135.10 |
$386 |
1.2× |
| Us breast unilateral complete (76641) |
$334.95 |
$957 |
3.0× |
| Us breast unilateral limited (76642) |
$162.40 |
$464 |
1.7× |
| Us chest (76604) |
$279.65 |
$799 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$254.80 |
$728 |
2.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$112.52 |
$321.50 |
1.0× |
| Us guided compression repair (76936) |
$140 |
$400 |
0.6× |
| Us infant hips dynamic (76885) |
$132.48 |
$378.50 |
1.4× |
| Us kidney transplant (76776) |
$200.72 |
$573.50 |
1.8× |
| Us ob detailed single fetus (76811) |
$125.82 |
$359.50 |
0.5× |
| Us ob transvaginal (76817) |
$47.78 |
$136.50 |
0.4× |
| Us pelvic non ob complete (76856) |
$435.58 |
$1,244.50 |
3.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$199.50 |
$570 |
1.8× |
| Us pregnancy ltd (76815) |
$61.78 |
$176.50 |
0.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$62.48 |
$178.50 |
0.6× |
| Us retroperitoneal complete (76770) |
$496.30 |
$1,418 |
4.4× |
| Us retroperitoneal limited (76775) |
$278.95 |
$797 |
2.5× |
| Us scrotum and contents (76870) |
$409.68 |
$1,170.50 |
3.7× |
| Us soft tissue head/neck (76536) |
$326.90 |
$934 |
2.9× |
| Us spinal canal and contents (76800) |
$187.95 |
$537 |
1.7× |
| Us transrectal (76872) |
$48.30 |
$138 |
0.4× |
| Us xtr non-vasc lmtd (76882) |
$166.60 |
$476 |
1.5× |
| Venogram extremity bilateral (75822) |
$661.50 |
$1,890 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$3,432.10 |
$382 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,426.25 |
$2,135.50 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$1,194.90 |
$1,781.50 |
0.7× |
| Venography Renal Bilateral (75833) |
$3,216.15 |
$4,721 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,339.40 |
$3,449 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,459.10 |
$3,615.50 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$67.02 |
$191.50 |
0.7× |
| Wrist 2 views (73100) |
$37.10 |
$106 |
0.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$48.65 |
$139 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$41.82 |
$119.50 |
0.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$44.10 |
$126 |
0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$46.90 |
$134 |
0.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$47.25 |
$135 |
0.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$186.38 |
$532.50 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$69.65 |
$199 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$77 |
$220 |
0.8× |
| X-ray exam hip uni 4/> views (73503) |
$285.42 |
$815.50 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$303.62 |
$867.50 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$351.92 |
$1,005.50 |
3.2× |
| X-ray exam of femur 1 (73551) |
$46.90 |
$134 |
0.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$368.02 |
$1,051.50 |
2.0× |
| X-ray eye for foreign body (70030) |
$90.30 |
$258 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$331.28 |
$946.50 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$223.65 |
$639 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$44.10 |
$126 |
0.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$103.60 |
$296 |
0.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$56.88 |
$162.50 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$235.02 |
$671.50 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$45.50 |
$130 |
0.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$102.90 |
$294 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$164.68 |
$470.50 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$57.92 |
$165.50 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$118.30 |
$338 |
1.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$35.88 |
$102.50 |
0.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$43.05 |
$123 |
0.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$124.60 |
$356 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$250.60 |
$716 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$277.55 |
$793 |
2.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$688.80 |
$1,968 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$34.82 |
$99.50 |
0.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$19.42 |
$55.50 |
0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$26.78 |
$76.50 |
0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$62.65 |
$179 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$39.20 |
$112 |
0.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$46.90 |
$134 |
0.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$62.65 |
$179 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$53.72 |
$153.50 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$311.32 |
$889.50 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$256.20 |
$732 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$180.60 |
$516 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$53.20 |
$152 |
0.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$40.60 |
$116 |
0.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$50.40 |
$144 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$56.88 |
$162.50 |
0.6× |
| Xr arthrogram ankle (73615) |
$401.80 |
$1,148 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$54.08 |
$154.50 |
0.5× |
| Xr chest 4+ views (71048) |
$258.48 |
$738.50 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$26.60 |
$76 |
0.3× |
| Xr shoulder 1 view (73020) |
$68.42 |
$195.50 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$48.82 |
$139.50 |
0.4× |
| Xr tibia/fibula 2 views (73590) |
$64.58 |
$184.50 |
0.7× |
| Xr tmj bilateral (70330) |
$229.95 |
$657 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$48.12 |
$137.50 |
0.5× |