| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,593 |
$8,593 |
6.4× |
| Abdomen 1 View (74018) |
$679 |
$679 |
8.1× |
| Abdomen 2 views (74019) |
$689 |
$689 |
6.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,433 |
$1,433 |
3.7× |
| Angio internal mammary (75756) |
$3,817 |
$3,817 |
1.3× |
| Angio pulmonary bilat (75743) |
$5,943 |
$5,943 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$16,484 |
$16,484 |
5.4× |
| Angiography extremity unilateral rs&i (75710) |
$5,681 |
$5,681 |
1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,544 |
$5,544 |
1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,351 |
$2,351 |
0.8× |
| Ankle 2 views (73600) |
$428 |
$428 |
5.1× |
| Aortography thoracic serialography rs&i (75605) |
$6,237 |
$6,237 |
1.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,677 |
$6,677 |
2.2× |
| Artery X-Rays Abdomen (75726) |
$5,943 |
$5,943 |
1.1× |
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines |
$5,943–$17,167 |
$5,943–$17,167 |
varies |
| Artery X-Rays Spine (75705) |
$5,599 |
$5,599 |
1.0× |
| Arthrogram hip (73525) |
$1,298 |
$1,298 |
3.8× |
| Arthrogram Wrist (73115) |
$2,331 |
$2,331 |
6.9× |
| Basic radiation dosimetry calculation (77300) |
$459 |
$459 |
3.5× |
| Bone age studies (77072) |
$395 |
$395 |
3.9× |
| Bone Imaging 3 Phase (78315) |
$2,585 |
$2,585 |
6.7× |
Bone Imaging Limited Area (78300)
range across 2 matching MRF lines |
$1,763–$2,240 |
$1,763–$2,240 |
varies |
| Bone Imaging Multiple Areas (78305) |
$1,328 |
$1,328 |
3.4× |
| Bone Imaging Whole Body (78306) |
$2,856 |
$2,856 |
7.4× |
| Bone survey infant (77076) |
$661 |
$661 |
6.5× |
| Brachytx isodose complex (77318) |
$3,023 |
$3,023 |
8.4× |
| Brachytx isodose intermed (77317) |
$1,611 |
$1,611 |
4.5× |
| Brachytx Isodose Plan Simple (77316) |
$1,377 |
$1,377 |
3.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,242 |
$3,242 |
6.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$9,162 |
$9,162 |
6.6× |
| Cat Scan Follow-Up Study (76380) |
$1,658 |
$1,658 |
19.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,947 |
$1,947 |
3.7× |
| Cerebrospinal Fluid Scan (78630) |
$3,242 |
$3,242 |
6.2× |
Chest 1 view (71045)
range across 2 matching MRF lines |
$400–$766 |
$400–$766 |
varies |
| Chest 2 views (71046) |
$965 |
$965 |
11.5× |
| Chest 3 views (71047) |
$1,282 |
$1,282 |
15.2× |
| Chest 4 or more views (71048) |
$1,295 |
$1,295 |
12.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$411 |
$411 |
4.1× |
| Clavicle complete (73000) |
$495 |
$495 |
5.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$340 |
$340 |
3.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,051 |
$1,051 |
8.1× |
| Contrast Exam Abdominl Aorta (75625) |
$16,484 |
$16,484 |
5.4× |
| Contrast X-Ray Bladder (74430) |
$1,442 |
$1,442 |
4.3× |
| Contrast X-Ray Of Elbow (73085) |
$2,229 |
$2,229 |
6.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,391 |
$1,391 |
4.1× |
CT abdomen and pelvis without and with contrast (74178)
range across 7 matching MRF lines |
$4,322–$6,773 |
$4,322–$6,773 |
varies |
| CT abdomen and pelvis without contrast (74176) |
$4,576 |
$4,576 |
19.8× |
| CT abdomen w contrast (74160) |
$2,995 |
$2,995 |
17.7× |
| CT abdomen w wo contrast (74170) |
$2,317 |
$2,317 |
13.7× |
| CT abdomen w/o contrast (74150) |
$1,967 |
$1,967 |
19.5× |
| CT Angio Abdomen and Pelvis (74174) |
$5,436 |
$5,436 |
16.1× |
| CT Angio Chest (71275) |
$3,845 |
$3,845 |
22.7× |
| CT Angio Head (70496) |
$3,376 |
$3,376 |
19.9× |
| CT angio hrt w/3d image (75574) |
$2,719 |
$2,719 |
8.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,433 |
$3,433 |
20.2× |
| CT Angio Neck (70498) |
$3,376 |
$3,376 |
19.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,433 |
$3,433 |
20.2× |
| CT cervical spine w/ contrast (72126) |
$2,945 |
$2,945 |
8.7× |
| CT cervical spine w/o contrast (72125) |
$2,513 |
$2,513 |
24.9× |
| CT cervical spine w/wo cont (72127) |
$4,232 |
$4,232 |
25.0× |
| CT chest w contrast (71260) |
$3,355 |
$3,355 |
19.8× |
| CT chest w/wo contrast (71270) |
$3,709 |
$3,709 |
21.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$2,249 |
$2,249 |
13.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,249 |
$2,249 |
22.3× |
| CT head/brain with contrast (70460) |
$2,945 |
$2,945 |
17.4× |
| CT head/brain without and with contrast (70470) |
$3,306 |
$3,306 |
19.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,709 |
$3,709 |
11.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$99 |
$99 |
1.2× |
| CT hrt w/3d image congen (75573) |
$3,709 |
$3,709 |
11.0× |
| CT iac w contrast (70481) |
$2,945 |
$2,945 |
17.4× |
| CT l-spine w&w/o contrast (72133) |
$2,898 |
$2,898 |
17.1× |
| CT lower ext w/o (73700) |
$1,967 |
$1,967 |
19.5× |
| CT lower extremity w/contrast material (73701) |
$2,995 |
$2,995 |
17.7× |
| CT lumbar spine w contrast (72132) |
$2,581 |
$2,581 |
7.7× |
| CT lumbar spine w/o contrast (72131) |
$1,967 |
$1,967 |
19.5× |
| CT maxillofacial w contrast (70487) |
$2,945 |
$2,945 |
17.4× |
| CT maxillofacial wo contrast (70486) |
$1,951 |
$1,951 |
19.3× |
| CT neck tissue combo (70492) |
$3,306 |
$3,306 |
19.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,306 |
$3,306 |
19.5× |
| CT orbits w/o contrast (70480) |
$1,951 |
$1,951 |
19.3× |
| CT pelvis w&w/o contrast (72194) |
$2,898 |
$2,898 |
17.1× |
| CT pelvis w/o contrast (72192) |
$1,967 |
$1,967 |
19.5× |
| CT scan of leg combo (73702) |
$2,898 |
$2,898 |
17.1× |
| CT scans face/jaw combo (70488) |
$3,758 |
$3,758 |
22.2× |
| CT soft tissue neck w contrast (70491) |
$2,945 |
$2,945 |
17.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,951 |
$1,951 |
19.3× |
| CT thoracic spine w contrast (72129) |
$2,581 |
$2,581 |
15.2× |
| CT thoracic spine w/o contrast (72128) |
$1,967 |
$1,967 |
19.5× |
| CT thoracic spine w/wo cont (72130) |
$3,709 |
$3,709 |
21.9× |
| CT thorax w/o contrast (71250) |
$2,203 |
$2,203 |
21.8× |
| CT unlisted procedure (76497) |
$2,996 |
$2,996 |
35.6× |
| CT upper ext wo (73200) |
$1,967 |
$1,967 |
19.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,294 |
$3,294 |
19.4× |
| CT upper extremity with contrast (73201) |
$2,995 |
$2,995 |
8.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,940 |
$3,940 |
23.2× |
| Cta Abdomen (74175) |
$2,719 |
$2,719 |
16.0× |
| CTA pelvis (72191) |
$3,433 |
$3,433 |
20.2× |
| Dilation ureters/urethra rs&i (74485) |
$913 |
$913 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,980 |
$1,980 |
1.0× |
| Diskography lumbar (72295) |
$3,449 |
$3,449 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$632 |
$632 |
6.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,102 |
$1,102 |
10.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$686 |
$686 |
6.8× |
| Dxa Bone Density Axial (77080) |
$676 |
$676 |
6.7× |
| Dxa bone density study (77085) |
$609 |
$609 |
6.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$256 |
$256 |
3.0× |
| Echo exam of fetal heart (76825) |
$6,780 |
$6,780 |
12.8× |
| Echo exam uterus (76831) |
$896 |
$896 |
3.9× |
| Echo Guide For Artery Repair (76936) |
$1,078 |
$1,078 |
5.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$4,144 |
$4,144 |
18.0× |
| Echograp Trans R Pros Study (76873) |
$862 |
$862 |
8.5× |
| Esophagram (74220) |
$736 |
$736 |
4.3× |
| Fetal Biophys Profile W/Nst (76818) |
$1,323 |
$1,323 |
13.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,442 |
$1,442 |
14.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,295 |
$1,295 |
5.6× |
Follow-Up Angiography (75898)
range across 2 matching MRF lines |
$1,393–$2,799 |
$1,393–$2,799 |
varies |
| Foot 2 views (73620) |
$562 |
$562 |
6.7× |
| Forearm 2 views (73090) |
$563 |
$563 |
6.7× |
| Gastric emptying imaging study (78264) |
$1,932 |
$1,932 |
5.0× |
| Gated Heart Planar Single (78472) |
$1,849 |
$1,849 |
4.8× |
| Hand 2 views (73120) |
$508 |
$508 |
5.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$8,052 |
$8,052 |
12.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,965 |
$6,965 |
10.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,883 |
$5,883 |
8.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,599 |
$4,599 |
1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,933 |
$2,933 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$2,307 |
$2,307 |
4.4× |
| Hepatobiliary System Imaging (78226) |
$2,518 |
$2,518 |
6.5× |
| Ht Musc Image Planar Mult (78454) |
$5,554 |
$5,554 |
4.4× |
| Ht Muscle Image Spect Sing (78451) |
$1,659 |
$1,659 |
1.3× |
| Hysterosalpingogram (74740) |
$1,767 |
$1,767 |
7.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,173 |
$1,173 |
13.9× |
| Infusion Ivp (74410) |
$870 |
$870 |
5.1× |
| Interstitial radiation source applic complex (77778) |
$10,883 |
$10,883 |
16.2× |
| K Flow/Funct Image Multiple (78709) |
$3,737 |
$3,737 |
7.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,941 |
$1,941 |
3.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,941 |
$1,941 |
3.7× |
| Knee 3 Views (73562) |
$627 |
$627 |
7.5× |
| Leveen/Shunt Patency Exam (78291) |
$2,043 |
$2,043 |
5.3× |
| Liver & Spleen Imaging Static Only (78215) |
$1,870 |
$1,870 |
4.8× |
| Liver imaging w/vascular flow (78202) |
$5,167 |
$5,167 |
9.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,564 |
$1,564 |
3.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,666 |
$1,666 |
3.2× |
| Lung Ventilation Imaging (78579) |
$903 |
$903 |
2.3× |
| Lymph System Imaging (78195) |
$2,238 |
$2,238 |
4.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,812 |
$1,812 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$3,438 |
$3,438 |
14.9× |
| Mammary ductogram or galactogram multiple (77054) |
$516 |
$516 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$2,060 |
$2,060 |
8.9× |
| Meckels Divert Exam (78290) |
$1,511 |
$1,511 |
3.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,508 |
$6,508 |
18.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,610 |
$4,610 |
13.7× |
| MRA head w/o contrast (70544) |
$3,323 |
$3,323 |
14.4× |
| MRA head with contrast (70545) |
$6,174 |
$6,174 |
18.3× |
| MRA neck w contrast (70548) |
$6,174 |
$6,174 |
18.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,323 |
$4,323 |
12.8× |
| MRA neck w/o contrast (70547) |
$3,323 |
$3,323 |
14.4× |
| MRI abdomen w contrast (74182) |
$7,289 |
$7,289 |
21.6× |
| MRI abdomen w/o contrast (74181) |
$4,120 |
$4,120 |
17.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,133 |
$4,133 |
5.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,266 |
$5,266 |
15.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,133 |
$4,133 |
5.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,408 |
$3,408 |
14.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$4,174 |
$4,174 |
18.1× |
| MRI cervical spine w contrast (72142) |
$3,146 |
$3,146 |
9.3× |
| MRI cervical spine w/o cont (72141) |
$3,010 |
$3,010 |
13.1× |
| MRI chest w/o contrast (71550) |
$3,923 |
$3,923 |
17.0× |
| MRI chest with contrast (71551) |
$7,289 |
$7,289 |
9.6× |
| MRI chest wo w contrast (71552) |
$5,220 |
$5,220 |
15.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,133 |
$4,133 |
12.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,266 |
$5,266 |
15.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,438 |
$3,438 |
14.9× |
| MRI lumbar spine w contrast (72149) |
$4,642 |
$4,642 |
13.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,610 |
$4,610 |
13.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,010 |
$3,010 |
13.1× |
| MRI orbit face neck w contrast (70542) |
$4,825 |
$4,825 |
14.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,610 |
$4,610 |
13.7× |
| MRI pelvis w contrast (72196) |
$6,789 |
$6,789 |
20.1× |
| MRI pelvis w/o & w contrast (72197) |
$5,220 |
$5,220 |
15.5× |
| MRI pelvis w/o contrast (72195) |
$3,660 |
$3,660 |
15.9× |
| MRI spectroscopy (76390) |
$6,165 |
$6,165 |
73.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,923 |
$3,923 |
17.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$5,851 |
$5,851 |
17.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,438 |
$3,438 |
14.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,220 |
$5,220 |
15.5× |
| MRI, abdomen, combo (74183) |
$5,353 |
$5,353 |
15.9× |
| MRI, dorsal spine combo (72157) |
$5,492 |
$5,492 |
16.3× |
| MRI, dorsal spine contrast (72147) |
$4,133 |
$4,133 |
12.3× |
| MRI, joint upper extrem (73221) |
$3,438 |
$3,438 |
14.9× |
| MRI, joint upper extrem combo (73223) |
$5,220 |
$5,220 |
15.5× |
| MRI, lumbar spine combo (72158) |
$5,220 |
$5,220 |
15.5× |
| Myelogram cervical (72240) |
$797 |
$797 |
1.1× |
| Myelogram Lumbar (72265) |
$797 |
$797 |
1.1× |
| Myelography thoracic (72255) |
$797 |
$797 |
1.1× |
| Myelograpy 2/more regions rs&i (72270) |
$1,448 |
$1,448 |
1.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$1,849 |
$1,849 |
4.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,567 |
$4,567 |
3.6× |
| Myocardial Spect Multiple Studies (78452) |
$5,554 |
$5,554 |
4.4× |
| N-invas est c ffr sw aly CTA (75580) |
$1,644 |
$1,644 |
2.0× |
| Neck soft tissue (70360) |
$373 |
$373 |
4.4× |
| Nm unlisted gi procedure (78299) |
$2,275 |
$2,275 |
5.9× |
| Nonvascular Shunt X-Ray (75809) |
$539 |
$539 |
5.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,511 |
$13,511 |
10.1× |
| Nuclear Rx Intra-Arterial (79445) |
$827 |
$827 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$2,257 |
$2,257 |
10.0× |
| Ob us nuchal meas 1 gest (76813) |
$379 |
$379 |
3.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$953 |
$953 |
9.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$953 |
$953 |
9.4× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$634 |
$634 |
6.3× |
| Panoramic X-ray of jaws (70355) |
$559 |
$559 |
6.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,270 |
$3,270 |
6.2× |
| Parathyroid Planar Imaging (78070) |
$1,593 |
$1,593 |
4.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,593 |
$1,593 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$544 |
$544 |
5.4× |
| Peritoneogram Rs&I (74190) |
$726 |
$726 |
1.4× |
| Pet Image W/Ct Lmtd (78814) |
$9,162 |
$9,162 |
6.6× |
| PET image w/CT, full body (78816) |
$9,162 |
$9,162 |
6.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$9,162 |
$9,162 |
6.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,681 |
$5,681 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,870 |
$1,870 |
4.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$874 |
$874 |
8.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$880 |
$880 |
1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$563 |
$563 |
6.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$562 |
$562 |
6.7× |
| Radex elbow complete minimum 3 views (73080) |
$567 |
$567 |
6.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$596 |
$596 |
5.9× |
| Radex fingr minimum 2 views (73140) |
$462 |
$462 |
5.5× |
| Radex foot complete minimum 3 views (73630) |
$563 |
$563 |
6.7× |
| Radex Hand Minimum 3 Views (73130) |
$562 |
$562 |
6.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$562 |
$562 |
6.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$702 |
$702 |
6.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$501 |
$501 |
6.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$662 |
$662 |
7.9× |
| Radex shoulder complete minimum 2 views (73030) |
$562 |
$562 |
6.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$291 |
$291 |
3.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,128 |
$1,128 |
6.7× |
| Radex Spine 1 View Specify Level (72020) |
$770 |
$770 |
9.2× |
| Radex Sternum Minimum 2 Views (71120) |
$531 |
$531 |
6.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$386 |
$386 |
4.6× |
| Radex Toe Minimum 2 Views (73660) |
$462 |
$462 |
5.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$562 |
$562 |
5.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$563 |
$563 |
6.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$981 |
$981 |
9.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,960 |
$14,960 |
2.1× |
| Radiation treatment delivery level 1 (77402) |
$930 |
$930 |
9.4× |
| Radiation treatment delivery level 2 (77407) |
$1,142 |
$1,142 |
3.1× |
| Radiation treatment delivery level 3 (77412) |
$1,327 |
$1,327 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$562 |
$562 |
5.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$680 |
$680 |
6.7× |
| Radiologic exam colon double contrast study (74280) |
$1,253 |
$1,253 |
7.4× |
| Radiologic exam colon single contrast study (74270) |
$1,063 |
$1,063 |
6.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$638 |
$638 |
3.8× |
| Radiologic exam knee complete 4/more views (73564) |
$859 |
$859 |
8.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$494 |
$494 |
4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$803 |
$803 |
4.7× |
| Radiologic exam swallow function contrast study (74230) |
$755 |
$755 |
4.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,122 |
$1,122 |
6.6× |
| Radiologic examination femur 1 view (73551) |
$199 |
$199 |
2.4× |
| Radiologic examination femur minimum 2 views (73552) |
$199 |
$199 |
2.4× |
| Radiologic examination knee 1/2 views (73560) |
$852 |
$852 |
10.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$871 |
$871 |
8.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$611 |
$611 |
7.3× |
| Ribs bilateral 3 views (71110) |
$724 |
$724 |
7.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,328 |
$1,328 |
3.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,334 |
$3,334 |
8.6× |
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804)
range across 2 matching MRF lines |
$3,334–$5,930 |
$3,334–$5,930 |
varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$4,589 |
$4,589 |
8.7× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines |
$1,623–$5,930 |
$1,623–$5,930 |
varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,589 |
$4,589 |
3.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,206 |
$5,206 |
3.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$4,589 |
$4,589 |
3.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,901 |
$2,901 |
12.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,085 |
$1,085 |
4.8× |
| Salivary Gland Imaging Serial Images (78231) |
$901 |
$901 |
2.3× |
| Scapula (73010) |
$462 |
$462 |
4.6× |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines |
$106–$152 |
$106–$152 |
varies |
| Sella turcica (70240) |
$267 |
$267 |
3.2× |
| Shoulder 1 view (73020) |
$295 |
$295 |
3.5× |
| Shoulder Arthrography (73040) |
$2,229 |
$2,229 |
6.6× |
| Sialogram (70390) |
$305 |
$305 |
1.3× |
| Skull less than 4 views (70250) |
$968 |
$968 |
9.6× |
| Special dosimetry (77331) |
$206 |
$206 |
1.6× |
| Special Physics Consult (77370) |
$1,655 |
$1,655 |
12.7× |
| Special teletherapy port plan (77321) |
$1,044 |
$1,044 |
2.9× |
| Special treatment procedure (77470) |
$2,879 |
$2,879 |
5.4× |
| Stereotactic Body Radiation Delivery (77373) |
$7,979 |
$7,979 |
4.6× |
| Sternoclavicular joints (71130) |
$387 |
$387 |
4.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$5,285 |
$5,285 |
53.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,811 |
$2,811 |
7.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,196 |
$2,196 |
6.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,015 |
$2,015 |
5.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,167 |
$1,167 |
3.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$930 |
$930 |
7.2× |
| Thoracic spine 2 views (72070) |
$562 |
$562 |
5.6× |
| Thoracic spine 3 views (72072) |
$617 |
$617 |
6.1× |
| Thoracolumbar 2 views (72080) |
$562 |
$562 |
6.7× |
| Thyroid Met Imaging Body (78018) |
$2,512 |
$2,512 |
4.8× |
| Thyroid Uptake Measurement (78012) |
$345 |
$345 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$562 |
$562 |
1.5× |
| Tx Devices Design & Construction Complex (77334) |
$930 |
$930 |
2.6× |
| Tx devices design & construction intermediate (77333) |
$718 |
$718 |
5.5× |
| Tx devices design & construction simple (77332) |
$1,443 |
$1,443 |
11.1× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$577–$634 |
$577–$634 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$1,026 |
$1,026 |
10.2× |
| Ultrasound, abdomen limited (76705) |
$1,331 |
$1,331 |
13.2× |
| Umbilical-artery Doppler (OB) (76820) |
$651 |
$651 |
6.4× |
| Unlisted Dx Radiographic Procedure (76499) |
$221 |
$221 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$729 |
$729 |
8.7× |
| Unlisted us procedure (76999) |
$507 |
$507 |
6.0× |
| Upper gi w/o kub (74240) |
$1,031 |
$1,031 |
6.1× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$626 |
$626 |
56.6× |
| Urea breath test c-14 isotopic analysis (78268) |
$114 |
$114 |
1.2× |
| Ureteral Reflux Study (78740) |
$2,308 |
$2,308 |
6.0× |
| Urethrocystogram voiding (74455) |
$1,442 |
$1,442 |
6.3× |
| Urethrocystography retrograde (74450) |
$910 |
$910 |
3.9× |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
$577–$659 |
$577–$659 |
varies |
| Us chest (76604) |
$1,346 |
$1,346 |
13.3× |
| Us complete joint (76881) |
$898 |
$898 |
8.9× |
| Us exam, pelvic, limited (76857) |
$973 |
$973 |
9.6× |
| Us head (76506) |
$1,442 |
$1,442 |
14.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$876 |
$876 |
8.7× |
Us ob detailed single fetus (76811)
range across 2 matching MRF lines |
$656–$1,764 |
$656–$1,764 |
varies |
| Us ob limited 1 or more fetuses (76815) |
$876 |
$876 |
8.7× |
| Us ob transvaginal (76817) |
$812 |
$812 |
8.0× |
| Us pelvic non ob complete (76856) |
$1,280 |
$1,280 |
12.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,280 |
$1,280 |
12.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$1,270 |
$1,270 |
12.6× |
| Us retroperitoneal complete (76770) |
$1,140 |
$1,140 |
11.3× |
| Us retroperitoneal limited (76775) |
$929 |
$929 |
9.2× |
| Us scrotum and contents (76870) |
$947 |
$947 |
9.4× |
| Us spinal canal and contents (76800) |
$1,173 |
$1,173 |
11.6× |
| Us thyroid (76536) |
$950 |
$950 |
9.4× |
| Us transrectal (76872) |
$1,455 |
$1,455 |
14.4× |
| Vein X-Ray Chest (75827) |
$3,375 |
$3,375 |
2.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,349 |
$3,349 |
1.1× |
| Vein X-Ray Spleen/Liver (75810) |
$2,065 |
$2,065 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$2,967 |
$2,967 |
1.0× |
| Venography Adrenal Unilateral (75840) |
$1,129 |
$1,129 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$5,355 |
$5,355 |
1.8× |
| Venography extremity bilateral rs&i (75822) |
$2,319 |
$2,319 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$2,175 |
$2,175 |
1.4× |
| Venography Renal Bilateral (75833) |
$5,486 |
$5,486 |
1.8× |
| Venography Renal Unilateral (75831) |
$16,484 |
$16,484 |
5.4× |
Venous sampling by catheter (75893)
range across 2 matching MRF lines |
$5,874–$16,484 |
$5,874–$16,484 |
varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,648 |
$1,648 |
4.3× |
| Vertebral fracture assessment via dxa (77086) |
$211 |
$211 |
2.5× |
| Wrist 2 views (73100) |
$445 |
$445 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$462 |
$462 |
5.5× |
| X-ray antegrade pyelogram tube (74425) |
$894 |
$894 |
2.7× |
| X-Ray Aorta Leg Arteries (75630) |
$5,943 |
$5,943 |
1.9× |
| X-Ray Bend Only L-S Spine (72120) |
$661 |
$661 |
6.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$457 |
$457 |
5.4× |
| X-Ray Exam Breast Specimen (76098) |
$3,697 |
$3,697 |
7.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$395 |
$395 |
4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$661 |
$661 |
6.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$595 |
$595 |
5.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$395 |
$395 |
4.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$199 |
$199 |
2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$643 |
$643 |
6.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$661 |
$661 |
6.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$328 |
$328 |
3.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,098 |
$1,098 |
10.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$871 |
$871 |
10.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$778 |
$778 |
7.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$662 |
$662 |
6.6× |
| X-ray eye for foreign body (70030) |
$378 |
$378 |
4.5× |
| X-ray humerus (73060) |
$588 |
$588 |
7.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,442 |
$1,442 |
8.5× |
| X-ray IV pyelogram+tomography (74415) |
$534 |
$534 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$508 |
$508 |
6.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$765 |
$765 |
9.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$908 |
$908 |
9.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$777 |
$777 |
7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$553 |
$553 |
5.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$560 |
$560 |
5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$562 |
$562 |
6.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$680 |
$680 |
8.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,011 |
$1,011 |
10.0× |
| X-Ray Stress View (77071) |
$256 |
$256 |
3.0× |
| X-ray thoracic spine 4 vw (72074) |
$500 |
$500 |
4.9× |
| X-Ray Tmj Unilat (70328) |
$358 |
$358 |
4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$656 |
$656 |
1.9× |
| X-Rays Bone Length Studies (77073) |
$358 |
$358 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$871 |
$871 |
8.6× |
| Xr c-spine 4 or 5 views (72050) |
$864 |
$864 |
8.5× |
| Xr facial bones less than 3 views (70140) |
$455 |
$455 |
5.4× |
| Xr orbits complete 4 views (70200) |
$577 |
$577 |
5.7× |