| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,736 |
$9,807 |
2.0× |
| Abdomen 2 views (74019) |
$149 |
$535 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$581 |
$2,086 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,738 |
$9,816 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,031 |
$7,280 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,154 |
$4,139 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,532 |
$9,078 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,952 |
$6,999 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,356 |
$4,861 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,985 |
$7,118 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,755 |
$13,461 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$953 |
$3,418 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,154 |
$4,139 |
0.4× |
| Ankle 2 views (73600) |
$124 |
$445 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$430 |
$1,543 |
1.2× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,544 |
$9,120 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,353 |
$8,435 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,069 |
$7,416 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,254 |
$4,498 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$932 |
$3,343 |
0.3× |
| Arthrogram elbow (73085) |
$237 |
$850 |
0.7× |
| Arthrogram hip (73525) |
$343 |
$1,230 |
1.0× |
| Arthrogram shoulder (73040) |
$328 |
$1,177 |
0.9× |
| Arthrogram wrist (73115) |
$268 |
$964 |
0.8× |
| Arthrography knee lt (73580) |
$297 |
$1,066 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$313 |
$1,124 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$446 |
$1,602 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$638 |
$2,290 |
1.6× |
| Bone age studies (77072) |
$102 |
$366 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$703 |
$2,521 |
1.8× |
| Bone survey complete (77075) |
$341 |
$1,225 |
3.3× |
| Brachytx isodose complex (77318) |
$283 |
$1,016 |
0.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$358 |
$1,286 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,598 |
$5,729 |
1.1× |
| Brain Imaging Vascular Flow Only (78610) |
$444 |
$1,592 |
0.8× |
| Cardiac shunt detection (78428) |
$280 |
$1,007 |
0.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$392 |
$1,408 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$157 |
$564 |
1.8× |
| Chest 1 view (71045) |
$127 |
$457 |
1.5× |
| Chest 3 views (71047) |
$116 |
$416 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$296 |
$1,062 |
1.7× |
| Clavicle complete (73000) |
$115 |
$415 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$295 |
$1,059 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$339 |
$1,218 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,573 |
$5,641 |
4.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,272 |
$4,562 |
5.3× |
| CT abdomen w contrast (74160) |
$771 |
$2,765 |
4.4× |
| CT abdomen w wo contrast (74170) |
$859 |
$3,082 |
4.9× |
| CT abdomen w/o contrast (74150) |
$609 |
$2,183 |
5.8× |
| CT angio hrt w/3d image (75574) |
$537 |
$1,926.50 |
1.5× |
| CT angiography upper extremity lt (73206) |
$1,017.50 |
$3,649 |
5.8× |
| CT c-spine w/o contrast (72125) |
$836 |
$2,998 |
8.0× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$135 |
$484 |
0.8× |
| CT cervical spine w&w/o contrast (72127) |
$969 |
$3,474 |
5.5× |
| CT cervical spine with contrast (72126) |
$881 |
$3,158 |
2.5× |
| CT chest w/wo contrast (71270) |
$920 |
$3,299 |
5.2× |
| CT chest with contrast (71260) |
$836 |
$2,999 |
4.8× |
| CT head/brain with contrast (70460) |
$797 |
$2,858 |
4.5× |
| CT head/brain without and with contrast (70470) |
$827 |
$2,965 |
4.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$494 |
$1,771 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$46 |
$166 |
0.5× |
| CT iac w contrast (70481) |
$794 |
$2,849 |
4.5× |
| CT limited/localized follow up study (76380) |
$303 |
$1,089 |
3.5× |
| CT lower ext w/o (73700) |
$612 |
$2,196 |
5.8× |
| CT lower extremity w wo contrast (73702) |
$763 |
$2,735 |
4.3× |
| CT lower extremity with contrast (73701) |
$634 |
$2,274 |
3.6× |
| CT lumbar spine w & w/o contrast (72133) |
$898 |
$3,219 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$869 |
$3,117 |
8.3× |
| CT lumbar spine with contrast (72132) |
$881 |
$3,160 |
2.5× |
| CT maxillofacial w contrast (70487) |
$716 |
$2,569 |
4.1× |
| CT maxillofacial w/o contrast (70486) |
$659 |
$2,365 |
6.3× |
| CT maxillofacial w/wo contrast (70488) |
$832 |
$2,984 |
4.7× |
| CT neck soft tissue w contrast (70491) |
$704 |
$2,524 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$874 |
$3,134 |
5.0× |
| CT orbits w/o contrast (70480) |
$516 |
$1,853 |
4.9× |
| CT pelvis w & w/o contrast (72194) |
$886 |
$3,176 |
5.0× |
| CT pelvis w/o contrast (72192) |
$670 |
$2,402 |
6.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$789 |
$2,829 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$607 |
$2,177 |
5.8× |
| CT thoracic spine w/contrast (72129) |
$789 |
$2,830 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$828 |
$2,970 |
7.9× |
| CT thoracic spine w/wo contrast (72130) |
$946 |
$3,391 |
5.4× |
| CT thorax w/o contrast (71250) |
$633 |
$2,271 |
6.0× |
| CT unlisted procedure (76497) |
$141 |
$507 |
1.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$680 |
$2,440 |
3.9× |
| CT upper extremity w/o contrast rt (73200) |
$556 |
$1,994 |
5.3× |
| CT upper extremity with contrast (73201) |
$648 |
$2,324 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$953 |
$3,418 |
5.4× |
| Cta Abdomen (74175) |
$1,027 |
$3,683 |
5.8× |
| CTA abdomen pelvis (74174) |
$1,586 |
$5,686 |
4.5× |
| CTA chest (71275) |
$1,037 |
$3,719 |
5.9× |
| Cta Head (70496) |
$969 |
$3,474 |
5.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$268 |
$961 |
0.8× |
| CTA lwr ext w&w/o contrast (73706) |
$952 |
$3,414 |
5.4× |
| Cta Neck (70498) |
$1,080 |
$3,871 |
6.1× |
| Cta Pelvis (72191) |
$1,933 |
$6,931 |
11.0× |
| Cystography minimum 3 views rs&i (74430) |
$464 |
$1,666 |
1.3× |
| Diskogram cervical (72285) |
$1,091 |
$3,912 |
0.6× |
| Diskography lumbar (72295) |
$1,337 |
$4,795 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$178 |
$641 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$63 |
$227 |
0.7× |
| Echoencephalography real time imaging (76506) |
$151 |
$544 |
1.4× |
| Esophagus (74220) |
$227 |
$816 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$169 |
$609 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$191 |
$685 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$338 |
$1,214 |
1.4× |
| Foot 2 views (73620) |
$115 |
$415 |
1.3× |
| Forearm 2 views (73090) |
$118 |
$425 |
1.4× |
| Gated Heart Planar Single (78472) |
$580 |
$2,080 |
1.4× |
| Hand 2 views (73120) |
$132 |
$474 |
1.3× |
| Hand 3 views (73130) |
$189 |
$678 |
2.2× |
| Heart Infarct Image (78466) |
$312 |
$1,119 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,172 |
$4,201 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$677.50 |
$2,431.50 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$547 |
$1,962 |
1.4× |
| Ht muscle image spect sing (78451) |
$1,777 |
$6,372 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$118 |
$424 |
1.4× |
| Hysterosalpingogram (74740) |
$230.50 |
$828 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$1,269 |
$4,551 |
1.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$321 |
$1,154 |
0.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$305 |
$1,096 |
0.6× |
| Intracavitary radiation source applic simple (77761) |
$289 |
$1,037 |
0.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$135 |
$484 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$595 |
$2,133 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$636 |
$2,281 |
1.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$602 |
$2,158 |
1.1× |
| Knee 3 views (73562) |
$168 |
$603 |
1.9× |
| Liver & spleen imaging static only (78215) |
$332 |
$1,192 |
0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$452 |
$1,622 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$536 |
$1,923 |
1.0× |
| Lung perfusion differential (78597) |
$446 |
$1,602 |
1.1× |
| Lung Ventilation Imaging (78579) |
$187.50 |
$674 |
0.5× |
| Lymphoscintigraphy (78195) |
$595 |
$2,136 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$188 |
$675.50 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$140 |
$504 |
0.6× |
| Meckels Diverticulum (78290) |
$390 |
$1,401 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$518 |
$1,858 |
1.4× |
| Mr safety determination physician/other qhp (76016) |
$66 |
$238 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$31 |
$114 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$66 |
$238 |
0.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$174 |
$626 |
0.7× |
| MRA head w & w/o contrast (70546) |
$1,200 |
$4,304 |
3.4× |
| MRA head w/o contrast (70544) |
$1,105 |
$3,964 |
4.6× |
| MRA head with contrast (70545) |
$1,161 |
$4,162 |
3.3× |
| MRA neck w contrast (70548) |
$930 |
$3,334 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,207 |
$4,327 |
3.5× |
| MRA neck w/o contrast (70547) |
$917 |
$3,288 |
3.8× |
| MRI abdomen w contrast (74182) |
$990 |
$3,551 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,434 |
$5,140 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$900 |
$3,228 |
3.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,062 |
$3,808 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,224 |
$4,390 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$656 |
$2,352 |
2.7× |
| MRI breast w/o contrast unilat (77046) |
$195 |
$699 |
0.8× |
| MRI c-spine with contrast (72142) |
$1,118 |
$4,008 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$997 |
$3,574 |
4.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,146 |
$4,108 |
3.3× |
| MRI chest w/o contrast (71550) |
$961 |
$3,446 |
4.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$971 |
$3,482 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,176 |
$4,216 |
3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,336.50 |
$4,791.50 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$961 |
$3,446 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,279 |
$4,585 |
3.7× |
| MRI orbit/face/neck w/contrast (70542) |
$888 |
$3,183 |
2.5× |
| MRI pelvis w contrast (72196) |
$1,310 |
$4,696 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,327 |
$4,759 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$1,247 |
$4,472 |
5.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,253 |
$4,493 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,330 |
$4,770 |
3.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,401 |
$5,025 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,395 |
$5,001 |
4.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,465 |
$5,251 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,119 |
$4,012 |
3.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,479 |
$5,303 |
4.2× |
| MRI thoracic spine w/o contrast (72146) |
$975 |
$3,496 |
4.1× |
| MRI tmj (70336) |
$680 |
$2,439 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$865.50 |
$3,104.50 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,143 |
$4,097 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$849.50 |
$3,046 |
3.6× |
| Myelogram Cervical (72240) |
$546 |
$1,959 |
0.7× |
| Myelogram Lumbar (72265) |
$545.50 |
$1,958 |
0.7× |
| Myelogram thoracic (72255) |
$391.50 |
$1,405 |
0.5× |
| Myelography 2 or more regions (72270) |
$722 |
$2,589 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,446 |
$8,768 |
1.9× |
| Neck soft tissue (70360) |
$115 |
$415 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$183 |
$659 |
0.5× |
| Nm cisternogram (78630) |
$675 |
$2,421 |
1.2× |
| Nm gastric emptying study (78264) |
$500 |
$1,793 |
1.2× |
| Nm gastroesophageal reflux study (78262) |
$374 |
$1,343 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$346 |
$1,241 |
0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,764 |
$13,493 |
2.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,172 |
$4,201 |
0.9× |
| Nuclear medicine of heart pumping function (78473) |
$416 |
$1,492 |
1.0× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$552 |
$1,981 |
1.0× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$706 |
$2,533 |
0.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$521 |
$1,869 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$407.50 |
$1,462 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$544 |
$1,953 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$164 |
$589.50 |
1.6× |
| Orthopantogram (70355) |
$125 |
$451 |
1.4× |
| Osseous survey infant (77076) |
$116 |
$419 |
1.1× |
| Osseous survey limited (77074) |
$170 |
$611 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$730 |
$2,619 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$487 |
$1,748 |
1.2× |
| Parathyroid imaging (78070) |
$487.50 |
$1,749.50 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$140 |
$502 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$2,342 |
$8,395 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$1,798 |
$6,447 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$2,132 |
$7,644 |
1.5× |
| PET imaging limited area chest head/neck (78811) |
$1,712 |
$6,138 |
1.3× |
| Pr heart first pass single,planar (78481) |
$303 |
$1,088 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,383 |
$4,958 |
4.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$958 |
$3,435 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$909 |
$3,259 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$485.50 |
$1,741.50 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$641 |
$2,298.50 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$454 |
$1,628 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$160 |
$575 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$279 |
$1,002 |
2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,736 |
$13,391 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$469 |
$1,684 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$114 |
$409 |
1.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$379 |
$1,359 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$150 |
$540 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$167 |
$601 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$147 |
$527 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$141 |
$506 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$333 |
$1,194 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$234 |
$840 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$425 |
$1,524 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$386 |
$1,385 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$115 |
$415 |
1.3× |
| Radiological examination surgical specimen (76098) |
$211 |
$757 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,739 |
$6,234 |
0.5× |
| Ribs bilateral 3 views (71110) |
$169 |
$609 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$291.50 |
$1,047 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,194 |
$7,867 |
4.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,171 |
$4,200 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$967 |
$3,466 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,691 |
$6,061 |
1.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,192 |
$4,274 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$313 |
$1,124 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$190 |
$682.50 |
0.8× |
| Salivary gland imaging (78230) |
$269 |
$967 |
0.7× |
| Salivary gland imaging serial images (78231) |
$279 |
$1,002 |
0.7× |
| Scanogram (77073) |
$205 |
$738 |
2.0× |
| Scapula complete (73010) |
$144 |
$518 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$27 |
$98 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$146 |
$526 |
1.4× |
| Simulation intermediate (77285) |
$479 |
$1,719 |
1.3× |
| Small bowel series (74250) |
$279 |
$1,001 |
1.6× |
| Spec medical radj physics consltj (77370) |
$502 |
$1,802 |
3.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$243 |
$872 |
0.6× |
| Special dosimetry (77331) |
$104 |
$374 |
0.8× |
| Special treatment procedure (77470) |
$980 |
$3,513 |
1.8× |
| Speech evaluation complex (70371) |
$112.50 |
$405 |
0.5× |
| Spine thoracic 3 views (72072) |
$145 |
$520 |
1.4× |
| Stereotactic body radiation delivery (77373) |
$1,511 |
$5,419 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$283 |
$1,016 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$148 |
$531 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$258.50 |
$928.50 |
1.1× |
| Testicular Imaging With Vascular Flow (78761) |
$288 |
$1,033 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$955 |
$3,425 |
2.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$591 |
$2,121 |
4.4× |
| Thoracolumbar 2 views (72080) |
$138 |
$496 |
1.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$604 |
$2,166 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$253 |
$908 |
0.6× |
| Thyroid uptake measurement (78012) |
$284 |
$1,019 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$361 |
$1,294 |
0.9× |
| Tmj unilateral (70328) |
$85 |
$306 |
1.0× |
| Tomogram (76100) |
$89 |
$319 |
0.8× |
| Treatment device intermediate (77333) |
$174 |
$624 |
1.3× |
| Treatment devices simple (77332) |
$138 |
$498 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$872 |
$3,127 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$328.50 |
$1,178 |
0.8× |
| Tx devices design & construction complex (77334) |
$673 |
$2,413 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$289 |
$1,037 |
2.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$186 |
$667 |
2.1× |
| Unlisted magnetic resonance procedure (76498) |
$258 |
$926 |
3.0× |
| Unlisted Ultrasound Procedure (76999) |
$182 |
$654 |
2.1× |
| Upper Extremity Infant (73092) |
$90 |
$325 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$266 |
$956 |
1.1× |
| Urethrocystography voiding (74455) |
$257.50 |
$925.50 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$313 |
$1,123 |
1.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$286 |
$1,028 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$154 |
$552 |
1.5× |
| Us breast unilateral complete (76641) |
$265 |
$950 |
2.5× |
| Us breast unilateral limited (76642) |
$163 |
$585 |
1.9× |
| Us chest (76604) |
$185 |
$665 |
1.8× |
| Us elastography parenchyma (76981) |
$135 |
$487 |
1.3× |
| Us guided compression repair (76936) |
$214.50 |
$770.50 |
1.0× |
| Us infant hips dynamic (76885) |
$99 |
$358 |
1.1× |
| Us kidney transplant (76776) |
$165 |
$593 |
1.6× |
| Us ob transvaginal (76817) |
$195 |
$700 |
1.9× |
| Us pelvic non ob complete (76856) |
$359 |
$1,290 |
3.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$207 |
$743 |
2.0× |
| Us pregnancy ltd (76815) |
$181 |
$649 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$263 |
$946 |
2.5× |
| Us retroperitoneal complete (76770) |
$364 |
$1,306 |
3.5× |
| Us retroperitoneal limited (76775) |
$243 |
$872 |
2.3× |
| Us scrotum and contents (76870) |
$304 |
$1,090 |
2.9× |
| Us soft tissue head/neck (76536) |
$371 |
$1,330 |
3.5× |
| Us spinal canal and contents (76800) |
$140 |
$502 |
1.3× |
| Us transrectal (76872) |
$177 |
$635 |
1.7× |
| Us transrectal prostate volume (76873) |
$291 |
$1,045 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$183 |
$659 |
1.7× |
| Venogram extremity bilateral (75822) |
$1,045 |
$3,747 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$1,861 |
$6,672 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,059 |
$3,798 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$988 |
$3,543 |
0.6× |
| Venography Renal Bilateral (75833) |
$956 |
$3,428 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$1,221 |
$4,379 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$832 |
$2,985 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,455 |
$5,218 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$68 |
$244 |
0.8× |
| Wrist 2 views (73100) |
$120 |
$432 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$195 |
$702 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$97 |
$351 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$189 |
$679 |
2.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$355 |
$1,274 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$112 |
$404 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$169 |
$609 |
1.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$152 |
$548 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$102 |
$366 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$132 |
$475 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$155 |
$556 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$288 |
$1,034 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$323 |
$1,159 |
3.1× |
| X-ray exam of femur 1 (73551) |
$91 |
$329 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$307 |
$1,101 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$164 |
$589 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$107 |
$385 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$127 |
$457 |
1.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$649 |
$2,328 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$112 |
$402 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$103 |
$370 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$185 |
$664 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$127 |
$457 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$94 |
$340 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$140 |
$502 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$275 |
$989 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$117 |
$421 |
1.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$101 |
$365 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$176 |
$634 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$143 |
$513 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$213 |
$767 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$896 |
$3,214 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$115 |
$415 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$219 |
$787 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$181 |
$649 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$193 |
$695 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$191 |
$687 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$210 |
$756 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$150 |
$539 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$97 |
$349 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$183 |
$657 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$158 |
$568 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$109 |
$393 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$97 |
$349 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$103 |
$370 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$140 |
$502 |
1.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$152 |
$547 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$120 |
$432 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$157 |
$563 |
1.8× |
| Xr arthrogram ankle (73615) |
$246 |
$882 |
0.7× |
| Xr c-spine 6 or more views (72052) |
$221 |
$793 |
2.1× |
| Xr chest 4+ views (71048) |
$130 |
$469 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$127 |
$457 |
1.5× |
| Xr shoulder 1 view (73020) |
$132.50 |
$476.50 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$194 |
$697 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$138 |
$498 |
1.6× |
| Xr tmj bilateral (70330) |
$126 |
$453 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$128 |
$462 |
1.5× |