| 3-D radiotherapy plan dose-volume histograms (77295) |
$648 |
$3,240 |
0.5× |
| Abdomen 2 views (74019) |
$107.94 |
$539.66 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$334.21 |
$1,671.01 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$670.59 |
$3,352.91 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$1,029.35 |
$5,146.74 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$900.73 |
$4,503.62 |
0.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$874.83 |
$4,374.15 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$704.47 |
$3,522.31 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$820.87 |
$4,104.32 |
0.3× |
| Angiography Spinal Selective Rs&I (75705) |
$854.99 |
$4,274.93 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$1,029.35 |
$5,146.74 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$153.67 |
$768.35 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$625.09 |
$3,125.43 |
0.2× |
| Ankle 2 views (73600) |
$68.97 |
$344.85 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$117.37 |
$586.85 |
0.4× |
| Aortogram thoracic (75605) |
$873.38 |
$4,366.89 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$989.78 |
$4,948.90 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,068.92 |
$5,344.57 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$670.59 |
$3,352.91 |
0.2× |
| Arthrogram elbow (73085) |
$103.10 |
$515.46 |
0.3× |
| Arthrogram hip (73525) |
$84.22 |
$421.08 |
0.3× |
| Arthrogram wrist (73115) |
$117.37 |
$586.85 |
0.4× |
| Arthrography knee lt (73580) |
$88.33 |
$441.65 |
0.3× |
| Basic radiation dosimetry calculation (77300) |
$92.60 |
$463 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$268.62 |
$1,343.10 |
0.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$294.03 |
$1,470.15 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$402.93 |
$2,014.65 |
1.2× |
| Bone age studies (77072) |
$43.81 |
$219.01 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$424.71 |
$2,123.55 |
1.2× |
| Bone survey complete (77075) |
$184.41 |
$922.02 |
2.0× |
| Brachytx isodose complex (77318) |
$301.40 |
$1,507 |
0.9× |
| Brachytx isodose intermed (77317) |
$236 |
$1,180 |
0.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$170 |
$850 |
0.5× |
| Brain image w/flow 4 + views (78606) |
$466.10 |
$2,330.46 |
1.0× |
| Brain imaging < 4 static views (78600) |
$182.96 |
$914.76 |
0.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$220.47 |
$1,102.31 |
0.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$202.80 |
$1,013.98 |
0.4× |
| Brain Imaging Vascular Flow Only (78610) |
$209.09 |
$1,045.44 |
0.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,089 |
$5,445 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$91.96 |
$459.80 |
1.2× |
| Chest 1 view (71045) |
$71.15 |
$355.74 |
0.9× |
| Chest 3 views (71047) |
$90.75 |
$453.75 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$140.61 |
$703.01 |
0.9× |
| Clavicle complete (73000) |
$71.88 |
$359.37 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$156.20 |
$781 |
1.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$80.11 |
$400.51 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,134.50 |
$5,672.48 |
3.8× |
| CT abdomen and pelvis without contrast (74176) |
$806.35 |
$4,031.72 |
3.9× |
| CT abdomen w contrast (74160) |
$568.46 |
$2,842.29 |
3.8× |
| CT abdomen w wo contrast (74170) |
$672.28 |
$3,361.38 |
4.4× |
| CT abdomen w/o contrast (74150) |
$464.40 |
$2,321.99 |
5.2× |
| CT angio hrt w/3d image (75574) |
$502.88 |
$2,514.38 |
1.7× |
| CT angiography upper extremity lt (73206) |
$442.14 |
$2,210.67 |
2.9× |
| CT c-spine w/o contrast (72125) |
$513.77 |
$2,568.83 |
5.7× |
| CT cervical spine w&w/o contrast (72127) |
$679.54 |
$3,397.68 |
4.5× |
| CT cervical spine with contrast (72126) |
$557.33 |
$2,786.63 |
1.9× |
| CT chest w/wo contrast (71270) |
$634.53 |
$3,172.62 |
4.2× |
| CT chest with contrast (71260) |
$524.42 |
$2,622.07 |
3.5× |
| CT colonography screening (74263) |
$346.79 |
$1,733.93 |
1.7× |
| CT colonography w/dye (74262) |
$401.72 |
$2,008.60 |
2.7× |
| CT colonography w/o cntrst (74261) |
$266.93 |
$1,334.63 |
3.0× |
| CT head/brain with contrast (70460) |
$465.13 |
$2,325.62 |
3.1× |
| CT head/brain without and with contrast (70470) |
$566.04 |
$2,830.19 |
3.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$465.37 |
$2,326.83 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$21.54 |
$107.69 |
0.3× |
| CT hrt w/3d image congen (75573) |
$474.57 |
$2,372.81 |
1.6× |
| CT iac w contrast (70481) |
$465.61 |
$2,328.04 |
3.1× |
| CT limited/localized follow up study (76380) |
$203.77 |
$1,018.82 |
2.7× |
| CT lower ext w/o (73700) |
$451.09 |
$2,255.44 |
5.0× |
| CT lower extremity w wo contrast (73702) |
$568.46 |
$2,842.29 |
3.8× |
| CT lower extremity with contrast (73701) |
$451.09 |
$2,255.44 |
3.0× |
| CT lumbar spine w & w/o contrast (72133) |
$669.38 |
$3,346.86 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$507.96 |
$2,539.79 |
5.6× |
| CT lumbar spine with contrast (72132) |
$569.91 |
$2,849.55 |
1.9× |
| CT maxillofacial w contrast (70487) |
$471.66 |
$2,358.29 |
3.1× |
| CT maxillofacial w/o contrast (70486) |
$423.75 |
$2,118.71 |
4.7× |
| CT maxillofacial w/wo contrast (70488) |
$567.25 |
$2,836.24 |
3.8× |
| CT neck soft tissue w contrast (70491) |
$502.15 |
$2,510.75 |
3.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$543.54 |
$2,717.66 |
3.6× |
| CT orbits w/o contrast (70480) |
$439.72 |
$2,198.57 |
4.9× |
| CT pelvis w & w/o contrast (72194) |
$644.21 |
$3,221.02 |
4.3× |
| CT pelvis w/o contrast (72192) |
$458.59 |
$2,292.95 |
5.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$597.99 |
$2,989.91 |
4.0× |
| CT soft tissue neck w/o contrast (70490) |
$435.36 |
$2,176.79 |
4.8× |
| CT thoracic spine w/contrast (72129) |
$435.36 |
$2,176.79 |
2.9× |
| CT thoracic spine w/o contrast (72128) |
$482.55 |
$2,412.74 |
5.4× |
| CT thoracic spine w/wo contrast (72130) |
$431.73 |
$2,158.64 |
2.9× |
| CT thorax w/o contrast (71250) |
$439.72 |
$2,198.57 |
4.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$546.44 |
$2,732.18 |
3.6× |
| CT upper extremity w/o contrast rt (73200) |
$412.86 |
$2,064.26 |
4.6× |
| CT upper extremity with contrast (73201) |
$465.85 |
$2,329.25 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$656.31 |
$3,281.52 |
4.3× |
| Cta Abdomen (74175) |
$807.32 |
$4,036.56 |
5.3× |
| CTA abdomen pelvis (74174) |
$666.96 |
$3,334.76 |
2.2× |
| CTA chest (71275) |
$442.14 |
$2,210.67 |
2.9× |
| Cta Head (70496) |
$442.14 |
$2,210.67 |
2.9× |
| CTA lwr ext w&w/o contrast (73706) |
$474.57 |
$2,372.81 |
3.1× |
| Cta Neck (70498) |
$605.73 |
$3,028.63 |
4.0× |
| Cta Pelvis (72191) |
$433.43 |
$2,167.11 |
2.9× |
| Cystography minimum 3 views rs&i (74430) |
$96.08 |
$480.37 |
0.3× |
| Diskogram cervical (72285) |
$625.09 |
$3,125.43 |
0.4× |
| Diskography lumbar (72295) |
$638.16 |
$3,190.77 |
0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$123.91 |
$619.52 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$101.64 |
$508.20 |
1.1× |
| Echo exam of fetal heart (76825) |
$351.63 |
$1,758.13 |
0.7× |
| Echoencephalography real time imaging (76506) |
$79.14 |
$395.67 |
0.9× |
| Esophagus (74220) |
$132.86 |
$664.29 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$124.63 |
$623.15 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$94.87 |
$474.32 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$116.16 |
$580.80 |
0.6× |
| Foot 2 views (73620) |
$44.77 |
$223.85 |
0.6× |
| Forearm 2 views (73090) |
$77.20 |
$385.99 |
1.0× |
| Gated Heart Planar Single (78472) |
$397.85 |
$1,989.24 |
1.2× |
| Hand 2 views (73120) |
$68.97 |
$344.85 |
0.8× |
| Hand 3 views (73130) |
$80.59 |
$402.93 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$923.20 |
$4,616 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,124.20 |
$5,621 |
1.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,349.40 |
$6,747 |
2.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$201.60 |
$1,008 |
0.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$168 |
$840 |
0.5× |
| Heart Infarct Image (78466) |
$276.85 |
$1,384.24 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$683.90 |
$3,419.46 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$400.03 |
$2,000.13 |
0.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$400.03 |
$2,000.13 |
1.2× |
| Ht muscle image spect sing (78451) |
$742.94 |
$3,714.70 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$77.69 |
$388.41 |
1.0× |
| Hysterosalpingogram (74740) |
$129.23 |
$646.14 |
0.6× |
| Interstitial radiation source applic complex (77778) |
$583.40 |
$2,917 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$62.20 |
$310.97 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$382.36 |
$1,911.80 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$391.56 |
$1,957.78 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$257.49 |
$1,287.44 |
0.6× |
| Knee 3 views (73562) |
$82.04 |
$410.19 |
1.1× |
| Liver & spleen imaging static only (78215) |
$322.35 |
$1,611.72 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$321.86 |
$1,609.30 |
0.7× |
| Lung perfusion differential (78597) |
$305.65 |
$1,528.23 |
0.9× |
| Lung Ventilation Imaging (78579) |
$245.39 |
$1,226.94 |
0.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$625.09 |
$3,125.43 |
0.2× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$101.16 |
$505.78 |
0.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$153.67 |
$768.35 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$153.67 |
$768.35 |
0.1× |
| Lymphoscintigraphy (78195) |
$196.27 |
$981.31 |
0.4× |
| Meckels Diverticulum (78290) |
$308.07 |
$1,540.33 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$124.60 |
$623 |
0.4× |
| MRA head w & w/o contrast (70546) |
$701.20 |
$3,505.98 |
2.3× |
| MRA head w/o contrast (70544) |
$550.55 |
$2,752.75 |
2.7× |
| MRA head with contrast (70545) |
$564.35 |
$2,821.72 |
1.9× |
| MRA neck w contrast (70548) |
$375.59 |
$1,877.92 |
1.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$574.27 |
$2,871.33 |
1.9× |
| MRA neck w/o contrast (70547) |
$382.85 |
$1,914.22 |
1.9× |
| MRI abdomen w contrast (74182) |
$859.10 |
$4,295.50 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$960.50 |
$4,802.49 |
3.2× |
| MRI abdomen w/o contrast (74181) |
$762.30 |
$3,811.50 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$822.80 |
$4,114 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$802.23 |
$4,011.15 |
1.2× |
| MRI c-spine with contrast (72142) |
$809.25 |
$4,046.24 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$735.20 |
$3,675.98 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$756.25 |
$3,781.25 |
3.7× |
| MRI chest w/o & w/contrast material (71552) |
$960.50 |
$4,802.49 |
3.2× |
| MRI chest w/o contrast (71550) |
$747.54 |
$3,737.69 |
3.6× |
| MRI chest with contrast (71551) |
$494.41 |
$2,472.03 |
0.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$704.22 |
$3,521.10 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$825.95 |
$4,129.73 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$487.63 |
$2,438.15 |
2.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$665.50 |
$3,327.50 |
3.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$997.77 |
$4,988.83 |
3.3× |
| MRI orbit/face/neck w/contrast (70542) |
$743.67 |
$3,718.33 |
2.5× |
| MRI pelvis w contrast (72196) |
$817.96 |
$4,089.80 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$959.78 |
$4,798.86 |
3.2× |
| MRI pelvis w/o contrast (72195) |
$738.58 |
$3,692.92 |
3.6× |
| MRI scan of arm joint before and after contrast (73223) |
$960.50 |
$4,802.49 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$943.80 |
$4,719 |
3.1× |
| MRI spectroscopy (76390) |
$495.62 |
$2,478.08 |
6.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$962.20 |
$4,810.96 |
3.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$787.71 |
$3,938.55 |
2.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$959.29 |
$4,796.44 |
3.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$790.38 |
$3,951.86 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$962.92 |
$4,814.59 |
3.2× |
| MRI thoracic spine w/o contrast (72146) |
$756.50 |
$3,782.46 |
3.7× |
| MRI tmj (70336) |
$597.99 |
$2,989.91 |
2.9× |
| MRI upper ext joint w/o contrast (73221) |
$711 |
$3,554.98 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$953.24 |
$4,766.19 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$664.78 |
$3,323.87 |
3.2× |
| Myelogram Cervical (72240) |
$380.43 |
$1,902.12 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$882.58 |
$4,412.87 |
0.8× |
| Neck soft tissue (70360) |
$71.88 |
$359.37 |
1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$145.20 |
$726 |
0.4× |
| Nm cisternogram (78630) |
$360.83 |
$1,804.11 |
0.8× |
| Nm csf leak detection (78650) |
$333.72 |
$1,668.59 |
0.3× |
| Nm gastric emptying study (78264) |
$382.12 |
$1,910.59 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$170.13 |
$850.63 |
0.5× |
| Nm peritoneal-venous shunt patency (78291) |
$144.48 |
$722.37 |
0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$635 |
$3,175 |
0.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$999.22 |
$4,996.09 |
0.8× |
| Nuclear medicine of heart pumping function (78473) |
$490.54 |
$2,452.67 |
1.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$127.05 |
$635.25 |
0.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$311.46 |
$1,557.27 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$222.64 |
$1,113.20 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$242.97 |
$1,214.84 |
1.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$101.64 |
$508.20 |
1.1× |
| Orthopantogram (70355) |
$39.21 |
$196.02 |
0.5× |
| Osseous survey infant (77076) |
$101.64 |
$508.20 |
1.1× |
| Osseous survey limited (77074) |
$143.27 |
$716.32 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$242.97 |
$1,214.84 |
0.5× |
| Parathyrd planar w/wo subtrj (78071) |
$242.97 |
$1,214.84 |
0.7× |
| Parathyroid imaging (78070) |
$303.71 |
$1,518.55 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$73.09 |
$365.42 |
0.8× |
| Peritoneogram rs&i (74190) |
$130.93 |
$654.61 |
0.3× |
| PET image w/CT, skull-thigh (78815) |
$1,500.89 |
$7,504.42 |
1.2× |
| Pr heart first pass single,planar (78481) |
$237.41 |
$1,187.01 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$946.22 |
$4,731.10 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$820.87 |
$4,104.32 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$804.65 |
$4,023.25 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$307.83 |
$1,539.12 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$430.52 |
$2,152.59 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$94.14 |
$470.69 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$68.97 |
$344.85 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$93.17 |
$465.85 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$134.07 |
$670.34 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$141.57 |
$707.85 |
1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,772.60 |
$18,863 |
0.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$211 |
$1,055 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$130 |
$650 |
1.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$190 |
$950 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$106 |
$529.98 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$85.43 |
$427.13 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$114.47 |
$572.33 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$78.65 |
$393.25 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$188.04 |
$940.17 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$179.57 |
$897.82 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$165.29 |
$826.43 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$95.59 |
$477.95 |
1.3× |
| Radiological examination surgical specimen (76098) |
$130.68 |
$653.40 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$670.59 |
$3,352.91 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$897.82 |
$4,489.10 |
0.3× |
| Ribs bilateral 3 views (71110) |
$106 |
$529.98 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$234.99 |
$1,174.91 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$494.41 |
$2,472.03 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$622.67 |
$3,113.33 |
1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$547.89 |
$2,739.44 |
0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$696.96 |
$3,484.80 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$547.89 |
$2,739.44 |
0.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$310.73 |
$1,553.64 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$233.29 |
$1,166.44 |
1.2× |
| Sacroiliac Joints < 3 Views (72200) |
$66.31 |
$331.54 |
0.7× |
| Scanogram (77073) |
$62.44 |
$312.18 |
0.7× |
| Scapula complete (73010) |
$76.48 |
$382.36 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$18.15 |
$90.75 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$201.35 |
$1,006.72 |
2.2× |
| Sialogram (70390) |
$101.64 |
$508.20 |
0.5× |
| Simulation intermediate (77285) |
$212.40 |
$1,062 |
0.7× |
| Small bowel series (74250) |
$161.18 |
$805.86 |
1.1× |
| Spec medical radj physics consltj (77370) |
$128.40 |
$642 |
1.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$204 |
$1,020 |
0.6× |
| Special dosimetry (77331) |
$71.80 |
$359 |
0.6× |
| Special treatment procedure (77470) |
$249.60 |
$1,248 |
0.5× |
| Spine thoracic 3 views (72072) |
$89.30 |
$446.49 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$2,605.20 |
$13,026 |
1.7× |
| Superior sagittal sinus venogram (75870) |
$211.27 |
$1,056.33 |
0.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$186.40 |
$932 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$119.20 |
$596 |
0.4× |
| Testicular Imaging With Vascular Flow (78761) |
$137.70 |
$688.49 |
0.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$329.20 |
$1,646 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$168.80 |
$844 |
1.5× |
| Therapeutic Enema (74283) |
$235.95 |
$1,179.75 |
1.6× |
| Thoracolumbar 2 views (72080) |
$88.33 |
$441.65 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$389.38 |
$1,946.89 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$181.50 |
$907.50 |
0.5× |
| Thyroid uptake measurement (78012) |
$181.50 |
$907.50 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$302.50 |
$1,512.50 |
0.9× |
| Tmj unilateral (70328) |
$55.91 |
$279.51 |
0.7× |
| Treatment device intermediate (77333) |
$116.60 |
$583 |
1.0× |
| Treatment devices simple (77332) |
$112.40 |
$562 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$701.80 |
$3,509 |
1.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$196.75 |
$983.73 |
0.6× |
| Tx devices design & construction complex (77334) |
$195.60 |
$978 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$199.65 |
$998.25 |
2.2× |
| Umbilical-artery Doppler (OB) (76820) |
$121.73 |
$608.63 |
1.4× |
| Unlisted magnetic resonance procedure (76498) |
$349.69 |
$1,748.45 |
4.7× |
| Upper Extremity Infant (73092) |
$66.55 |
$332.75 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$121.25 |
$606.21 |
0.6× |
| Urethrocystography voiding (74455) |
$181.50 |
$907.50 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$227 |
$1,134.98 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$120.52 |
$602.58 |
1.3× |
| Us breast unilateral complete (76641) |
$104.06 |
$520.30 |
1.2× |
| Us breast unilateral limited (76642) |
$69.22 |
$346.06 |
0.9× |
| Us chest (76604) |
$117.86 |
$589.27 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$98.98 |
$494.89 |
1.1× |
| Us guided compression repair (76936) |
$233.53 |
$1,167.65 |
1.3× |
| Us infant hips dynamic (76885) |
$107.45 |
$537.24 |
1.4× |
| Us kidney transplant (76776) |
$133.59 |
$667.92 |
1.5× |
| Us ob detailed single fetus (76811) |
$258.94 |
$1,294.70 |
1.3× |
| Us ob transvaginal (76817) |
$116.40 |
$582.01 |
1.3× |
| Us pelvic non ob complete (76856) |
$188.52 |
$942.59 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$116.16 |
$580.80 |
1.3× |
| Us pregnancy ltd (76815) |
$107.45 |
$537.24 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$169.89 |
$849.42 |
1.9× |
| Us retroperitoneal complete (76770) |
$217.32 |
$1,086.58 |
2.4× |
| Us retroperitoneal limited (76775) |
$161.66 |
$808.28 |
1.8× |
| Us scrotum and contents (76870) |
$169.89 |
$849.42 |
1.9× |
| Us soft tissue head/neck (76536) |
$159.72 |
$798.60 |
1.8× |
| Us spinal canal and contents (76800) |
$114.95 |
$574.75 |
1.3× |
| Us transrectal prostate volume (76873) |
$128.26 |
$641.30 |
1.4× |
| Us xtr non-vasc lmtd (76882) |
$98.98 |
$494.89 |
1.1× |
| Venogram extremity bilateral (75822) |
$544.02 |
$2,720.08 |
0.4× |
| Venogram orbital (75880) |
$625.09 |
$3,125.43 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$1,013.98 |
$5,069.90 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$480.62 |
$2,403.06 |
0.4× |
| Venography epidural rs&i (75872) |
$625.09 |
$3,125.43 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$422.54 |
$2,112.66 |
0.3× |
| Venography Renal Bilateral (75833) |
$782.39 |
$3,911.93 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$718.26 |
$3,591.28 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$625.09 |
$3,125.43 |
0.2× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$670.59 |
$3,352.91 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$66.55 |
$332.75 |
0.9× |
| Wrist 2 views (73100) |
$67.52 |
$337.59 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$141.57 |
$707.85 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$49.61 |
$248.05 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$80.59 |
$402.93 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$236.20 |
$1,180.96 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$71.15 |
$355.74 |
0.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$71.15 |
$355.74 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$117.37 |
$586.85 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$74.06 |
$370.26 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$81.32 |
$406.56 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$116.16 |
$580.80 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$111.08 |
$555.39 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$177.15 |
$885.72 |
2.0× |
| X-ray exam of femur 1 (73551) |
$71.88 |
$359.37 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$81.07 |
$405.35 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$108.66 |
$543.29 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$95.84 |
$479.16 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$79.86 |
$399.30 |
1.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$770.77 |
$3,853.85 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$65.59 |
$327.91 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$53.73 |
$268.62 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$90.51 |
$452.54 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$68.97 |
$344.85 |
0.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$68.97 |
$344.85 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$97.05 |
$485.21 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$143.03 |
$715.11 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$143.03 |
$715.11 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$86.40 |
$431.97 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$44.05 |
$220.22 |
0.6× |
| X-ray of voice box or throat (70370) |
$108.90 |
$544.50 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$53.97 |
$269.83 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$89.30 |
$446.49 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$101.16 |
$505.78 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$129.72 |
$648.56 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$54.21 |
$271.04 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$106 |
$529.98 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$139.88 |
$699.38 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.39 |
$356.95 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$85.19 |
$425.92 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$85.19 |
$425.92 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$106 |
$529.98 |
1.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$35.82 |
$179.08 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$127.30 |
$636.46 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$50.82 |
$254.10 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$34.37 |
$171.82 |
0.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$50.82 |
$254.10 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$83.49 |
$417.45 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$89.30 |
$446.49 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$89.30 |
$446.49 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$62.44 |
$312.18 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$67.52 |
$337.59 |
0.9× |
| Xr arthrogram ankle (73615) |
$80.83 |
$404.14 |
0.3× |
| Xr c-spine 6 or more views (72052) |
$87.37 |
$436.81 |
1.0× |
| Xr chest 4+ views (71048) |
$96.80 |
$484 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$62.68 |
$313.39 |
0.8× |
| Xr shoulder 1 view (73020) |
$36.55 |
$182.71 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$128.99 |
$644.93 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$78.41 |
$392.04 |
1.0× |
| Xr tmj bilateral (70330) |
$83.49 |
$417.45 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$44.77 |
$223.85 |
0.6× |