| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,847.15 |
$2,997 |
2.1× |
| Abdomen 1 View (74018) |
$190 |
$200 |
2.2× |
| Abdomen 2 views (74019) |
$298.30 |
$314 |
2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,783.50 |
$2,930 |
7.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$2,750.25 |
$2,895 |
2.1× |
| Adrenal Cortex & Medulla Img (78075) |
$1,235 |
$1,300 |
1.0× |
| Angio internal mammary (75756) |
$1,976.95 |
$2,081 |
0.6× |
| Angio pulmonary bilat (75743) |
$5,023.60 |
$5,288 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,635.40 |
$5,932 |
1.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,643.50 |
$1,730 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,431.65 |
$1,507 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,023.60 |
$5,288 |
1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,713.80 |
$1,804 |
0.5× |
| Ankle 2 views (73600) |
$237.50 |
$250 |
2.7× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,105.80 |
$1,164 |
0.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$5,071.10 |
$5,338 |
1.6× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,255.90 |
$1,322 |
0.2× |
| Artery X-Rays Adrenal Gland (75731) |
$4,332 |
$4,560 |
1.4× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,412.65 |
$1,487 |
0.3× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$1,739.45 |
$1,831 |
0.3× |
| Arthrogram hip (73525) |
$967.10 |
$1,018 |
2.8× |
| Arthrogram Wrist (73115) |
$873.05 |
$919 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$363.85 |
$383 |
2.7× |
| Bone age studies (77072) |
$150.10 |
$158 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$2,766.40 |
$2,912 |
7.0× |
| Bone Imaging Limited Area (78300) |
$1,388.90 |
$1,462 |
3.5× |
| Bone Imaging Multiple Areas (78305) |
$1,756.55 |
$1,849 |
4.4× |
| Bone Imaging Whole Body (78306) |
$1,939.90 |
$2,042 |
4.9× |
| Bone marrow imaging limited area (78102) |
$1,195.10 |
$1,258 |
3.0× |
| Bone survey infant (77076) |
$680.20 |
$716 |
6.5× |
| Brachytx isodose complex (77318) |
$2,167.90 |
$2,282 |
5.8× |
| Brachytx Isodose Plan Simple (77316) |
$1,234.05 |
$1,299 |
3.3× |
| Brain Flow Imaging Only (78610) |
$1,619.75 |
$1,705 |
3.0× |
| Brain Image W/Flow < 4 Views (78601) |
$1,742.30 |
$1,834 |
4.4× |
| Brain imaging < 4 static views (78600) |
$1,510.50 |
$1,590 |
3.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,069.45 |
$3,231 |
5.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,605.50 |
$1,690 |
3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$10,179.25 |
$10,715 |
7.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,110.30 |
$3,274 |
9.0× |
| Cardiac Shunt Detection (78428) |
$1,320.50 |
$1,390 |
3.3× |
| Cerebrospinal Fluid Scan (78630) |
$2,791.10 |
$2,938 |
5.2× |
| Chest 1 view (71045) |
$115.90 |
$122 |
1.3× |
| Chest 2 views (71046) |
$217.55 |
$229 |
2.5× |
| Chest 3 views (71047) |
$274.55 |
$289 |
3.2× |
| Chest 4 or more views (71048) |
$280.25 |
$295 |
2.7× |
| Clavicle complete (73000) |
$208.05 |
$219 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$188.10 |
$198 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$836 |
$880 |
6.2× |
| Contrast Exam Abdominl Aorta (75625) |
$1,099.15 |
$1,157 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$224.20 |
$236 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$912.95 |
$961 |
2.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$966.15 |
$1,017 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,367.75 |
$3,545 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,852.50 |
$1,950 |
7.8× |
| CT abdomen w contrast (74160) |
$1,301.50 |
$1,370 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,501 |
$1,580 |
8.6× |
| CT abdomen w/o contrast (74150) |
$967.10 |
$1,018 |
9.3× |
| CT Angio Abdomen and Pelvis (74174) |
$2,160.30 |
$2,274 |
6.2× |
| CT Angio Chest (71275) |
$1,620.70 |
$1,706 |
9.3× |
| CT Angio Head (70496) |
$1,918.05 |
$2,019 |
11.0× |
| CT angio hrt w/3d image (75574) |
$1,834.45 |
$1,931 |
5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,101.40 |
$2,212 |
12.0× |
| CT Angio Neck (70498) |
$1,882.90 |
$1,982 |
10.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,100.45 |
$2,211 |
12.0× |
| CT cervical spine w/ contrast (72126) |
$1,777.45 |
$1,871 |
5.1× |
| CT cervical spine w/o contrast (72125) |
$1,570.35 |
$1,653 |
15.1× |
| CT cervical spine w/wo cont (72127) |
$2,188.80 |
$2,304 |
12.5× |
| CT chest w contrast (71260) |
$1,292.95 |
$1,361 |
7.4× |
| CT chest w/wo contrast (71270) |
$1,822.10 |
$1,918 |
10.4× |
| CT colonography screening (74263) |
$1,498.15 |
$1,577 |
6.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$2,073.85 |
$2,183 |
11.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,216.95 |
$1,281 |
11.7× |
| CT head/brain with contrast (70460) |
$1,391.75 |
$1,465 |
8.0× |
| CT head/brain without and with contrast (70470) |
$1,703.35 |
$1,793 |
9.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,537.10 |
$1,618 |
4.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$113.05 |
$119 |
1.3× |
| CT hrt w/3d image congen (75573) |
$2,080.50 |
$2,190 |
6.0× |
| CT iac w contrast (70481) |
$2,172.65 |
$2,287 |
12.4× |
| CT l-spine w&w/o contrast (72133) |
$1,839.20 |
$1,936 |
10.5× |
| CT lower ext w/o (73700) |
$1,322.40 |
$1,392 |
12.7× |
| CT lower extremity w/contrast material (73701) |
$1,309.10 |
$1,378 |
7.5× |
| CT lumbar spine w contrast (72132) |
$1,495.30 |
$1,574 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$1,209.35 |
$1,273 |
11.6× |
| CT maxillofacial w contrast (70487) |
$1,492.45 |
$1,571 |
8.5× |
| CT maxillofacial wo contrast (70486) |
$1,570.35 |
$1,653 |
15.1× |
| CT neck tissue combo (70492) |
$1,887.65 |
$1,987 |
10.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,401.60 |
$2,528 |
13.8× |
| CT orbits w/o contrast (70480) |
$1,570.35 |
$1,653 |
15.1× |
| CT pelvis w&w/o contrast (72194) |
$2,658.10 |
$2,798 |
15.2× |
| CT pelvis w/o contrast (72192) |
$1,218.85 |
$1,283 |
11.7× |
| CT scan of leg combo (73702) |
$1,891.45 |
$1,991 |
10.8× |
| CT scans face/jaw combo (70488) |
$1,485.80 |
$1,564 |
8.5× |
| CT soft tissue neck w contrast (70491) |
$1,570.35 |
$1,653 |
9.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,183.70 |
$1,246 |
11.4× |
| CT thoracic spine w contrast (72129) |
$1,499.10 |
$1,578 |
8.6× |
| CT thoracic spine w/o contrast (72128) |
$989.90 |
$1,042 |
9.5× |
| CT thoracic spine w/wo cont (72130) |
$1,855.35 |
$1,953 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,322.40 |
$1,392 |
12.7× |
| CT unlisted procedure (76497) |
$442.51 |
$465.80 |
5.1× |
| CT upper ext wo (73200) |
$1,256.85 |
$1,323 |
12.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,913.30 |
$2,014 |
11.0× |
| CT upper extremity with contrast (73201) |
$1,457.30 |
$1,534 |
4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,839.20 |
$1,936 |
10.5× |
| Cta Abdomen (74175) |
$1,922.80 |
$2,024 |
11.0× |
| CTA pelvis (72191) |
$2,733.15 |
$2,877 |
15.7× |
| Dilation ureters/urethra rs&i (74485) |
$699.20 |
$736 |
0.3× |
| Discography Cerv/Thor Spine (72285) |
$3,208.15 |
$3,377 |
1.7× |
| Diskography lumbar (72295) |
$2,992.50 |
$3,150 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$278.35 |
$293 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$523.45 |
$551 |
5.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$768.55 |
$809 |
7.4× |
| Dxa Bone Density Axial (77080) |
$345.80 |
$364 |
3.3× |
| Dxa bone density study (77085) |
$546.25 |
$575 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$189.05 |
$199 |
2.2× |
| Echo exam of fetal heart (76825) |
$2,155.55 |
$2,269 |
4.0× |
| Echo exam uterus (76831) |
$910.10 |
$958 |
3.8× |
| Echo Guide For Artery Repair (76936) |
$2,344.60 |
$2,468 |
10.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,846.80 |
$1,944 |
7.8× |
| Esophagram (74220) |
$686.85 |
$723 |
3.9× |
| Fetal Biophys Profile W/Nst (76818) |
$757.15 |
$797 |
7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$551.95 |
$581 |
5.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,886.10 |
$3,038 |
12.2× |
| Fluoroscopy up to 1 hr (76000) |
$512.05 |
$539 |
2.2× |
| Follow-Up Angiography (75898) |
$870.20 |
$916 |
0.3× |
| Foot 2 views (73620) |
$200.45 |
$211 |
2.3× |
| Forearm 2 views (73090) |
$189.05 |
$199 |
2.2× |
| Gastric emptying imaging study (78264) |
$2,760.70 |
$2,906 |
6.9× |
| Gastroesophageal Reflux Exam (78262) |
$2,266.70 |
$2,386 |
5.7× |
| Gated Heart Planar Single (78472) |
$1,678.65 |
$1,767 |
4.2× |
| Gated Heart, Multiple (78473) |
$2,076.70 |
$2,186 |
5.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$3,905.45 |
$4,111 |
7.2× |
| Hand 2 views (73120) |
$193.80 |
$204 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$4,287.35 |
$4,513 |
6.2× |
| Heart Image (Pet) Multiple (78492) |
$9,821.10 |
$10,338 |
6.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,800 |
$4,000 |
1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,198.90 |
$1,262 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$2,946.90 |
$3,102 |
5.5× |
| Hepatobiliary System Imaging (78226) |
$2,734.10 |
$2,878 |
6.9× |
| Ht Muscle Image Spect Sing (78451) |
$2,533.65 |
$2,667 |
2.0× |
| Hysterosalpingogram (74740) |
$587.10 |
$618 |
2.5× |
Image fusion (77399)
range across 3 matching MRF lines |
$208.81–$513.95 |
$219.80–$541 |
varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,014.60 |
$1,068 |
11.7× |
| Infant hip ultrasound, limited static exam (76886) |
$849.30 |
$894 |
9.8× |
| Interstitial radiation source applic complex (77778) |
$3,946.30 |
$4,154 |
5.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$5,647.75 |
$5,945 |
8.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$5,084.40 |
$5,352 |
9.2× |
| Intracavitary radiation source applic simple (77761) |
$2,824.35 |
$2,973 |
5.1× |
Intraop radiaj tx deliver electrons sngl tx sess (77425)
likely a partial charge, not the full procedure |
$487.35 |
$513 |
0.1× |
Intraop radiaj tx deliver xray single tx session (77424)
likely a partial charge, not the full procedure |
$487.35 |
$513 |
0.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,064.95 |
$1,121 |
2.0× |
| K Flow/Funct Image W/O Drug (78707) |
$1,723.30 |
$1,814 |
3.2× |
| Kidney Imaging Morphol (78700) |
$1,386.05 |
$1,459 |
3.5× |
| Knee 3 Views (73562) |
$289.75 |
$305 |
3.3× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$986.10 |
$1,038 |
2.5× |
| Liver & Spleen Imaging Static Only (78215) |
$1,584.60 |
$1,668 |
4.0× |
| Liver imaging static only (78201) |
$1,548.50 |
$1,630 |
2.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,476.65 |
$2,607 |
4.6× |
| Lung perfusion differential (78597) |
$1,537.10 |
$1,618 |
3.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,611.55 |
$2,749 |
4.8× |
| Lung Ventilation Imaging (78579) |
$1,504.80 |
$1,584 |
3.8× |
| Lymph System Imaging (78195) |
$2,770.20 |
$2,916 |
5.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$3,027.65 |
$3,187 |
1.9× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,540.30 |
$2,674 |
4.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,364.65 |
$5,647 |
1.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,260.40 |
$3,432 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$2,588.75 |
$2,725 |
10.9× |
| Mammary ductogram or galactogram multiple (77054) |
$323 |
$340 |
1.4× |
| Mammary ductogram or galactogram single (77053) |
$238.45 |
$251 |
1.0× |
| Meckels Divert Exam (78290) |
$2,783.50 |
$2,930 |
7.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,055.20 |
$3,216 |
8.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$120.65 |
$127 |
4.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,513.10 |
$3,698 |
10.1× |
| MRA head w/o contrast (70544) |
$2,103.30 |
$2,214 |
8.9× |
| MRA head with contrast (70545) |
$2,903.20 |
$3,056 |
8.4× |
| MRA neck w contrast (70548) |
$3,134.05 |
$3,299 |
9.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,513.10 |
$3,698 |
10.1× |
| MRA neck w/o contrast (70547) |
$2,403.50 |
$2,530 |
10.1× |
| MRI abdomen w contrast (74182) |
$3,853.20 |
$4,056 |
11.1× |
| MRI abdomen w/o contrast (74181) |
$2,383.55 |
$2,509 |
10.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,991.90 |
$4,202 |
5.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,798.45 |
$5,051 |
13.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,739.80 |
$2,884 |
3.5× |
| MRI bone marrow blood supply (77084) |
$2,880.40 |
$3,032 |
12.1× |
| MRI brain functional w/o physician admnistration (70554) |
$3,063.75 |
$3,225 |
12.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,854.40 |
$1,952 |
7.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,859.15 |
$1,957 |
7.8× |
| MRI cardiac w/o contrast (75557) |
$2,138.45 |
$2,251 |
9.0× |
| MRI cervical spine w contrast (72142) |
$2,093.80 |
$2,204 |
6.0× |
| MRI cervical spine w/o cont (72141) |
$1,556.10 |
$1,638 |
6.6× |
| MRI chest w/o contrast (71550) |
$2,856.65 |
$3,007 |
12.0× |
| MRI chest with contrast (71551) |
$3,937.75 |
$4,145 |
5.0× |
| MRI chest wo w contrast (71552) |
$4,142.95 |
$4,361 |
11.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,387.70 |
$3,566 |
9.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,642.30 |
$3,834 |
10.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,521.30 |
$2,654 |
10.6× |
| MRI lumbar spine w contrast (72149) |
$3,060.90 |
$3,222 |
8.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,052 |
$2,160 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,426.30 |
$2,554 |
10.2× |
| MRI orbit face neck w contrast (70542) |
$2,838.60 |
$2,988 |
8.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,002 |
$3,160 |
8.6× |
| MRI pelvis w contrast (72196) |
$3,408.60 |
$3,588 |
9.8× |
| MRI pelvis w/o & w contrast (72197) |
$3,617.60 |
$3,808 |
10.4× |
| MRI pelvis w/o contrast (72195) |
$2,502.30 |
$2,634 |
10.5× |
| MRI spectroscopy (76390) |
$2,153.65 |
$2,267 |
24.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,670.10 |
$1,758 |
7.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,391.50 |
$3,570 |
9.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,521.30 |
$2,654 |
10.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,619.50 |
$3,810 |
10.4× |
| MRI, abdomen, combo (74183) |
$3,624.25 |
$3,815 |
10.4× |
| MRI, dorsal spine combo (72157) |
$2,440.55 |
$2,569 |
7.0× |
| MRI, dorsal spine contrast (72147) |
$2,461.45 |
$2,591 |
7.1× |
| MRI, joint upper extrem (73221) |
$1,847.75 |
$1,945 |
7.8× |
| MRI, joint upper extrem combo (73223) |
$3,311.70 |
$3,486 |
9.5× |
| MRI, lumbar spine combo (72158) |
$3,510.25 |
$3,695 |
10.1× |
| Myelography thoracic (72255) |
$670.70 |
$706 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$11,625.15 |
$12,237 |
9.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,368.35 |
$2,493 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,638.50 |
$3,830 |
2.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$124.45 |
$131 |
0.1× |
| N-invas est c ffr sw aly CTA (75580) |
$7,038.55 |
$7,409 |
8.2× |
| Neck soft tissue (70360) |
$206.15 |
$217 |
2.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,603.60 |
$1,688 |
4.2× |
| Nm csf leak detection (78650) |
$2,779.70 |
$2,926 |
2.2× |
| Nm unlisted gi procedure (78299) |
$1,616.90 |
$1,702 |
4.1× |
| Nonvascular Shunt X-Ray (75809) |
$211.85 |
$223 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$16,288.70 |
$17,146 |
11.8× |
| Nuclear Rx Intra-Arterial (79445) |
$456.95 |
$481 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$437.95 |
$461 |
1.9× |
| Ob us nuchal meas 1 gest (76813) |
$670.70 |
$706 |
6.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$588.05 |
$619 |
5.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$909.15 |
$957 |
6.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$532.95 |
$561 |
5.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$1,054.50 |
$1,110 |
10.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$57.95 |
$61 |
2.0× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$541.50 |
$570 |
5.2× |
| Panoramic X-ray of jaws (70355) |
$100.70 |
$106 |
1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,146.40 |
$3,312 |
5.8× |
| Parathyroid Planar Imaging (78070) |
$2,416.80 |
$2,544 |
6.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,788.25 |
$2,935 |
7.0× |
| Pelvis 1 or 2 views (72170) |
$250.80 |
$264 |
2.4× |
| Peritoneogram Rs&I (74190) |
$552.90 |
$582 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$11,581.45 |
$12,191 |
8.1× |
| PET image w/CT, full body (78816) |
$10,117.50 |
$10,650 |
7.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$10,106.10 |
$10,638 |
7.1× |
| Pet Myocardial Sngl Study (78491) |
$3,790.50 |
$3,990 |
2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,332 |
$4,560 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,887.65 |
$1,987 |
4.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$298.30 |
$314 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$303.05 |
$319 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$247.95 |
$261 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$208.05 |
$219 |
2.4× |
| Radex elbow complete minimum 3 views (73080) |
$245.10 |
$258 |
2.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$309.70 |
$326 |
3.0× |
| Radex fingr minimum 2 views (73140) |
$268.85 |
$283 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$228 |
$240 |
2.6× |
| Radex Hand Minimum 3 Views (73130) |
$239.40 |
$252 |
2.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$216.60 |
$228 |
2.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$414.20 |
$436 |
4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$260.30 |
$274 |
3.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$633.65 |
$667 |
7.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$238.45 |
$251 |
2.8× |
| Radex shoulder complete minimum 2 views (73030) |
$212.80 |
$224 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$228 |
$240 |
2.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$2,013.05 |
$2,119 |
11.5× |
| Radex Spine 1 View Specify Level (72020) |
$157.70 |
$166 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$211.85 |
$223 |
2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$378.10 |
$398 |
4.4× |
| Radex Toe Minimum 2 Views (73660) |
$237.50 |
$250 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$208.05 |
$219 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$290.70 |
$306 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$669.75 |
$705 |
6.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$45,127.85 |
$47,503 |
6.2× |
| Radiation treatment delivery level 1 (77402) |
$1,534.25 |
$1,615 |
15.1× |
| Radiation treatment delivery level 2 (77407) |
$944.30 |
$994 |
2.5× |
| Radiation treatment delivery level 3 (77412) |
$2,802.50 |
$2,950 |
5.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$274.55 |
$289 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$266.95 |
$281 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$1,720.45 |
$1,811 |
9.9× |
| Radiologic exam colon single contrast study (74270) |
$1,064 |
$1,120 |
6.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$771.40 |
$812 |
4.4× |
| Radiologic exam knee complete 4/more views (73564) |
$306.85 |
$323 |
2.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$302.10 |
$318 |
2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$851.20 |
$896 |
4.9× |
| Radiologic exam swallow function contrast study (74230) |
$1,050.70 |
$1,106 |
6.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$975.65 |
$1,027 |
5.6× |
| Radiologic examination femur 1 view (73551) |
$213.75 |
$225 |
2.5× |
| Radiologic examination femur minimum 2 views (73552) |
$252.70 |
$266 |
2.9× |
| Radiologic examination knee 1/2 views (73560) |
$248.90 |
$262 |
2.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$462.65 |
$487 |
4.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$222.30 |
$234 |
2.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$97.85 |
$103 |
1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$5,906.15 |
$6,217 |
15.4× |
| Renal Cyst Study (74470) |
$532 |
$560 |
1.0× |
| Ribs bilateral 3 views (71110) |
$260.30 |
$274 |
2.5× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$148.20–$153.90 |
$156–$162 |
varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,052.95 |
$2,161 |
5.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,782.30 |
$5,034 |
8.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,622 |
$2,760 |
4.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,680.90 |
$2,822 |
5.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,625.90 |
$5,922 |
4.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,441.35 |
$7,833 |
5.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,777.20 |
$3,976 |
2.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$876.85 |
$923 |
3.8× |
| Rp Therapy Intravenous Administration (79101) |
$432.25 |
$455 |
1.9× |
| Salivary Gland Function Study (78232) |
$730.55 |
$769 |
1.8× |
| Salivary Gland Imaging Serial Images (78231) |
$964.25 |
$1,015 |
2.4× |
| Scapula (73010) |
$229.90 |
$242 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$33.25 |
$35 |
1.4× |
| Sella turcica (70240) |
$220.40 |
$232 |
2.5× |
| Shoulder 1 view (73020) |
$165.30 |
$174 |
1.9× |
| Shoulder Arthrography (73040) |
$968.05 |
$1,019 |
2.8× |
| Skull less than 4 views (70250) |
$257.45 |
$271 |
2.5× |
| Special dosimetry (77331) |
$1,041.20 |
$1,096 |
7.8× |
| Special Physics Consult (77370) |
$1,281.55 |
$1,349 |
9.6× |
| Special teletherapy port plan (77321) |
$459.80 |
$484 |
1.2× |
Special treatment procedure (77470)
range across 13 matching MRF lines |
$505.40–$5,065.40 |
$532–$5,332 |
varies |
| Speech evaluation, complex (70371) |
$507.30 |
$534 |
2.1× |
| Spleen Imaging (78185) |
$1,785.05 |
$1,879 |
4.5× |
| Srs Multisource (77371) |
$69,597 |
$73,260 |
9.5× |
| Stereotactic Body Radiation Delivery (77373) |
$14,500.80 |
$15,264 |
8.1× |
| Sternoclavicular joints (71130) |
$273.60 |
$288 |
3.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$4,564.75 |
$4,805 |
44.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,491.50 |
$1,570 |
4.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$818.90 |
$862 |
2.2× |
| Testicular Imaging W/Flow (78761) |
$1,605.50 |
$1,690 |
4.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$4,625.55 |
$4,869 |
12.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,538.40 |
$2,672 |
19.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,360.40 |
$1,432 |
7.8× |
| Thoracic spine 2 views (72070) |
$249.85 |
$263 |
2.4× |
| Thoracic spine 3 views (72072) |
$258.40 |
$272 |
2.5× |
| Thoracolumbar 2 views (72080) |
$215.65 |
$227 |
2.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,734.70 |
$1,826 |
4.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,590.30 |
$1,674 |
4.0× |
| Thyroid Met Imaging Body (78018) |
$2,521.30 |
$2,654 |
4.7× |
| Thyroid Uptake Measurement (78012) |
$641.25 |
$675 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,014 |
$2,120 |
5.1× |
| Tx Devices Design & Construction Complex (77334) |
$935.75 |
$985 |
2.5× |
| Tx devices design & construction intermediate (77333) |
$907.25 |
$955 |
6.8× |
| Tx devices design & construction simple (77332) |
$862.60 |
$908 |
6.4× |
| Ultrasound Breast Limited (76642) |
$608.95 |
$641 |
7.0× |
| Ultrasound elastography first target lesion (76982) |
$744.80 |
$784 |
7.2× |
| Ultrasound Elastography Parenchyma (76981) |
$870.20 |
$916 |
8.4× |
| Ultrasound Exam Aaa Screen (76706) |
$742.90 |
$782 |
7.1× |
| Ultrasound, abdomen limited (76705) |
$692.55 |
$729 |
6.7× |
| Umbilical-artery Doppler (OB) (76820) |
$287.85 |
$303 |
2.8× |
Unlisted Dx Radiographic Procedure (76499)
range across 3 matching MRF lines |
$47.02–$79.04 |
$49.50–$83.20 |
varies |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$1,729.95–$9,424 |
$1,821–$9,920 |
varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$8,654.50 |
$9,110 |
21.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$3,537.80 |
$3,724 |
34.8× |
| Upper gi w/o kub (74240) |
$818.90 |
$862 |
4.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$152 |
$160 |
13.7× |
| Urea breath test c-14 isotopic analysis (78268) |
$830.30 |
$874 |
8.8× |
| Ureteral Reflux Study (78740) |
$1,758.45 |
$1,851 |
4.4× |
| Urethrocystogram voiding (74455) |
$684 |
$720 |
2.9× |
| Urethrocystography retrograde (74450) |
$615.60 |
$648 |
2.6× |
| Us breast unilateral complete (76641) |
$789.45 |
$831 |
7.6× |
| Us chest (76604) |
$685.90 |
$722 |
6.6× |
| Us complete joint (76881) |
$931 |
$980 |
8.9× |
| Us exam, pelvic, limited (76857) |
$253.65 |
$267 |
2.4× |
| Us head (76506) |
$963.30 |
$1,014 |
9.3× |
| Us kidney transplant (76776) |
$1,327.15 |
$1,397 |
12.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$126.35 |
$133 |
1.2× |
| Us ob detailed single fetus (76811) |
$946.20 |
$996 |
4.0× |
| Us ob limited 1 or more fetuses (76815) |
$582.35 |
$613 |
5.6× |
| Us ob transvaginal (76817) |
$661.20 |
$696 |
6.4× |
| Us pelvic non ob complete (76856) |
$843.60 |
$888 |
8.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$821.75 |
$865 |
7.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$807.50 |
$850 |
7.8× |
| Us retroperitoneal complete (76770) |
$858.80 |
$904 |
8.3× |
| Us retroperitoneal limited (76775) |
$321.10 |
$338 |
3.1× |
| Us scrotum and contents (76870) |
$396.15 |
$417 |
3.8× |
| Us spinal canal and contents (76800) |
$902.50 |
$950 |
8.7× |
| Us thyroid (76536) |
$984.20 |
$1,036 |
9.5× |
| Us transrectal (76872) |
$681.15 |
$717 |
6.5× |
| Vein X-Ray Chest (75827) |
$1,102 |
$1,160 |
0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,191.30 |
$1,254 |
0.4× |
| Vein X-Ray Spleen/Liver (75810) |
$6,720.30 |
$7,074 |
2.1× |
| Venogram Sinus/Jugular (75860) |
$1,161.85 |
$1,223 |
0.4× |
| Venography Adrenal Unilateral (75840) |
$1,229.30 |
$1,294 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,066.85 |
$1,123 |
0.3× |
| Venography extremity bilateral rs&i (75822) |
$1,134.30 |
$1,194 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,072.55 |
$1,129 |
0.7× |
| Venography Orbital Rs&I (75880) |
$5,703.80 |
$6,004 |
9.1× |
| Venography Renal Bilateral (75833) |
$5,023.60 |
$5,288 |
1.6× |
| Venography Renal Unilateral (75831) |
$5,023.60 |
$5,288 |
1.6× |
| Venous sampling by catheter (75893) |
$3,458 |
$3,640 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$357.20 |
$376 |
4.1× |
| Wrist 2 views (73100) |
$225.15 |
$237 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$271.70 |
$286 |
3.1× |
| X-ray antegrade pyelogram tube (74425) |
$551 |
$580 |
1.6× |
| X-Ray Aorta Leg Arteries (75630) |
$1,105.80 |
$1,164 |
0.4× |
| X-Ray Bend Only L-S Spine (72120) |
$319.20 |
$336 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$208.05 |
$219 |
2.4× |
| X-Ray Exam Breast Specimen (76098) |
$93.10 |
$98 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$281.20 |
$296 |
3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$508.25 |
$535 |
4.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$553.85 |
$583 |
5.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$220.40 |
$232 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$332.50 |
$350 |
3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$409.45 |
$431 |
3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$309.70 |
$326 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$370.50 |
$390 |
3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$448.40 |
$472 |
4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$240.35 |
$253 |
2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$421.80 |
$444 |
4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$247 |
$260 |
2.4× |
| X-ray eye for foreign body (70030) |
$203.30 |
$214 |
2.3× |
| X-ray head for orthodontia (70350) |
$106.40 |
$112 |
1.2× |
| X-ray humerus (73060) |
$225.15 |
$237 |
2.6× |
| X-ray IV pyelogram (ivp) (74400) |
$1,167.55 |
$1,229 |
6.7× |
| X-ray IV pyelogram+tomography (74415) |
$1,192.25 |
$1,255 |
6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$259.35 |
$273 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$297.35 |
$313 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$313.50 |
$330 |
3.0× |
| X-ray nose-rectum child f.b. (76010) |
$176.70 |
$186 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$341.05 |
$359 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$256.50 |
$270 |
2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$318.25 |
$335 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$213.75 |
$225 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$271.70 |
$286 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$305.90 |
$322 |
2.9× |
| X-ray thoracic spine 4 vw (72074) |
$311.60 |
$328 |
3.0× |
| X-Ray Tmj Unilat (70328) |
$235.60 |
$248 |
2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,109.60 |
$1,168 |
3.2× |
| X-Rays Bone Length Studies (77073) |
$236.55 |
$249 |
2.3× |
| X-Rays Bone Survey Complete (77075) |
$666.90 |
$702 |
6.4× |
| Xr c-spine 4 or 5 views (72050) |
$321.10 |
$338 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$206.15 |
$217 |
2.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$271.70 |
$286 |
2.6× |
| Xr orbits complete 4 views (70200) |
$305.90 |
$322 |
2.9× |
| Xr Tomogram Single Plane (76100) |
$639.35 |
$673 |
6.1× |