| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,845.25 |
$2,995 |
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) |
$3,305.05 |
$3,479 |
8.5× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$3,266.10 |
$3,438 |
2.6× |
| Adrenal Cortex & Medulla Img (78075) |
$1,466.80 |
$1,544 |
1.2× |
| 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 |
0.6× |
| Ankle 2 views (73600) |
$267.90 |
$282 |
3.2× |
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 |
1.7× |
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) |
$4,332 |
$4,560 |
0.8× |
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 |
2.9× |
| Arthrogram Wrist (73115) |
$987.05 |
$1,039 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$363.85 |
$383 |
2.8× |
| Bone age studies (77072) |
$169.10 |
$178 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$3,285.10 |
$3,458 |
8.5× |
| Bone Imaging Limited Area (78300) |
$1,650.15 |
$1,737 |
4.2× |
| Bone Imaging Multiple Areas (78305) |
$2,085.25 |
$2,195 |
5.4× |
| Bone Imaging Whole Body (78306) |
$2,303.75 |
$2,425 |
5.9× |
| Bone marrow imaging limited area (78102) |
$1,419.30 |
$1,494 |
3.7× |
| Bone survey infant (77076) |
$768.55 |
$809 |
7.6× |
| Brachytx isodose complex (77318) |
$2,166.95 |
$2,281 |
6.0× |
| Brachytx Isodose Plan Simple (77316) |
$1,234.05 |
$1,299 |
3.4× |
| Brain Flow Imaging Only (78610) |
$1,922.80 |
$2,024 |
3.6× |
| Brain Image W/Flow < 4 Views (78601) |
$2,069.10 |
$2,178 |
5.3× |
| Brain imaging < 4 static views (78600) |
$1,793.60 |
$1,888 |
4.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,645.15 |
$3,837 |
6.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,906.65 |
$2,007 |
3.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$13,815.85 |
$14,543 |
9.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,928.25 |
$4,135 |
11.6× |
| Cardiac Shunt Detection (78428) |
$1,568.45 |
$1,651 |
4.0× |
| Cerebrospinal Fluid Scan (78630) |
$3,313.60 |
$3,488 |
6.3× |
| Chest 1 view (71045) |
$110.20 |
$116 |
1.3× |
| Chest 2 views (71046) |
$206.15 |
$217 |
2.4× |
| Chest 3 views (71047) |
$260.30 |
$274 |
3.1× |
| Chest 4 or more views (71048) |
$266.95 |
$281 |
2.6× |
| Clavicle complete (73000) |
$234.65 |
$247 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$188.10 |
$198 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$836 |
$880 |
6.4× |
| Contrast Exam Abdominl Aorta (75625) |
$4,730.05 |
$4,979 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$224.20 |
$236 |
0.7× |
| Contrast X-Ray Of Elbow (73085) |
$912.95 |
$961 |
2.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,092.50 |
$1,150 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,367.75 |
$3,545 |
9.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,852.50 |
$1,950 |
8.0× |
| CT abdomen w contrast (74160) |
$1,766.05 |
$1,859 |
10.4× |
| CT abdomen w wo contrast (74170) |
$2,036.80 |
$2,144 |
12.0× |
| CT abdomen w/o contrast (74150) |
$941.45 |
$991 |
9.3× |
| CT Angio Abdomen and Pelvis (74174) |
$2,933.60 |
$3,088 |
8.7× |
| CT Angio Chest (71275) |
$2,199.25 |
$2,315 |
12.9× |
| CT Angio Head (70496) |
$2,191.65 |
$2,307 |
12.9× |
| CT angio hrt w/3d image (75574) |
$2,489.95 |
$2,621 |
7.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,495.65 |
$2,627 |
14.6× |
| CT Angio Neck (70498) |
$2,151.75 |
$2,265 |
12.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,494.70 |
$2,626 |
14.6× |
| CT cervical spine w/ contrast (72126) |
$1,778.40 |
$1,872 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,183.70 |
$1,246 |
11.7× |
| CT cervical spine w/wo cont (72127) |
$2,188.80 |
$2,304 |
12.8× |
| CT chest w contrast (71260) |
$1,755.60 |
$1,848 |
10.3× |
| CT chest w/wo contrast (71270) |
$2,164.10 |
$2,278 |
12.7× |
| CT colonography screening (74263) |
$2,033 |
$2,140 |
8.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$2,463.35 |
$2,593 |
14.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,173.25 |
$1,235 |
11.6× |
| CT head/brain with contrast (70460) |
$1,391.75 |
$1,465 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,703.35 |
$1,793 |
10.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,085.25 |
$2,195 |
6.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$134.90 |
$142 |
1.6× |
| CT hrt w/3d image congen (75573) |
$2,470 |
$2,600 |
7.3× |
| CT iac w contrast (70481) |
$2,172.65 |
$2,287 |
12.8× |
| CT l-spine w&w/o contrast (72133) |
$2,184.05 |
$2,299 |
12.8× |
| CT lower ext w/o (73700) |
$1,175.15 |
$1,237 |
11.6× |
| CT lower extremity w/contrast material (73701) |
$1,777.45 |
$1,871 |
10.4× |
| CT lumbar spine w contrast (72132) |
$1,775.55 |
$1,869 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$1,175.15 |
$1,237 |
11.6× |
| CT maxillofacial w contrast (70487) |
$1,181.80 |
$1,244 |
6.9× |
| CT maxillofacial wo contrast (70486) |
$1,026.95 |
$1,081 |
10.1× |
| CT neck tissue combo (70492) |
$2,159.35 |
$2,273 |
12.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,401.60 |
$2,528 |
14.1× |
| CT orbits w/o contrast (70480) |
$1,183.70 |
$1,246 |
11.7× |
| CT pelvis w&w/o contrast (72194) |
$2,658.10 |
$2,798 |
15.6× |
| CT pelvis w/o contrast (72192) |
$1,218.85 |
$1,283 |
12.0× |
| CT scan of leg combo (73702) |
$2,246.75 |
$2,365 |
13.2× |
| CT scans face/jaw combo (70488) |
$1,485.80 |
$1,564 |
8.7× |
| CT soft tissue neck w contrast (70491) |
$1,755.60 |
$1,848 |
10.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,183.70 |
$1,246 |
11.7× |
| CT thoracic spine w contrast (72129) |
$1,779.35 |
$1,873 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$1,175.15 |
$1,237 |
11.6× |
| CT thoracic spine w/wo cont (72130) |
$2,203.05 |
$2,319 |
12.9× |
| CT thorax w/o contrast (71250) |
$1,181.80 |
$1,244 |
11.6× |
| CT unlisted procedure (76497) |
$442.51 |
$465.80 |
5.2× |
| CT upper ext wo (73200) |
$1,175.15 |
$1,237 |
11.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,272.40 |
$2,392 |
13.3× |
| CT upper extremity with contrast (73201) |
$1,730.90 |
$1,822 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,495.65 |
$2,627 |
14.6× |
| Cta Abdomen (74175) |
$2,283.80 |
$2,404 |
13.4× |
| CTA pelvis (72191) |
$3,245.20 |
$3,416 |
19.0× |
| Dilation ureters/urethra rs&i (74485) |
$699.20 |
$736 |
0.3× |
| Discography Cerv/Thor Spine (72285) |
$3,626.15 |
$3,817 |
1.9× |
| Diskography lumbar (72295) |
$3,382.95 |
$3,561 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$278.35 |
$293 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$523.45 |
$551 |
5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$768.55 |
$809 |
7.6× |
| Dxa Bone Density Axial (77080) |
$391.40 |
$412 |
3.9× |
| Dxa bone density study (77085) |
$546.25 |
$575 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$213.75 |
$225 |
2.5× |
| Echo exam of fetal heart (76825) |
$2,155.55 |
$2,269 |
4.1× |
| Echo exam uterus (76831) |
$910.10 |
$958 |
3.9× |
| Echo Guide For Artery Repair (76936) |
$2,347.45 |
$2,471 |
11.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,846.80 |
$1,944 |
8.0× |
| Esophagram (74220) |
$686.85 |
$723 |
4.0× |
| Fetal Biophys Profile W/Nst (76818) |
$757.15 |
$797 |
7.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$551.95 |
$581 |
5.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,646.10 |
$3,838 |
15.7× |
| Fluoroscopy up to 1 hr (76000) |
$512.05 |
$539 |
2.2× |
| Follow-Up Angiography (75898) |
$870.20 |
$916 |
0.3× |
| Foot 2 views (73620) |
$226.10 |
$238 |
2.7× |
| Forearm 2 views (73090) |
$212.80 |
$224 |
2.5× |
| Gastric emptying imaging study (78264) |
$3,277.50 |
$3,450 |
8.4× |
| Gastroesophageal Reflux Exam (78262) |
$2,692.30 |
$2,834 |
6.9× |
| Gated Heart Planar Single (78472) |
$1,994.05 |
$2,099 |
5.1× |
| Gated Heart, Multiple (78473) |
$2,466.20 |
$2,596 |
6.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$4,637.90 |
$4,882 |
8.8× |
| Hand 2 views (73120) |
$219.45 |
$231 |
2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$4,285.45 |
$4,511 |
6.3× |
| Heart Image (Pet) Multiple (78492) |
$11,663.15 |
$12,277 |
8.4× |
| 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) |
$3,498.85 |
$3,683 |
6.6× |
| Hepatobiliary System Imaging (78226) |
$3,247.10 |
$3,418 |
8.4× |
| Ht Muscle Image Spect Sing (78451) |
$3,008.65 |
$3,167 |
2.4× |
| 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 |
12.0× |
| Infant hip ultrasound, limited static exam (76886) |
$849.30 |
$894 |
10.0× |
| Interstitial radiation source applic complex (77778) |
$3,944.40 |
$4,152 |
5.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$5,643.95 |
$5,941 |
8.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$5,080.60 |
$5,348 |
9.5× |
| Intracavitary radiation source applic simple (77761) |
$2,823.40 |
$2,972 |
5.3× |
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) |
$1,264.45 |
$1,331 |
2.4× |
| K Flow/Funct Image W/O Drug (78707) |
$2,047.25 |
$2,155 |
3.9× |
| Kidney Imaging Morphol (78700) |
$1,646.35 |
$1,733 |
4.2× |
| Knee 3 Views (73562) |
$327.75 |
$345 |
3.9× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$1,170.40 |
$1,232 |
3.0× |
| Liver & Spleen Imaging Static Only (78215) |
$1,881.95 |
$1,981 |
4.8× |
| Liver imaging static only (78201) |
$1,839.20 |
$1,936 |
3.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,941.20 |
$3,096 |
5.6× |
| Lung perfusion differential (78597) |
$1,826.85 |
$1,923 |
4.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,100.80 |
$3,264 |
5.9× |
| Lung Ventilation Imaging (78579) |
$1,786.95 |
$1,881 |
4.6× |
| Lymph System Imaging (78195) |
$3,290.80 |
$3,464 |
6.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$3,027.65 |
$3,187 |
2.0× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,540.30 |
$2,674 |
4.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,364.65 |
$5,647 |
1.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,260.40 |
$3,432 |
1.1× |
| Magnetic Image Jaw Joint (70336) |
$3,269.90 |
$3,442 |
14.1× |
| Mammary ductogram or galactogram multiple (77054) |
$306.85 |
$323 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$227.05 |
$239 |
1.0× |
| Meckels Divert Exam (78290) |
$3,306 |
$3,480 |
8.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,053.30 |
$3,214 |
8.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$120.65 |
$127 |
4.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,767.10 |
$5,018 |
14.1× |
| MRA head w/o contrast (70544) |
$2,854.75 |
$3,005 |
12.3× |
| MRA head with contrast (70545) |
$3,447.55 |
$3,629 |
10.2× |
| MRA neck w contrast (70548) |
$3,722.10 |
$3,918 |
11.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,767.10 |
$5,018 |
14.1× |
| MRA neck w/o contrast (70547) |
$2,854.75 |
$3,005 |
12.3× |
| MRI abdomen w contrast (74182) |
$4,867.80 |
$5,124 |
14.4× |
| MRI abdomen w/o contrast (74181) |
$3,440.90 |
$3,622 |
14.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,991.90 |
$4,202 |
5.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,798.45 |
$5,051 |
14.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,954.85 |
$4,163 |
5.2× |
| MRI bone marrow blood supply (77084) |
$3,638.50 |
$3,830 |
15.7× |
| MRI brain functional w/o physician admnistration (70554) |
$3,637.55 |
$3,829 |
15.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,342.70 |
$2,466 |
10.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,348.40 |
$2,472 |
10.1× |
| MRI cardiac w/o contrast (75557) |
$2,700.85 |
$2,843 |
11.7× |
| MRI cervical spine w contrast (72142) |
$2,486.15 |
$2,617 |
7.3× |
| MRI cervical spine w/o cont (72141) |
$1,573.20 |
$1,656 |
6.8× |
| MRI chest w/o contrast (71550) |
$3,608.10 |
$3,798 |
15.6× |
| MRI chest with contrast (71551) |
$4,974.20 |
$5,236 |
6.5× |
| MRI chest wo w contrast (71552) |
$5,981.20 |
$6,296 |
17.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,279.75 |
$4,505 |
12.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,257.30 |
$5,534 |
15.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,641.35 |
$3,833 |
15.7× |
| MRI lumbar spine w contrast (72149) |
$3,060.90 |
$3,222 |
9.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,785.40 |
$2,932 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,880.40 |
$3,032 |
12.4× |
| MRI orbit face neck w contrast (70542) |
$3,370.60 |
$3,548 |
9.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,074.55 |
$4,289 |
12.0× |
| MRI pelvis w contrast (72196) |
$4,305.40 |
$4,532 |
12.7× |
| MRI pelvis w/o & w contrast (72197) |
$5,222.15 |
$5,497 |
15.4× |
| MRI pelvis w/o contrast (72195) |
$3,612.85 |
$3,803 |
15.6× |
| MRI spectroscopy (76390) |
$2,719.85 |
$2,863 |
32.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,987.40 |
$2,092 |
8.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$4,284.50 |
$4,510 |
12.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,641.35 |
$3,833 |
15.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,225.95 |
$5,501 |
15.4× |
| MRI, abdomen, combo (74183) |
$5,233.55 |
$5,509 |
15.4× |
| MRI, dorsal spine combo (72157) |
$3,522.60 |
$3,708 |
10.4× |
| MRI, dorsal spine contrast (72147) |
$3,108.40 |
$3,272 |
9.2× |
| MRI, joint upper extrem (73221) |
$2,217.30 |
$2,334 |
9.6× |
| MRI, joint upper extrem combo (73223) |
$4,780.40 |
$5,032 |
14.1× |
| MRI, lumbar spine combo (72158) |
$3,510.25 |
$3,695 |
10.4× |
| Myelography thoracic (72255) |
$670.70 |
$706 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$13,804.45 |
$14,531 |
11.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,812 |
$2,960 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,320.60 |
$4,548 |
3.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$148.20 |
$156 |
0.1× |
| N-invas est c ffr sw aly CTA (75580) |
$8,358.10 |
$8,798 |
10.0× |
| Neck soft tissue (70360) |
$206.15 |
$217 |
2.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,602.65 |
$1,687 |
4.3× |
| Nm csf leak detection (78650) |
$3,300.30 |
$3,474 |
2.6× |
| Nm unlisted gi procedure (78299) |
$1,616.90 |
$1,702 |
4.2× |
| Nonvascular Shunt X-Ray (75809) |
$211.85 |
$223 |
2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$16,279.20 |
$17,136 |
12.1× |
| Nuclear Rx Intra-Arterial (79445) |
$542.45 |
$571 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$519.65 |
$547 |
2.3× |
| Ob us nuchal meas 1 gest (76813) |
$670.70 |
$706 |
6.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$588.05 |
$619 |
5.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$909.15 |
$957 |
7.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$532.95 |
$561 |
5.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$1,054.50 |
$1,110 |
10.4× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$113.05 |
$119 |
4.0× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$541.50 |
$570 |
5.3× |
| Panoramic X-ray of jaws (70355) |
$114 |
$120 |
1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,736.35 |
$3,933 |
7.1× |
| Parathyroid Planar Imaging (78070) |
$2,869.95 |
$3,021 |
7.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,311.70 |
$3,486 |
8.5× |
| Pelvis 1 or 2 views (72170) |
$284.05 |
$299 |
2.8× |
| Peritoneogram Rs&I (74190) |
$552.90 |
$582 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$13,753.15 |
$14,477 |
9.9× |
| PET image w/CT, full body (78816) |
$11,732.50 |
$12,350 |
8.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$9,025 |
$9,500 |
6.5× |
| Pet Myocardial Sngl Study (78491) |
$4,502.05 |
$4,739 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,332 |
$4,560 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,242 |
$2,360 |
5.8× |
| 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) |
$280.25 |
$295 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$235.60 |
$248 |
2.8× |
| Radex elbow complete minimum 3 views (73080) |
$277.40 |
$292 |
3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$350.55 |
$369 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$304 |
$320 |
3.6× |
| Radex foot complete minimum 3 views (73630) |
$258.40 |
$272 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$270.75 |
$285 |
3.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$245.10 |
$258 |
2.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$468.35 |
$493 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$294.50 |
$310 |
3.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$633.65 |
$667 |
7.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$268.85 |
$283 |
3.2× |
| Radex shoulder complete minimum 2 views (73030) |
$240.35 |
$253 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$257.45 |
$271 |
3.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$2,013.05 |
$2,119 |
11.8× |
| Radex Spine 1 View Specify Level (72020) |
$177.65 |
$187 |
2.1× |
| Radex Sternum Minimum 2 Views (71120) |
$239.40 |
$252 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$427.50 |
$450 |
5.1× |
| Radex Toe Minimum 2 Views (73660) |
$268.85 |
$283 |
3.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$235.60 |
$248 |
2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$328.70 |
$346 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$757.15 |
$797 |
7.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$45,102.20 |
$47,476 |
6.3× |
| Radiation treatment delivery level 1 (77402) |
$1,533.30 |
$1,614 |
15.5× |
| Radiation treatment delivery level 2 (77407) |
$944.30 |
$994 |
2.5× |
| Radiation treatment delivery level 3 (77412) |
$2,801.55 |
$2,949 |
5.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$310.65 |
$327 |
3.1× |
| 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 |
10.1× |
| Radiologic exam colon single contrast study (74270) |
$1,064 |
$1,120 |
6.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$771.40 |
$812 |
4.5× |
| Radiologic exam knee complete 4/more views (73564) |
$346.75 |
$365 |
3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$342 |
$360 |
3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$851.20 |
$896 |
5.0× |
| Radiologic exam swallow function contrast study (74230) |
$1,050.70 |
$1,106 |
6.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$975.65 |
$1,027 |
5.7× |
| Radiologic examination femur 1 view (73551) |
$241.30 |
$254 |
2.9× |
| Radiologic examination femur minimum 2 views (73552) |
$285.95 |
$301 |
3.4× |
| Radiologic examination knee 1/2 views (73560) |
$281.20 |
$296 |
3.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$522.50 |
$550 |
5.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$251.75 |
$265 |
3.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$110.20 |
$116 |
1.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$5,903.30 |
$6,214 |
15.8× |
| Renal Cyst Study (74470) |
$532 |
$560 |
1.0× |
| Ribs bilateral 3 views (71110) |
$293.55 |
$309 |
2.9× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$153.90–$175.75 |
$162–$185 |
varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,437.70 |
$2,566 |
6.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,678.15 |
$5,977 |
10.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$3,114.10 |
$3,278 |
5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,184.40 |
$3,352 |
6.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,681.35 |
$7,033 |
5.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$8,835.95 |
$9,301 |
6.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$4,485.90 |
$4,722 |
3.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$875.90 |
$922 |
3.9× |
| Rp Therapy Intravenous Administration (79101) |
$513 |
$540 |
2.3× |
| Salivary Gland Function Study (78232) |
$867.35 |
$913 |
2.2× |
| Salivary Gland Imaging Serial Images (78231) |
$1,145.70 |
$1,206 |
3.0× |
| Scapula (73010) |
$260.30 |
$274 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$31.35 |
$33 |
1.3× |
| Sella turcica (70240) |
$248.90 |
$262 |
2.9× |
| Shoulder 1 view (73020) |
$186.20 |
$196 |
2.2× |
| Shoulder Arthrography (73040) |
$968.05 |
$1,019 |
2.9× |
| Skull less than 4 views (70250) |
$290.70 |
$306 |
2.9× |
| Special dosimetry (77331) |
$1,040.25 |
$1,095 |
8.0× |
| Special Physics Consult (77370) |
$1,280.60 |
$1,348 |
9.8× |
| Special teletherapy port plan (77321) |
$459.80 |
$484 |
1.3× |
Special treatment procedure (77470)
range across 13 matching MRF lines |
$505.40–$10,494.65 |
$532–$11,047 |
varies |
| Speech evaluation, complex (70371) |
$507.30 |
$534 |
2.2× |
| Spleen Imaging (78185) |
$2,120.40 |
$2,232 |
5.5× |
| Srs Multisource (77371) |
$69,557.10 |
$73,218 |
9.7× |
| Stereotactic Body Radiation Delivery (77373) |
$14,492.25 |
$15,255 |
8.3× |
| Sternoclavicular joints (71130) |
$308.75 |
$325 |
3.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$4,561.90 |
$4,802 |
46.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,490.55 |
$1,569 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,451.60 |
$1,528 |
4.0× |
| Testicular Imaging W/Flow (78761) |
$1,905.70 |
$2,006 |
4.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$4,622.70 |
$4,866 |
12.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,536.50 |
$2,670 |
19.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,360.40 |
$1,432 |
8.0× |
| Thoracic spine 2 views (72070) |
$282.15 |
$297 |
2.8× |
| Thoracic spine 3 views (72072) |
$292.60 |
$308 |
2.9× |
| Thoracolumbar 2 views (72080) |
$244.15 |
$257 |
2.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$2,059.60 |
$2,168 |
5.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,887.65 |
$1,987 |
4.9× |
| Thyroid Met Imaging Body (78018) |
$2,994.40 |
$3,152 |
5.7× |
| Thyroid Uptake Measurement (78012) |
$761.90 |
$802 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,392.10 |
$2,518 |
6.2× |
| Tx Devices Design & Construction Complex (77334) |
$934.80 |
$984 |
2.6× |
| Tx devices design & construction intermediate (77333) |
$103.55 |
$109 |
0.8× |
| Tx devices design & construction simple (77332) |
$861.65 |
$907 |
6.6× |
| Ultrasound Breast Limited (76642) |
$608.95 |
$641 |
7.2× |
| Ultrasound elastography first target lesion (76982) |
$744.80 |
$784 |
7.3× |
| Ultrasound Elastography Parenchyma (76981) |
$870.20 |
$916 |
8.6× |
| Ultrasound Exam Aaa Screen (76706) |
$742.90 |
$782 |
7.3× |
| Ultrasound, abdomen limited (76705) |
$692.55 |
$729 |
6.8× |
| 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 |
22.3× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$3,537.80 |
$3,724 |
35.7× |
| Upper gi w/o kub (74240) |
$818.90 |
$862 |
4.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$180.50 |
$190 |
16.3× |
| Urea breath test c-14 isotopic analysis (78268) |
$986.10 |
$1,038 |
10.4× |
| Ureteral Reflux Study (78740) |
$2,088.10 |
$2,198 |
5.4× |
| Urethrocystogram voiding (74455) |
$684 |
$720 |
3.0× |
| Urethrocystography retrograde (74450) |
$615.60 |
$648 |
2.7× |
| Us breast unilateral complete (76641) |
$789.45 |
$831 |
7.8× |
| Us chest (76604) |
$685.90 |
$722 |
6.8× |
| Us complete joint (76881) |
$931 |
$980 |
9.2× |
| Us exam, pelvic, limited (76857) |
$253.65 |
$267 |
2.5× |
| Us head (76506) |
$963.30 |
$1,014 |
9.5× |
| Us kidney transplant (76776) |
$1,327.15 |
$1,397 |
13.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$126.35 |
$133 |
1.2× |
| Us ob detailed single fetus (76811) |
$947.15 |
$997 |
4.1× |
| Us ob limited 1 or more fetuses (76815) |
$582.35 |
$613 |
5.7× |
| Us ob transvaginal (76817) |
$661.20 |
$696 |
6.5× |
| Us pelvic non ob complete (76856) |
$843.60 |
$888 |
8.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$821.75 |
$865 |
8.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$807.50 |
$850 |
8.0× |
| Us retroperitoneal complete (76770) |
$858.80 |
$904 |
8.5× |
| Us retroperitoneal limited (76775) |
$321.10 |
$338 |
3.2× |
| Us scrotum and contents (76870) |
$396.15 |
$417 |
3.9× |
| Us spinal canal and contents (76800) |
$902.50 |
$950 |
8.9× |
| Us thyroid (76536) |
$984.20 |
$1,036 |
9.7× |
| Us transrectal (76872) |
$1,063.05 |
$1,119 |
10.5× |
| 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 |
2.2× |
| Venogram Sinus/Jugular (75860) |
$1,991.20 |
$2,096 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$1,229.30 |
$1,294 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$5,023.60 |
$5,288 |
1.6× |
| 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 |
9.4× |
| 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 |
4.2× |
| Wrist 2 views (73100) |
$254.60 |
$268 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$306.85 |
$323 |
3.6× |
| X-ray antegrade pyelogram tube (74425) |
$551 |
$580 |
1.6× |
| X-Ray Aorta Leg Arteries (75630) |
$4,332 |
$4,560 |
1.4× |
| X-Ray Bend Only L-S Spine (72120) |
$361 |
$380 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$235.60 |
$248 |
2.8× |
| X-Ray Exam Breast Specimen (76098) |
$88.35 |
$93 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$318.25 |
$335 |
3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$574.75 |
$605 |
5.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$626.05 |
$659 |
6.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$249.85 |
$263 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$375.25 |
$395 |
4.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$462.65 |
$487 |
4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$349.60 |
$368 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$418.95 |
$441 |
4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$507.30 |
$534 |
5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$271.70 |
$286 |
3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$476.90 |
$502 |
4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$279.30 |
$294 |
2.8× |
| X-ray eye for foreign body (70030) |
$203.30 |
$214 |
2.4× |
| X-ray head for orthodontia (70350) |
$119.70 |
$126 |
1.4× |
| X-ray humerus (73060) |
$254.60 |
$268 |
3.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,167.55 |
$1,229 |
6.9× |
| X-ray IV pyelogram+tomography (74415) |
$1,192.25 |
$1,255 |
7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$293.55 |
$309 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$336.30 |
$354 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$313.50 |
$330 |
3.1× |
| X-ray nose-rectum child f.b. (76010) |
$176.70 |
$186 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$385.70 |
$406 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$289.75 |
$305 |
2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$359.10 |
$378 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.30 |
$254 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$307.80 |
$324 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$345.80 |
$364 |
3.4× |
| X-ray thoracic spine 4 vw (72074) |
$351.50 |
$370 |
3.5× |
| X-Ray Tmj Unilat (70328) |
$266.95 |
$281 |
3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,109.60 |
$1,168 |
3.3× |
| X-Rays Bone Length Studies (77073) |
$267.90 |
$282 |
2.6× |
| X-Rays Bone Survey Complete (77075) |
$754.30 |
$794 |
7.4× |
| Xr c-spine 4 or 5 views (72050) |
$362.90 |
$382 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$232.75 |
$245 |
2.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$306.85 |
$323 |
3.0× |
| Xr orbits complete 4 views (70200) |
$345.80 |
$364 |
3.4× |
| Xr Tomogram Single Plane (76100) |
$639.35 |
$673 |
6.3× |