| 3-D radiotherapy plan dose-volume histograms (77295) |
$12,125.80 |
$12,764 |
9.0× |
| Abdomen 1 View (74018) |
$447.45 |
$471 |
5.3× |
| Abdomen 2 views (74019) |
$323 |
$340 |
3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,695.75 |
$1,785 |
4.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$2,751.20 |
$2,896 |
2.2× |
| Adrenal Cortex & Medulla Img (78075) |
$1,235 |
$1,300 |
1.0× |
| Angio internal mammary (75756) |
$1,236.90 |
$1,302 |
0.4× |
| Angio pulmonary bilat (75743) |
$4,695.85 |
$4,943 |
1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,695.85 |
$4,943 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$4,048.90 |
$4,262 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$4,048.90 |
$4,262 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,186.65 |
$4,407 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,064 |
$1,120 |
0.3× |
| Ankle 2 views (73600) |
$388.55 |
$409 |
4.6× |
| Aortography thoracic serialography rs&i (75605) |
$4,048.90 |
$4,262 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,225.60 |
$4,448 |
1.4× |
| Artery X-Rays Abdomen (75726) |
$4,048.90 |
$4,262 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$3,610 |
$3,800 |
1.2× |
| Artery X-Rays Pelvis (75736) |
$4,048.90 |
$4,262 |
0.7× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,216 |
$1,280 |
0.2× |
| Arthrogram hip (73525) |
$1,207.45 |
$1,271 |
3.6× |
| Arthrogram Wrist (73115) |
$699.20 |
$736 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$2,330.35 |
$2,453 |
17.8× |
| Bone age studies (77072) |
$137.75 |
$145 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,428.80 |
$1,504 |
3.7× |
| Bone Imaging Limited Area (78300) |
$900.60 |
$948 |
2.3× |
| Bone Imaging Multiple Areas (78305) |
$1,756.55 |
$1,849 |
4.5× |
| Bone Imaging Whole Body (78306) |
$1,377.50 |
$1,450 |
3.5× |
| Bone marrow imaging limited area (78102) |
$1,196.05 |
$1,259 |
3.1× |
| Bone survey infant (77076) |
$1,193.20 |
$1,256 |
11.7× |
| Brachytx isodose complex (77318) |
$1,824.95 |
$1,921 |
5.0× |
| Brachytx Isodose Plan Simple (77316) |
$1,039.30 |
$1,094 |
2.9× |
| Brain Flow Imaging Only (78610) |
$1,580.80 |
$1,664 |
3.0× |
| Brain Image W/Flow < 4 Views (78601) |
$1,743.25 |
$1,835 |
4.5× |
| Brain imaging < 4 static views (78600) |
$1,510.50 |
$1,590 |
3.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$967.10 |
$1,018 |
1.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,606.45 |
$1,691 |
3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$11,634.65 |
$12,247 |
8.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,929.20 |
$4,136 |
11.6× |
| Cardiac Shunt Detection (78428) |
$1,321.45 |
$1,391 |
3.4× |
| Cerebrospinal Fluid Scan (78630) |
$2,791.10 |
$2,938 |
5.3× |
| Chest 1 view (71045) |
$419.90 |
$442 |
5.0× |
| Chest 2 views (71046) |
$561.45 |
$591 |
6.6× |
| Chest 3 views (71047) |
$274.55 |
$289 |
3.2× |
| Chest 4 or more views (71048) |
$576.65 |
$607 |
5.7× |
| Clavicle complete (73000) |
$371.45 |
$391 |
4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$188.10 |
$198 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$703.95 |
$741 |
5.4× |
| Contrast Exam Abdominl Aorta (75625) |
$4,048.90 |
$4,262 |
1.3× |
| Contrast X-Ray Bladder (74430) |
$533.90 |
$562 |
1.6× |
| Contrast X-Ray Of Elbow (73085) |
$760.95 |
$801 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$773.30 |
$814 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,914.60 |
$3,068 |
8.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,286.30 |
$1,354 |
5.6× |
| CT abdomen w contrast (74160) |
$1,931.35 |
$2,033 |
11.3× |
| CT abdomen w wo contrast (74170) |
$2,226.80 |
$2,344 |
13.1× |
| CT abdomen w/o contrast (74150) |
$1,029.80 |
$1,084 |
10.1× |
| CT Angio Abdomen and Pelvis (74174) |
$3,207.20 |
$3,376 |
9.5× |
CT Angio Chest (71275)
range across 3 matching MRF lines |
$2,316.10–$2,404.45 |
$2,438–$2,531 |
varies |
CT Angio Head (70496)
range across 2 matching MRF lines |
$2,306.60–$2,768.30 |
$2,428–$2,914 |
varies |
| CT angio hrt w/3d image (75574) |
$2,722.70 |
$2,866 |
8.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,728.40 |
$2,872 |
16.0× |
CT Angio Neck (70498)
range across 2 matching MRF lines |
$2,265.75–$2,717.95 |
$2,385–$2,861 |
varies |
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 3 matching MRF lines |
$2,625.80–$2,727.45 |
$2,764–$2,871 |
varies |
| CT cervical spine w/ contrast (72126) |
$2,244.85 |
$2,363 |
6.6× |
| CT cervical spine w/o contrast (72125) |
$1,496.25 |
$1,575 |
14.7× |
| CT cervical spine w/wo cont (72127) |
$2,764.50 |
$2,910 |
16.2× |
| CT chest w contrast (71260) |
$1,919 |
$2,020 |
11.3× |
| CT chest w/wo contrast (71270) |
$2,366.45 |
$2,491 |
13.9× |
| CT colonography screening (74263) |
$2,223 |
$2,340 |
9.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$2,692.30 |
$2,834 |
15.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,283.45 |
$1,351 |
12.6× |
| CT head/brain with contrast (70460) |
$1,392.70 |
$1,466 |
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) |
$2,280 |
$2,400 |
6.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$147.25 |
$155 |
1.7× |
| CT hrt w/3d image congen (75573) |
$2,700.85 |
$2,843 |
8.0× |
| CT iac w contrast (70481) |
$2,744.55 |
$2,889 |
16.1× |
| CT l-spine w&w/o contrast (72133) |
$2,388.30 |
$2,514 |
14.0× |
| CT lower ext w/o (73700) |
$1,483.90 |
$1,562 |
14.6× |
| CT lower extremity w/contrast material (73701) |
$2,244.85 |
$2,363 |
13.2× |
| CT lumbar spine w contrast (72132) |
$1,940.85 |
$2,043 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$1,285.35 |
$1,353 |
12.7× |
| CT maxillofacial w contrast (70487) |
$1,493.40 |
$1,572 |
8.8× |
| CT maxillofacial wo contrast (70486) |
$1,297.70 |
$1,366 |
12.8× |
| CT neck tissue combo (70492) |
$2,726.50 |
$2,870 |
16.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,034.30 |
$3,194 |
17.8× |
| CT orbits w/o contrast (70480) |
$1,496.25 |
$1,575 |
14.7× |
| CT pelvis w&w/o contrast (72194) |
$2,300.90 |
$2,422 |
13.5× |
| CT pelvis w/o contrast (72192) |
$1,055.45 |
$1,111 |
10.4× |
| CT scan of leg combo (73702) |
$2,455.75 |
$2,585 |
14.4× |
| CT scans face/jaw combo (70488) |
$1,877.20 |
$1,976 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$2,217.30 |
$2,334 |
13.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,496.25 |
$1,575 |
14.7× |
| CT thoracic spine w contrast (72129) |
$1,945.60 |
$2,048 |
11.4× |
| CT thoracic spine w/o contrast (72128) |
$1,285.35 |
$1,353 |
12.7× |
| CT thoracic spine w/wo cont (72130) |
$2,408.25 |
$2,535 |
14.1× |
| CT thorax w/o contrast (71250) |
$1,292 |
$1,360 |
12.7× |
| CT unlisted procedure (76497) |
$442.51 |
$465.80 |
5.2× |
| CT upper ext wo (73200) |
$1,285.35 |
$1,353 |
12.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,484.25 |
$2,615 |
14.6× |
| CT upper extremity with contrast (73201) |
$1,892.40 |
$1,992 |
5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,728.40 |
$2,872 |
16.0× |
| Cta Abdomen (74175) |
$2,496.60 |
$2,628 |
14.7× |
| CTA pelvis (72191) |
$2,484.25 |
$2,615 |
14.6× |
| Dilation ureters/urethra rs&i (74485) |
$757.15 |
$797 |
0.4× |
| Discography Cerv/Thor Spine (72285) |
$2,566.90 |
$2,702 |
1.4× |
| Diskography lumbar (72295) |
$2,394 |
$2,520 |
1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$334.40 |
$352 |
3.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$628.90 |
$662 |
6.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$640.30 |
$674 |
6.3× |
| Dxa Bone Density Axial (77080) |
$140.60 |
$148 |
1.4× |
| Dxa bone density study (77085) |
$455.05 |
$479 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$152 |
$160 |
1.8× |
| Echo exam of fetal heart (76825) |
$2,586.85 |
$2,723 |
4.9× |
| Echo exam uterus (76831) |
$1,092.50 |
$1,150 |
4.7× |
| Echo Guide For Artery Repair (76936) |
$650.75 |
$685 |
3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,216.35 |
$2,333 |
9.6× |
| Esophagram (74220) |
$972.80 |
$1,024 |
5.7× |
| Fetal Biophys Profile W/Nst (76818) |
$324.90 |
$342 |
3.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$259.35 |
$273 |
2.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,646.10 |
$3,838 |
15.7× |
| Fluoroscopy up to 1 hr (76000) |
$817 |
$860 |
3.5× |
| Follow-Up Angiography (75898) |
$774.25 |
$815 |
0.3× |
| Foot 2 views (73620) |
$406.60 |
$428 |
4.8× |
| Forearm 2 views (73090) |
$418 |
$440 |
4.9× |
| Gastric emptying imaging study (78264) |
$1,993.10 |
$2,098 |
5.1× |
| Gastroesophageal Reflux Exam (78262) |
$1,029.80 |
$1,084 |
2.7× |
| Gated Heart Planar Single (78472) |
$1,552.30 |
$1,634 |
4.0× |
| Gated Heart, Multiple (78473) |
$2,077.65 |
$2,187 |
5.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$3,906.40 |
$4,112 |
7.4× |
| Hand 2 views (73120) |
$349.60 |
$368 |
3.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,609.05 |
$3,799 |
5.3× |
| Heart Image (Pet) Multiple (78492) |
$9,822.05 |
$10,339 |
7.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$993.70 |
$1,046 |
0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$999.40 |
$1,052 |
0.3× |
| Hepatobil Syst Image W/Drug (78227) |
$4,051.75 |
$4,265 |
7.7× |
| Hepatobiliary System Imaging (78226) |
$1,607.40 |
$1,692 |
4.1× |
| Ht Muscle Image Spect Sing (78451) |
$3,028.60 |
$3,188 |
2.4× |
| Hysterosalpingogram (74740) |
$547.20 |
$576 |
2.4× |
Image fusion (77399)
range across 3 matching MRF lines |
$208.81–$534.85 |
$219.80–$563 |
varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$210.90 |
$222 |
2.5× |
| Infant hip ultrasound, limited static exam (76886) |
$1,019.35 |
$1,073 |
12.1× |
| Interstitial radiation source applic complex (77778) |
$3,321.20 |
$3,496 |
4.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,753.80 |
$5,004 |
7.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$4,278.80 |
$4,504 |
8.0× |
| Intracavitary radiation source applic simple (77761) |
$2,377.85 |
$2,503 |
4.4× |
Intraop radiaj tx deliver electrons sngl tx sess (77425)
likely a partial charge, not the full procedure |
$410.40 |
$432 |
0.1× |
Intraop radiaj tx deliver xray single tx session (77424)
likely a partial charge, not the full procedure |
$410.40 |
$432 |
0.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,349 |
$1,420 |
2.6× |
| K Flow/Funct Image W/O Drug (78707) |
$993.70 |
$1,046 |
1.9× |
| Kidney Imaging Morphol (78700) |
$1,387 |
$1,460 |
3.6× |
| Knee 3 Views (73562) |
$482.60 |
$508 |
5.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$730.55 |
$769 |
1.9× |
| Liver & Spleen Imaging Static Only (78215) |
$844.55 |
$889 |
2.2× |
| Liver imaging static only (78201) |
$1,549.45 |
$1,631 |
2.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,477.60 |
$2,608 |
4.7× |
| Lung perfusion differential (78597) |
$745.75 |
$785 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$807.50 |
$850 |
1.5× |
| Lung Ventilation Imaging (78579) |
$1,504.80 |
$1,584 |
3.9× |
| Lymph System Imaging (78195) |
$1,256.85 |
$1,323 |
2.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,523.20 |
$2,656 |
1.7× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,116.60 |
$2,228 |
3.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,104 |
$4,320 |
1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,717 |
$2,860 |
0.9× |
| Magnetic Image Jaw Joint (70336) |
$3,269.90 |
$3,442 |
14.1× |
| Mammary ductogram or galactogram multiple (77054) |
$323.95 |
$341 |
1.4× |
| Mammary ductogram or galactogram single (77053) |
$239.40 |
$252 |
1.0× |
| Meckels Divert Exam (78290) |
$1,485.80 |
$1,564 |
3.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,571.65 |
$2,707 |
7.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$120.65 |
$127 |
4.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$6,022.05 |
$6,339 |
17.8× |
| MRA head w/o contrast (70544) |
$3,606.20 |
$3,796 |
15.6× |
| MRA head with contrast (70545) |
$4,354.80 |
$4,584 |
12.9× |
| MRA neck w contrast (70548) |
$4,701.55 |
$4,949 |
13.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,022.05 |
$6,339 |
17.8× |
| MRA neck w/o contrast (70547) |
$3,606.20 |
$3,796 |
15.6× |
| MRI abdomen w contrast (74182) |
$3,800 |
$4,000 |
11.2× |
| MRI abdomen w/o contrast (74181) |
$3,440.90 |
$3,622 |
14.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,992.85 |
$4,203 |
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) |
$3,639.45 |
$3,831 |
15.7× |
| MRI brain functional w/o physician admnistration (70554) |
$4,596.10 |
$4,838 |
19.8× |
| 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) |
$3,140.70 |
$3,306 |
9.3× |
| MRI cervical spine w/o cont (72141) |
$1,987.40 |
$2,092 |
8.6× |
| 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) |
$5,982.15 |
$6,297 |
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) |
$5,258.25 |
$5,535 |
15.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,882.30 |
$3,034 |
12.4× |
| MRI lumbar spine w contrast (72149) |
$2,375 |
$2,500 |
7.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,785.40 |
$2,932 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,639.45 |
$3,831 |
15.7× |
| MRI orbit face neck w contrast (70542) |
$4,257.90 |
$4,482 |
12.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,147.10 |
$5,418 |
15.2× |
| MRI pelvis w contrast (72196) |
$3,800 |
$4,000 |
11.2× |
| MRI pelvis w/o & w contrast (72197) |
$4,134.40 |
$4,352 |
12.2× |
| MRI pelvis w/o contrast (72195) |
$3,612.85 |
$3,803 |
15.6× |
| MRI spectroscopy (76390) |
$2,720.80 |
$2,864 |
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) |
$4,143.90 |
$4,362 |
12.2× |
| MRI, dorsal spine combo (72157) |
$3,522.60 |
$3,708 |
10.4× |
| MRI, dorsal spine contrast (72147) |
$3,109.35 |
$3,273 |
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) |
$2,778.75 |
$2,925 |
8.2× |
| Myelography thoracic (72255) |
$558.60 |
$588 |
0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$11,625.15 |
$12,237 |
9.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,368.35 |
$2,493 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,058.40 |
$4,272 |
3.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$124.45 |
$131 |
0.1× |
| N-invas est c ffr sw aly CTA (75580) |
$9,137.10 |
$9,618 |
11.0× |
| Neck soft tissue (70360) |
$362.90 |
$382 |
4.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,349.95 |
$1,421 |
3.6× |
| Nm csf leak detection (78650) |
$2,779.70 |
$2,926 |
2.2× |
| Nm unlisted gi procedure (78299) |
$1,616.90 |
$1,702 |
4.2× |
| Nonvascular Shunt X-Ray (75809) |
$229.90 |
$242 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,709.45 |
$14,431 |
10.2× |
| Nuclear Rx Intra-Arterial (79445) |
$926.25 |
$975 |
4.1× |
| Nuclear Rx Oral Admin (79005) |
$1,152.35 |
$1,213 |
5.1× |
| Ob us nuchal meas 1 gest (76813) |
$805.60 |
$848 |
7.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$705.85 |
$743 |
7.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$1,091.55 |
$1,149 |
8.4× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$640.30 |
$674 |
6.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$532 |
$560 |
5.2× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$70.30 |
$74 |
2.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$649.80 |
$684 |
6.4× |
| Panoramic X-ray of jaws (70355) |
$80.75 |
$85 |
1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,243.55 |
$1,309 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$976.60 |
$1,028 |
2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,789.20 |
$2,936 |
7.2× |
| Pelvis 1 or 2 views (72170) |
$354.35 |
$373 |
3.5× |
| Peritoneogram Rs&I (74190) |
$599.45 |
$631 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$11,582.40 |
$12,192 |
8.3× |
| PET image w/CT, full body (78816) |
$11,562.45 |
$12,171 |
8.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$11,551.05 |
$12,159 |
8.3× |
| Pet Myocardial Sngl Study (78491) |
$3,791.45 |
$3,991 |
2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,610 |
$3,800 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$745.75 |
$785 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$537.70 |
$566 |
5.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$779 |
$820 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$422.75 |
$445 |
5.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$323 |
$340 |
3.8× |
| Radex elbow complete minimum 3 views (73080) |
$390.45 |
$411 |
4.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$517.75 |
$545 |
5.1× |
| Radex fingr minimum 2 views (73140) |
$364.80 |
$384 |
4.3× |
Radex foot complete minimum 3 views (73630)
range across 4 matching MRF lines |
$326.04–$403.75 |
$343.20–$425 |
varies |
| Radex Hand Minimum 3 Views (73130) |
$350.55 |
$369 |
4.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$173.85 |
$183 |
2.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$331.55 |
$349 |
3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$371.45 |
$391 |
4.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$685.90 |
$722 |
8.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$311.60 |
$328 |
3.7× |
| Radex shoulder complete minimum 2 views (73030) |
$437 |
$460 |
5.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$273.60 |
$288 |
3.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$2,179.30 |
$2,294 |
12.8× |
| Radex Spine 1 View Specify Level (72020) |
$410.40 |
$432 |
4.9× |
| Radex Sternum Minimum 2 Views (71120) |
$294.50 |
$310 |
3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$303.05 |
$319 |
3.6× |
| Radex Toe Minimum 2 Views (73660) |
$321.10 |
$338 |
3.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$167.20 |
$176 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$350.55 |
$369 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$5,900.45 |
$6,211 |
58.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$37,981 |
$39,980 |
5.3× |
| Radiation treatment delivery level 1 (77402) |
$1,292 |
$1,360 |
13.0× |
| Radiation treatment delivery level 2 (77407) |
$795.15 |
$837 |
2.1× |
| Radiation treatment delivery level 3 (77412) |
$2,359.80 |
$2,484 |
4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$488.30 |
$514 |
4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$558.60 |
$588 |
5.5× |
| Radiologic exam colon double contrast study (74280) |
$1,585.55 |
$1,669 |
9.3× |
| Radiologic exam colon single contrast study (74270) |
$1,475.35 |
$1,553 |
8.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$836 |
$880 |
4.9× |
| Radiologic exam knee complete 4/more views (73564) |
$246.05 |
$259 |
2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$769.50 |
$810 |
7.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,137.15 |
$1,197 |
6.7× |
| Radiologic exam swallow function contrast study (74230) |
$285.95 |
$301 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,657.75 |
$1,745 |
9.7× |
| Radiologic examination femur 1 view (73551) |
$171.95 |
$181 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$423.70 |
$446 |
5.0× |
| Radiologic examination knee 1/2 views (73560) |
$391.40 |
$412 |
4.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$574.75 |
$605 |
5.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$422.75 |
$445 |
5.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$78.85 |
$83 |
0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$4,971.35 |
$5,233 |
13.3× |
| Renal Cyst Study (74470) |
$576.65 |
$607 |
1.1× |
| Ribs bilateral 3 views (71110) |
$292.60 |
$308 |
2.9× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$153.90–$870.20 |
$162–$916 |
varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,121.95 |
$1,181 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,782.30 |
$5,034 |
9.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,445.90 |
$1,522 |
2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,447.80 |
$1,524 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,626.85 |
$5,923 |
4.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,441.35 |
$7,833 |
5.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,777.20 |
$3,976 |
3.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,664.40 |
$1,752 |
7.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,052.60 |
$1,108 |
4.6× |
| Salivary Gland Function Study (78232) |
$730.55 |
$769 |
1.9× |
| Salivary Gland Imaging Serial Images (78231) |
$965.20 |
$1,016 |
2.5× |
| Scapula (73010) |
$285.95 |
$301 |
2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$33.25 |
$35 |
1.4× |
| Sella turcica (70240) |
$246.05 |
$259 |
2.9× |
| Shoulder 1 view (73020) |
$310.65 |
$327 |
3.7× |
| Shoulder Arthrography (73040) |
$697.30 |
$734 |
2.1× |
| Skull less than 4 views (70250) |
$196.65 |
$207 |
1.9× |
| Special dosimetry (77331) |
$876.85 |
$923 |
6.7× |
| Special Physics Consult (77370) |
$1,079.20 |
$1,136 |
8.3× |
| Special teletherapy port plan (77321) |
$387.60 |
$408 |
1.1× |
Special treatment procedure (77470)
range across 13 matching MRF lines |
$425.60–$10,494.65 |
$448–$11,047 |
varies |
| Speech evaluation, complex (70371) |
$549.10 |
$578 |
2.4× |
| Spleen Imaging (78185) |
$1,786 |
$1,880 |
4.6× |
| Srs Multisource (77371) |
$58,575.10 |
$61,658 |
8.2× |
| Stereotactic Body Radiation Delivery (77373) |
$12,204.65 |
$12,847 |
7.0× |
| Sternoclavicular joints (71130) |
$228.95 |
$241 |
2.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$3,841.80 |
$4,044 |
38.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,255.90 |
$1,322 |
3.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,791.70 |
$1,886 |
4.9× |
| Testicular Imaging W/Flow (78761) |
$1,605.50 |
$1,690 |
4.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$3,893.10 |
$4,098 |
10.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,136.55 |
$2,249 |
16.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,133.35 |
$1,193 |
6.7× |
| Thoracic spine 2 views (72070) |
$96.90 |
$102 |
1.0× |
| Thoracic spine 3 views (72072) |
$513 |
$540 |
5.1× |
| Thoracolumbar 2 views (72080) |
$172.90 |
$182 |
2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,734.70 |
$1,826 |
4.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,590.30 |
$1,674 |
4.1× |
| Thyroid Met Imaging Body (78018) |
$1,656.80 |
$1,744 |
3.1× |
| Thyroid Uptake Measurement (78012) |
$913.90 |
$962 |
2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,215.05 |
$1,279 |
3.1× |
| Tx Devices Design & Construction Complex (77334) |
$787.55 |
$829 |
2.2× |
| Tx devices design & construction intermediate (77333) |
$87.40 |
$92 |
0.7× |
| Tx devices design & construction simple (77332) |
$725.80 |
$764 |
5.6× |
| Ultrasound Breast Limited (76642) |
$216.60 |
$228 |
2.6× |
| Ultrasound elastography first target lesion (76982) |
$893.95 |
$941 |
8.8× |
| Ultrasound Elastography Parenchyma (76981) |
$1,045 |
$1,100 |
10.3× |
| Ultrasound Exam Aaa Screen (76706) |
$892.05 |
$939 |
8.8× |
| Ultrasound, abdomen limited (76705) |
$566.20 |
$596 |
5.6× |
| Umbilical-artery Doppler (OB) (76820) |
$180.50 |
$190 |
1.8× |
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) |
$641.25 |
$675 |
3.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$171 |
$180 |
15.5× |
| Urea breath test c-14 isotopic analysis (78268) |
$268.85 |
$283 |
2.8× |
| Ureteral Reflux Study (78740) |
$1,759.40 |
$1,852 |
4.5× |
| Urethrocystogram voiding (74455) |
$411.35 |
$433 |
1.8× |
| Urethrocystography retrograde (74450) |
$666.90 |
$702 |
2.9× |
| Us breast unilateral complete (76641) |
$444.60 |
$468 |
4.4× |
| Us chest (76604) |
$585.20 |
$616 |
5.8× |
| Us complete joint (76881) |
$259.35 |
$273 |
2.6× |
| Us exam, pelvic, limited (76857) |
$205.20 |
$216 |
2.0× |
| Us head (76506) |
$406.60 |
$428 |
4.0× |
| Us kidney transplant (76776) |
$1,531.40 |
$1,612 |
15.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$112.10 |
$118 |
1.1× |
| Us ob detailed single fetus (76811) |
$449.35 |
$473 |
1.9× |
| Us ob limited 1 or more fetuses (76815) |
$347.70 |
$366 |
3.4× |
| Us ob transvaginal (76817) |
$292.60 |
$308 |
2.9× |
| Us pelvic non ob complete (76856) |
$399 |
$420 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$553.85 |
$583 |
5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$313.50 |
$330 |
3.1× |
| Us retroperitoneal complete (76770) |
$463.60 |
$488 |
4.6× |
| Us retroperitoneal limited (76775) |
$309.70 |
$326 |
3.0× |
| Us scrotum and contents (76870) |
$255.55 |
$269 |
2.5× |
| Us spinal canal and contents (76800) |
$223.25 |
$235 |
2.2× |
| Us thyroid (76536) |
$484.50 |
$510 |
4.8× |
| Us transrectal (76872) |
$1,275.85 |
$1,343 |
12.6× |
| Vein X-Ray Chest (75827) |
$2,070.05 |
$2,179 |
1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$992.75 |
$1,045 |
0.3× |
| Vein X-Ray Spleen/Liver (75810) |
$5,600.25 |
$5,895 |
1.8× |
| Venogram Sinus/Jugular (75860) |
$968.05 |
$1,019 |
0.3× |
| Venography Adrenal Unilateral (75840) |
$1,024.10 |
$1,078 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$889.20 |
$936 |
0.3× |
| Venography extremity bilateral rs&i (75822) |
$1,563.70 |
$1,646 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,784.10 |
$1,878 |
1.2× |
| Venography Orbital Rs&I (75880) |
$4,752.85 |
$5,003 |
7.8× |
| Venography Renal Bilateral (75833) |
$4,695.85 |
$4,943 |
1.5× |
| Venography Renal Unilateral (75831) |
$954.75 |
$1,005 |
0.3× |
| Venous sampling by catheter (75893) |
$2,881.35 |
$3,033 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$298.30 |
$314 |
3.5× |
| Wrist 2 views (73100) |
$350.55 |
$369 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$323 |
$340 |
3.8× |
| X-ray antegrade pyelogram tube (74425) |
$1,348.05 |
$1,419 |
4.0× |
| X-Ray Aorta Leg Arteries (75630) |
$4,048.90 |
$4,262 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$399.95 |
$421 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$320.15 |
$337 |
3.8× |
| X-Ray Exam Breast Specimen (76098) |
$955.70 |
$1,006 |
1.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$225.15 |
$237 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$699.20 |
$736 |
6.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$443.65 |
$467 |
4.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$278.35 |
$293 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$321.10 |
$338 |
3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$327.75 |
$345 |
3.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$422.75 |
$445 |
4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$296.40 |
$312 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$359.10 |
$378 |
3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$450.30 |
$474 |
5.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$756.20 |
$796 |
7.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$324.90 |
$342 |
3.2× |
| X-ray eye for foreign body (70030) |
$263.15 |
$277 |
3.1× |
| X-ray head for orthodontia (70350) |
$85.50 |
$90 |
1.0× |
| X-ray humerus (73060) |
$423.70 |
$446 |
5.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,264.45 |
$1,331 |
7.4× |
| X-ray IV pyelogram+tomography (74415) |
$1,291.05 |
$1,359 |
7.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$208.05 |
$219 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$343.90 |
$362 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$452.20 |
$476 |
4.5× |
| X-ray nose-rectum child f.b. (76010) |
$191.90 |
$202 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$273.60 |
$288 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$205.20 |
$216 |
2.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$254.60 |
$268 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$377.15 |
$397 |
4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$390.45 |
$411 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$394.25 |
$415 |
3.9× |
| X-ray thoracic spine 4 vw (72074) |
$248.90 |
$262 |
2.5× |
| X-Ray Tmj Unilat (70328) |
$189.05 |
$199 |
2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$426.55 |
$449 |
1.3× |
| X-Rays Bone Length Studies (77073) |
$190 |
$200 |
1.9× |
| X-Rays Bone Survey Complete (77075) |
$1,207.45 |
$1,271 |
11.9× |
| Xr c-spine 4 or 5 views (72050) |
$597.55 |
$629 |
5.9× |
| Xr facial bones less than 3 views (70140) |
$165.30 |
$174 |
2.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$217.55 |
$229 |
2.1× |
| Xr orbits complete 4 views (70200) |
$503.50 |
$530 |
5.0× |
| Xr Tomogram Single Plane (76100) |
$691.60 |
$728 |
6.8× |