| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,454.25 |
$9,939 |
4.5× |
| Abdomen 2 views (74019) |
$409.50 |
$546 |
3.3× |
| Angiography extremity bilateral rs&i (75716) |
$7,063.50 |
$9,418 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$6,569.25 |
$8,759 |
1.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,487.50 |
$8,650 |
1.0× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,723.50 |
$2,298 |
0.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,619.25 |
$14,159 |
1.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,391 |
$3,188 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,305.50 |
$3,074 |
0.6× |
| Ankle 2 views (73600) |
$319.50 |
$426 |
3.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,204.50 |
$9,606 |
1.9× |
| Aortography abdominal serialography rs&i (75625) |
$5,832 |
$7,776 |
1.5× |
| Basic dosimetry (77300) |
$986.25 |
$1,315 |
6.1× |
| Bone &/joint imaging whole body (78306) |
$1,425.75 |
$1,901 |
3.0× |
| Bone age studies (77072) |
$261.75 |
$349 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,933.50 |
$2,578 |
4.0× |
| Bone Marrow Imaging Limited Area (78102) |
$943.50 |
$1,258 |
2.0× |
| Bone survey complete (77075) |
$964.50 |
$1,286 |
7.7× |
| Brachytx isodose complex (77318) |
$1,268.25 |
$1,691 |
2.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$717.75 |
$957 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,779.75 |
$6,373 |
2.8× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,509 |
$2,012 |
3.1× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$4,011 |
$5,348 |
6.2× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$4,313.25 |
$5,751 |
4.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,444.75 |
$4,593 |
8.2× |
| Cardiac shunt detection (78428) |
$1,303.50 |
$1,738 |
2.7× |
| Cervical spine 2 or 3 views (72040) |
$426.75 |
$569 |
4.1× |
| Chest 1 view (71045) |
$280.50 |
$374 |
2.7× |
| Chest xray 3 views (71047) |
$425.25 |
$567 |
4.1× |
| Clavicle complete (73000) |
$319.50 |
$426 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$708.75 |
$945 |
5.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,047.75 |
$1,397 |
6.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,698.50 |
$3,598 |
6.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,323.75 |
$1,765 |
4.6× |
| CT abdomen w contrast (74160) |
$2,259.75 |
$3,013 |
10.7× |
| CT abdomen w wo contrast (74170) |
$2,434.50 |
$3,246 |
11.6× |
| CT abdomen w/o contrast (74150) |
$1,596.75 |
$2,129 |
12.7× |
| CT angio hrt w/3d image (75574) |
$2,659.50 |
$3,546 |
6.4× |
| CT c-spine w/contrast (72126) |
$2,091.75 |
$2,789 |
5.0× |
| CT c-spine w/o contrast (72125) |
$1,719 |
$2,292 |
13.7× |
| CT chest w contrast (71260) |
$2,118.75 |
$2,825 |
10.1× |
| CT chest w/wo contrast (71270) |
$2,717.25 |
$3,623 |
12.9× |
| CT colonography screening (74263) |
$3,360 |
$4,480 |
11.8× |
| CT colonography w/dye (74262) |
$4,341.75 |
$5,789 |
20.7× |
| CT colonography w/o cntrst (74261) |
$3,874.50 |
$5,166 |
30.9× |
| CT head/brain with contrast (70460) |
$1,775.25 |
$2,367 |
8.4× |
| CT head/brain without and with contrast (70470) |
$2,116.50 |
$2,822 |
10.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$813 |
$1,084 |
1.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$335.25 |
$447 |
3.2× |
| CT hrt w/3d image congen (75573) |
$1,089.75 |
$1,453 |
2.6× |
| CT iac w contrast (70481) |
$2,458.12 |
$3,277.50 |
11.7× |
| CT limited/localized follow up study (76380) |
$1,002.75 |
$1,337 |
9.6× |
| CT lower ext w/o (73700) |
$1,649.25 |
$2,199 |
13.2× |
| CT lower extremity w/contrast material (73701) |
$1,944 |
$2,592 |
9.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,601 |
$3,468 |
12.4× |
| CT lumbar spine w/contrast (72132) |
$2,100.75 |
$2,801 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$1,708.50 |
$2,278 |
13.6× |
| CT maxillofacial w contrast (70487) |
$2,199.75 |
$2,933 |
10.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,637 |
$3,516 |
12.5× |
| CT maxillofacial wo contrast (70486) |
$1,795.50 |
$2,394 |
14.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,851.12 |
$3,801.50 |
13.6× |
| CT orbits w/o contrast (70480) |
$2,136 |
$2,848 |
17.0× |
| CT pelvis w/o contrast (72192) |
$1,617 |
$2,156 |
12.9× |
| CT pelvis w/wo contrast (72194) |
$2,600.25 |
$3,467 |
12.4× |
| CT soft tissue neck w contrast (70491) |
$2,142.75 |
$2,857 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,622.75 |
$3,497 |
12.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,764 |
$2,352 |
14.1× |
| CT thoracic spine w/contrast (72129) |
$2,076 |
$2,768 |
9.9× |
| CT thoracic spine w/o contrast (72128) |
$1,694.25 |
$2,259 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,740.75 |
$2,321 |
13.9× |
| CT unlisted procedure (76497) |
$1,638 |
$2,184 |
15.7× |
| CT upper ext wo (73200) |
$1,591.50 |
$2,122 |
12.7× |
| CT upper extremity with contrast (73201) |
$1,905.75 |
$2,541 |
4.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,903.25 |
$3,871 |
13.8× |
| Cta Abdomen (74175) |
$2,502 |
$3,336 |
11.9× |
| CTA abdomen pelvis (74174) |
$3,394.50 |
$4,526 |
8.1× |
| CTA chest (71275) |
$3,125.25 |
$4,167 |
14.9× |
| Cta Head (70496) |
$3,700.50 |
$4,934 |
17.6× |
| Cta Neck (70498) |
$3,553.50 |
$4,738 |
16.9× |
| Cta Pelvis (72191) |
$2,562.75 |
$3,417 |
12.2× |
| Cystography minimum 3 views rs&i (74430) |
$820.50 |
$1,094 |
2.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$257.25 |
$343 |
2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$322.50 |
$430 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$494.25 |
$659 |
3.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$495 |
$660 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$289.50 |
$386 |
2.8× |
| Dxa bone density study axial skeleton (77085) |
$469.50 |
$626 |
3.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$696 |
$928 |
2.4× |
| Esophagus (74220) |
$991.50 |
$1,322 |
4.7× |
| Facial bones min 3 views (70150) |
$487.50 |
$650 |
3.9× |
| Fetal Echo (76825) |
$1,161.75 |
$1,549 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$1,296.75 |
$1,729 |
4.5× |
| Foot 2 views (73620) |
$310.50 |
$414 |
3.0× |
| Forearm 2 views (73090) |
$307.50 |
$410 |
2.9× |
| Functional MRI brain by tech (70554) |
$3,825.75 |
$5,101 |
13.4× |
| Hand 2 views (73120) |
$321 |
$428 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,397.25 |
$1,863 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,546.25 |
$3,395 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,015.50 |
$5,354 |
4.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$7,177.50 |
$9,570 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,415 |
$3,220 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,545 |
$2,060 |
3.2× |
| Hysterosalpingogram (74740) |
$946.50 |
$1,262 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$5,497.50 |
$7,330 |
6.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$436.50 |
$582 |
3.5× |
| Kidney imaging morphology (78700) |
$1,146 |
$1,528 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,328.25 |
$1,771 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,650 |
$2,200 |
2.5× |
| Knee 3 views (73562) |
$404.25 |
$539 |
3.9× |
| Lung perf&ventilat diferentl (78598) |
$1,650.75 |
$2,201 |
2.5× |
| Lung perfusion differential (78597) |
$1,071 |
$1,428 |
2.2× |
| Lymphoscintigraphy (78195) |
$2,015.25 |
$2,687 |
3.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,583.62 |
$2,111.50 |
1.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70559) |
$7,448.25 |
$9,931 |
35.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,878 |
$6,504 |
11.7× |
| Magnetic Resonance Elastography (76391) |
$1,101 |
$1,468 |
3.9× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$519.75 |
$693 |
5.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,709.50 |
$8,946 |
15.0× |
| MRA head w/o contrast (70544) |
$3,663 |
$4,884 |
12.8× |
| MRA neck w contrast (70548) |
$3,722.25 |
$4,963 |
8.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,252.50 |
$5,670 |
10.2× |
| MRA neck w/o contrast (70547) |
$3,522.75 |
$4,697 |
12.3× |
| MRI abdomen w contrast (74182) |
$4,767.75 |
$6,357 |
11.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,888.50 |
$6,518 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$3,247.50 |
$4,330 |
11.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,649 |
$3,532 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,381 |
$4,508 |
8.1× |
| MRI breast w/o contrast bilateral (77047) |
$4,144.50 |
$5,526 |
14.5× |
| MRI c-spine with contrast (72142) |
$4,025.25 |
$5,367 |
9.6× |
| MRI cardiac w/o contrast (75557) |
$3,312 |
$4,416 |
11.6× |
| MRI cervical spine w/o contrast (72141) |
$3,309.75 |
$4,413 |
11.6× |
| MRI chest w/o & w/contrast material (71552) |
$5,789.25 |
$7,719 |
13.8× |
| MRI chest w/o contrast (71550) |
$4,144.50 |
$5,526 |
14.5× |
| MRI chest with contrast (71551) |
$4,582.50 |
$6,110 |
4.9× |
| MRI fetal sngl/1st gestation (74712) |
$1,974.75 |
$2,633 |
6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,870.50 |
$6,494 |
11.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,628.50 |
$4,838 |
12.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,553.50 |
$4,738 |
12.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,082.25 |
$5,443 |
9.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,878.75 |
$6,505 |
11.7× |
| MRI pelvis w/o contrast (72195) |
$3,684.75 |
$4,913 |
12.9× |
| MRI spectroscopy (76390) |
$2,682.75 |
$3,577 |
25.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,840.50 |
$6,454 |
11.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,700.50 |
$4,934 |
8.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,788 |
$6,384 |
11.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,691.50 |
$4,922 |
8.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,464.75 |
$5,953 |
10.7× |
| MRI temporomandibular joint (70336) |
$3,222.75 |
$4,297 |
11.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,329.25 |
$4,439 |
11.6× |
| MRI up ext w/o contrast (73218) |
$3,765 |
$5,020 |
13.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,696.25 |
$3,595 |
9.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,662.25 |
$4,883 |
2.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$6,261 |
$8,348 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$4,008.75 |
$5,345 |
2.6× |
| Myocardial spect single study at rest or stress (78451) |
$3,828 |
$5,104 |
2.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$6,128.25 |
$8,171 |
3.6× |
| N-invas est c ffr sw aly CTA (75580) |
$5,831.25 |
$7,775 |
5.7× |
| Neck soft tissue (70360) |
$314.25 |
$419 |
3.0× |
| Nm gastric emptying study (78264) |
$1,639.50 |
$2,186 |
3.4× |
| Nonvascular shunt X-ray (75809) |
$602.25 |
$803 |
4.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$15,705 |
$20,940 |
9.5× |
| Nuclear Rx Oral Admin (79005) |
$642 |
$856 |
2.3× |
| Orthopantogram (70355) |
$129 |
$172 |
1.2× |
| Parathyrd planar w/spect&CT (78072) |
$2,522.25 |
$3,363 |
3.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,196.75 |
$2,929 |
4.6× |
| Pelvis 1 or 2 views (72170) |
$258.75 |
$345 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$4,783.50 |
$6,378 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,833 |
$6,444 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,839 |
$6,452 |
2.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,950.75 |
$6,601 |
3.2× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$4,979.25 |
$6,639 |
2.9× |
| Proton tx delivery complex (77525) |
$6,109.50 |
$8,146 |
4.1× |
| Proton tx delivery simple w/o compensation (77520) |
$3,657 |
$4,876 |
5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,204.50 |
$9,606 |
1.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,409.75 |
$3,213 |
0.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,800 |
$2,400 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$826.50 |
$1,102 |
1.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$442.50 |
$590 |
4.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$315 |
$420 |
3.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$406.50 |
$542 |
3.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$290.25 |
$387 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$516 |
$688 |
4.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$565.50 |
$754 |
4.5× |
| Radex fingr minimum 2 views (73140) |
$354.75 |
$473 |
3.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$365.25 |
$487 |
3.5× |
| Radex Hand Minimum 3 Views (73130) |
$365.25 |
$487 |
3.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$423 |
$564 |
3.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$321.75 |
$429 |
2.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$462.75 |
$617 |
3.7× |
| Radex Humerus Minimum 2 Views (73060) |
$333.75 |
$445 |
3.2× |
| Radex Kne 1/2 Views (73560) |
$327 |
$436 |
3.1× |
| Radex Kne Compl 4/More Views (73564) |
$485.25 |
$647 |
3.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$408 |
$544 |
3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$371.25 |
$495 |
3.6× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$308.25 |
$411 |
2.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$339 |
$452 |
3.3× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$571.50 |
$762 |
4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$543.75 |
$725 |
5.2× |
| Radex Toe Minimum 2 Views (73660) |
$341.25 |
$455 |
3.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$408 |
$544 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$672.75 |
$897 |
5.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$31,943.25 |
$42,591 |
3.6× |
| Radiation treatment delivery level 3 (77412) |
$1,887.75 |
$2,517 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$290.25 |
$387 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$447 |
$596 |
3.6× |
| Radiologic exam chest 2 views (71046) |
$354 |
$472 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$1,916.25 |
$2,555 |
9.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$709.50 |
$946 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,523.25 |
$2,031 |
7.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,248 |
$1,664 |
5.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$303 |
$404 |
2.9× |
| Radiological examination surgical specimen (76098) |
$871.50 |
$1,162 |
1.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,776 |
$2,368 |
3.8× |
| Ribs bilateral 3 views (71110) |
$454.50 |
$606 |
3.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,866 |
$2,488 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,143.25 |
$4,191 |
4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,652.25 |
$6,203 |
3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,719.75 |
$6,293 |
2.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,784.50 |
$5,046 |
2.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,884 |
$2,512 |
6.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,012.50 |
$1,350 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$233.25 |
$311 |
1.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$678.75 |
$905 |
2.4× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$887.25 |
$1,183 |
1.9× |
| Scapula (73010) |
$332.25 |
$443 |
2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$162.75 |
$217 |
7.0× |
| Shoulder 1 view (73020) |
$255 |
$340 |
2.4× |
| Small bowel series (74250) |
$993 |
$1,324 |
4.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,485.75 |
$1,981 |
3.3× |
| Special dosimetry (77331) |
$538.50 |
$718 |
3.3× |
| Special Physics Consult (77370) |
$859.50 |
$1,146 |
5.3× |
| Special treatment procedure (77470) |
$4,605 |
$6,140 |
7.0× |
| Spine thoracic 3 views (72072) |
$432 |
$576 |
3.4× |
| Stereotactic Body Radiation Delivery (77373) |
$23,896.50 |
$31,862 |
11.2× |
| Tbs technical calculation only (77091) |
$351.75 |
$469 |
3.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,263.50 |
$3,018 |
5.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,074.75 |
$5,433 |
9.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,202 |
$2,936 |
13.7× |
| Thoracolumbar 2 views (72080) |
$310.50 |
$414 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,820.25 |
$2,427 |
2.8× |
| Thyroid uptake measurement (78012) |
$242.25 |
$323 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$711 |
$948 |
1.5× |
| Treatment device complex (77334) |
$2,082.75 |
$2,777 |
4.6× |
| Treatment devices simple (77332) |
$1,013.25 |
$1,351 |
6.3× |
| Ultrasound breast complete (76641) |
$357 |
$476 |
2.8× |
| Ultrasound Exam Aaa Screen (76706) |
$336.75 |
$449 |
2.7× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,623 |
$2,164 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$348 |
$464 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$410.25 |
$547 |
3.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$997.50 |
$1,330 |
9.6× |
| Unlisted fluoroscopic procedure (76496) |
$4,174.12 |
$5,565.50 |
40.0× |
| Unlisted magnetic resonance procedure (76498) |
$11,076.75 |
$14,769 |
106.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$270 |
$360 |
0.6× |
| Urethrocystogram voiding (74455) |
$1,161 |
$1,548 |
4.1× |
| Urethrocystography retrograde rs&i (74450) |
$858 |
$1,144 |
3.0× |
| Us breast unilateral limited (76642) |
$273 |
$364 |
2.6× |
| Us chest (76604) |
$268.50 |
$358 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$627 |
$836 |
5.0× |
| Us elastography parenchyma (76981) |
$250.50 |
$334 |
2.0× |
| Us encephalogram (76506) |
$906.75 |
$1,209 |
7.2× |
| Us hips infant static (76886) |
$659.25 |
$879 |
6.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$181.50 |
$242 |
1.4× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$291 |
$388 |
2.3× |
| Us ob limited (76815) |
$467.25 |
$623 |
3.7× |
| Us ob transvaginal (76817) |
$528 |
$704 |
4.2× |
| Us pelvic non ob complete (76856) |
$673.50 |
$898 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$323.25 |
$431 |
2.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$659.25 |
$879 |
5.3× |
| Us retroperitoneal complete (76770) |
$410.25 |
$547 |
3.3× |
| Us retroperitoneal limited (76775) |
$354 |
$472 |
2.8× |
| Us scrotum and contents (76870) |
$669.75 |
$893 |
5.3× |
| Us soft tissue head/neck (76536) |
$621 |
$828 |
5.0× |
| Us spinal canal and contents (76800) |
$848.25 |
$1,131 |
6.8× |
| Us transrectal (76872) |
$819 |
$1,092 |
6.5× |
| Us transrectal prostate volume (76873) |
$960 |
$1,280 |
7.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$792 |
$1,056 |
6.3× |
| Venogram extremity bilateral (75822) |
$2,051.25 |
$2,735 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$1,587.75 |
$2,117 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$5,650.50 |
$7,534 |
1.5× |
| Venous sampling by catheter (75893) |
$5,952.75 |
$7,937 |
0.9× |
| Wrist 2 views (73100) |
$340.50 |
$454 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$421.50 |
$562 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$263.25 |
$351 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$342 |
$456 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$382.50 |
$510 |
3.1× |
| X-ray exam of femur 2/> (73552) |
$261 |
$348 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$321.75 |
$429 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$362.25 |
$483 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$450.75 |
$601 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$837 |
$1,116 |
6.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$493.50 |
$658 |
3.9× |
| X-ray retrograde pyelogram (74420) |
$1,023 |
$1,364 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$365.25 |
$487 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$447 |
$596 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$603 |
$804 |
4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$407.25 |
$543 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$328.50 |
$438 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$431.25 |
$575 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$536.25 |
$715 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$411 |
$548 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$259.50 |
$346 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$423 |
$564 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$364.50 |
$486 |
3.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$377.25 |
$503 |
3.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$518.25 |
$691 |
4.1× |
| Xr bone length studies (77073) |
$417 |
$556 |
3.3× |
| Xr c-spine 4 or 5 views (72050) |
$596.25 |
$795 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$768.75 |
$1,025 |
6.1× |
| Xr chest 4+ views (71048) |
$513 |
$684 |
4.1× |
| Xr urogram antegrade (74425) |
$1,095.75 |
$1,461 |
2.6× |