| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,258.80 |
$22,683.75 |
5.2× |
| Abdomen 2 views (74019) |
$378.08 |
$1,181.50 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,099.12 |
$3,434.75 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,977.76 |
$6,180.50 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,249.84 |
$3,905.75 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,190.32 |
$3,719.75 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$1,183.60 |
$3,698.75 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,680.32 |
$8,376 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,030.88 |
$9,471.50 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,926.32 |
$6,019.75 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,939.36 |
$6,060.50 |
0.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,547.28 |
$11,085.25 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$623.36 |
$1,948 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$870.16 |
$2,719.25 |
0.3× |
| Ankle 2 views (73600) |
$375.60 |
$1,173.75 |
4.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$548.96 |
$1,715.50 |
1.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,655.20 |
$8,297.50 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$750.40 |
$2,345 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$714.56 |
$2,233 |
0.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,337.68 |
$4,180.25 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$797.92 |
$2,493.50 |
0.3× |
| Arthrogram elbow (73085) |
$490.72 |
$1,533.50 |
1.4× |
| Arthrogram hip (73525) |
$667.28 |
$2,085.25 |
1.9× |
| Arthrogram shoulder (73040) |
$1,001.44 |
$3,129.50 |
2.9× |
| Arthrogram wrist (73115) |
$481.28 |
$1,504 |
1.4× |
| Arthrography knee lt (73580) |
$1,047 |
$3,271.88 |
3.0× |
| Basic radiation dosimetry calculation (77300) |
$731.04 |
$2,284.50 |
5.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,095.20 |
$3,422.50 |
2.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,150.48 |
$3,595.25 |
2.9× |
| Bone &/joint imaging whole body (78306) |
$1,366.96 |
$4,271.75 |
3.4× |
| Bone age studies (77072) |
$303.68 |
$949 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,433.28 |
$4,479 |
3.6× |
| Bone survey complete (77075) |
$812.32 |
$2,538.50 |
7.7× |
| Brachytx isodose complex (77318) |
$1,557.04 |
$4,865.75 |
4.1× |
| Brain image w/flow 4 + views (78606) |
$830.32 |
$2,594.75 |
1.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$688.48 |
$2,151.50 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,719.92 |
$11,624.75 |
2.6× |
| Brain Imaging Vascular Flow Only (78610) |
$352.32 |
$1,101 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,285.84 |
$4,018.25 |
3.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$275.36 |
$860.50 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$374 |
$1,168.75 |
4.3× |
| Chest 1 view (71045) |
$323.92 |
$1,012.25 |
3.7× |
| Chest 3 views (71047) |
$406.80 |
$1,271.25 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$482.56 |
$1,508 |
2.7× |
| Cineradiography/videoradiography (76120) |
$85.20 |
$266.25 |
0.8× |
| Clavicle complete (73000) |
$438 |
$1,368.75 |
5.0× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$28,664.56 |
$89,576.75 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,425.36 |
$4,454.25 |
13.6× |
| Continuing medical physics consltj pr wk (77336) |
$721.84 |
$2,255.75 |
5.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,788.24 |
$11,838.25 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,688.48 |
$8,401.50 |
11.2× |
| CT abdomen w contrast (74160) |
$2,668.40 |
$8,338.75 |
15.1× |
| CT abdomen w wo contrast (74170) |
$2,882.40 |
$9,007.50 |
16.4× |
| CT abdomen w/o contrast (74150) |
$2,015.84 |
$6,299.50 |
19.2× |
| CT angio hrt w/3d image (75574) |
$1,667.92 |
$5,212.25 |
4.8× |
| CT angiography upper extremity lt (73206) |
$3,776.88 |
$11,802.75 |
21.4× |
| CT c-spine w/o contrast (72125) |
$1,260.72 |
$3,939.75 |
12.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,290.72 |
$7,158.50 |
13.0× |
| CT cervical spine with contrast (72126) |
$1,667.68 |
$5,211.50 |
4.8× |
| CT chest w/wo contrast (71270) |
$2,165.28 |
$6,766.50 |
12.3× |
| CT chest with contrast (71260) |
$1,513.44 |
$4,729.50 |
8.6× |
| CT colonography screening (74263) |
$1,171.28 |
$3,660.25 |
4.9× |
| CT colonography w/dye (74262) |
$678.40 |
$2,120 |
3.9× |
| CT colonography w/o cntrst (74261) |
$497.04 |
$1,553.25 |
4.7× |
| CT head/brain with contrast (70460) |
$1,242.24 |
$3,882 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,443.60 |
$4,511.25 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,037.12 |
$3,241 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$490.88 |
$1,534 |
5.6× |
| CT hrt w/3d image congen (75573) |
$1,605.52 |
$5,017.25 |
4.6× |
| CT iac w contrast (70481) |
$1,507.60 |
$4,711.25 |
8.6× |
| CT limited/localized follow up study (76380) |
$453.36 |
$1,416.75 |
5.2× |
| CT lower ext w/o (73700) |
$1,885.20 |
$5,891.25 |
18.0× |
| CT lower extremity w wo contrast (73702) |
$2,314.08 |
$7,231.50 |
13.1× |
| CT lower extremity with contrast (73701) |
$2,103.76 |
$6,574.25 |
11.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,005.04 |
$9,390.75 |
17.1× |
| CT lumbar spine w/o contrast (72131) |
$1,577.92 |
$4,931 |
15.0× |
| CT lumbar spine with contrast (72132) |
$2,156.48 |
$6,739 |
6.2× |
| CT maxillofacial w contrast (70487) |
$1,807.12 |
$5,647.25 |
10.3× |
| CT maxillofacial w/o contrast (70486) |
$1,308.48 |
$4,089 |
12.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,902.56 |
$5,945.50 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$1,590.64 |
$4,970.75 |
9.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,108.64 |
$6,589.50 |
12.0× |
| CT orbits w/o contrast (70480) |
$1,179.52 |
$3,686 |
11.2× |
| CT pelvis w & w/o contrast (72194) |
$2,037.12 |
$6,366 |
11.6× |
| CT pelvis w/o contrast (72192) |
$1,623.04 |
$5,072 |
15.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,741.76 |
$5,443 |
9.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,145.04 |
$3,578.25 |
10.9× |
| CT thoracic spine w/contrast (72129) |
$2,608.88 |
$8,152.75 |
14.8× |
| CT thoracic spine w/o contrast (72128) |
$1,872.32 |
$5,851 |
17.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,467.92 |
$10,837.25 |
19.7× |
| CT thorax w/o contrast (71250) |
$1,251.84 |
$3,912 |
11.9× |
| CT unlisted procedure (76497) |
$539.52 |
$1,686 |
6.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,004 |
$9,387.50 |
17.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,652 |
$5,162.50 |
15.7× |
| CT upper extremity with contrast (73201) |
$2,211.60 |
$6,911.25 |
6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,842.88 |
$5,759 |
10.5× |
| Cta Abdomen (74175) |
$2,417.20 |
$7,553.75 |
13.7× |
| CTA abdomen pelvis (74174) |
$3,633.92 |
$11,356 |
10.4× |
| CTA chest (71275) |
$1,476.56 |
$4,614.25 |
8.4× |
| Cta Head (70496) |
$1,128.40 |
$3,526.25 |
6.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,888.48 |
$9,026.50 |
16.4× |
| Cta Neck (70498) |
$1,265.92 |
$3,956 |
7.2× |
| Cta Pelvis (72191) |
$2,020.32 |
$6,313.50 |
11.5× |
| Cystography minimum 3 views rs&i (74430) |
$686.32 |
$2,144.75 |
2.0× |
| Diskography lumbar (72295) |
$1,512.64 |
$4,727 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$603.52 |
$1,886 |
5.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$897.20 |
$2,803.75 |
8.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$442.24 |
$1,382 |
4.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$311.28 |
$972.75 |
3.0× |
| Dxa bone density study axial skeleton (77085) |
$434.96 |
$1,359.25 |
4.1× |
| Echo exam of fetal heart (76825) |
$1,220.56 |
$3,814.25 |
2.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,057.28 |
$3,304 |
4.4× |
| Echoencephalography real time imaging (76506) |
$558.88 |
$1,746.50 |
5.3× |
| Esophagus (74220) |
$558.08 |
$1,744 |
3.2× |
| Fetal biophysical profile non-stress testing (76818) |
$1,113.84 |
$3,480.75 |
10.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,100.48 |
$3,439 |
10.5× |
| Fluoroscopy up to 1 hr (76000) |
$632.96 |
$1,978 |
2.6× |
| Foot 2 views (73620) |
$422.20 |
$1,319.38 |
4.8× |
| Forearm 2 views (73090) |
$425.20 |
$1,328.75 |
4.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$218.72 |
$683.50 |
0.9× |
| Functional MRI brain by phys/psych (70555) |
$226.16 |
$706.75 |
0.9× |
| Functional MRI brain by tech (70554) |
$778 |
$2,431.25 |
3.2× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,095.60 |
$3,423.75 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,260.08 |
$3,937.75 |
3.1× |
| Hand 2 views (73120) |
$429.30 |
$1,341.56 |
4.1× |
| Hand 3 views (73130) |
$495.20 |
$1,547.50 |
5.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,872.08 |
$15,225.25 |
7.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,801.36 |
$18,129.25 |
8.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$6,412.80 |
$20,040 |
9.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,231.52 |
$6,973.50 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,440.88 |
$4,502.75 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,297.04 |
$4,053.25 |
3.2× |
| Ht muscle image spect sing (78451) |
$2,825.44 |
$8,829.50 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$463.20 |
$1,447.50 |
5.3× |
| Hysterosalpingogram (74740) |
$820.80 |
$2,565 |
3.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$476.64 |
$1,489.50 |
1.2× |
| Kidney imaging morphology (78700) |
$801.84 |
$2,505.75 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,033.12 |
$3,228.50 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,180.64 |
$3,689.50 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,139.04 |
$3,559.50 |
2.1× |
| Knee 3 views (73562) |
$525.80 |
$1,643.12 |
6.0× |
| Liver & spleen imaging static only (78215) |
$1,011.20 |
$3,160 |
2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,061.44 |
$3,317 |
2.6× |
| Liver imaging w/vascular flow (78202) |
$1,011.20 |
$3,160 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$938.72 |
$2,933.50 |
1.7× |
| Lung perfusion differential (78597) |
$853.28 |
$2,666.50 |
2.1× |
| Lung Ventilation Imaging (78579) |
$853.28 |
$2,666.50 |
2.1× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$166.56 |
$520.50 |
0.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$221.92 |
$693.50 |
0.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$332.96 |
$1,040.50 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$110.96 |
$346.75 |
0.0× |
| Lymphoscintigraphy (78195) |
$1,142.08 |
$3,569 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$389.36 |
$1,216.75 |
1.6× |
| Meckels Diverticulum (78290) |
$831.12 |
$2,597.25 |
2.1× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$540.40 |
$1,688.75 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,500.72 |
$7,814.75 |
6.6× |
| Mr safety determination physician/other qhp (76016) |
$180.16 |
$563 |
2.1× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$366.56 |
$1,145.50 |
6.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$140.48 |
$439 |
4.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$281.04 |
$878.25 |
2.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$553.60 |
$1,730 |
2.3× |
| MRA head w & w/o contrast (70546) |
$2,304.48 |
$7,201.50 |
6.6× |
| MRA head w/o contrast (70544) |
$1,345.28 |
$4,204 |
5.6× |
| MRA head with contrast (70545) |
$1,547.20 |
$4,835 |
4.4× |
| MRA neck w contrast (70548) |
$1,535.36 |
$4,798 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,889.68 |
$5,905.25 |
5.4× |
| MRA neck w/o contrast (70547) |
$1,335.12 |
$4,172.25 |
5.6× |
| MRI abdomen w contrast (74182) |
$1,806.64 |
$5,645.75 |
5.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,069.84 |
$6,468.25 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,506.24 |
$4,707 |
6.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,810.40 |
$5,657.50 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,319.44 |
$4,123.25 |
1.7× |
| MRI bone marrow blood supply (77084) |
$404.24 |
$1,263.25 |
1.7× |
| MRI breast w/o contrast bilateral (77047) |
$1,123.60 |
$3,511.25 |
4.7× |
| MRI c-spine with contrast (72142) |
$2,036.48 |
$6,364 |
5.8× |
| MRI cardiac w/o cont stress (75559) |
$1,572.48 |
$4,914 |
2.9× |
| MRI cardiac w/o contrast (75557) |
$1,173.68 |
$3,667.75 |
4.9× |
| MRI cervical spine w/o contrast (72141) |
$1,715.60 |
$5,361.25 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,586.96 |
$4,959.25 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,164.56 |
$3,639.25 |
4.9× |
| MRI chest with contrast (71551) |
$1,336.64 |
$4,177 |
1.7× |
| MRI fetal sngl/1st gestation (74712) |
$298 |
$931.25 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,748.32 |
$5,463.50 |
5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,629.44 |
$5,092 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,771.10 |
$5,534.69 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,332 |
$4,162.50 |
5.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,918.24 |
$5,994.50 |
5.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,501.92 |
$4,693.50 |
4.3× |
| MRI pelvis w contrast (72196) |
$1,978.40 |
$6,182.50 |
5.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,055.12 |
$6,422.25 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,641.36 |
$5,129.25 |
6.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,455.92 |
$4,549.75 |
4.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,785.52 |
$5,579.75 |
2.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,963.60 |
$6,136.25 |
5.6× |
| MRI spectroscopy (76390) |
$1,066.16 |
$3,331.75 |
12.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,509.52 |
$7,842.25 |
7.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,792.88 |
$5,602.75 |
5.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,175.68 |
$6,799 |
6.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,660.48 |
$5,189 |
4.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,041.52 |
$6,379.75 |
5.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,633.28 |
$5,104 |
6.8× |
| MRI tmj (70336) |
$1,160.64 |
$3,627 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,702.80 |
$5,321.25 |
7.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,335.20 |
$7,297.50 |
6.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,323.92 |
$4,137.25 |
5.5× |
| Myelogram Cervical (72240) |
$1,795.04 |
$5,609.50 |
2.3× |
| Myelogram Lumbar (72265) |
$1,592.24 |
$4,975.75 |
2.0× |
| Myelogram thoracic (72255) |
$1,533.52 |
$4,792.25 |
1.9× |
| Myelography 2 or more regions (72270) |
$1,709.12 |
$5,341 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,005.76 |
$12,518 |
3.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,649.52 |
$5,154.75 |
1.1× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,291.52 |
$7,161 |
1.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,369.76 |
$7,405.50 |
1.1× |
| Neck soft tissue (70360) |
$265.44 |
$829.50 |
3.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$343.84 |
$1,074.50 |
0.9× |
| Nm adrenal scan (78075) |
$948.88 |
$2,965.25 |
0.7× |
| Nm bone marrow wb (78104) |
$1,199.36 |
$3,748 |
3.0× |
| Nm cisternogram (78630) |
$259.28 |
$810.25 |
0.5× |
| Nm gastric emptying study (78264) |
$1,100.24 |
$3,438.25 |
2.7× |
| Nm gastroesophageal reflux study (78262) |
$428.56 |
$1,339.25 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,489.60 |
$23,405 |
5.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$907.36 |
$2,835.50 |
2.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,043.68 |
$3,261.50 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$1,378.72 |
$4,308.50 |
5.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$703.92 |
$2,199.75 |
6.7× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$334.08 |
$1,044 |
3.2× |
| Orthopantogram (70355) |
$238.72 |
$746 |
2.7× |
| Osseous survey infant (77076) |
$676.72 |
$2,114.75 |
6.4× |
| Osseous survey limited (77074) |
$652.32 |
$2,038.50 |
6.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,214 |
$3,793.75 |
3.0× |
| Parathyroid imaging (78070) |
$1,016.56 |
$3,176.75 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$301.84 |
$943.25 |
2.9× |
| Peritoneogram rs&i (74190) |
$456.16 |
$1,425.50 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$4,119.92 |
$12,874.75 |
2.9× |
| PET imaging CT for attenuation limited area (78814) |
$3,421.76 |
$10,693 |
2.4× |
| PET imaging for CT attenuation whole body (78816) |
$4,323.28 |
$13,510.25 |
3.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,266.80 |
$7,083.75 |
6.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$772.16 |
$2,413 |
0.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$735.52 |
$2,298.50 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$481.92 |
$1,506 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,163.44 |
$3,635.75 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$840.72 |
$2,627.25 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$523.60 |
$1,636.25 |
6.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$529.20 |
$1,653.75 |
5.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$795.44 |
$2,485.75 |
7.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$285.84 |
$893.25 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$758.48 |
$2,370.25 |
7.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,457.84 |
$51,430.75 |
2.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$788.72 |
$2,464.75 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$462.24 |
$1,444.50 |
4.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$332 |
$1,037.50 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$419.76 |
$1,311.75 |
4.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$389.28 |
$1,216.50 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$770.24 |
$2,407 |
4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$657.60 |
$2,055 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,082.48 |
$3,382.75 |
6.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$736.56 |
$2,301.75 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$588.30 |
$1,838.44 |
6.7× |
| Radiological examination surgical specimen (76098) |
$290.80 |
$908.75 |
0.5× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$548.72 |
$1,714.75 |
2.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$959.04 |
$2,997 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,148.80 |
$9,840 |
1.0× |
| Ribs bilateral 3 views (71110) |
$886.96 |
$2,771.75 |
8.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,557.44 |
$4,867 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,635.36 |
$5,110.50 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,724.72 |
$5,389.75 |
3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,901.60 |
$5,942.50 |
1.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,810.96 |
$5,659.25 |
1.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$246.56 |
$770.50 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$217.92 |
$681 |
0.9× |
| Sacroiliac Joints < 3 Views (72200) |
$228.64 |
$714.50 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$712.24 |
$2,225.75 |
3.0× |
| Scanogram (77073) |
$413.92 |
$1,293.50 |
3.9× |
| Scapula complete (73010) |
$392.16 |
$1,225.50 |
3.7× |
| Screening digital breast tomosynthesis (77063) |
$32 |
$100 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$445.76 |
$1,393 |
4.2× |
| Sialogram (70390) |
$423.12 |
$1,322.25 |
1.8× |
| Small bowel series (74250) |
$676.32 |
$2,113.50 |
3.8× |
| Spec medical radj physics consltj (77370) |
$3,751.40 |
$11,723.12 |
27.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,389.12 |
$4,341 |
3.7× |
| Special dosimetry (77331) |
$476.56 |
$1,489.25 |
3.5× |
| Special treatment procedure (77470) |
$3,733.20 |
$11,666.25 |
6.7× |
| Spine thoracic 3 views (72072) |
$546 |
$1,706.25 |
5.2× |
| Splenoportograpy rs&i (75810) |
$757.92 |
$2,368.50 |
0.2× |
| Stereotactic body radiation delivery (77373) |
$7,685.20 |
$24,016.25 |
4.3× |
| Superior sagittal sinus venogram (75870) |
$518.32 |
$1,619.75 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$550.08 |
$1,719 |
5.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,455.04 |
$4,547 |
3.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,482.56 |
$7,758 |
6.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$861.28 |
$2,691.50 |
6.4× |
| Therapeutic Enema (74283) |
$994.88 |
$3,109 |
5.6× |
| Thoracolumbar 2 views (72080) |
$380.08 |
$1,187.75 |
4.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,085.28 |
$3,391.50 |
2.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$710.72 |
$2,221 |
1.8× |
| Thyroid uptake measurement (78012) |
$447.28 |
$1,397.75 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,315.04 |
$4,109.50 |
3.3× |
| Tmj unilateral (70328) |
$258.64 |
$808.25 |
3.0× |
| Tomogram (76100) |
$529.12 |
$1,653.50 |
5.0× |
| Treatment device intermediate (77333) |
$1,179.44 |
$3,685.75 |
8.7× |
| Treatment devices simple (77332) |
$1,142.24 |
$3,569.50 |
8.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,717.04 |
$5,365.75 |
3.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,116.24 |
$3,488.25 |
2.8× |
| Tx devices design & construction complex (77334) |
$1,438.40 |
$4,495 |
3.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,317.28 |
$4,116.50 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$824.48 |
$2,576.50 |
7.9× |
| Umbilical-artery Doppler (OB) (76820) |
$394.72 |
$1,233.50 |
3.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$180.16 |
$563 |
2.1× |
| Unlisted fluoroscopic procedure (76496) |
$202.16 |
$631.75 |
2.3× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$766.56 |
$2,395.50 |
1.9× |
| Unlisted Ultrasound Procedure (76999) |
$148.96 |
$465.50 |
1.7× |
| Upper Extremity Infant (73092) |
$174.16 |
$544.25 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$753.60 |
$2,355 |
3.1× |
| Urethrocystography voiding (74455) |
$742.96 |
$2,321.75 |
3.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,204.80 |
$3,765 |
6.8× |
| Us abdl aorta screen aaa (76706) |
$629.28 |
$1,966.50 |
6.0× |
| Us breast unilateral complete (76641) |
$921.40 |
$2,879.38 |
8.8× |
| Us breast unilateral limited (76642) |
$894.10 |
$2,794.06 |
10.2× |
| Us chest (76604) |
$601.28 |
$1,879 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$976.80 |
$3,052.50 |
9.3× |
| Us elastography parenchyma (76981) |
$840.08 |
$2,625.25 |
8.0× |
| Us guided compression repair (76936) |
$127.52 |
$398.50 |
0.6× |
| Us infant hips dynamic (76885) |
$1,005.20 |
$3,141.25 |
11.5× |
| Us infant hips limited static (76886) |
$640.88 |
$2,002.75 |
7.3× |
| Us kidney transplant (76776) |
$997.68 |
$3,117.75 |
9.5× |
| Us ob detailed single fetus (76811) |
$1,130.96 |
$3,534.25 |
4.7× |
| Us ob transvaginal (76817) |
$1,142.64 |
$3,570.75 |
10.9× |
| Us pelvic non ob complete (76856) |
$1,009.04 |
$3,153.25 |
9.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$721.28 |
$2,254 |
6.9× |
| Us pregnancy ltd (76815) |
$767.20 |
$2,397.50 |
7.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$833.60 |
$2,605 |
7.9× |
| Us retroperitoneal complete (76770) |
$738.32 |
$2,307.25 |
7.0× |
| Us retroperitoneal limited (76775) |
$1,003.04 |
$3,134.50 |
9.6× |
| Us scrotum and contents (76870) |
$904.16 |
$2,825.50 |
8.6× |
| Us soft tissue head/neck (76536) |
$706.08 |
$2,206.50 |
6.7× |
| Us spinal canal and contents (76800) |
$794.40 |
$2,482.50 |
7.6× |
| Us transrectal (76872) |
$969.44 |
$3,029.50 |
9.2× |
| Us transrectal prostate volume (76873) |
$644.96 |
$2,015.50 |
6.1× |
| Us xtr non-vasc lmtd (76882) |
$853.92 |
$2,668.50 |
8.1× |
| Vascular flow imaging (78445) |
$322 |
$1,006.25 |
0.8× |
| Venogram extremity bilateral (75822) |
$1,067.04 |
$3,334.50 |
0.7× |
| Venogram orbital (75880) |
$579.20 |
$1,810 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$1,354.32 |
$4,232.25 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$1,701.92 |
$5,318.50 |
1.1× |
| Venography epidural rs&i (75872) |
$222.08 |
$694 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$836.80 |
$2,615 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,991.28 |
$9,347.75 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$1,380.64 |
$4,314.50 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$454.08 |
$1,419 |
0.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$2,835.92 |
$8,862.25 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$554.48 |
$1,732.75 |
6.3× |
| Wrist 2 views (73100) |
$405 |
$1,265.62 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$533.20 |
$1,666.25 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$500.48 |
$1,564 |
5.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$498.50 |
$1,557.82 |
5.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,033.52 |
$3,229.75 |
5.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$463.90 |
$1,449.69 |
5.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$519.60 |
$1,623.75 |
5.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$664.72 |
$2,077.25 |
6.3× |
| X-ray exam hip uni 1 view (73501) |
$228.32 |
$713.50 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$459.60 |
$1,436.25 |
5.3× |
| X-ray exam hip uni 4/> views (73503) |
$831.28 |
$2,597.75 |
7.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$954.32 |
$2,982.25 |
9.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,445.20 |
$4,516.25 |
13.8× |
| X-ray exam of femur 1 (73551) |
$333.60 |
$1,042.50 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$519.52 |
$1,623.50 |
4.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$393.36 |
$1,229.25 |
4.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$487.20 |
$1,522.50 |
5.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$970.72 |
$3,033.50 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$372.10 |
$1,162.82 |
4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$383.52 |
$1,198.50 |
4.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$659.20 |
$2,060 |
6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$379.28 |
$1,185.25 |
4.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$221.44 |
$692 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$443.92 |
$1,387.25 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$769.04 |
$2,403.25 |
7.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$331.76 |
$1,036.75 |
3.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$209.76 |
$655.50 |
2.4× |
| X-ray of voice box or throat (70370) |
$1,657.04 |
$5,178.25 |
19.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$516 |
$1,612.50 |
4.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$394.96 |
$1,234.25 |
3.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$298.88 |
$934 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,082.16 |
$3,381.75 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$393.20 |
$1,228.75 |
4.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$434.80 |
$1,358.75 |
4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$895.36 |
$2,798 |
8.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$271.12 |
$847.25 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$346.16 |
$1,081.75 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$549 |
$1,715.62 |
6.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$497.04 |
$1,553.25 |
5.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$320.56 |
$1,001.75 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$588.16 |
$1,838 |
5.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$387.36 |
$1,210.50 |
3.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$282.24 |
$882 |
3.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$164.16 |
$513 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$307.20 |
$960 |
3.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$470.64 |
$1,470.75 |
4.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$573.44 |
$1,792 |
5.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$294.24 |
$919.50 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$481.30 |
$1,504.06 |
5.5× |
| Xr c-spine 6 or more views (72052) |
$697.76 |
$2,180.50 |
6.6× |
| Xr chest 4+ views (71048) |
$410.56 |
$1,283 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$289.92 |
$906 |
3.3× |
| Xr shoulder 1 view (73020) |
$457.10 |
$1,428.44 |
5.2× |
| Xr spine cervical 4 or 5 views (72050) |
$664.72 |
$2,077.25 |
6.3× |
| Xr tibia/fibula 2 views (73590) |
$521.40 |
$1,629.38 |
6.0× |
| Xr tmj bilateral (70330) |
$436.88 |
$1,365.25 |
5.0× |
| Xray knee 1 or 2 views rt (73560) |
$368.20 |
$1,150.62 |
4.2× |