| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,531.20 |
$23,535 |
5.4× |
| Abdomen 2 views (74019) |
$381.12 |
$1,191 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,165.28 |
$3,641.50 |
2.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,977.76 |
$6,180.50 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,500 |
$4,687.50 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,355.36 |
$4,235.50 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$1,183.60 |
$3,698.75 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,915.84 |
$12,237 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,056.80 |
$9,552.50 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,961.04 |
$6,128.25 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,037.12 |
$6,366 |
0.4× |
| 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) |
$1,029.44 |
$3,217 |
0.3× |
| Ankle 2 views (73600) |
$380.40 |
$1,188.75 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$597.28 |
$1,866.50 |
1.7× |
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) |
$943.20 |
$2,947.50 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$857.68 |
$2,680.25 |
0.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,704.08 |
$5,325.25 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$803.92 |
$2,512.25 |
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) |
$560.56 |
$1,751.75 |
1.6× |
| Arthrography knee lt (73580) |
$1,079.20 |
$3,372.50 |
3.1× |
| Basic radiation dosimetry calculation (77300) |
$846.24 |
$2,644.50 |
6.3× |
| 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) |
$307.60 |
$961.25 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,440.16 |
$4,500.50 |
3.6× |
| Bone survey complete (77075) |
$822.72 |
$2,571 |
7.8× |
| Brachytx isodose complex (77318) |
$1,824.08 |
$5,700.25 |
4.8× |
| Brain image w/flow 4 + views (78606) |
$1,279.52 |
$3,998.50 |
2.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,001.20 |
$3,128.75 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,731.36 |
$11,660.50 |
2.6× |
| Brain Imaging Vascular Flow Only (78610) |
$584.32 |
$1,826 |
1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,371.20 |
$4,285 |
3.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$555.92 |
$1,737.25 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$382.72 |
$1,196 |
4.4× |
| Chest 1 view (71045) |
$323.92 |
$1,012.25 |
3.7× |
| Chest 3 views (71047) |
$451.28 |
$1,410.25 |
5.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$486.56 |
$1,520.50 |
2.8× |
| Cineradiography/videoradiography (76120) |
$85.84 |
$268.25 |
0.8× |
| Clavicle complete (73000) |
$443.60 |
$1,386.25 |
5.1× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$29,678.84 |
$92,746.38 |
4.0× |
| 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) |
$748.88 |
$2,340.25 |
5.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,788.24 |
$11,838.25 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,724.72 |
$8,514.75 |
11.4× |
| 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) |
$1,390.32 |
$4,344.75 |
13.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,469.36 |
$7,716.75 |
14.0× |
| CT cervical spine with contrast (72126) |
$1,898.72 |
$5,933.50 |
5.4× |
| CT chest w/wo contrast (71270) |
$2,165.28 |
$6,766.50 |
12.3× |
| CT chest with contrast (71260) |
$1,659.12 |
$5,184.75 |
9.4× |
| 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) |
$529.44 |
$1,654.50 |
5.0× |
| CT head/brain with contrast (70460) |
$1,282.88 |
$4,009 |
7.3× |
| CT head/brain without and with contrast (70470) |
$1,443.60 |
$4,511.25 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,047.36 |
$3,273 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$495.76 |
$1,549.25 |
5.7× |
| CT hrt w/3d image congen (75573) |
$1,667.96 |
$5,212.38 |
4.8× |
| CT iac w contrast (70481) |
$1,654.80 |
$5,171.25 |
9.4× |
| 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) |
$1,639.60 |
$5,123.75 |
15.6× |
| CT lumbar spine with contrast (72132) |
$2,156.48 |
$6,739 |
6.2× |
| CT maxillofacial w contrast (70487) |
$1,917.52 |
$5,992.25 |
10.9× |
| CT maxillofacial w/o contrast (70486) |
$1,434.16 |
$4,481.75 |
13.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,060.32 |
$6,438.50 |
11.7× |
| 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) |
$2,269.04 |
$7,090.75 |
12.9× |
| 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) |
$1,790.56 |
$5,595.50 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,197.12 |
$3,741 |
11.4× |
| 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) |
$1,346.80 |
$4,208.75 |
12.8× |
| 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) |
$1,965.20 |
$6,141.25 |
11.2× |
| Cta Abdomen (74175) |
$2,417.20 |
$7,553.75 |
13.7× |
| CTA abdomen pelvis (74174) |
$3,858 |
$12,056.25 |
11.0× |
| CTA chest (71275) |
$1,601.92 |
$5,006 |
9.1× |
| Cta Head (70496) |
$1,450.80 |
$4,533.75 |
8.2× |
| CTA lwr ext w&w/o contrast (73706) |
$3,846.24 |
$12,019.50 |
21.8× |
| 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) |
$691.84 |
$2,162 |
2.0× |
| Diskography lumbar (72295) |
$1,531.92 |
$4,787.25 |
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) |
$362.40 |
$1,132.50 |
3.5× |
| Dxa bone density study axial skeleton (77085) |
$512.80 |
$1,602.50 |
4.9× |
| 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) |
$562.56 |
$1,758 |
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) |
$430.60 |
$1,345.62 |
4.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$221.44 |
$692 |
0.9× |
| Functional MRI brain by phys/psych (70555) |
$226.88 |
$709 |
0.9× |
| Functional MRI brain by tech (70554) |
$780.48 |
$2,439 |
3.3× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,410 |
$4,406.25 |
2.6× |
| Gated Heart Planar Single (78472) |
$1,390.48 |
$4,345.25 |
3.5× |
| Hand 2 views (73120) |
$434.80 |
$1,358.75 |
4.1× |
| Hand 3 views (73130) |
$495.20 |
$1,547.50 |
5.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,387.92 |
$16,837.25 |
7.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,362.88 |
$19,884 |
9.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$7,709.36 |
$24,091.75 |
11.0× |
| 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) |
$3,328.48 |
$10,401.50 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$469.02 |
$1,465.68 |
5.4× |
| Hysterosalpingogram (74740) |
$820.80 |
$2,565 |
3.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$554 |
$1,731.25 |
1.4× |
| Kidney imaging morphology (78700) |
$905.28 |
$2,829 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,402.40 |
$4,382.50 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,542.64 |
$4,820.75 |
2.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,696.88 |
$5,302.75 |
3.1× |
| Knee 3 views (73562) |
$612.32 |
$1,913.50 |
7.0× |
| Liver & spleen imaging static only (78215) |
$1,030.88 |
$3,221.50 |
2.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,134 |
$3,543.75 |
2.8× |
| Liver imaging w/vascular flow (78202) |
$1,030.88 |
$3,221.50 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$1,589.04 |
$4,965.75 |
2.9× |
| Lung perfusion differential (78597) |
$945.68 |
$2,955.25 |
2.4× |
| Lung Ventilation Imaging (78579) |
$947.28 |
$2,960.25 |
2.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,959.76 |
$9,249.25 |
0.9× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$3,432.80 |
$10,727.50 |
5.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$3,776.08 |
$11,800.25 |
2.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,690.80 |
$8,408.75 |
0.8× |
| Lymphoscintigraphy (78195) |
$1,196.36 |
$3,738.62 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$389.36 |
$1,216.75 |
1.6× |
| Meckels Diverticulum (78290) |
$1,057.92 |
$3,306 |
2.6× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$560.64 |
$1,752 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,430.56 |
$10,720.50 |
9.1× |
| Mr safety determination physician/other qhp (76016) |
$216.16 |
$675.50 |
2.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$439.84 |
$1,374.50 |
7.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$158.24 |
$494.50 |
5.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$337.28 |
$1,054 |
3.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$664.24 |
$2,075.75 |
2.8× |
| MRA head w & w/o contrast (70546) |
$2,320.08 |
$7,250.25 |
6.6× |
| MRA head w/o contrast (70544) |
$1,707.92 |
$5,337.25 |
7.1× |
| MRA head with contrast (70545) |
$1,878.72 |
$5,871 |
5.4× |
| MRA neck w contrast (70548) |
$2,335.84 |
$7,299.50 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,401.04 |
$7,503.25 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,696.56 |
$5,301.75 |
7.1× |
| MRI abdomen w contrast (74182) |
$1,933.04 |
$6,040.75 |
5.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,380 |
$7,437.50 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$1,578.48 |
$4,932.75 |
6.6× |
| 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) |
$1,463.60 |
$4,573.75 |
1.9× |
| MRI bone marrow blood supply (77084) |
$579.76 |
$1,811.75 |
2.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,768.88 |
$5,527.75 |
7.4× |
| MRI c-spine with contrast (72142) |
$2,470.96 |
$7,721.75 |
7.1× |
| MRI cardiac w/o cont stress (75559) |
$1,676.88 |
$5,240.25 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$1,251.60 |
$3,911.25 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$2,078.24 |
$6,494.50 |
8.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,944.40 |
$6,076.25 |
5.5× |
| MRI chest w/o contrast (71550) |
$1,426.96 |
$4,459.25 |
6.0× |
| MRI chest with contrast (71551) |
$1,965.60 |
$6,142.50 |
2.5× |
| MRI fetal sngl/1st gestation (74712) |
$327.92 |
$1,024.75 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,869.36 |
$8,966.75 |
8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,159.84 |
$6,749.50 |
6.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,908 |
$5,962.50 |
8.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,692.40 |
$5,288.75 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,385.28 |
$7,454 |
6.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,821.76 |
$5,693 |
5.2× |
| MRI pelvis w contrast (72196) |
$1,978.40 |
$6,182.50 |
5.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,342.24 |
$7,319.50 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$1,641.36 |
$5,129.25 |
6.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,243.84 |
$7,012 |
6.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,904.08 |
$5,950.25 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,093.92 |
$6,543.50 |
6.0× |
| MRI spectroscopy (76390) |
$1,100.08 |
$3,437.75 |
12.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,010.40 |
$9,407.50 |
8.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,269.36 |
$7,091.75 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,582.16 |
$8,069.25 |
7.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,016.32 |
$6,301 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,347.60 |
$7,336.25 |
6.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,999.28 |
$6,247.75 |
8.3× |
| MRI tmj (70336) |
$1,449.28 |
$4,529 |
6.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,020.20 |
$6,313.12 |
8.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,988.70 |
$9,339.69 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,434.40 |
$4,482.50 |
6.0× |
| 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) |
$2,091.20 |
$6,535 |
1.5× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,905.12 |
$9,078.50 |
1.3× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,004.24 |
$9,388.25 |
1.4× |
| Neck soft tissue (70360) |
$275.36 |
$860.50 |
3.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$343.84 |
$1,074.50 |
0.9× |
| Nm adrenal scan (78075) |
$1,102.64 |
$3,445.75 |
0.8× |
| Nm bone marrow wb (78104) |
$1,199.36 |
$3,748 |
3.0× |
| Nm cisternogram (78630) |
$296 |
$925 |
0.5× |
| Nm gastric emptying study (78264) |
$1,165.28 |
$3,641.50 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$635.04 |
$1,984.50 |
1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,772.72 |
$27,414.75 |
6.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,172.08 |
$3,662.75 |
2.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,281.84 |
$4,005.75 |
3.2× |
| 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) |
$241.76 |
$755.50 |
2.8× |
| Osseous survey infant (77076) |
$685.36 |
$2,141.75 |
6.5× |
| Osseous survey limited (77074) |
$660.56 |
$2,064.25 |
6.3× |
| 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) |
$459.84 |
$1,437 |
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) |
$2,969.80 |
$9,280.62 |
8.5× |
| 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) |
$546.24 |
$1,707 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,163.44 |
$3,635.75 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$855.44 |
$2,673.25 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$530.24 |
$1,657 |
6.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$535.92 |
$1,674.75 |
5.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$805.60 |
$2,517.50 |
7.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$315.04 |
$984.50 |
3.0× |
| 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) |
$17,075.44 |
$53,360.75 |
2.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,101.44 |
$3,442 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$468.08 |
$1,462.75 |
4.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$334.80 |
$1,046.25 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$423.20 |
$1,322.50 |
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) |
$1,091.20 |
$3,410 |
6.2× |
| 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) |
$595.80 |
$1,861.88 |
6.8× |
| Radiological examination surgical specimen (76098) |
$290.80 |
$908.75 |
0.5× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$660.48 |
$2,064 |
2.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,034 |
$3,231.25 |
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) |
$898.24 |
$2,807 |
8.6× |
| 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) |
$246.56 |
$770.50 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$231.52 |
$723.50 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$712.24 |
$2,225.75 |
3.0× |
| Scanogram (77073) |
$419.20 |
$1,310 |
4.0× |
| Scapula complete (73010) |
$397.20 |
$1,241.25 |
3.8× |
| Screening digital breast tomosynthesis (77063) |
$32 |
$100 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$450.08 |
$1,406.50 |
4.3× |
| Sialogram (70390) |
$426.48 |
$1,332.75 |
1.8× |
| Small bowel series (74250) |
$681.84 |
$2,130.75 |
3.9× |
| Spec medical radj physics consltj (77370) |
$3,892.20 |
$12,163.12 |
28.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,441.28 |
$4,504 |
3.8× |
| Special dosimetry (77331) |
$500.24 |
$1,563.25 |
3.7× |
| Special treatment procedure (77470) |
$3,873.28 |
$12,104 |
7.0× |
| Spine thoracic 3 views (72072) |
$552.96 |
$1,728 |
5.3× |
| Splenoportograpy rs&i (75810) |
$757.92 |
$2,368.50 |
0.2× |
| Stereotactic body radiation delivery (77373) |
$7,901.44 |
$24,692 |
4.4× |
| Superior sagittal sinus venogram (75870) |
$518.32 |
$1,619.75 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$570.72 |
$1,783.50 |
5.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,509.60 |
$4,717.50 |
4.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,575.76 |
$8,049.25 |
6.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,097.28 |
$3,429 |
8.1× |
| Therapeutic Enema (74283) |
$994.88 |
$3,109 |
5.6× |
| Thoracolumbar 2 views (72080) |
$384.88 |
$1,202.75 |
4.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,154.96 |
$3,609.25 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$740 |
$2,312.50 |
1.8× |
| Thyroid uptake measurement (78012) |
$465.76 |
$1,455.50 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,315.04 |
$4,109.50 |
3.3× |
| Tmj unilateral (70328) |
$261.92 |
$818.50 |
3.0× |
| Tomogram (76100) |
$533.44 |
$1,667 |
5.1× |
| Treatment device intermediate (77333) |
$1,430.08 |
$4,469 |
10.6× |
| Treatment devices simple (77332) |
$1,384.56 |
$4,326.75 |
10.3× |
| 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) |
$1,317.84 |
$4,118.25 |
3.3× |
| Tx devices design & construction complex (77334) |
$1,492.40 |
$4,663.75 |
4.0× |
| 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) |
$932.56 |
$2,914.25 |
2.3× |
| Unlisted Ultrasound Procedure (76999) |
$148.96 |
$465.50 |
1.7× |
| Upper Extremity Infant (73092) |
$278.80 |
$871.25 |
2.7× |
| Urethrocystography retrograde rs&i (74450) |
$759.68 |
$2,374 |
3.2× |
| Urethrocystography voiding (74455) |
$742.96 |
$2,321.75 |
3.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,214.56 |
$3,795.50 |
6.9× |
| 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) |
$236.56 |
$739.25 |
1.1× |
| 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) |
$822.88 |
$2,571.50 |
7.8× |
| 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) |
$1,791.20 |
$5,597.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,864.96 |
$5,828 |
1.2× |
| Venography epidural rs&i (75872) |
$240.40 |
$751.25 |
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) |
$523.76 |
$1,636.75 |
0.2× |
| 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) |
$410.20 |
$1,281.88 |
4.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$537.44 |
$1,679.50 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$532.88 |
$1,665.25 |
6.1× |
| 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) |
$469.80 |
$1,468.12 |
5.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$526.20 |
$1,644.38 |
6.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$673.20 |
$2,103.75 |
6.4× |
| X-ray exam hip uni 1 view (73501) |
$231.28 |
$722.75 |
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) |
$841.92 |
$2,631 |
8.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$966.48 |
$3,020.25 |
9.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,463.60 |
$4,573.75 |
13.9× |
| X-ray exam of femur 1 (73551) |
$337.84 |
$1,055.75 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$526.16 |
$1,644.25 |
5.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$398.40 |
$1,245 |
4.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$527.70 |
$1,649.06 |
6.0× |
| 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) |
$372.18 |
$1,163.06 |
4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$388.40 |
$1,213.75 |
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) |
$384.16 |
$1,200.50 |
4.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$234.24 |
$732 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$449.52 |
$1,404.75 |
4.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$778.80 |
$2,433.75 |
7.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$336 |
$1,050 |
3.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$211.52 |
$661 |
2.4× |
| X-ray of voice box or throat (70370) |
$2,591.44 |
$8,098.25 |
29.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$522.64 |
$1,633.25 |
5.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$402.64 |
$1,258.25 |
3.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$301.28 |
$941.50 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,177.60 |
$3,680 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$398.24 |
$1,244.50 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$440.32 |
$1,376 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$906.72 |
$2,833.50 |
8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$272 |
$850 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$350.64 |
$1,095.75 |
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) |
$503.44 |
$1,573.25 |
5.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$324.64 |
$1,014.50 |
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) |
$392.24 |
$1,225.75 |
3.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$296.56 |
$926.75 |
3.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$172.08 |
$537.75 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$311.12 |
$972.25 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$476.64 |
$1,489.50 |
4.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$580.72 |
$1,814.75 |
5.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$298 |
$931.25 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$560.50 |
$1,751.56 |
6.4× |
| Xr c-spine 6 or more views (72052) |
$706.64 |
$2,208.25 |
6.7× |
| Xr chest 4+ views (71048) |
$812.32 |
$2,538.50 |
7.7× |
| Xr finger(s) 2+ views (73140) |
$293.60 |
$917.50 |
3.4× |
| Xr shoulder 1 view (73020) |
$462.90 |
$1,446.56 |
5.3× |
| Xr spine cervical 4 or 5 views (72050) |
$673.20 |
$2,103.75 |
6.4× |
| Xr tibia/fibula 2 views (73590) |
$529 |
$1,653.12 |
6.1× |
| Xr tmj bilateral (70330) |
$442.48 |
$1,382.75 |
5.1× |
| Xray knee 1 or 2 views rt (73560) |
$368.20 |
$1,150.62 |
4.2× |