| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,494.80 |
$9,158 |
4.1× |
| Abdomen 1 View (74018) |
$190.20 |
$317 |
2.2× |
| Abdomen 2 views (74019) |
$412.20 |
$687 |
4.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,583.60 |
$4,306 |
6.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,558.20 |
$2,597 |
1.2× |
| Angio internal mammary (75756) |
$3,442.80 |
$5,738 |
1.1× |
| Angio pulmonary bilat (75743) |
$7,975.80 |
$13,293 |
2.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,681.80 |
$7,803 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$8,482.20 |
$14,137 |
2.8× |
Angiography extremity unilateral rs&i (75710)
range across 6 matching MRF lines |
$20,560.85–$142,883.51 |
$34,268.08–$238,139.18 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,703.80 |
$6,173 |
1.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,442.80 |
$5,738 |
1.1× |
| Ankle 2 views (73600) |
$400.20 |
$667 |
4.7× |
| Aortography thoracic serialography rs&i (75605) |
$142,883.51 |
$238,139.18 |
26.4× |
| Artery X-Rays Abdomen (75726) |
$8,083.20 |
$13,472 |
1.5× |
| Artery X-Rays Adrenal Gland (75731) |
$2,497.80 |
$4,163 |
0.8× |
| Artery X-Rays Pelvis (75736) |
$8,083.20 |
$13,472 |
1.5× |
| Artery X-Rays Spine (75705) |
$8,924.40 |
$14,874 |
1.7× |
| Arthrogram ankle (73615) |
$2,732.40 |
$4,554 |
8.1× |
| Arthrogram hip (73525) |
$2,350.80 |
$3,918 |
6.9× |
| Arthrogram Wrist (73115) |
$2,350.80 |
$3,918 |
6.9× |
| Basic radiation dosimetry calculation (77300) |
$1,096.80 |
$1,828 |
8.4× |
| Bone age studies (77072) |
$400.20 |
$667 |
3.9× |
| Bone Imaging 3 Phase (78315) |
$2,566.80 |
$4,278 |
6.6× |
| Bone Imaging Limited Area (78300) |
$2,725.80 |
$4,543 |
7.0× |
| Bone Imaging Multiple Areas (78305) |
$2,725.80 |
$4,543 |
7.0× |
| Bone Imaging Whole Body (78306) |
$2,566.80 |
$4,278 |
6.6× |
| Bone marrow imaging limited area (78102) |
$2,554.20 |
$4,257 |
6.6× |
| Bone survey infant (77076) |
$693 |
$1,155 |
6.8× |
| Brachytx isodose complex (77318) |
$2,429.40 |
$4,049 |
6.7× |
| Brachytx isodose intermed (77317) |
$1,096.80 |
$1,828 |
3.0× |
| Brachytx Isodose Plan Simple (77316) |
$1,096.80 |
$1,828 |
3.0× |
| Brain Image W/Flow < 4 Views (78601) |
$3,379.20 |
$5,632 |
8.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$936.60 |
$1,561 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,556.80 |
$10,928 |
4.7× |
| Cardiac Shunt Detection (78428) |
$3,389.40 |
$5,649 |
8.7× |
| Cat Scan Follow-Up Study (76380) |
$639 |
$1,065 |
7.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,245.80 |
$3,743 |
4.3× |
| Cerebrospinal Fluid Scan (78630) |
$2,245.80 |
$3,743 |
4.3× |
| Chest 1 view (71045) |
$67.20 |
$112 |
0.8× |
| Chest 2 views (71046) |
$129 |
$215 |
1.5× |
| Chest 3 views (71047) |
$228 |
$380 |
2.7× |
| Chest 4 or more views (71048) |
$303 |
$505 |
3.0× |
| Cholecystography Oral Contrast (74290) |
$846 |
$1,410 |
5.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$903.60 |
$1,506 |
1.2× |
| Clavicle complete (73000) |
$400.20 |
$667 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$239.40 |
$399 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,096.80 |
$1,828 |
8.4× |
| Contrast Exam Abdominl Aorta (75625) |
$65,495.90 |
$109,159.83 |
21.4× |
| Contrast X-Ray Bladder (74430) |
$1,108.80 |
$1,848 |
3.3× |
| Contrast X-Ray Of Elbow (73085) |
$2,732.40 |
$4,554 |
8.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$2,732.40 |
$4,554 |
8.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,400.60 |
$4,001 |
7.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,086 |
$1,810 |
4.7× |
| CT abdomen w contrast (74160) |
$1,209 |
$2,015 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,327.80 |
$2,213 |
7.8× |
| CT abdomen w/o contrast (74150) |
$639 |
$1,065 |
6.3× |
| CT Angio Abdomen and Pelvis (74174) |
$543 |
$905 |
1.6× |
| CT Angio Chest (71275) |
$543 |
$905 |
3.2× |
| CT Angio Head (70496) |
$543 |
$905 |
3.2× |
| CT angio hrt w/3d image (75574) |
$639 |
$1,065 |
1.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$639 |
$1,065 |
3.8× |
| CT Angio Neck (70498) |
$543 |
$905 |
3.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$639 |
$1,065 |
3.8× |
| CT cervical spine w/ contrast (72126) |
$734.40 |
$1,224 |
2.2× |
| CT cervical spine w/o contrast (72125) |
$543 |
$905 |
5.3× |
| CT cervical spine w/wo cont (72127) |
$845.40 |
$1,409 |
5.0× |
| CT chest w contrast (71260) |
$1,027.80 |
$1,713 |
6.0× |
| CT chest w/wo contrast (71270) |
$1,327.80 |
$2,213 |
7.8× |
| CT colonography screening (74263) |
$899.40 |
$1,499 |
3.9× |
| CT head/brain with contrast (70460) |
$734.40 |
$1,224 |
4.3× |
| CT head/brain without and with contrast (70470) |
$845.40 |
$1,409 |
5.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,169.40 |
$1,949 |
3.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$128 |
$128 |
1.5× |
| CT iac w contrast (70481) |
$734.40 |
$1,224 |
4.3× |
| CT l-spine w&w/o contrast (72133) |
$845.40 |
$1,409 |
5.0× |
| CT lower ext w/o (73700) |
$639 |
$1,065 |
6.3× |
| CT lower extremity w/contrast material (73701) |
$734.40 |
$1,224 |
4.3× |
| CT lumbar spine w contrast (72132) |
$734.40 |
$1,224 |
2.2× |
| CT lumbar spine w/o contrast (72131) |
$639 |
$1,065 |
6.3× |
| CT maxillofacial w contrast (70487) |
$734.40 |
$1,224 |
4.3× |
| CT maxillofacial wo contrast (70486) |
$639 |
$1,065 |
6.3× |
| CT neck tissue combo (70492) |
$845.40 |
$1,409 |
5.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$845.40 |
$1,409 |
5.0× |
| CT orbits w/o contrast (70480) |
$639 |
$1,065 |
6.3× |
| CT pelvis w&w/o contrast (72194) |
$845.40 |
$1,409 |
5.0× |
| CT pelvis w/o contrast (72192) |
$1,149.60 |
$1,916 |
11.3× |
| CT scan of leg combo (73702) |
$845.40 |
$1,409 |
5.0× |
| CT scans face/jaw combo (70488) |
$845.40 |
$1,409 |
5.0× |
| CT soft tissue neck w contrast (70491) |
$734.40 |
$1,224 |
4.3× |
| CT soft tissue neck w/o contrast (70490) |
$639 |
$1,065 |
6.3× |
| CT thoracic spine w contrast (72129) |
$734.40 |
$1,224 |
4.3× |
| CT thoracic spine w/o contrast (72128) |
$639 |
$1,065 |
6.3× |
| CT thoracic spine w/wo cont (72130) |
$845.40 |
$1,409 |
5.0× |
| CT thorax w/o contrast (71250) |
$543 |
$905 |
5.3× |
| CT upper ext wo (73200) |
$639 |
$1,065 |
6.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$845.40 |
$1,409 |
5.0× |
| CT upper extremity with contrast (73201) |
$734.40 |
$1,224 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$639 |
$1,065 |
3.8× |
| Cta Abdomen (74175) |
$639 |
$1,065 |
3.8× |
| CTA pelvis (72191) |
$639 |
$1,065 |
3.8× |
| Dilation ureters/urethra rs&i (74485) |
$1,371.60 |
$2,286 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$3,550.80 |
$5,918 |
1.9× |
| Diskography lumbar (72295) |
$5,316.60 |
$8,861 |
2.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$70.20 |
$117 |
0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$214.20 |
$357 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,646.40 |
$2,744 |
16.2× |
| Dxa Bone Density Axial (77080) |
$222 |
$370 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$253.20 |
$422 |
3.0× |
| Echo exam of fetal heart (76825) |
$795 |
$1,325 |
1.5× |
| Echo exam uterus (76831) |
$159.60 |
$266 |
0.7× |
| Echo Guide For Artery Repair (76936) |
$841.20 |
$1,402 |
4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$581.40 |
$969 |
2.5× |
| Echograp Trans R Pros Study (76873) |
$1,005.60 |
$1,676 |
9.9× |
| Esophagram (74220) |
$613.80 |
$1,023 |
3.6× |
| Fetal Biophys Profile W/Nst (76818) |
$214.20 |
$357 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$214.20 |
$357 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$334.80 |
$558 |
1.4× |
| Follow-Up Angiography (75898) |
$5,172.60 |
$8,621 |
1.7× |
| Foot 2 views (73620) |
$400.20 |
$667 |
4.7× |
| Forearm 2 views (73090) |
$400.20 |
$667 |
4.7× |
| Gastric emptying imaging study (78264) |
$3,670.80 |
$6,118 |
9.5× |
| Gastric Mucosa Imaging (78261) |
$2,431.20 |
$4,052 |
6.3× |
| Gastroesophageal Reflux Exam (78262) |
$2,583.60 |
$4,306 |
6.7× |
| Gated Heart Planar Single (78472) |
$2,825.40 |
$4,709 |
7.3× |
| Gated Heart, Multiple (78473) |
$3,001.20 |
$5,002 |
7.7× |
| GI Endoscopic US S&I (76975) |
$657.60 |
$1,096 |
2.8× |
| Hand 2 views (73120) |
$400.20 |
$667 |
3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$5,185.80 |
$8,643 |
7.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$5,185.80 |
$8,643 |
7.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,185.80 |
$8,643 |
7.7× |
| Heart first pass single,planar (78481) |
$2,825.40 |
$4,709 |
5.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,960.40 |
$9,934 |
1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,539.20 |
$4,232 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$2,800.20 |
$4,667 |
5.3× |
| Hepatobiliary System Imaging (78226) |
$2,976 |
$4,960 |
7.7× |
| Ht Musc Image Planar Mult (78454) |
$4,574.40 |
$7,624 |
3.6× |
| Ht Muscle Image Spect Sing (78451) |
$2,825.40 |
$4,709 |
2.2× |
| Hysterosalpingogram (74740) |
$2,408.40 |
$4,014 |
10.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$909 |
$1,515 |
10.8× |
| Infant hip ultrasound, limited static exam (76886) |
$180 |
$300 |
2.1× |
| Interstitial radiation source applic complex (77778) |
$8,436.60 |
$14,061 |
12.5× |
| K Flow/Funct Image Multiple (78709) |
$2,802.60 |
$4,671 |
5.3× |
| K Flow/Funct Image W/Drug (78708) |
$2,410.80 |
$4,018 |
4.6× |
| K Flow/Funct Image W/O Drug (78707) |
$766.20 |
$1,277 |
1.5× |
| Kidney Imaging Morphol (78700) |
$656.40 |
$1,094 |
1.7× |
| Knee 3 Views (73562) |
$420 |
$700 |
5.0× |
| Leveen/Shunt Patency Exam (78291) |
$702.60 |
$1,171 |
1.8× |
| Liver & Spleen Imaging Static Only (78215) |
$2,976 |
$4,960 |
7.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,800.20 |
$4,667 |
7.2× |
| Liver imaging static only (78201) |
$2,098.20 |
$3,497 |
4.0× |
| Liver imaging w/vascular flow (78202) |
$2,098.20 |
$3,497 |
4.0× |
| Lung perfusion differential (78597) |
$3,407.40 |
$5,679 |
8.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,407.40 |
$5,679 |
6.5× |
| Lung Ventilation Imaging (78579) |
$3,152.40 |
$5,254 |
8.1× |
| Lymph System Imaging (78195) |
$2,713.80 |
$4,523 |
5.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,537.80 |
$2,563 |
1.0× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,008.60 |
$1,681 |
1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,161.80 |
$3,603 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$5,172.60 |
$8,621 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$1,234.80 |
$2,058 |
5.3× |
| Meckels Divert Exam (78290) |
$2,583.60 |
$4,306 |
6.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,839.60 |
$3,066 |
5.1× |
| Myelogram cervical (72240) |
$737.40 |
$1,229 |
1.0× |
| Myelogram Lumbar (72265) |
$737.40 |
$1,229 |
1.0× |
| Myelography thoracic (72255) |
$1,806.60 |
$3,011 |
2.4× |
| Myelograpy 2/more regions rs&i (72270) |
$737.40 |
$1,229 |
1.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$740.40 |
$1,234 |
1.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,574.40 |
$7,624 |
3.6× |
| Myocardial Spect Multiple Studies (78452) |
$5,314.20 |
$8,857 |
4.2× |
| Neck soft tissue (70360) |
$300.60 |
$501 |
3.6× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$942 |
$1,570 |
2.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$364.80 |
$608 |
0.9× |
| Nm myocard infarct spect (78469) |
$2,825.40 |
$4,709 |
5.4× |
| Nonvascular Shunt X-Ray (75809) |
$944.40 |
$1,574 |
9.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,494.80 |
$9,158 |
4.1× |
| Nuclear Rx Intra-Arterial (79445) |
$1,320.60 |
$2,201 |
5.8× |
| Nuclear Rx Oral Admin (79005) |
$10,619.40 |
$17,699 |
46.8× |
| Ob us nuchal meas 1 gest (76813) |
$1,936.80 |
$3,228 |
19.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$185.40 |
$309 |
1.8× |
| Optic foramina (70190) |
$502.20 |
$837 |
5.9× |
| Panoramic X-ray of jaws (70355) |
$392.40 |
$654 |
4.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,016 |
$3,360 |
3.8× |
| Parathyroid Planar Imaging (78070) |
$1,366.20 |
$2,277 |
3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,917 |
$3,195 |
4.9× |
| Pelvis 1 or 2 views (72170) |
$400.20 |
$667 |
3.9× |
| Peritoneogram Rs&I (74190) |
$1,008.60 |
$1,681 |
1.9× |
| Pet Image Skull-Thigh (78812) |
$4,316.40 |
$7,194 |
3.1× |
| Pet Image W/Ct Lmtd (78814) |
$4,682.40 |
$7,804 |
3.4× |
| PET image w/CT, full body (78816) |
$4,682.40 |
$7,804 |
3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,920.40 |
$11,534 |
5.0× |
| PET whole body (78813) |
$4,316.40 |
$7,194 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,157 |
$8,595 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,178.60 |
$3,631 |
5.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$684 |
$1,140 |
6.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$719.40 |
$1,199 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$546 |
$910 |
6.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$400.20 |
$667 |
4.7× |
| Radex elbow complete minimum 3 views (73080) |
$400.20 |
$667 |
4.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$420 |
$700 |
4.1× |
| Radex fingr minimum 2 views (73140) |
$528 |
$880 |
6.2× |
| Radex foot complete minimum 3 views (73630) |
$513 |
$855 |
6.1× |
| Radex Hand Minimum 3 Views (73130) |
$525.60 |
$876 |
6.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$502.20 |
$837 |
5.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$502.20 |
$837 |
4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$502.20 |
$837 |
5.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$657.60 |
$1,096 |
7.8× |
| Radex shoulder complete minimum 2 views (73030) |
$420 |
$700 |
5.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$502.20 |
$837 |
5.9× |
| Radex Spine 1 View Specify Level (72020) |
$400.20 |
$667 |
4.7× |
| Radex Sternum Minimum 2 Views (71120) |
$502.20 |
$837 |
5.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$491.40 |
$819 |
5.8× |
| Radex Toe Minimum 2 Views (73660) |
$400.20 |
$667 |
4.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$502.20 |
$837 |
4.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$420 |
$700 |
5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$693 |
$1,155 |
6.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,900.20 |
$28,167 |
2.4× |
| Radiation treatment delivery level 1 (77402) |
$980.40 |
$1,634 |
9.9× |
| Radiation treatment delivery level 2 (77407) |
$2,959.20 |
$4,932 |
7.9× |
| Radiation treatment delivery level 3 (77412) |
$2,959.20 |
$4,932 |
5.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$502.20 |
$837 |
4.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$680.40 |
$1,134 |
6.7× |
| Radiologic exam colon double contrast study (74280) |
$946.80 |
$1,578 |
5.6× |
| Radiologic exam colon single contrast study (74270) |
$613.80 |
$1,023 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$420 |
$700 |
4.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$420 |
$700 |
4.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,221 |
$2,035 |
7.2× |
| Radiologic exam swallow function contrast study (74230) |
$613.80 |
$1,023 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$613.80 |
$1,023 |
3.6× |
| Radiologic examination femur 1 view (73551) |
$392.40 |
$654 |
4.6× |
| Radiologic examination femur minimum 2 views (73552) |
$400.20 |
$667 |
4.7× |
| Radiologic examination knee 1/2 views (73560) |
$400.20 |
$667 |
4.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$850.80 |
$1,418 |
8.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$400.20 |
$667 |
4.7× |
| Radiopharm Dacryocystography (78660) |
$2,386.80 |
$3,978 |
6.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$169.20 |
$282 |
0.5× |
| Renal Cyst Study (74470) |
$543.60 |
$906 |
1.0× |
| Ribs bilateral 3 views (71110) |
$440.40 |
$734 |
4.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,766 |
$4,610 |
7.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,766.60 |
$4,611 |
7.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,962.40 |
$11,604 |
13.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,959.20 |
$4,932 |
5.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,766.60 |
$4,611 |
5.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,183 |
$5,305 |
2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,556.60 |
$4,261 |
2.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,124.60 |
$3,541 |
9.4× |
| Rp Therapy Intravenous Administration (79101) |
$13,213.80 |
$22,023 |
58.3× |
| Scapula (73010) |
$400.20 |
$667 |
3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$27.60 |
$46 |
1.2× |
| Sella turcica (70240) |
$502.20 |
$837 |
5.9× |
| Shoulder 1 view (73020) |
$400.20 |
$667 |
4.7× |
| Shoulder Arthrography (73040) |
$1,384.20 |
$2,307 |
4.1× |
| Sialogram (70390) |
$990.60 |
$1,651 |
4.3× |
| Skull less than 4 views (70250) |
$400.20 |
$667 |
3.9× |
| Special dosimetry (77331) |
$1,096.80 |
$1,828 |
8.4× |
| Special Physics Consult (77370) |
$1,096.80 |
$1,828 |
8.4× |
| Special teletherapy port plan (77321) |
$2,522.40 |
$4,204 |
6.9× |
| Special treatment procedure (77470) |
$381.60 |
$636 |
0.7× |
| Srs Multisource (77371) |
$14,880.60 |
$24,801 |
2.1× |
| Stereotactic Body Radiation Delivery (77373) |
$3,871.20 |
$6,452 |
2.2× |
| Sternoclavicular joints (71130) |
$502.20 |
$837 |
5.9× |
| Superior sagittal sinus venogram (75870) |
$5,172.60 |
$8,621 |
1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$241.80 |
$403 |
0.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$594 |
$990 |
1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,384.20 |
$2,307 |
6.0× |
| Testicular Imaging W/Flow (78761) |
$2,562 |
$4,270 |
6.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,522.40 |
$4,204 |
6.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,522.40 |
$4,204 |
6.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$87.60 |
$146 |
0.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$927.60 |
$1,546 |
5.4× |
| Thoracic spine 2 views (72070) |
$400.20 |
$667 |
3.9× |
| Thoracic spine 3 views (72072) |
$420 |
$700 |
4.1× |
| Thoracolumbar 2 views (72080) |
$400.20 |
$667 |
4.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$670.20 |
$1,117 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,882.20 |
$3,137 |
4.8× |
| Thyroid Met Imaging Body (78018) |
$1,732.80 |
$2,888 |
3.3× |
| Thyroid Uptake Measurement (78012) |
$1,087.20 |
$1,812 |
2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,016 |
$3,360 |
5.2× |
| Tx Devices Design & Construction Complex (77334) |
$1,842 |
$3,070 |
5.1× |
| Tx devices design & construction intermediate (77333) |
$1,842 |
$3,070 |
14.1× |
| Tx devices design & construction simple (77332) |
$87.60 |
$146 |
0.7× |
| Ultrasound Breast Limited (76642) |
$202.80 |
$338 |
2.4× |
| Ultrasound elastography first target lesion (76982) |
$700.80 |
$1,168 |
6.9× |
| Ultrasound Elastography Parenchyma (76981) |
$921.60 |
$1,536 |
9.1× |
| Ultrasound Exam Aaa Screen (76706) |
$486 |
$810 |
4.8× |
| Ultrasound, abdomen limited (76705) |
$185.40 |
$309 |
1.8× |
| Umbilical-artery Doppler (OB) (76820) |
$1,646.40 |
$2,744 |
16.2× |
| Unlisted Dx Radiographic Procedure (76499) |
$223.80 |
$373 |
2.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$3,573.60 |
$5,956 |
36.1× |
| Unlisted us procedure (76999) |
$754.20 |
$1,257 |
8.9× |
| Upper gi w/o kub (74240) |
$780.60 |
$1,301 |
4.6× |
| Ureteral Reflux Study (78740) |
$2,562 |
$4,270 |
6.6× |
| Urethrocystogram voiding (74455) |
$1,108.80 |
$1,848 |
4.8× |
| Urethrocystography retrograde (74450) |
$1,524.60 |
$2,541 |
6.6× |
| Us breast unilateral complete (76641) |
$128.40 |
$214 |
1.3× |
| Us chest (76604) |
$1,200 |
$2,000 |
11.8× |
| Us complete joint (76881) |
$703.80 |
$1,173 |
6.9× |
| Us exam, pelvic, limited (76857) |
$237 |
$395 |
2.3× |
| Us head (76506) |
$880.80 |
$1,468 |
8.7× |
| Us kidney transplant (76776) |
$777.60 |
$1,296 |
7.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,081.20 |
$1,802 |
10.6× |
| Us ob detailed single fetus (76811) |
$267.60 |
$446 |
1.2× |
| Us ob limited 1 or more fetuses (76815) |
$525.60 |
$876 |
5.2× |
| Us ob transvaginal (76817) |
$577.80 |
$963 |
5.7× |
| Us pelvic non ob complete (76856) |
$235.80 |
$393 |
2.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$214.20 |
$357 |
2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$117 |
$195 |
1.2× |
| Us retroperitoneal complete (76770) |
$1,674 |
$2,790 |
16.5× |
| Us retroperitoneal limited (76775) |
$1,709.40 |
$2,849 |
16.8× |
| Us scrotum and contents (76870) |
$921.60 |
$1,536 |
9.1× |
| Us spinal canal and contents (76800) |
$1,923 |
$3,205 |
18.9× |
| Us thyroid (76536) |
$1,447.80 |
$2,413 |
14.3× |
| Us transrectal (76872) |
$1,129.20 |
$1,882 |
11.1× |
| Vein X-Ray Chest (75827) |
$2,196.60 |
$3,661 |
1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,539.20 |
$4,232 |
0.8× |
| Vein X-Ray Skull Epidural (75872) |
$2,539.20 |
$4,232 |
4.2× |
| Vein X-Ray Spleen/Liver (75810) |
$2,539.20 |
$4,232 |
0.8× |
| Venogram Sinus/Jugular (75860) |
$2,161.80 |
$3,603 |
0.7× |
| Venography Adrenal Unilateral (75840) |
$5,960.40 |
$9,934 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,196.60 |
$3,661 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$3,509.40 |
$5,849 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$2,238 |
$3,730 |
1.5× |
| Venography Orbital Rs&I (75880) |
$2,161.80 |
$3,603 |
3.5× |
| Venography Renal Bilateral (75833) |
$3,442.80 |
$5,738 |
1.1× |
| Venography Renal Unilateral (75831) |
$2,196.60 |
$3,661 |
0.7× |
| Venous sampling by catheter (75893) |
$8,924.40 |
$14,874 |
1.7× |
| Wrist 2 views (73100) |
$400.20 |
$667 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$502.20 |
$837 |
5.9× |
| X-ray antegrade pyelogram tube (74425) |
$745.20 |
$1,242 |
2.2× |
| X-Ray Aorta Leg Arteries (75630) |
$8,482.20 |
$14,137 |
2.8× |
| X-Ray Bend Only L-S Spine (72120) |
$400.20 |
$667 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$400.20 |
$667 |
4.7× |
| X-Ray Exam Breast Specimen (76098) |
$471.60 |
$786 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$400.20 |
$667 |
4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$420 |
$700 |
4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$871.80 |
$1,453 |
8.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$360 |
$600 |
4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$420 |
$700 |
5.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$480.60 |
$801 |
4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$420 |
$700 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$801 |
$1,335 |
7.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$801 |
$1,335 |
7.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$871.80 |
$1,453 |
8.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$420 |
$700 |
5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$871.80 |
$1,453 |
8.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$685.80 |
$1,143 |
6.8× |
| X-ray eye for foreign body (70030) |
$300.60 |
$501 |
3.6× |
| X-ray humerus (73060) |
$400.20 |
$667 |
4.7× |
| X-ray IV pyelogram (ivp) (74400) |
$1,524.60 |
$2,541 |
8.9× |
| X-ray IV pyelogram+tomography (74415) |
$1,524.60 |
$2,541 |
8.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$491.40 |
$819 |
5.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$444 |
$740 |
5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$420 |
$700 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$412.20 |
$687 |
4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$871.80 |
$1,453 |
8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$400.20 |
$667 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$400.20 |
$667 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$420 |
$700 |
5.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$693 |
$1,155 |
6.8× |
| X-ray thoracic spine 4 vw (72074) |
$420 |
$700 |
4.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,524.60 |
$2,541 |
4.5× |
| X-Rays Bone Length Studies (77073) |
$400.20 |
$667 |
3.9× |
| X-Rays Bone Survey Complete (77075) |
$693 |
$1,155 |
6.8× |
| Xr c-spine 4 or 5 views (72050) |
$693 |
$1,155 |
6.8× |
| Xr facial bones less than 3 views (70140) |
$502.20 |
$837 |
5.9× |
| Xr orbits complete 4 views (70200) |
$502.20 |
$837 |
4.9× |
| Xr Tomogram Single Plane (76100) |
$871.80 |
$1,453 |
8.6× |