| 3-D radiotherapy plan dose-volume histograms (77295) |
$16,314.68 |
$25,099.50 |
12.2× |
| Abdomen 2 views (74019) |
$258.05 |
$397 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$786.50 |
$1,210 |
2.0× |
| Acute venous thrombus image (78456) |
$775.45 |
$1,193 |
0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,247.70 |
$3,458 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,437.50 |
$3,750 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,921.40 |
$2,956 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$995.80 |
$1,532 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,598.05 |
$3,997 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,085.20 |
$3,208 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,861.60 |
$2,864 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$2,748.85 |
$4,229 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,718.65 |
$5,721 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,203.80 |
$1,852 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,472.90 |
$2,266 |
0.5× |
| Ankle 2 views (73600) |
$189.15 |
$291 |
2.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$556.08 |
$855.50 |
1.6× |
| Aortogram thoracic (75605) |
$3,289.65 |
$5,061 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,061.15 |
$3,171 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,467.40 |
$3,796 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$1,592.50 |
$2,450 |
0.5× |
| Arthrogram elbow (73085) |
$419.90 |
$646 |
1.2× |
| Arthrogram hip (73525) |
$507.65 |
$781 |
1.5× |
| Arthrogram shoulder (73040) |
$650 |
$1,000 |
1.9× |
| Arthrogram wrist (73115) |
$301.60 |
$464 |
0.9× |
| Arthrography knee lt (73580) |
$447.85 |
$689 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$15,847.65 |
$24,381 |
121.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$720.52 |
$1,108.50 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$987.35 |
$1,519 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,011.08 |
$1,555.50 |
2.6× |
| Bone age studies (77072) |
$168.35 |
$259 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,332.82 |
$2,050.50 |
3.4× |
| Bone survey complete (77075) |
$440.70 |
$678 |
4.4× |
| Brachytx isodose complex (77318) |
$2,568.80 |
$3,952 |
7.1× |
| Brachytx isodose intermed (77317) |
$1,491.75 |
$2,295 |
4.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$5,801.90 |
$8,926 |
16.0× |
| Brain image w/flow 4 + views (78606) |
$1,291.55 |
$1,987 |
2.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$932.10 |
$1,434 |
2.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$744.25 |
$1,145 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,320.20 |
$5,108 |
2.4× |
| Brain Imaging Vascular Flow Only (78610) |
$531.70 |
$818 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$743.60 |
$1,144 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$118.62 |
$182.50 |
1.4× |
| Chest 1 view (71045) |
$145.60 |
$224 |
1.7× |
| Chest 3 views (71047) |
$282.10 |
$434 |
3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$396.50 |
$610 |
2.3× |
| Clavicle complete (73000) |
$203.45 |
$313 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$241.15 |
$371 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$14,522.96 |
$22,343.01 |
111.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$233.35 |
$359 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,849.95 |
$5,923 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,460.90 |
$3,786 |
10.6× |
| CT abdomen w contrast (74160) |
$1,397.50 |
$2,150 |
8.2× |
| CT abdomen w wo contrast (74170) |
$1,758.25 |
$2,705 |
10.3× |
| CT abdomen w/o contrast (74150) |
$982.15 |
$1,511 |
9.7× |
| CT angio hrt w/3d image (75574) |
$2,144.35 |
$3,299 |
6.3× |
| CT angiography upper extremity lt (73206) |
$886.60 |
$1,364 |
5.2× |
| CT c-spine w/o contrast (72125) |
$1,324.70 |
$2,038 |
13.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$1,495 |
$2,300 |
8.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,519.70 |
$2,338 |
8.9× |
| CT cervical spine with contrast (72126) |
$1,433.25 |
$2,205 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,790.75 |
$2,755 |
10.5× |
| CT chest with contrast (71260) |
$1,519.70 |
$2,338 |
8.9× |
| CT head/brain with contrast (70460) |
$1,402.70 |
$2,158 |
8.3× |
| CT head/brain without and with contrast (70470) |
$1,688.70 |
$2,598 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$64.35 |
$99 |
0.8× |
| CT hrt w/3d image congen (75573) |
$1,177.80 |
$1,812 |
3.5× |
| CT iac w contrast (70481) |
$646.10 |
$994 |
3.8× |
| CT limited/localized follow up study (76380) |
$618.80 |
$952 |
7.3× |
| CT lower ext w/o (73700) |
$847.60 |
$1,304 |
8.4× |
| CT lower extremity w wo contrast (73702) |
$963.95 |
$1,483 |
5.7× |
| CT lower extremity with contrast (73701) |
$881.40 |
$1,356 |
5.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,737.45 |
$2,673 |
10.2× |
| CT lumbar spine w/o contrast (72131) |
$1,472.25 |
$2,265 |
14.5× |
| CT lumbar spine with contrast (72132) |
$1,657.50 |
$2,550 |
4.9× |
| CT maxillofacial w contrast (70487) |
$1,015.30 |
$1,562 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$807.95 |
$1,243 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,179.10 |
$1,814 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,430 |
$2,200 |
8.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$892.45 |
$1,373 |
5.3× |
| CT orbits w/o contrast (70480) |
$611.65 |
$941 |
6.0× |
| CT pelvis w & w/o contrast (72194) |
$1,738.75 |
$2,675 |
10.2× |
| CT pelvis w/o contrast (72192) |
$1,396.85 |
$2,149 |
13.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$292.50 |
$450 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,655.55 |
$2,547 |
9.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,015.95 |
$1,563 |
10.0× |
| CT thoracic spine w/contrast (72129) |
$1,652.95 |
$2,543 |
9.7× |
| CT thoracic spine w/o contrast (72128) |
$1,470.95 |
$2,263 |
14.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,796.60 |
$2,764 |
10.6× |
| CT thorax w/o contrast (71250) |
$982.15 |
$1,511 |
9.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$865.80 |
$1,332 |
5.1× |
| CT upper extremity w/o contrast rt (73200) |
$668.85 |
$1,029 |
6.6× |
| CT upper extremity with contrast (73201) |
$718.90 |
$1,106 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,178.80 |
$3,352 |
12.8× |
| Cta Abdomen (74175) |
$1,587.95 |
$2,443 |
9.3× |
| CTA abdomen pelvis (74174) |
$3,463.20 |
$5,328 |
10.2× |
| CTA chest (71275) |
$1,756.95 |
$2,703 |
10.3× |
| Cta Head (70496) |
$1,124.50 |
$1,730 |
6.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,678.65 |
$4,121 |
7.9× |
| CTA lwr ext w&w/o contrast (73706) |
$780 |
$1,200 |
4.6× |
| Cta Neck (70498) |
$1,894.10 |
$2,914 |
11.1× |
| Cta Pelvis (72191) |
$1,517.75 |
$2,335 |
8.9× |
| Cystography minimum 3 views rs&i (74430) |
$246.35 |
$379 |
0.7× |
| Dacryocystography (70170) |
$349.70 |
$538 |
1.5× |
| Diskogram cervical (72285) |
$1,330.55 |
$2,047 |
0.7× |
| Diskography lumbar (72295) |
$1,230.45 |
$1,893 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$240.50 |
$370 |
2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$260.65 |
$401 |
2.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$321.10 |
$494 |
3.2× |
| Echoencephalography real time imaging (76506) |
$440.05 |
$677 |
4.3× |
| Esophagus (74220) |
$245.05 |
$377 |
1.4× |
| Fetal biophysical profile non-stress testing (76818) |
$278.85 |
$429 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$245.05 |
$377 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$354.25 |
$545 |
1.5× |
| Foot 2 views (73620) |
$219.05 |
$337 |
2.6× |
| Forearm 2 views (73090) |
$171.60 |
$264 |
2.0× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,714.70 |
$2,638 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,260.02 |
$1,938.50 |
3.3× |
| Hand 2 views (73120) |
$174.85 |
$269 |
1.7× |
| Hand 3 views (73130) |
$215.80 |
$332 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,863.90 |
$4,406 |
4.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,645.85 |
$5,609 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,440.15 |
$6,831 |
6.6× |
| Heart Infarct Image (78466) |
$803.72 |
$1,236.50 |
2.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,246.40 |
$3,456 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,026.35 |
$1,579 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,139.45 |
$1,753 |
2.9× |
| Ht muscle image spect sing (78451) |
$828.10 |
$1,274 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$221 |
$340 |
2.6× |
| Hysterosalpingogram (74740) |
$453.70 |
$698 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$2,910.05 |
$4,477 |
4.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,747.55 |
$4,227 |
4.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,185.30 |
$3,362 |
4.1× |
| Intracavitary radiation source applic simple (77761) |
$1,639.95 |
$2,523 |
3.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$241.15 |
$371 |
2.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$513.50 |
$790 |
1.3× |
| Kidney imaging morphology (78700) |
$394.55 |
$607 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,095.15 |
$1,684.85 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$736.02 |
$1,132.35 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$750.10 |
$1,154 |
1.4× |
| Knee 3 views (73562) |
$238.55 |
$367 |
2.8× |
| Liver & spleen imaging static only (78215) |
$855.40 |
$1,316 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$818.35 |
$1,259 |
2.1× |
| Liver imaging static only (78201) |
$826.15 |
$1,271 |
1.6× |
| Liver imaging w/vascular flow (78202) |
$913.25 |
$1,405 |
1.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,797.25 |
$2,765 |
0.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,145.95 |
$1,763 |
0.4× |
| Lymphoscintigraphy (78195) |
$5,572.04 |
$8,572.38 |
10.6× |
| Mammary ductogram or galactogram multiple (77054) |
$351.65 |
$541 |
1.5× |
| Mammary ductogram or galactogram single (77053) |
$216.45 |
$333 |
0.9× |
| Meckels Diverticulum (78290) |
$880.10 |
$1,354 |
2.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$19,273.82 |
$29,652.02 |
53.1× |
| MRA head w & w/o contrast (70546) |
$2,308.80 |
$3,552 |
6.8× |
| MRA head w/o contrast (70544) |
$1,574.30 |
$2,422 |
6.8× |
| MRA head with contrast (70545) |
$1,795.95 |
$2,763 |
5.3× |
| MRA neck w contrast (70548) |
$1,187.55 |
$1,827 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,617.85 |
$2,489 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,160.90 |
$1,786 |
5.0× |
| MRI abdomen w contrast (74182) |
$1,963 |
$3,020 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,334.15 |
$3,591 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$1,806.35 |
$2,779 |
7.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,452.75 |
$2,235 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,404.65 |
$2,161 |
1.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,685.45 |
$2,593 |
7.3× |
| MRI c-spine with contrast (72142) |
$2,405.65 |
$3,701 |
7.1× |
| MRI cervical spine w/o contrast (72141) |
$2,153.45 |
$3,313 |
9.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,087.80 |
$3,212 |
6.2× |
| MRI chest w/o contrast (71550) |
$1,066.65 |
$1,641 |
4.6× |
| MRI chest with contrast (71551) |
$1,378 |
$2,120 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,207.05 |
$1,857 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,168.70 |
$1,798 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,071.85 |
$1,649 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,371.50 |
$2,110 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,451.15 |
$3,771 |
7.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,119.65 |
$3,261 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,505.40 |
$2,316 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,702.35 |
$2,619 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,184.95 |
$1,823 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,519.70 |
$2,338 |
4.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,560.65 |
$2,401 |
4.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,869.75 |
$4,415 |
8.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,356.25 |
$3,625 |
7.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,952.30 |
$4,542 |
8.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,338.70 |
$3,598 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,886 |
$4,440 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,976 |
$3,040 |
8.6× |
| MRI tmj (70336) |
$1,103.70 |
$1,698 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,262.30 |
$1,942 |
5.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,394.25 |
$2,145 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,159.60 |
$1,784 |
5.0× |
| Myelogram Cervical (72240) |
$780.65 |
$1,201 |
1.0× |
| Myelogram Lumbar (72265) |
$963.30 |
$1,482 |
1.3× |
| Myelogram thoracic (72255) |
$888.55 |
$1,367 |
1.2× |
| Myelography 2 or more regions (72270) |
$887.25 |
$1,365 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,610.75 |
$5,555 |
2.9× |
| Myocardial infarct spect (78469) |
$887.25 |
$1,365 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,837.74 |
$4,365.75 |
2.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,577.95 |
$7,043 |
3.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,363.75 |
$5,175 |
2.4× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,501.74 |
$6,925.75 |
2.1× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$7,019.35 |
$10,799 |
3.3× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$5,291 |
$8,140 |
3.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,665 |
$4,100 |
3.2× |
| Neck soft tissue (70360) |
$192.40 |
$296 |
2.3× |
| Nm adrenal scan (78075) |
$1,214.85 |
$1,869 |
1.0× |
| Nm bone marrow multiple (78103) |
$672.75 |
$1,035 |
1.7× |
| Nm cisternogram (78630) |
$1,641.90 |
$2,526 |
3.1× |
| Nm csf leak detection (78650) |
$1,319.50 |
$2,030 |
1.1× |
| Nm gastric emptying study (78264) |
$1,158.62 |
$1,782.50 |
3.0× |
| Nm gastroesophageal reflux study (78262) |
$802.75 |
$1,235 |
2.1× |
| Nm peritoneal-venous shunt patency (78291) |
$662.35 |
$1,019 |
1.7× |
| Nm red cell sequestration (78140) |
$618.80 |
$952 |
1.6× |
| Nm whole blood volume (78122) |
$755.95 |
$1,163 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$18,941.32 |
$29,140.50 |
14.1× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$4,627.35 |
$7,119 |
3.3× |
| Nuclear medicine of heart pumping function (78473) |
$1,649.05 |
$2,537 |
4.3× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$3,500.90 |
$5,386 |
2.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$499.20 |
$768 |
1.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,291.55 |
$1,987 |
3.3× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$744.90 |
$1,146 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$1,805.05 |
$2,777 |
8.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$228.15 |
$351 |
2.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$274.30 |
$422 |
2.7× |
| Orthopantogram (70355) |
$190.45 |
$293 |
2.3× |
| Osseous survey infant (77076) |
$265.20 |
$408 |
2.6× |
| Osseous survey limited (77074) |
$336.70 |
$518 |
3.3× |
| Parathyrd planar w/wo subtrj (78071) |
$1,402.05 |
$2,157 |
3.6× |
| Parathyroid imaging (78070) |
$1,182.35 |
$1,819 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$241.15 |
$371 |
2.4× |
| PET image w/CT, skull-thigh (78815) |
$4,150.90 |
$6,386 |
3.0× |
| PET imaging CT for attenuation limited area (78814) |
$3,623.10 |
$5,574 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,853.55 |
$7,467 |
3.5× |
| PET imaging limited area chest head/neck (78811) |
$3,518.45 |
$5,413 |
2.8× |
| Pr heart first pass single,planar (78481) |
$545.35 |
$839 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,435.20 |
$2,208 |
4.2× |
| Pr red cell survival study (78130) |
$558.35 |
$859 |
1.4× |
| Pr sono bone density measure,peripheral (76977) |
$100.75 |
$155 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,371.82 |
$2,110.50 |
3.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,589.90 |
$2,446 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$389.35 |
$599 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$164.45 |
$253 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$359.45 |
$553 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$170.95 |
$263 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$234.65 |
$361 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$604.50 |
$930 |
6.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$21,085.02 |
$32,438.50 |
3.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$9,919 |
$15,260 |
18.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$4,808.70 |
$7,398 |
48.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$15,500.88 |
$23,847.50 |
41.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$215.80 |
$332 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$234 |
$360 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$301.60 |
$464 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$265.85 |
$409 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$456.30 |
$702 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$471.25 |
$725 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$612.30 |
$942 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$284.05 |
$437 |
3.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$137.80 |
$212 |
1.6× |
| Radiological examination surgical specimen (76098) |
$206.05 |
$317 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,160.60 |
$3,324 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,376.40 |
$3,656 |
0.8× |
| Ribs bilateral 3 views (71110) |
$239.20 |
$368 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$629.20 |
$968 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$977.92 |
$1,504.50 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,908.10 |
$4,474 |
5.5× |
| Rp Therapy Intravenous Administration (79101) |
$625.30 |
$962 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$131.95 |
$203 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$323.70 |
$498 |
1.4× |
| Salivary gland imaging serial images (78231) |
$1,079.65 |
$1,661 |
2.8× |
| Scanogram (77073) |
$186.55 |
$287 |
1.8× |
| Scapula complete (73010) |
$188.50 |
$290 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$73.45 |
$113 |
3.1× |
| Sella turcica (70240) |
$124.15 |
$191 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$408.85 |
$629 |
4.0× |
| Sialogram (70390) |
$532.35 |
$819 |
2.3× |
| Simulation intermediate (77285) |
$1,025.70 |
$1,578 |
2.8× |
| Small bowel series (74250) |
$337.35 |
$519 |
2.0× |
| Spec medical radj physics consltj (77370) |
$17,973.15 |
$27,651 |
138.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$9,969.70 |
$15,338 |
27.5× |
| Special dosimetry (77331) |
$8,058.38 |
$12,397.50 |
61.9× |
| Special treatment procedure (77470) |
$15,455.70 |
$23,778 |
28.9× |
| Spine thoracic 3 views (72072) |
$218.40 |
$336 |
2.2× |
| Spleen imaging only (78185) |
$614.25 |
$945 |
1.6× |
| Splenoportograpy rs&i (75810) |
$1,444.30 |
$2,222 |
0.5× |
| Stereotactic body radiation delivery (77373) |
$21,070.08 |
$32,415.50 |
12.2× |
| Superior sagittal sinus venogram (75870) |
$1,904.50 |
$2,930 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$15,889.25 |
$24,445 |
43.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,047.20 |
$4,688 |
8.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$286 |
$440 |
1.2× |
| Testicular Imaging With Vascular Flow (78761) |
$641.55 |
$987 |
1.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$15,550.60 |
$23,924 |
42.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$14,819.02 |
$22,798.50 |
113.8× |
| Therapeutic Enema (74283) |
$757.25 |
$1,165 |
4.5× |
| Thoracolumbar 2 views (72080) |
$187.85 |
$289 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,354.60 |
$2,084 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,031.88 |
$1,587.50 |
2.7× |
| Tmj unilateral (70328) |
$120.25 |
$185 |
1.4× |
| Tomogram (76100) |
$339.95 |
$523 |
3.4× |
| Treatment device intermediate (77333) |
$22,765.28 |
$35,023.50 |
174.9× |
| Treatment devices simple (77332) |
$13,897.65 |
$21,381 |
106.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,174.25 |
$3,345 |
4.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$612.95 |
$943 |
1.6× |
| Tx devices design & construction complex (77334) |
$15,209.35 |
$23,399 |
41.9× |
| Ultrasound, abdomen limited (76705) |
$482.30 |
$742 |
4.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,032.20 |
$1,588 |
12.2× |
| Upper Extremity Infant (73092) |
$66.95 |
$103 |
0.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$514.15 |
$791 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$303.55 |
$467 |
1.3× |
| Urethrocystography voiding (74455) |
$460.85 |
$709 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$911.30 |
$1,402 |
5.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$883.35 |
$1,359 |
5.2× |
| Us abdl aorta screen aaa (76706) |
$286.65 |
$441 |
2.8× |
| Us breast unilateral complete (76641) |
$248.95 |
$383 |
2.5× |
| Us breast unilateral limited (76642) |
$208 |
$320 |
2.5× |
| Us chest (76604) |
$430.30 |
$662 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$371.15 |
$571 |
3.7× |
| Us guided compression repair (76936) |
$599.30 |
$922 |
2.9× |
| Us infant hips dynamic (76885) |
$247.65 |
$381 |
2.9× |
| Us infant hips limited static (76886) |
$161.20 |
$248 |
1.9× |
| Us kidney transplant (76776) |
$478.40 |
$736 |
4.7× |
| Us ob detailed single fetus (76811) |
$413.40 |
$636 |
1.8× |
| Us ob transvaginal (76817) |
$356.20 |
$548 |
3.5× |
| Us pelvic non ob complete (76856) |
$403 |
$620 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$274.95 |
$423 |
2.7× |
| Us pregnancy ltd (76815) |
$310.70 |
$478 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$386.10 |
$594 |
3.8× |
| Us retroperitoneal complete (76770) |
$553.80 |
$852 |
5.5× |
| Us retroperitoneal limited (76775) |
$193.70 |
$298 |
1.9× |
| Us scrotum and contents (76870) |
$411.45 |
$633 |
4.1× |
| Us soft tissue head/neck (76536) |
$403.65 |
$621 |
4.0× |
| Us spinal canal and contents (76800) |
$414.70 |
$638 |
4.1× |
| Us transrectal (76872) |
$278.20 |
$428 |
2.7× |
| Us transrectal prostate volume (76873) |
$523.90 |
$806 |
5.2× |
| Us xtr non-vasc lmtd (76882) |
$408.20 |
$628 |
4.0× |
| Vascular flow imaging (78445) |
$616.20 |
$948 |
1.6× |
| Vasogram (74440) |
$197.60 |
$304 |
0.9× |
| Venogram extremity bilateral (75822) |
$1,702.35 |
$2,619 |
1.1× |
| Venogram orbital (75880) |
$1,182.35 |
$1,819 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,594.80 |
$3,992 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,251.25 |
$1,925 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$1,138.15 |
$1,751 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,398.50 |
$3,690 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,209.35 |
$3,399 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,327.65 |
$3,581 |
0.8× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,241.85 |
$3,449 |
0.4× |
| Wrist 2 views (73100) |
$253.50 |
$390 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$417.30 |
$642 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$174.20 |
$268 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$264.55 |
$407 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$559.65 |
$861 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$218.08 |
$335.50 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$217.75 |
$335 |
2.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$499.20 |
$768 |
4.9× |
| X-ray exam hip uni 1 view (73501) |
$131.95 |
$203 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$199.55 |
$307 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$260.65 |
$401 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$204.75 |
$315 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$333.45 |
$513 |
3.3× |
| X-ray exam of femur 1 (73551) |
$153.40 |
$236 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$545.35 |
$839 |
3.2× |
| X-ray eye for foreign body (70030) |
$155.35 |
$239 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$205.40 |
$316 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$189.80 |
$292 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$269.10 |
$414 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,214.85 |
$1,869 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$165.75 |
$255 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$159.25 |
$245 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$258.70 |
$398 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$169 |
$260 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$146.90 |
$226 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$248.95 |
$383 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$393.90 |
$606 |
3.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$117.65 |
$181 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$211.25 |
$325 |
2.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$135.20 |
$208 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$254.15 |
$391 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$252.85 |
$389 |
2.5× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$704.60 |
$1,084 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$317.20 |
$488 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$189.80 |
$292 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$213.85 |
$329 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$265.85 |
$409 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$167.05 |
$257 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$213.85 |
$329 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$232.70 |
$358 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$189.80 |
$292 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$150.15 |
$231 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$321.10 |
$494 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$177.45 |
$273 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$145.60 |
$224 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$177.45 |
$273 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$130.65 |
$201 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$202.15 |
$311 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$269.10 |
$414 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$137.15 |
$211 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$312 |
$480 |
3.7× |
| Xr arthrogram ankle (73615) |
$438.75 |
$675 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$464.75 |
$715 |
4.6× |
| Xr chest 4+ views (71048) |
$286.65 |
$441 |
2.8× |
| Xr Cholecystography Oral Contrast (74290) |
$233.35 |
$359 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$150.80 |
$232 |
1.8× |
| Xr internal auditory meati complete (70134) |
$324.35 |
$499 |
0.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$123.50 |
$190 |
1.2× |
| Xr optic foramina (70190) |
$128.05 |
$197 |
1.5× |
| Xr shoulder 1 view (73020) |
$182.65 |
$281 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$289.25 |
$445 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$200.20 |
$308 |
2.4× |
| Xr tmj bilateral (70330) |
$168.35 |
$259 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$181.35 |
$279 |
2.2× |