| 3-D radiotherapy plan dose-volume histograms (77295) |
$19,338.80 |
$29,752 |
14.5× |
| Abdomen 2 views (74019) |
$518.05 |
$797 |
5.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,163.18 |
$1,789.50 |
3.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$11,402.95 |
$17,543 |
3.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,719.95 |
$5,723 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$2,483 |
$3,820 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$6,059.95 |
$9,323 |
2.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,694.95 |
$7,223 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,097.25 |
$4,765 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,275 |
$3,500 |
0.7× |
| Angiography Spinal Selective Rs&I (75705) |
$5,743.40 |
$8,836 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,815.80 |
$4,332 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$842.40 |
$1,296 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,290.25 |
$1,985 |
0.4× |
| Ankle 2 views (73600) |
$367.25 |
$565 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$702.65 |
$1,081 |
2.1× |
| Aortogram thoracic (75605) |
$2,822.95 |
$4,343 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,073.25 |
$7,805 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,971.80 |
$4,572 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$6,815.25 |
$10,485 |
2.2× |
| Arthrogram elbow (73085) |
$425.10 |
$654 |
1.3× |
| Arthrogram hip (73525) |
$529.75 |
$815 |
1.6× |
| Arthrogram shoulder (73040) |
$641.55 |
$987 |
1.9× |
| Arthrogram wrist (73115) |
$583.70 |
$898 |
1.7× |
| Arthrography knee lt (73580) |
$578.50 |
$890 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$19,128.52 |
$29,428.50 |
148.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$896.35 |
$1,379 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$2,541.94 |
$3,910.68 |
6.6× |
| Bone age studies (77072) |
$339.95 |
$523 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$1,565.20 |
$2,408 |
4.1× |
| Bone survey complete (77075) |
$1,242.15 |
$1,911 |
12.4× |
| Brachytx isodose complex (77318) |
$5,315.70 |
$8,178 |
14.8× |
| Brachytx isodose intermed (77317) |
$14,380.37 |
$22,123.65 |
39.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$12,958.36 |
$19,935.95 |
36.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,124.92 |
$7,884.50 |
3.7× |
| Brain Imaging Vascular Flow Only (78610) |
$1,550.90 |
$2,386 |
3.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$908.70 |
$1,398 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$425.10 |
$654 |
5.1× |
| Chest 1 view (71045) |
$325.65 |
$501 |
3.9× |
| Chest 3 views (71047) |
$341.90 |
$526 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$582.40 |
$896 |
3.5× |
| Clavicle complete (73000) |
$419.90 |
$646 |
5.0× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$43,801.26 |
$67,386.54 |
6.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$666.90 |
$1,026 |
6.6× |
| Continuing medical physics consltj pr wk (77336) |
$16,837.28 |
$25,903.50 |
130.2× |
| Corpora cavernosography (74445) |
$613.60 |
$944 |
6.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,589.95 |
$5,523 |
10.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,638.35 |
$4,059 |
11.5× |
| CT abdomen w contrast (74160) |
$1,871.35 |
$2,879 |
11.1× |
| CT abdomen w wo contrast (74170) |
$2,188.55 |
$3,367 |
13.0× |
| CT abdomen w/o contrast (74150) |
$1,575.60 |
$2,424 |
15.7× |
| CT angiography upper extremity lt (73206) |
$1,492.40 |
$2,296 |
8.8× |
| CT c-spine w/o contrast (72125) |
$2,093.65 |
$3,221 |
20.8× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$911.95 |
$1,403 |
5.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,425.15 |
$3,731 |
14.4× |
| CT cervical spine with contrast (72126) |
$2,155.40 |
$3,316 |
6.4× |
| CT chest w/wo contrast (71270) |
$3,023.80 |
$4,652 |
17.9× |
| CT chest with contrast (71260) |
$1,768 |
$2,720 |
10.5× |
| CT head/brain with contrast (70460) |
$1,528.80 |
$2,352 |
9.1× |
| CT head/brain without and with contrast (70470) |
$3,149.90 |
$4,846 |
18.7× |
| CT iac w contrast (70481) |
$1,781 |
$2,740 |
10.6× |
| CT limited/localized follow up study (76380) |
$732.55 |
$1,127 |
8.8× |
| CT lower ext w/o (73700) |
$1,347.45 |
$2,073 |
13.4× |
| CT lower extremity w wo contrast (73702) |
$1,558.70 |
$2,398 |
9.2× |
| CT lower extremity with contrast (73701) |
$2,325.05 |
$3,577 |
13.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,972.10 |
$3,034 |
11.7× |
| CT lumbar spine w/o contrast (72131) |
$1,595.10 |
$2,454 |
15.9× |
| CT lumbar spine with contrast (72132) |
$1,815.45 |
$2,793 |
5.4× |
| CT maxillofacial w contrast (70487) |
$2,835.95 |
$4,363 |
16.8× |
| CT maxillofacial w/o contrast (70486) |
$2,387.78 |
$3,673.50 |
23.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,845.35 |
$2,839 |
10.9× |
| CT neck soft tissue w contrast (70491) |
$2,284.10 |
$3,514 |
13.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,784.90 |
$2,746 |
10.6× |
| CT orbits w/o contrast (70480) |
$1,600.30 |
$2,462 |
15.9× |
| CT pelvis w & w/o contrast (72194) |
$1,676.35 |
$2,579 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,447.55 |
$2,227 |
14.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,933.45 |
$4,513 |
17.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,965.60 |
$3,024 |
19.5× |
| CT thoracic spine w/contrast (72129) |
$1,641.90 |
$2,526 |
9.7× |
| CT thoracic spine w/o contrast (72128) |
$1,595.10 |
$2,454 |
15.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,796.60 |
$2,764 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,416.35 |
$2,179 |
14.1× |
| CT unlisted procedure (76497) |
$584.35 |
$899 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,605.50 |
$2,470 |
9.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,297.40 |
$1,996 |
12.9× |
| CT upper extremity with contrast (73201) |
$1,428.70 |
$2,198 |
4.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,685.50 |
$5,670 |
21.8× |
| Cta Abdomen (74175) |
$2,148.25 |
$3,305 |
12.7× |
| CTA abdomen pelvis (74174) |
$3,001.05 |
$4,617 |
8.9× |
| CTA chest (71275) |
$2,015.65 |
$3,101 |
11.9× |
| Cta Head (70496) |
$1,784.25 |
$2,745 |
10.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,682.90 |
$5,666 |
11.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,603.90 |
$4,006 |
15.4× |
| Cta Neck (70498) |
$1,698.45 |
$2,613 |
10.1× |
| Cta Pelvis (72191) |
$1,575.60 |
$2,424 |
9.3× |
| Cystography minimum 3 views rs&i (74430) |
$663.65 |
$1,021 |
2.0× |
| Diskogram cervical (72285) |
$2,375.10 |
$3,654 |
1.3× |
| Diskography lumbar (72295) |
$2,575.30 |
$3,962 |
1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$466.05 |
$717 |
4.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$366.60 |
$564 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$234.65 |
$361 |
2.8× |
| Dxa bone density study axial skeleton (77085) |
$528.45 |
$813 |
5.3× |
| Echo exam of fetal heart (76825) |
$2,518.75 |
$3,875 |
4.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$826.15 |
$1,271 |
3.6× |
| Echoencephalography real time imaging (76506) |
$715.65 |
$1,101 |
7.1× |
| Esophageal motility (78258) |
$1,608.10 |
$2,474 |
4.2× |
| Esophagus (74220) |
$567.45 |
$873 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$568.10 |
$874 |
5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$572 |
$880 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$474.50 |
$730 |
2.1× |
| Foot 2 views (73620) |
$396.50 |
$610 |
4.7× |
| Forearm 2 views (73090) |
$487.50 |
$750 |
5.8× |
| Gated Heart Planar Single (78472) |
$2,165.48 |
$3,331.50 |
5.6× |
| Hand 2 views (73120) |
$422.82 |
$650.50 |
4.2× |
| Hand 3 views (73130) |
$256.75 |
$395 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,652 |
$4,080 |
4.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,103.75 |
$4,775 |
4.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,207.45 |
$6,473 |
6.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$4,019.60 |
$6,184 |
10.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,648.10 |
$4,074 |
7.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,852.50 |
$2,850 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,764.32 |
$2,714.34 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,374.45 |
$3,653 |
6.2× |
| Ht muscle image spect sing (78451) |
$2,331.55 |
$3,587 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$416.65 |
$641 |
5.0× |
| Hysterosalpingogram (74740) |
$1,061.45 |
$1,633 |
4.6× |
| Interstitial radiation source applic complex (77778) |
$6,247.80 |
$9,612 |
9.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,743.70 |
$7,298 |
7.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$17,893.20 |
$27,528 |
33.7× |
| Intracavitary radiation source applic simple (77761) |
$7,001.80 |
$10,772 |
13.2× |
| Kidney imaging morphology (78700) |
$3,072.55 |
$4,727 |
8.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,555.45 |
$2,393 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,429.70 |
$3,738 |
4.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,763.45 |
$2,713 |
3.4× |
| Knee 3 views (73562) |
$472.55 |
$727 |
5.6× |
| Liver & spleen imaging static only (78215) |
$915.20 |
$1,408 |
2.4× |
| Liver imaging static only (78201) |
$22,424.44 |
$34,499.14 |
42.9× |
| Lung perf&ventilat diferentl (78598) |
$2,407.60 |
$3,704 |
4.6× |
| Lung perfusion differential (78597) |
$2,189.20 |
$3,368 |
5.7× |
| Lung Ventilation Imaging (78579) |
$932.10 |
$1,434 |
2.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,452.15 |
$5,311 |
1.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,118.35 |
$3,259 |
0.7× |
| Lymphoscintigraphy (78195) |
$9,644.15 |
$14,837.16 |
18.5× |
| Mammary ductogram or galactogram single (77053) |
$359.45 |
$553 |
1.6× |
| Meckels Diverticulum (78290) |
$1,170 |
$1,800 |
3.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$24,387.68 |
$37,519.50 |
67.7× |
| Mr elastography (76391) |
$1,372.15 |
$2,111 |
6.0× |
| MRA head w & w/o contrast (70546) |
$2,253.55 |
$3,467 |
6.7× |
| MRA head w/o contrast (70544) |
$1,781 |
$2,740 |
7.8× |
| MRA head with contrast (70545) |
$1,901.90 |
$2,926 |
5.7× |
| MRA neck w contrast (70548) |
$2,051.40 |
$3,156 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,165.15 |
$3,331 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,493.05 |
$2,297 |
6.5× |
| MRI abdomen w contrast (74182) |
$2,960.10 |
$4,554 |
8.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,923.05 |
$4,497 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$2,073.50 |
$3,190 |
9.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,959.75 |
$3,015 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,082.95 |
$4,743 |
4.1× |
| MRI breast w/o contrast bilateral (77047) |
$2,177.50 |
$3,350 |
9.5× |
| MRI breast w/o contrast unilat (77046) |
$1,979.25 |
$3,045 |
8.6× |
| MRI c-spine with contrast (72142) |
$5,954 |
$9,160 |
17.7× |
| MRI cervical spine w/o contrast (72141) |
$2,096.25 |
$3,225 |
9.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,165.80 |
$3,332 |
6.5× |
| MRI chest w/o contrast (71550) |
$1,676.35 |
$2,579 |
7.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,189.25 |
$6,445 |
12.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,799.55 |
$4,307 |
8.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,903.20 |
$2,928 |
8.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,632.80 |
$2,512 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,083.95 |
$6,283 |
12.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,203.50 |
$3,390 |
6.6× |
| MRI pelvis w contrast (72196) |
$2,736.50 |
$4,210 |
8.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,783.95 |
$4,283 |
8.3× |
| MRI pelvis w/o contrast (72195) |
$2,049.45 |
$3,153 |
8.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,215.85 |
$3,409 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,611.05 |
$4,017 |
7.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,003 |
$4,620 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,950.65 |
$3,001 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,995.20 |
$4,608 |
8.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,176.85 |
$3,349 |
6.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,027.05 |
$4,657 |
9.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,037.75 |
$3,135 |
8.9× |
| MRI tmj (70336) |
$1,155.05 |
$1,777 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,994.85 |
$3,069 |
8.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,601.65 |
$5,541 |
10.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,680.90 |
$2,586 |
7.3× |
| Myelogram Cervical (72240) |
$2,841.15 |
$4,371 |
3.8× |
| Myelogram Lumbar (72265) |
$2,652 |
$4,080 |
3.5× |
| Myelogram thoracic (72255) |
$3,418.35 |
$5,259 |
4.5× |
| Myelography 2 or more regions (72270) |
$4,312.10 |
$6,634 |
5.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,838.60 |
$7,444 |
3.9× |
| Neck soft tissue (70360) |
$508.30 |
$782 |
6.1× |
| Nm cisternogram (78630) |
$3,859.05 |
$5,937 |
7.4× |
| Nm csf leak detection (78650) |
$1,034.80 |
$1,592 |
0.8× |
| Nm gastric emptying study (78264) |
$1,628.90 |
$2,506 |
4.2× |
| Nm gastroesophageal reflux study (78262) |
$1,552.85 |
$2,389 |
4.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$22,109.42 |
$34,014.50 |
16.6× |
| Nuclear Rx Oral Admin (79005) |
$6,194.82 |
$9,530.50 |
27.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$587.60 |
$904 |
5.8× |
| Orthopantogram (70355) |
$288.60 |
$444 |
3.4× |
| Osseous survey infant (77076) |
$460.85 |
$709 |
4.6× |
| Osseous survey limited (77074) |
$469.30 |
$722 |
4.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,732.90 |
$2,666 |
3.3× |
| Parathyrd planar w/wo subtrj (78071) |
$1,455.35 |
$2,239 |
3.8× |
| Parathyroid imaging (78070) |
$1,320.80 |
$2,032 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$259.35 |
$399 |
2.6× |
| Peritoneogram rs&i (74190) |
$1,194.05 |
$1,837 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$5,701.15 |
$8,771 |
4.1× |
| PET imaging CT for attenuation limited area (78814) |
$7,914.08 |
$12,175.50 |
5.8× |
| PET imaging for CT attenuation whole body (78816) |
$5,883.80 |
$9,052 |
4.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,408.90 |
$3,706 |
7.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,946.75 |
$2,995 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,553.50 |
$2,390 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$906.75 |
$1,395 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,563.25 |
$2,405 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$552.50 |
$850 |
1.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$301.60 |
$464 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$375.70 |
$578 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$391.30 |
$602 |
3.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$310.70 |
$478 |
3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$897.65 |
$1,381 |
8.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$39,584.30 |
$60,898.92 |
5.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$10,323.62 |
$15,882.50 |
19.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$6,827.60 |
$10,504 |
69.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$20,279.35 |
$31,199 |
54.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$333.45 |
$513 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$382.20 |
$588 |
4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$679.25 |
$1,045 |
6.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$411.45 |
$633 |
4.9× |
| Radiologic exam colon single contrast study (74270) |
$1,275.30 |
$1,962 |
7.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,068.28 |
$1,643.50 |
6.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,124.50 |
$1,730 |
6.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$278.20 |
$428 |
3.3× |
| Radiological examination surgical specimen (76098) |
$318.50 |
$490 |
0.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,181.45 |
$6,433 |
1.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,466.45 |
$5,333 |
1.1× |
| Ribs bilateral 3 views (71110) |
$675.35 |
$1,039 |
6.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,118.65 |
$1,721 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,602.25 |
$2,465 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$11,807.36 |
$18,165.17 |
22.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$15,351.94 |
$23,618.36 |
68.4× |
| Rp Therapy Intravenous Administration (79101) |
$49,071.75 |
$75,495 |
218.7× |
| Sacroiliac Joints < 3 Views (72200) |
$618.80 |
$952 |
6.2× |
| Scanogram (77073) |
$178.10 |
$274 |
1.8× |
| Scapula complete (73010) |
$247 |
$380 |
2.5× |
| Screening digital breast tomosynthesis (77063) |
$107.90 |
$166 |
4.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$350.35 |
$539 |
3.5× |
| Sialogram (70390) |
$838.50 |
$1,290 |
3.7× |
| Simulation intermediate (77285) |
$22,173.12 |
$34,112.50 |
61.6× |
| Small bowel series (74250) |
$686.40 |
$1,056 |
4.1× |
| Spec medical radj physics consltj (77370) |
$16,996.52 |
$26,148.50 |
131.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$9,220.58 |
$14,185.50 |
25.6× |
| Special dosimetry (77331) |
$9,593.02 |
$14,758.50 |
74.2× |
| Special treatment procedure (77470) |
$24,247.28 |
$37,303.52 |
45.6× |
| Speech evaluation complex (70371) |
$684.45 |
$1,053 |
3.0× |
| Spine thoracic 3 views (72072) |
$575.90 |
$886 |
5.7× |
| Splenoportograpy rs&i (75810) |
$4,716.40 |
$7,256 |
1.6× |
| Stereotactic body radiation delivery (77373) |
$35,512.75 |
$54,635 |
20.7× |
| Superior sagittal sinus venogram (75870) |
$2,117.05 |
$3,257 |
0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$349.70 |
$538 |
3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$19,630.32 |
$30,200.50 |
54.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,166.10 |
$1,794 |
3.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$2,065.70 |
$3,178 |
9.0× |
| Testicular Imaging With Vascular Flow (78761) |
$984.75 |
$1,515 |
2.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$17,395.30 |
$26,762 |
48.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$20,981.68 |
$32,279.50 |
162.3× |
| Therapeutic Enema (74283) |
$1,355.25 |
$2,085 |
8.0× |
| Thoracolumbar 2 views (72080) |
$286.65 |
$441 |
3.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$6,357.86 |
$9,781.32 |
12.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$644.80 |
$992 |
1.7× |
| Thyroid uptake measurement (78012) |
$892.45 |
$1,373 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,392.62 |
$2,142.50 |
3.6× |
| Tomogram (76100) |
$902.85 |
$1,389 |
9.0× |
| Treatment device intermediate (77333) |
$25,815.20 |
$39,715.70 |
199.7× |
| Treatment devices simple (77332) |
$14,784.90 |
$22,746 |
114.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,882.40 |
$2,896 |
3.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$759.20 |
$1,168 |
2.0× |
| Tx devices design & construction complex (77334) |
$16,971.50 |
$26,110 |
47.1× |
| Ultrasound elastography first target lesion (76982) |
$252.85 |
$389 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$901.55 |
$1,387 |
9.0× |
| Umbilical-artery Doppler (OB) (76820) |
$1,047.15 |
$1,611 |
10.4× |
| Unlisted fluoroscopic procedure (76496) |
$646.75 |
$995 |
7.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$3,658.20 |
$5,628 |
37.3× |
| Unlisted Ultrasound Procedure (76999) |
$253.50 |
$390 |
3.0× |
| Upper Extremity Infant (73092) |
$250.25 |
$385 |
2.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,175.85 |
$1,809 |
3.1× |
| Urethrocystography retrograde rs&i (74450) |
$656.50 |
$1,010 |
2.9× |
| Urethrocystography voiding (74455) |
$622.05 |
$957 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$955.50 |
$1,470 |
5.7× |
| Us abdl aorta screen aaa (76706) |
$317.20 |
$488 |
3.2× |
| Us breast unilateral complete (76641) |
$354.90 |
$546 |
3.5× |
| Us breast unilateral limited (76642) |
$301.60 |
$464 |
3.6× |
| Us chest (76604) |
$598 |
$920 |
5.9× |
| Us compl joint r-t w/image documentation (76881) |
$354.90 |
$546 |
3.5× |
| Us elastography parenchyma (76981) |
$302.25 |
$465 |
3.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$399.10 |
$614 |
4.0× |
| Us kidney transplant (76776) |
$584.35 |
$899 |
5.8× |
| Us ob detailed single fetus (76811) |
$714.35 |
$1,099 |
3.1× |
| Us ob transvaginal (76817) |
$697.45 |
$1,073 |
6.9× |
| Us pelvic non ob complete (76856) |
$990.60 |
$1,524 |
9.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$410.80 |
$632 |
4.1× |
| Us pregnancy ltd (76815) |
$668.20 |
$1,028 |
6.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$744.25 |
$1,145 |
7.4× |
| Us retroperitoneal complete (76770) |
$984.75 |
$1,515 |
9.8× |
| Us retroperitoneal limited (76775) |
$482.30 |
$742 |
4.8× |
| Us scrotum and contents (76870) |
$954.85 |
$1,469 |
9.5× |
| Us soft tissue head/neck (76536) |
$512.85 |
$789 |
5.1× |
| Us spinal canal and contents (76800) |
$305.50 |
$470 |
3.0× |
| Us transrectal (76872) |
$527.15 |
$811 |
5.2× |
| Us transrectal prostate volume (76873) |
$817.70 |
$1,258 |
8.1× |
| Us xtr non-vasc lmtd (76882) |
$376.35 |
$579 |
3.7× |
| Venogram extremity bilateral (75822) |
$1,493.05 |
$2,297 |
1.0× |
| Venogram orbital (75880) |
$1,497.60 |
$2,304 |
2.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,241.20 |
$3,448 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,827.15 |
$2,811 |
1.2× |
| Venography epidural rs&i (75872) |
$1,249.95 |
$1,923 |
2.1× |
| Venography extremity unilateral rs&i (75820) |
$1,163.50 |
$1,790 |
0.8× |
| Venography Renal Bilateral (75833) |
$5,428.15 |
$8,351 |
1.8× |
| Venography renal unilateral selective rs&i (75831) |
$3,930.22 |
$6,046.50 |
1.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,063.15 |
$6,251 |
1.3× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$7,471.10 |
$11,494 |
1.4× |
| Wrist 2 views (73100) |
$280.80 |
$432 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$831.35 |
$1,279 |
8.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$388.05 |
$597 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$435.50 |
$670 |
5.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,041.30 |
$1,602 |
6.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$516.75 |
$795 |
6.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$273.65 |
$421 |
3.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,079.65 |
$1,661 |
10.7× |
| X-ray exam hip uni 1 view (73501) |
$159.90 |
$246 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$244.40 |
$376 |
2.9× |
| X-ray exam hip uni 4/> views (73503) |
$434.20 |
$668 |
4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$454.35 |
$699 |
4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,155.70 |
$1,778 |
11.5× |
| X-ray exam of femur 1 (73551) |
$256.75 |
$395 |
3.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,885 |
$2,900 |
11.2× |
| X-ray eye for foreign body (70030) |
$158.60 |
$244 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$320.45 |
$493 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$465.40 |
$716 |
5.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$436.15 |
$671 |
5.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,847 |
$4,380 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$239.20 |
$368 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$227.50 |
$350 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$345.15 |
$531 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$174.85 |
$269 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$239.85 |
$369 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$317.20 |
$488 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$525.20 |
$808 |
5.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$300.30 |
$462 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$243.10 |
$374 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$200.20 |
$308 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$280.80 |
$432 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$329.55 |
$507 |
3.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$2,229.50 |
$3,430 |
4.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$758.55 |
$1,167 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$450.45 |
$693 |
5.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$320.45 |
$493 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$419.90 |
$646 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$300.30 |
$462 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$271.05 |
$417 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$465.40 |
$716 |
5.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$353.60 |
$544 |
4.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$289.25 |
$445 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$353.60 |
$544 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$273.65 |
$421 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$246.35 |
$379 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$211.25 |
$325 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$228.15 |
$351 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$286.65 |
$441 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$334.10 |
$514 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$345.80 |
$532 |
4.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$416 |
$640 |
5.0× |
| Xr arthrogram ankle (73615) |
$412.10 |
$634 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$553.80 |
$852 |
5.5× |
| Xr chest 4+ views (71048) |
$740.35 |
$1,139 |
7.4× |
| Xr Cholecystography Oral Contrast (74290) |
$872.95 |
$1,343 |
5.2× |
| Xr finger(s) 2+ views (73140) |
$331.50 |
$510 |
4.0× |
| Xr shoulder 1 view (73020) |
$219.70 |
$338 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$585.65 |
$901 |
5.8× |
| Xr tibia/fibula 2 views (73590) |
$428.35 |
$659 |
5.1× |
| Xr tmj bilateral (70330) |
$248.95 |
$383 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$250.25 |
$385 |
3.0× |