| 3-D radiotherapy plan dose-volume histograms (77295) |
$19,131.12 |
$29,432.50 |
13.8× |
| Abdomen 2 views (74019) |
$501.80 |
$772 |
4.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,348.75 |
$2,075 |
3.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,737.85 |
$7,289 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$4,737.85 |
$7,289 |
1.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,716.40 |
$7,256 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,737.85 |
$7,289 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,727.12 |
$7,272.50 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,737.85 |
$7,289 |
0.9× |
| Ankle 2 views (73600) |
$318.50 |
$490 |
3.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$416 |
$640 |
1.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,503.15 |
$3,851 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$4,737.85 |
$7,289 |
1.5× |
| Arthrogram elbow (73085) |
$209.95 |
$323 |
0.6× |
| Arthrogram hip (73525) |
$726.70 |
$1,118 |
2.1× |
| Arthrogram shoulder (73040) |
$984.10 |
$1,514 |
2.8× |
| Arthrogram wrist (73115) |
$429 |
$660 |
1.2× |
| Arthrography knee lt (73580) |
$796.90 |
$1,226 |
2.3× |
| Basic radiation dosimetry calculation (77300) |
$17,739.80 |
$27,292 |
131.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$950.95 |
$1,463 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$2,542.15 |
$3,911 |
6.3× |
| Bone age studies (77072) |
$292.50 |
$450 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,815.78 |
$2,793.50 |
4.5× |
| Bone Marrow Imaging Limited Area (78102) |
$783.90 |
$1,206 |
2.0× |
| Bone survey complete (77075) |
$1,022.45 |
$1,573 |
9.8× |
| Brain imaging < 4 static views (78600) |
$698.75 |
$1,075 |
1.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$780.65 |
$1,201 |
1.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$999.05 |
$1,537 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,482.35 |
$3,819 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$231.40 |
$356 |
0.4× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$330.85 |
$509 |
29.9× |
| Cervical spine 2 or 3 views (72040) |
$403.65 |
$621 |
4.6× |
| Chest 1 view (71045) |
$282.10 |
$434 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$523.25 |
$805 |
3.0× |
| Clavicle complete (73000) |
$285.35 |
$439 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$245.05 |
$377 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$16,053.70 |
$24,698 |
119.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,185.60 |
$1,824 |
3.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,080.95 |
$1,663 |
4.5× |
| CT abdomen w contrast (74160) |
$984.75 |
$1,515 |
5.6× |
| CT abdomen w wo contrast (74170) |
$1,080.95 |
$1,663 |
6.2× |
| CT abdomen w/o contrast (74150) |
$984.75 |
$1,515 |
9.4× |
| CT angio hrt w/3d image (75574) |
$2,146.95 |
$3,303 |
6.1× |
| CT angiography upper extremity lt (73206) |
$1,177.80 |
$1,812 |
6.7× |
| CT c-spine w/o contrast (72125) |
$1,821.95 |
$2,803 |
17.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$585 |
$900 |
3.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,031.90 |
$3,126 |
11.6× |
| CT cervical spine with contrast (72126) |
$1,795.30 |
$2,762 |
5.1× |
| CT chest w/wo contrast (71270) |
$2,346.50 |
$3,610 |
13.4× |
| CT chest with contrast (71260) |
$2,011.75 |
$3,095 |
11.5× |
| CT head/brain with contrast (70460) |
$1,633.45 |
$2,513 |
9.3× |
| CT head/brain without and with contrast (70470) |
$1,801.80 |
$2,772 |
10.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,575.60 |
$2,424 |
4.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84.50 |
$130 |
1.0× |
| CT hrt w/3d image congen (75573) |
$1,850.55 |
$2,847 |
5.3× |
| CT iac w contrast (70481) |
$1,534 |
$2,360 |
8.7× |
| CT lower ext w/o (73700) |
$1,864.85 |
$2,869 |
17.8× |
| CT lower extremity w wo contrast (73702) |
$1,942.85 |
$2,989 |
11.1× |
| CT lower extremity with contrast (73701) |
$1,864.85 |
$2,869 |
10.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,093 |
$3,220 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,834.30 |
$2,822 |
17.5× |
| CT lumbar spine with contrast (72132) |
$1,963 |
$3,020 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,763.45 |
$2,713 |
10.0× |
| CT maxillofacial w/o contrast (70486) |
$1,235.32 |
$1,900.50 |
11.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,117.70 |
$3,258 |
12.1× |
| CT neck soft tissue w contrast (70491) |
$2,193.75 |
$3,375 |
12.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,834.30 |
$2,822 |
10.4× |
| CT orbits w/o contrast (70480) |
$1,409.20 |
$2,168 |
13.5× |
| CT pelvis w & w/o contrast (72194) |
$1,080.95 |
$1,663 |
6.2× |
| CT pelvis w/o contrast (72192) |
$984.75 |
$1,515 |
9.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,976.65 |
$3,041 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,126.80 |
$3,272 |
20.3× |
| CT thoracic spine w/contrast (72129) |
$1,832.35 |
$2,819 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$1,883.05 |
$2,897 |
18.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,059.85 |
$3,169 |
11.7× |
| CT thorax w/o contrast (71250) |
$2,011.75 |
$3,095 |
19.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,287 |
$1,980 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$874.25 |
$1,345 |
8.3× |
| CT upper extremity with contrast (73201) |
$1,136.85 |
$1,749 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,225.25 |
$1,885 |
7.0× |
| Cta Abdomen (74175) |
$1,185.60 |
$1,824 |
6.7× |
| CTA abdomen pelvis (74174) |
$1,225.25 |
$1,885 |
3.5× |
| CTA chest (71275) |
$2,866.50 |
$4,410 |
16.3× |
| Cta Head (70496) |
$1,955.20 |
$3,008 |
11.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,060.50 |
$3,170 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,523.95 |
$3,883 |
14.4× |
| Cta Neck (70498) |
$2,555.80 |
$3,932 |
14.5× |
| Cta Pelvis (72191) |
$2,361.45 |
$3,633 |
13.4× |
| Cystography minimum 3 views rs&i (74430) |
$644.80 |
$992 |
1.8× |
| Diskography lumbar (72295) |
$1,786.85 |
$2,749 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$906.75 |
$1,395 |
8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,021.80 |
$1,572 |
9.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$564.20 |
$868 |
5.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$497.90 |
$766 |
4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$310.05 |
$477 |
3.6× |
| Dxa bone density study axial skeleton (77085) |
$224.25 |
$345 |
2.1× |
| Echo exam of fetal heart (76825) |
$1,326 |
$2,040 |
2.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$906.75 |
$1,395 |
3.8× |
| Echoencephalography real time imaging (76506) |
$584.35 |
$899 |
5.6× |
| Esophagus (74220) |
$611 |
$940 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$766.35 |
$1,179 |
7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$652.60 |
$1,004 |
6.2× |
| Fluoroscopy up to 1 hr (76000) |
$633.75 |
$975 |
2.7× |
| Foot 2 views (73620) |
$293.80 |
$452 |
3.4× |
| Forearm 2 views (73090) |
$273 |
$420 |
3.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,029.60 |
$1,584 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,940.25 |
$2,985 |
4.8× |
| Hand 2 views (73120) |
$306.80 |
$472 |
2.9× |
| Hand 3 views (73130) |
$321.75 |
$495 |
3.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,684.50 |
$4,130 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,332.64 |
$3,588.68 |
4.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,921.72 |
$2,956.50 |
4.8× |
| Ht muscle image spect sing (78451) |
$1,350.70 |
$2,078 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$300.95 |
$463 |
3.5× |
| Hysterosalpingogram (74740) |
$744.90 |
$1,146 |
3.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,514.85 |
$3,869 |
4.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,323.66 |
$5,113.33 |
6.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$4,008.55 |
$6,167 |
7.4× |
| Knee 3 views (73562) |
$332.80 |
$512 |
3.8× |
| Liver & spleen imaging static only (78215) |
$1,214.85 |
$1,869 |
3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$934.05 |
$1,437 |
2.3× |
| Liver imaging static only (78201) |
$44,582.36 |
$68,588.24 |
82.0× |
| Liver imaging w/vascular flow (78202) |
$1,658.15 |
$2,551 |
3.0× |
| Lung perf&ventilat diferentl (78598) |
$3,195.08 |
$4,915.50 |
5.9× |
| Lung perfusion differential (78597) |
$1,985.75 |
$3,055 |
5.0× |
| Lung Ventilation Imaging (78579) |
$724.10 |
$1,114 |
1.8× |
| Lymphoscintigraphy (78195) |
$14,809.52 |
$22,783.87 |
27.2× |
| Meckels Diverticulum (78290) |
$1,109.88 |
$1,707.50 |
2.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$20,494.50 |
$31,530 |
54.6× |
| MRA head w & w/o contrast (70546) |
$2,595.45 |
$3,993 |
7.4× |
| MRA head w/o contrast (70544) |
$2,076.75 |
$3,195 |
8.7× |
| MRA head with contrast (70545) |
$1,612 |
$2,480 |
4.6× |
| MRA neck w contrast (70548) |
$1,318.20 |
$2,028 |
3.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,122.90 |
$3,266 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,964.95 |
$3,023 |
8.2× |
| MRI abdomen w contrast (74182) |
$3,268.20 |
$5,028 |
9.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,729.70 |
$5,738 |
10.7× |
| MRI abdomen w/o contrast (74181) |
$2,797.60 |
$4,304 |
11.7× |
| MRI any jnt lwr ext with con lt (73722) |
$2,496 |
$3,840 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,681.25 |
$4,125 |
3.4× |
| MRI breast w/o contrast bilateral (77047) |
$2,449.20 |
$3,768 |
10.2× |
| MRI breast w/o contrast unilat (77046) |
$1,833 |
$2,820 |
7.7× |
| MRI c-spine with contrast (72142) |
$2,286.05 |
$3,517 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$2,286.05 |
$3,517 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,278.90 |
$3,506 |
6.5× |
| MRI chest w/o contrast (71550) |
$1,774.50 |
$2,730 |
7.4× |
| MRI chest with contrast (71551) |
$1,774.50 |
$2,730 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,646.15 |
$4,071 |
7.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,496 |
$3,840 |
7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,496 |
$3,840 |
10.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,752.10 |
$4,234 |
11.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,186.30 |
$4,902 |
9.1× |
| MRI pelvis w contrast (72196) |
$2,579.85 |
$3,969 |
7.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,313.05 |
$5,097 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,579.85 |
$3,969 |
10.8× |
| MRI scan of arm joint before and after contrast (73223) |
$3,216.20 |
$4,948 |
9.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,923.05 |
$4,497 |
8.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,038.10 |
$4,674 |
8.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,332.20 |
$3,588 |
6.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,075.80 |
$4,732 |
8.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,392 |
$3,680 |
6.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,146 |
$4,840 |
9.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,189.20 |
$3,368 |
9.2× |
| MRI tmj (70336) |
$707.85 |
$1,089 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,537.60 |
$3,904 |
10.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,216.20 |
$4,948 |
9.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,646.15 |
$4,071 |
11.1× |
| Myelogram Cervical (72240) |
$2,119 |
$3,260 |
2.7× |
| Myelogram Lumbar (72265) |
$2,119 |
$3,260 |
2.7× |
| Myelogram thoracic (72255) |
$2,119 |
$3,260 |
2.7× |
| Myelography 2 or more regions (72270) |
$2,736.50 |
$4,210 |
3.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,703.70 |
$5,698 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$6,259.82 |
$9,630.50 |
4.8× |
| Neck soft tissue (70360) |
$290.55 |
$447 |
3.3× |
| Nm adrenal scan (78075) |
$2,639.65 |
$4,061 |
2.0× |
| Nm bone marrow multiple (78103) |
$783.90 |
$1,206 |
2.0× |
| Nm bone marrow wb (78104) |
$783.90 |
$1,206 |
2.0× |
| Nm cisternogram (78630) |
$453.05 |
$697 |
0.8× |
| Nm csf leak detection (78650) |
$2,358.85 |
$3,629 |
1.8× |
| Nm gastric emptying study (78264) |
$1,711.45 |
$2,633 |
4.3× |
| Nm gastroesophageal reflux study (78262) |
$1,549.60 |
$2,384 |
3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$21,681.08 |
$33,355.50 |
15.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,082.90 |
$1,666 |
2.7× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$876.20 |
$1,348 |
2.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$744.90 |
$1,146 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$4,932.85 |
$7,589 |
21.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$220.35 |
$339 |
2.1× |
| Orthopantogram (70355) |
$167.05 |
$257 |
1.9× |
| Osseous survey infant (77076) |
$499.85 |
$769 |
4.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,132.95 |
$1,743 |
2.8× |
| Parathyroid imaging (78070) |
$1,042.60 |
$1,604 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$308.75 |
$475 |
2.9× |
| PET image w/CT, skull-thigh (78815) |
$8,203.32 |
$12,620.50 |
5.7× |
| PET imaging CT for attenuation limited area (78814) |
$7,299.50 |
$11,230 |
5.1× |
| PET imaging for CT attenuation whole body (78816) |
$8,153.28 |
$12,543.50 |
5.7× |
| PET whole body (78813) |
$6,882.85 |
$10,589 |
4.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,923.05 |
$4,497 |
8.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,483 |
$3,820 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,030.25 |
$1,585 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,734.25 |
$5,745 |
6.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$859.30 |
$1,322 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$235.95 |
$363 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$447.85 |
$689 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$529.10 |
$814 |
5.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$542.75 |
$835 |
5.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$28,082.60 |
$43,204 |
3.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$12,293.78 |
$18,913.50 |
22.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$619.45 |
$953 |
6.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$11,616.15 |
$17,871 |
30.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$334.10 |
$514 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$308.75 |
$475 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$485.55 |
$747 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$349.05 |
$537 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$737.75 |
$1,135 |
4.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,525.55 |
$2,347 |
8.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,540.50 |
$2,370 |
8.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$322.40 |
$496 |
3.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$217.10 |
$334 |
2.5× |
| Radiological examination surgical specimen (76098) |
$1,168.05 |
$1,797 |
2.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,930.55 |
$6,047 |
1.2× |
| Ribs bilateral 3 views (71110) |
$560.30 |
$862 |
5.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$827.45 |
$1,273 |
2.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,015.95 |
$1,563 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$15,162.84 |
$23,327.45 |
27.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,710.50 |
$4,170 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,074.50 |
$4,730 |
2.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,710.50 |
$4,170 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$41,324.04 |
$63,575.44 |
176.8× |
| Rp Therapy Intravenous Administration (79101) |
$55,095.95 |
$84,763 |
235.7× |
| Sacroiliac Joints < 3 Views (72200) |
$189.80 |
$292 |
1.8× |
| Salivary gland function study (78232) |
$879.45 |
$1,353 |
2.2× |
| Scanogram (77073) |
$249.60 |
$384 |
2.4× |
| Scapula complete (73010) |
$291.85 |
$449 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$104.65 |
$161 |
4.5× |
| Sella turcica (70240) |
$249.60 |
$384 |
2.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$248.30 |
$382 |
2.4× |
| Sialogram (70390) |
$456.30 |
$702 |
1.9× |
| Small bowel series (74250) |
$850.20 |
$1,308 |
4.8× |
| Spec medical radj physics consltj (77370) |
$29,621.15 |
$45,571 |
220.0× |
| Special treatment procedure (77470) |
$22,695.72 |
$34,916.50 |
41.0× |
| Spine thoracic 3 views (72072) |
$419.90 |
$646 |
4.0× |
| Stereotactic body radiation delivery (77373) |
$29,803.15 |
$45,851 |
16.6× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$521.30 |
$802 |
5.1× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$2,350.08 |
$3,615.50 |
62.8× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$2,350.08 |
$3,615.50 |
23.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$7,182.18 |
$11,049.50 |
19.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$848.90 |
$1,306 |
3.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$16,767.08 |
$25,795.50 |
44.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$13,894.08 |
$21,375.50 |
103.2× |
| Thoracolumbar 2 views (72080) |
$415.35 |
$639 |
4.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,464.12 |
$2,252.50 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$497.90 |
$766 |
1.2× |
| Thyroid uptake measurement (78012) |
$767 |
$1,180 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,365.32 |
$2,100.50 |
3.4× |
| Tmj unilateral (70328) |
$249.60 |
$384 |
2.9× |
| Treatment devices simple (77332) |
$14,747.85 |
$22,689 |
109.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,161.55 |
$1,787 |
2.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$4,050.48 |
$6,231.50 |
10.1× |
| Tx devices design & construction complex (77334) |
$17,080.38 |
$26,277.50 |
45.5× |
| Ultrasound, abdomen limited (76705) |
$1,060.15 |
$1,631 |
10.1× |
| Umbilical-artery Doppler (OB) (76820) |
$564.20 |
$868 |
5.4× |
| Unlisted magnetic resonance procedure (76498) |
$2,579.85 |
$3,969 |
29.6× |
| Upper Extremity Infant (73092) |
$339.30 |
$522 |
3.2× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$330.85 |
$509 |
3.5× |
| Urethrocystography retrograde rs&i (74450) |
$496.60 |
$764 |
2.1× |
| Urethrocystography voiding (74455) |
$923.65 |
$1,421 |
3.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$759.85 |
$1,169 |
4.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,194.05 |
$1,837 |
6.8× |
| Us abdl aorta screen aaa (76706) |
$257.40 |
$396 |
2.5× |
| Us breast unilateral complete (76641) |
$190.45 |
$293 |
1.8× |
| Us breast unilateral limited (76642) |
$190.45 |
$293 |
2.2× |
| Us chest (76604) |
$503.10 |
$774 |
4.8× |
| Us guided compression repair (76936) |
$668.85 |
$1,029 |
3.1× |
| Us infant hips dynamic (76885) |
$665.60 |
$1,024 |
7.6× |
| Us infant hips limited static (76886) |
$377.65 |
$581 |
4.3× |
| Us kidney transplant (76776) |
$716.95 |
$1,103 |
6.8× |
| Us ob detailed single fetus (76811) |
$1,190.15 |
$1,831 |
5.0× |
| Us ob transvaginal (76817) |
$342.55 |
$527 |
3.3× |
| Us pelvic non ob complete (76856) |
$830.70 |
$1,278 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$347.75 |
$535 |
3.3× |
| Us pregnancy ltd (76815) |
$627.25 |
$965 |
6.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$342.55 |
$527 |
3.3× |
| Us retroperitoneal complete (76770) |
$1,043.25 |
$1,605 |
10.0× |
| Us retroperitoneal limited (76775) |
$873.60 |
$1,344 |
8.3× |
| Us scrotum and contents (76870) |
$949 |
$1,460 |
9.1× |
| Us soft tissue head/neck (76536) |
$437.12 |
$672.50 |
4.2× |
| Us spinal canal and contents (76800) |
$382.85 |
$589 |
3.7× |
| Us transrectal (76872) |
$366.60 |
$564 |
3.5× |
| Us xtr non-vasc lmtd (76882) |
$775.45 |
$1,193 |
7.4× |
| Venogram extremity bilateral (75822) |
$1,672.45 |
$2,573 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,737.85 |
$7,289 |
1.5× |
| Venography caval superior serialography rs&i (75827) |
$1,672.45 |
$2,573 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$4,737.85 |
$7,289 |
3.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,424.50 |
$3,730 |
0.8× |
| Wrist 2 views (73100) |
$306.15 |
$471 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$549.25 |
$845 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$287.95 |
$443 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$333.45 |
$513 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,075.75 |
$1,655 |
6.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$295.10 |
$454 |
3.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$273 |
$420 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$273 |
$420 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$314.60 |
$484 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$291.85 |
$449 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$529.10 |
$814 |
5.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$583.05 |
$897 |
5.6× |
| X-ray exam of femur 1 (73551) |
$273 |
$420 |
3.1× |
| X-ray eye for foreign body (70030) |
$248.30 |
$382 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$508.30 |
$782 |
4.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$431.60 |
$664 |
5.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$331.50 |
$510 |
3.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$275.60 |
$424 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$271.05 |
$417 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$438.10 |
$674 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$143 |
$220 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$287.30 |
$442 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$328.25 |
$505 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$586.95 |
$903 |
5.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$286 |
$440 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$377 |
$580 |
4.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$248.30 |
$382 |
2.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$547.95 |
$843 |
5.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$273 |
$420 |
2.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$702 |
$1,080 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$450.45 |
$693 |
5.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$356.20 |
$548 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$356.20 |
$548 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$379.60 |
$584 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$338 |
$520 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$334.75 |
$515 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$515.45 |
$793 |
5.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$287.95 |
$443 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$423.80 |
$652 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$360.75 |
$555 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$312.65 |
$481 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$249.60 |
$384 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$348.40 |
$536 |
4.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$415.35 |
$639 |
4.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$451.75 |
$695 |
4.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$265.85 |
$409 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$319.80 |
$492 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$512.20 |
$788 |
4.9× |
| Xr chest 4+ views (71048) |
$458.90 |
$706 |
4.4× |
| Xr finger(s) 2+ views (73140) |
$290.55 |
$447 |
3.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$149.50 |
$230 |
1.4× |
| Xr shoulder 1 view (73020) |
$249.60 |
$384 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$475.15 |
$731 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$338 |
$520 |
3.9× |
| Xr tmj bilateral (70330) |
$332.80 |
$512 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$328.25 |
$505 |
3.8× |