| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,341.80 |
$6,505 |
1.6× |
| Abdomen 2 views (74019) |
$161.64 |
$449 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$736.56 |
$2,046 |
1.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,126.80 |
$3,130 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$1,499.40 |
$4,165 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$1,452.96 |
$4,036 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,282.12 |
$9,117 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,126.80 |
$3,130 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,126.80 |
$3,130 |
0.3× |
| Angiography Spinal Selective Rs&I (75705) |
$5,090.40 |
$14,140 |
0.9× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,229.12 |
$6,192 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,418.40 |
$3,940 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,135.08 |
$3,153 |
0.3× |
| Ankle 2 views (73600) |
$90 |
$250 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$449.28 |
$1,248 |
1.2× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,067.12 |
$5,742 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,423.16 |
$6,731 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,605.60 |
$4,460 |
0.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,853.28 |
$5,148 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$2,176.20 |
$6,045 |
0.7× |
| Arthrogram elbow (73085) |
$186.12 |
$517 |
0.5× |
| Arthrogram hip (73525) |
$285.12 |
$792 |
0.8× |
| Arthrogram shoulder (73040) |
$402.48 |
$1,118 |
1.1× |
| Arthrogram wrist (73115) |
$238.68 |
$663 |
0.7× |
| Arthrography knee lt (73580) |
$258.12 |
$717 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$229.32 |
$637 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$415.80 |
$1,155 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$460.44 |
$1,279 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$690.12 |
$1,917 |
1.7× |
| Bone age studies (77072) |
$116.28 |
$323 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$735.48 |
$2,043 |
1.8× |
| Bone survey complete (77075) |
$298.08 |
$828 |
2.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$229.32 |
$637 |
0.6× |
| Brain image w/flow 4 + views (78606) |
$664.20 |
$1,845 |
1.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$338.40 |
$940 |
0.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$672.12 |
$1,867 |
1.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$727.56 |
$2,021 |
1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,044.72 |
$2,902 |
2.9× |
| Cardiac shunt detection (78428) |
$391.32 |
$1,087 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$694.44 |
$1,929 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$116.28 |
$323 |
1.3× |
| Chest 1 view (71045) |
$92.88 |
$258 |
1.0× |
| Chest 3 views (71047) |
$138.24 |
$384 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$192.96 |
$536 |
1.1× |
| Cineradiography/videoradiography (76120) |
$123.48 |
$343 |
1.1× |
| Clavicle complete (73000) |
$147.96 |
$411 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$651.24 |
$1,809 |
6.0× |
| Continuing medical physics consltj pr wk (77336) |
$1,404.54 |
$3,901.50 |
10.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,989.72 |
$5,527 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,374.48 |
$3,818 |
5.5× |
| CT abdomen w contrast (74160) |
$932.94 |
$2,591.50 |
5.1× |
| CT abdomen w wo contrast (74170) |
$1,303.92 |
$3,622 |
7.2× |
| CT abdomen w/o contrast (74150) |
$783.36 |
$2,176 |
7.2× |
| CT angio hrt w/3d image (75574) |
$991.80 |
$2,755 |
2.7× |
| CT angiography upper extremity lt (73206) |
$726.48 |
$2,018 |
4.0× |
| CT c-spine w/o contrast (72125) |
$786.60 |
$2,185 |
7.2× |
| CT cervical spine w&w/o contrast (72127) |
$928.44 |
$2,579 |
5.1× |
| CT cervical spine with contrast (72126) |
$897.12 |
$2,492 |
2.5× |
| CT chest w/wo contrast (71270) |
$1,122.12 |
$3,117 |
6.2× |
| CT chest with contrast (71260) |
$1,060.92 |
$2,947 |
5.8× |
| CT head/brain with contrast (70460) |
$876.42 |
$2,434.50 |
4.8× |
| CT head/brain without and with contrast (70470) |
$967.32 |
$2,687 |
5.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$991.80 |
$2,755 |
2.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$101.88 |
$283 |
1.1× |
| CT hrt w/3d image congen (75573) |
$991.80 |
$2,755 |
2.7× |
| CT iac w contrast (70481) |
$1,001.88 |
$2,783 |
5.5× |
| CT limited/localized follow up study (76380) |
$441.36 |
$1,226 |
4.9× |
| CT lower ext w/o (73700) |
$1,151.82 |
$3,199.50 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,584.18 |
$4,400.50 |
8.7× |
| CT lower extremity with contrast (73701) |
$996.12 |
$2,767 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$897.12 |
$2,492 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$768.24 |
$2,134 |
7.1× |
| CT lumbar spine with contrast (72132) |
$894.60 |
$2,485 |
2.5× |
| CT maxillofacial w contrast (70487) |
$936 |
$2,600 |
5.1× |
| CT maxillofacial w/o contrast (70486) |
$510.48 |
$1,418 |
4.7× |
| CT maxillofacial w/wo contrast (70488) |
$858.60 |
$2,385 |
4.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,094.76 |
$3,041 |
6.0× |
| CT orbits w/o contrast (70480) |
$811.80 |
$2,255 |
7.5× |
| CT pelvis w & w/o contrast (72194) |
$985.68 |
$2,738 |
5.4× |
| CT pelvis w/o contrast (72192) |
$708.66 |
$1,968.50 |
6.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$934.92 |
$2,597 |
5.1× |
| CT soft tissue neck w/o contrast (70490) |
$705.96 |
$1,961 |
6.5× |
| CT thoracic spine w/contrast (72129) |
$960.48 |
$2,668 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$808.20 |
$2,245 |
7.4× |
| CT thoracic spine w/wo contrast (72130) |
$897.12 |
$2,492 |
4.9× |
| CT thorax w/o contrast (71250) |
$721.44 |
$2,004 |
6.6× |
| CT unlisted procedure (76497) |
$744.12 |
$2,067 |
8.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$917.82 |
$2,549.50 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,026.72 |
$2,852 |
9.5× |
| CT upper extremity with contrast (73201) |
$918.90 |
$2,552.50 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,120.50 |
$3,112.50 |
6.2× |
| Cta Abdomen (74175) |
$1,008 |
$2,800 |
5.5× |
| CTA abdomen pelvis (74174) |
$2,052.18 |
$5,700.50 |
5.7× |
| CTA chest (71275) |
$1,148.40 |
$3,190 |
6.3× |
| Cta Head (70496) |
$1,178.64 |
$3,274 |
6.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,103.40 |
$3,065 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$935.64 |
$2,599 |
5.1× |
| Cta Neck (70498) |
$1,124.28 |
$3,123 |
6.2× |
| Cta Pelvis (72191) |
$1,090.08 |
$3,028 |
6.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,385.82 |
$3,849.50 |
3.8× |
| Diskogram cervical (72285) |
$937.44 |
$2,604 |
0.5× |
| Diskography lumbar (72295) |
$1,328.40 |
$3,690 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$108.72 |
$302 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$126 |
$350 |
1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$99.90 |
$277.50 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$217.08 |
$603 |
2.0× |
| Echo exam of fetal heart (76825) |
$500.40 |
$1,390 |
0.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$500.40 |
$1,390 |
2.0× |
| Echoencephalography real time imaging (76506) |
$201.24 |
$559 |
1.9× |
| Esophagus (74220) |
$231.48 |
$643 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$118.80 |
$330 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$104.76 |
$291 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$238.32 |
$662 |
1.0× |
| Foot 2 views (73620) |
$90 |
$250 |
1.0× |
| Forearm 2 views (73090) |
$194.40 |
$540 |
2.2× |
| Functional MRI brain by phys/psych (70555) |
$931.68 |
$2,588 |
3.8× |
| Functional MRI brain by tech (70554) |
$528.12 |
$1,467 |
2.1× |
| Gated Heart Planar Single (78472) |
$653.76 |
$1,816 |
1.6× |
| Hand 2 views (73120) |
$165.96 |
$461 |
1.5× |
| Hand 3 views (73130) |
$194.40 |
$540 |
2.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,365.84 |
$3,794 |
1.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,972.80 |
$5,480 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,365.84 |
$3,794 |
1.9× |
| Heart Infarct Image (78466) |
$559.44 |
$1,554 |
1.3× |
| Heart infarct image w ef (78468) |
$496.80 |
$1,380 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,190.16 |
$3,306 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$347.76 |
$966 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$819.72 |
$2,277 |
2.0× |
| Ht muscle image spect sing (78451) |
$1,132.20 |
$3,145 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$194.40 |
$540 |
2.2× |
| Hysterosalpingogram (74740) |
$243.72 |
$677 |
1.0× |
| Image fusion (77399) |
$1,414.62 |
$3,929.50 |
10.1× |
| Interstitial radiation source applic complex (77778) |
$1,508.04 |
$4,189 |
2.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$801.72 |
$2,227 |
1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$801.72 |
$2,227 |
1.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$65.52 |
$182 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$622.44 |
$1,729 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,015.92 |
$2,822 |
1.8× |
| Knee 3 views (73562) |
$237.24 |
$659 |
2.6× |
| Liver & spleen imaging static only (78215) |
$484.56 |
$1,346 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$423.72 |
$1,177 |
1.0× |
| Liver imaging static only (78201) |
$892.08 |
$2,478 |
1.6× |
| Liver imaging w/vascular flow (78202) |
$892.08 |
$2,478 |
1.6× |
| Lung perfusion differential (78597) |
$912.24 |
$2,534 |
2.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,452.24 |
$4,034 |
0.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,145.52 |
$3,182 |
0.3× |
| Lymphoscintigraphy (78195) |
$498.96 |
$1,386 |
0.9× |
| Meckels Diverticulum (78290) |
$674.28 |
$1,873 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,930.76 |
$8,141 |
7.5× |
| Mr safety determination physician/other qhp (76016) |
$270.36 |
$751 |
3.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$182.52 |
$507 |
3.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$75.60 |
$210 |
2.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$281.88 |
$783 |
2.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$742.68 |
$2,063 |
3.0× |
| MRA head w & w/o contrast (70546) |
$1,362.96 |
$3,786 |
3.8× |
| MRA head w/o contrast (70544) |
$1,339.20 |
$3,720 |
5.4× |
| MRA head with contrast (70545) |
$1,338.48 |
$3,718 |
3.7× |
| MRA neck w contrast (70548) |
$986.40 |
$2,740 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,064.52 |
$2,957 |
2.9× |
| MRA neck w/o contrast (70547) |
$699.84 |
$1,944 |
2.8× |
| MRI abdomen w contrast (74182) |
$1,501.92 |
$4,172 |
4.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,723.32 |
$4,787 |
4.8× |
| MRI abdomen w/o contrast (74181) |
$1,236.96 |
$3,436 |
5.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,318.32 |
$3,662 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,319.40 |
$3,665 |
1.6× |
| MRI bone marrow blood supply (77084) |
$880.56 |
$2,446 |
3.6× |
| MRI breast w/o contrast bilateral (77047) |
$944.64 |
$2,624 |
3.8× |
| MRI breast w/o contrast unilat (77046) |
$1,061.82 |
$2,949.50 |
4.3× |
| MRI c-spine with contrast (72142) |
$1,005.84 |
$2,794 |
2.8× |
| MRI cardiac w/o contrast (75557) |
$665.64 |
$1,849 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$1,080.36 |
$3,001 |
4.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,570.32 |
$4,362 |
4.3× |
| MRI chest w/o contrast (71550) |
$1,168.20 |
$3,245 |
4.7× |
| MRI chest with contrast (71551) |
$1,005.84 |
$2,794 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,005.84 |
$2,794 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$846.54 |
$2,351.50 |
2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$930.60 |
$2,585 |
3.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,229.40 |
$3,415 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,461.96 |
$4,061 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,036.80 |
$2,880 |
2.9× |
| MRI pelvis w contrast (72196) |
$1,220.40 |
$3,390 |
3.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,613.52 |
$4,482 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,114.92 |
$3,097 |
4.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,380.60 |
$3,835 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,399.68 |
$3,888 |
3.9× |
| MRI spectroscopy (76390) |
$513.36 |
$1,426 |
5.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,489.68 |
$4,138 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,327.68 |
$3,688 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,746.36 |
$4,851 |
4.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,234.80 |
$3,430 |
3.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,376.64 |
$3,824 |
3.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,240.20 |
$3,445 |
5.0× |
| MRI tmj (70336) |
$682.92 |
$1,897 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,080.36 |
$3,001 |
4.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,038.24 |
$2,884 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$743.40 |
$2,065 |
3.0× |
| Myelogram Cervical (72240) |
$719.64 |
$1,999 |
0.9× |
| Myelogram Lumbar (72265) |
$719.64 |
$1,999 |
0.9× |
| Myelogram thoracic (72255) |
$719.64 |
$1,999 |
0.9× |
| Myelography 2 or more regions (72270) |
$722.16 |
$2,006 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,033.80 |
$11,205 |
3.0× |
| Myocardial infarct spect (78469) |
$923.76 |
$2,566 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,638.72 |
$4,552 |
1.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,458.60 |
$12,385 |
3.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,317.06 |
$3,658.50 |
1.5× |
| Neck soft tissue (70360) |
$120.60 |
$335 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$391.32 |
$1,087 |
0.9× |
| Nm cisternogram (78630) |
$1,473.84 |
$4,094 |
2.6× |
| Nm csf leak detection (78650) |
$892.08 |
$2,478 |
0.7× |
| Nm gastric emptying study (78264) |
$638.64 |
$1,774 |
1.5× |
| Nm gastroesophageal reflux study (78262) |
$397.44 |
$1,104 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$599.40 |
$1,665 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,338.20 |
$6,495 |
1.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$942.84 |
$2,619 |
0.7× |
| Nuclear medicine of heart pumping function (78473) |
$689.76 |
$1,916 |
1.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$942.84 |
$2,619 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$425.88 |
$1,183 |
1.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$207.72 |
$577 |
1.9× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$115.56 |
$321 |
1.1× |
| Orthopantogram (70355) |
$90 |
$250 |
1.0× |
| Osseous survey infant (77076) |
$245.52 |
$682 |
2.3× |
| Osseous survey limited (77074) |
$292.32 |
$812 |
2.7× |
| Parathyrd planar w/spect&CT (78072) |
$905.76 |
$2,516 |
1.6× |
| Parathyroid imaging (78070) |
$488.52 |
$1,357 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$111.24 |
$309 |
1.0× |
| Peritoneogram rs&i (74190) |
$377.28 |
$1,048 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$2,896.20 |
$8,045 |
2.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,705.68 |
$4,738 |
1.1× |
| PET imaging for CT attenuation whole body (78816) |
$3,604.68 |
$10,013 |
2.4× |
| Pr heart first pass single,planar (78481) |
$346.68 |
$963 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,215.90 |
$3,377.50 |
3.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,390.76 |
$6,641 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$556.20 |
$1,545 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$608.04 |
$1,689 |
1.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$95.40 |
$265 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$185.40 |
$515 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$211.32 |
$587 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$155.52 |
$432 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$265.68 |
$738 |
2.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,827.76 |
$43,966 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$454.32 |
$1,262 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$279.72 |
$777 |
2.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$360 |
$1,000 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$152.64 |
$424 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$111.24 |
$309 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$156.96 |
$436 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$129.60 |
$360 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$271.80 |
$755 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$352.08 |
$978 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$340.56 |
$946 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$258.66 |
$718.50 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$194.40 |
$540 |
2.2× |
| Radiological examination surgical specimen (76098) |
$458.28 |
$1,273 |
0.8× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$425.88 |
$1,183 |
1.8× |
| Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) |
$254.52 |
$707 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,420.64 |
$6,724 |
0.7× |
| Ribs bilateral 3 views (71110) |
$144.36 |
$401 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$995.76 |
$2,766 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$974.52 |
$2,707 |
1.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,439.44 |
$9,554 |
6.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,439.44 |
$9,554 |
2.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,901.68 |
$10,838 |
2.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,439.44 |
$9,554 |
2.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$556.20 |
$1,545 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$265.32 |
$737 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$273.78 |
$760.50 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$121.68 |
$338 |
1.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$265.68 |
$738 |
1.1× |
| Salivary gland imaging (78230) |
$410.40 |
$1,140 |
1.0× |
| Salivary gland imaging serial images (78231) |
$391.32 |
$1,087 |
0.9× |
| Scanogram (77073) |
$105.84 |
$294 |
1.0× |
| Scapula complete (73010) |
$117 |
$325 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$100.08 |
$278 |
4.3× |
| Sella turcica (70240) |
$114.12 |
$317 |
1.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$130.32 |
$362 |
1.2× |
| Sialogram (70390) |
$213.12 |
$592 |
0.9× |
| Small bowel series (74250) |
$215.64 |
$599 |
1.2× |
| Spec medical radj physics consltj (77370) |
$1,404.54 |
$3,901.50 |
10.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$637.56 |
$1,771 |
1.6× |
| Special dosimetry (77331) |
$229.32 |
$637 |
1.6× |
| Special treatment procedure (77470) |
$1,028.52 |
$2,857 |
1.8× |
| Spine thoracic 3 views (72072) |
$165.60 |
$460 |
1.5× |
| Stereotactic body radiation delivery (77373) |
$4,457.52 |
$12,382 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$229.32 |
$637 |
0.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$146.16 |
$406 |
0.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,668.60 |
$4,635 |
4.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$504 |
$1,400 |
3.6× |
| Thoracolumbar 2 views (72080) |
$121.32 |
$337 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$843.12 |
$2,342 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$362.88 |
$1,008 |
0.9× |
| Thyroid uptake measurement (78012) |
$320.76 |
$891 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$654.84 |
$1,819 |
1.6× |
| Tmj unilateral (70328) |
$97.92 |
$272 |
1.1× |
| Tomogram (76100) |
$223.92 |
$622 |
2.1× |
| Treatment device intermediate (77333) |
$437.04 |
$1,214 |
3.1× |
| Treatment devices simple (77332) |
$1,508.40 |
$4,190 |
10.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,439.44 |
$9,554 |
6.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$995.76 |
$2,766 |
2.4× |
| Tx devices design & construction complex (77334) |
$437.04 |
$1,214 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$175.32 |
$487 |
1.6× |
| Umbilical-artery Doppler (OB) (76820) |
$132.84 |
$369 |
1.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$77.22 |
$214.50 |
0.9× |
| Unlisted fluoroscopic procedure (76496) |
$1,326.42 |
$3,684.50 |
14.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,319.40 |
$3,665 |
14.6× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$153.72 |
$427 |
0.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$724.68 |
$2,013 |
6.8× |
| Upper Extremity Infant (73092) |
$83.34 |
$231.50 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$261.72 |
$727 |
1.1× |
| Urethrocystography voiding (74455) |
$212.40 |
$590 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$322.92 |
$897 |
1.8× |
| Us abdl aorta screen aaa (76706) |
$132.84 |
$369 |
1.2× |
| Us breast unilateral complete (76641) |
$163.80 |
$455 |
1.5× |
| Us breast unilateral limited (76642) |
$163.80 |
$455 |
1.8× |
| Us chest (76604) |
$140.40 |
$390 |
1.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$239.40 |
$665 |
2.2× |
| Us infant hips dynamic (76885) |
$159.48 |
$443 |
1.8× |
| Us kidney transplant (76776) |
$164.88 |
$458 |
1.5× |
| Us ob detailed single fetus (76811) |
$250.92 |
$697 |
1.0× |
| Us ob transvaginal (76817) |
$224.28 |
$623 |
2.1× |
| Us pelvic non ob complete (76856) |
$307.62 |
$854.50 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$156.24 |
$434 |
1.4× |
| Us pregnancy ltd (76815) |
$170.64 |
$474 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$175.32 |
$487 |
1.6× |
| Us retroperitoneal complete (76770) |
$307.80 |
$855 |
2.8× |
| Us retroperitoneal limited (76775) |
$189.36 |
$526 |
1.7× |
| Us scrotum and contents (76870) |
$307.80 |
$855 |
2.8× |
| Us soft tissue head/neck (76536) |
$211.68 |
$588 |
1.9× |
| Us spinal canal and contents (76800) |
$181.44 |
$504 |
1.7× |
| Us transrectal (76872) |
$307.80 |
$855 |
2.8× |
| Us transrectal prostate volume (76873) |
$307.44 |
$854 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$273.96 |
$761 |
2.5× |
| Vascular flow imaging (78445) |
$469.44 |
$1,304 |
1.1× |
| Venogram extremity bilateral (75822) |
$875.52 |
$2,432 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,771.64 |
$7,699 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,701.72 |
$4,727 |
1.0× |
| Venography epidural rs&i (75872) |
$892.08 |
$2,478 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,645.56 |
$4,571 |
1.0× |
| Venography Renal Bilateral (75833) |
$1,920.78 |
$5,335.50 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$1,929.06 |
$5,358.50 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,091.24 |
$5,809 |
0.6× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,067.12 |
$5,742 |
0.4× |
| Wrist 2 views (73100) |
$113.40 |
$315 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$199.08 |
$553 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$102.96 |
$286 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$129.96 |
$361 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$333.72 |
$927 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$95.40 |
$265 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$194.40 |
$540 |
2.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$213.12 |
$592 |
2.0× |
| X-ray exam hip uni 1 view (73501) |
$1,960.02 |
$5,444.50 |
21.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$109.80 |
$305 |
1.2× |
| X-ray exam of femur 1 (73551) |
$129.96 |
$361 |
1.4× |
| X-ray eye for foreign body (70030) |
$101.88 |
$283 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$168.84 |
$469 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$94.68 |
$263 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$169.38 |
$470.50 |
1.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,023.56 |
$5,621 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$138.96 |
$386 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$103.68 |
$288 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$194.94 |
$541.50 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$112.32 |
$312 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$80.10 |
$222.50 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$154.44 |
$429 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$195.48 |
$543 |
1.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$68.04 |
$189 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$134.28 |
$373 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$237.96 |
$661 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$160.20 |
$445 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$146.16 |
$406 |
1.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$449.28 |
$1,248 |
0.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$284.04 |
$789 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$122.40 |
$340 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$165.24 |
$459 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$186.84 |
$519 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$133.56 |
$371 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$96.12 |
$267 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$194.40 |
$540 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$143.64 |
$399 |
1.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$88.92 |
$247 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$138.24 |
$384 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$97.56 |
$271 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$92.52 |
$257 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$104.40 |
$290 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$137.16 |
$381 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$134.64 |
$374 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$78.84 |
$219 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$129.96 |
$361 |
1.4× |
| Xr arthrogram ankle (73615) |
$199.80 |
$555 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$285.12 |
$792 |
2.6× |
| Xr chest 4+ views (71048) |
$183.96 |
$511 |
1.7× |
| Xr finger(s) 2+ views (73140) |
$127.44 |
$354 |
1.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$95.40 |
$265 |
0.9× |
| Xr shoulder 1 view (73020) |
$110.88 |
$308 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$154.44 |
$429 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$129.96 |
$361 |
1.4× |
| Xr tmj bilateral (70330) |
$183.96 |
$511 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$194.40 |
$540 |
2.2× |