| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,641.57 |
$7,817 |
1.3× |
| Abdomen 2 views (74019) |
$164.22 |
$782 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$784.98 |
$3,738 |
2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,719.48 |
$8,188 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,060.31 |
$9,811 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,994.48 |
$9,497.50 |
0.7× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,142.63 |
$10,203 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,060.31 |
$9,811 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,719.48 |
$8,188 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,060.31 |
$9,811 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,928.64 |
$9,184 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,084.65 |
$5,165 |
0.4× |
| Ankle 2 views (73600) |
$55.76 |
$265.50 |
0.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$426.30 |
$2,030 |
1.4× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,060.31 |
$9,811 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,755.92 |
$8,361.50 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,909.95 |
$9,095 |
0.7× |
| Arthrogram elbow (73085) |
$276.57 |
$1,317 |
0.9× |
| Arthrogram hip (73525) |
$287.70 |
$1,370 |
0.9× |
| Arthrogram shoulder (73040) |
$276.57 |
$1,317 |
0.9× |
| Arthrogram wrist (73115) |
$276.57 |
$1,317 |
0.9× |
| Arthrography knee lt (73580) |
$276.57 |
$1,317 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$199.50 |
$950 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$330.96 |
$1,576 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$648.69 |
$3,089 |
1.8× |
| Bone age studies (77072) |
$123.27 |
$587 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$682.50 |
$3,250 |
1.9× |
| Bone Marrow Imaging Limited Area (78102) |
$320.46 |
$1,526 |
0.9× |
| Bone survey complete (77075) |
$259.77 |
$1,237 |
2.8× |
| Brachytx isodose complex (77318) |
$830.97 |
$3,957 |
2.5× |
| Brachytx isodose intermed (77317) |
$616.56 |
$2,936 |
1.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$598.29 |
$2,849 |
1.8× |
| Brain image w/flow 4 + views (78606) |
$470.19 |
$2,239 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$246.54 |
$1,174 |
0.5× |
| Cardiac shunt detection (78428) |
$142.38 |
$678 |
0.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$311.22 |
$1,482 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$129.78 |
$618 |
1.7× |
| Chest 1 view (71045) |
$179.97 |
$857 |
2.3× |
| Chest 3 views (71047) |
$99.54 |
$474 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$198.24 |
$944 |
1.3× |
| Clavicle complete (73000) |
$102.27 |
$487 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$46.62 |
$222 |
0.5× |
| Continuing medical physics consltj pr wk (77336) |
$215.25 |
$1,025 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,877.19 |
$8,939 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,467.06 |
$6,986 |
6.8× |
| CT abdomen w contrast (74160) |
$784.98 |
$3,738 |
5.0× |
| CT abdomen w wo contrast (74170) |
$921.06 |
$4,386 |
5.8× |
| CT abdomen w/o contrast (74150) |
$716.52 |
$3,412 |
7.6× |
| CT angio hrt w/3d image (75574) |
$921.06 |
$4,386 |
2.9× |
| CT angiography upper extremity lt (73206) |
$761.46 |
$3,626 |
4.8× |
| CT c-spine w/o contrast (72125) |
$545.79 |
$2,599 |
5.8× |
| CT cervical spine w&w/o contrast (72127) |
$590.31 |
$2,811 |
3.7× |
| CT cervical spine with contrast (72126) |
$545.79 |
$2,599 |
1.7× |
| CT chest w/wo contrast (71270) |
$921.06 |
$4,386 |
5.8× |
| CT chest with contrast (71260) |
$784.98 |
$3,738 |
5.0× |
| CT head/brain with contrast (70460) |
$614.04 |
$2,924 |
3.9× |
| CT head/brain without and with contrast (70470) |
$867.72 |
$4,132 |
5.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$885.57 |
$4,217 |
2.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$56.49 |
$269 |
0.7× |
| CT iac w contrast (70481) |
$650.58 |
$3,098 |
4.1× |
| CT limited/localized follow up study (76380) |
$262.92 |
$1,252 |
3.3× |
| CT lower ext w/o (73700) |
$670.11 |
$3,191 |
7.1× |
| CT lower extremity w wo contrast (73702) |
$818.79 |
$3,899 |
5.2× |
| CT lower extremity with contrast (73701) |
$731.22 |
$3,482 |
4.6× |
| CT lumbar spine w & w/o contrast (72133) |
$648.69 |
$3,089 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$682.50 |
$3,250 |
7.2× |
| CT lumbar spine with contrast (72132) |
$716.52 |
$3,412 |
2.3× |
| CT maxillofacial w contrast (70487) |
$396.90 |
$1,890 |
2.5× |
| CT maxillofacial w/o contrast (70486) |
$470.19 |
$2,239 |
5.0× |
| CT maxillofacial w/wo contrast (70488) |
$549.78 |
$2,618 |
3.5× |
| CT neck soft tissue w contrast (70491) |
$831.18 |
$3,958 |
5.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,063.65 |
$5,065 |
6.7× |
| CT orbits w/o contrast (70480) |
$470.19 |
$2,239 |
5.0× |
| CT pelvis w & w/o contrast (72194) |
$989.52 |
$4,712 |
6.2× |
| CT pelvis w/o contrast (72192) |
$699.20 |
$3,329.50 |
7.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$795.69 |
$3,789 |
5.0× |
| CT soft tissue neck w/o contrast (70490) |
$722.82 |
$3,442 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$648.69 |
$3,089 |
4.1× |
| CT thoracic spine w/o contrast (72128) |
$750.54 |
$3,574 |
8.0× |
| CT thoracic spine w/wo contrast (72130) |
$754.74 |
$3,594 |
4.8× |
| CT thorax w/o contrast (71250) |
$358.47 |
$1,707 |
3.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$787.29 |
$3,749 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$750.54 |
$3,574 |
8.0× |
| CT upper extremity with contrast (73201) |
$666.12 |
$3,172 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$989.52 |
$4,712 |
6.2× |
| Cta Abdomen (74175) |
$989.52 |
$4,712 |
6.2× |
| CTA abdomen pelvis (74174) |
$1,842.12 |
$8,772 |
5.8× |
| CTA chest (71275) |
$852.81 |
$4,061 |
5.4× |
| Cta Head (70496) |
$795.69 |
$3,789 |
5.0× |
| CTA lwr ext w&w/o contrast (73706) |
$776.90 |
$3,699.50 |
4.9× |
| Cta Neck (70498) |
$831.18 |
$3,958 |
5.2× |
| Cta Pelvis (72191) |
$820.05 |
$3,905 |
5.2× |
| Cystography minimum 3 views rs&i (74430) |
$187.53 |
$893 |
0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$118.44 |
$564 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$238.77 |
$1,137 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$85.26 |
$406 |
1.1× |
| Dxa bone density study axial skeleton (77085) |
$238.77 |
$1,137 |
2.5× |
| Echoencephalography real time imaging (76506) |
$164.22 |
$782 |
1.7× |
| Esophagus (74220) |
$200.97 |
$957 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$154.14 |
$734 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$131.25 |
$625 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$122.22 |
$582 |
0.6× |
| Foot 2 views (73620) |
$129.78 |
$618 |
1.7× |
| Forearm 2 views (73090) |
$76.44 |
$364 |
1.0× |
| Gated Heart Planar Single (78472) |
$1,069.11 |
$5,091 |
3.0× |
| Hand 2 views (73120) |
$82.64 |
$393.50 |
0.9× |
| Hand 3 views (73130) |
$98.28 |
$468 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,416.24 |
$6,744 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,195.34 |
$10,454 |
3.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,816.73 |
$13,413 |
4.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$716.52 |
$3,412 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$545.79 |
$2,599 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,057.56 |
$5,036 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$89.25 |
$425 |
1.1× |
| Hysterosalpingogram (74740) |
$241.08 |
$1,148 |
1.1× |
| Interstitial radiation source applic complex (77778) |
$824.04 |
$3,924 |
1.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$51.03 |
$243 |
0.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$784.98 |
$3,738 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$852.81 |
$4,061 |
1.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$590.31 |
$2,811 |
1.2× |
| Knee 3 views (73562) |
$115.71 |
$551 |
1.5× |
| Liver & spleen imaging static only (78215) |
$511.77 |
$2,437 |
1.4× |
| Lung perf&ventilat diferentl (78598) |
$839.58 |
$3,998 |
1.7× |
| Lung perfusion differential (78597) |
$439.32 |
$2,092 |
1.2× |
| Lung Ventilation Imaging (78579) |
$327.39 |
$1,559 |
0.9× |
| Lymphoscintigraphy (78195) |
$443.10 |
$2,110 |
0.9× |
| Meckels Diverticulum (78290) |
$511.77 |
$2,437 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$611.94 |
$2,914 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,330.77 |
$6,337 |
4.2× |
| MRA head w/o contrast (70544) |
$682.50 |
$3,250 |
3.2× |
| MRA head with contrast (70545) |
$924.84 |
$4,404 |
2.9× |
| MRA neck w contrast (70548) |
$924.84 |
$4,404 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,267.98 |
$6,038 |
4.0× |
| MRA neck w/o contrast (70547) |
$682.50 |
$3,250 |
3.2× |
| MRI abdomen w contrast (74182) |
$1,228.29 |
$5,849 |
3.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,354.52 |
$11,212 |
7.5× |
| MRI abdomen w/o contrast (74181) |
$1,535.10 |
$7,310 |
7.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,414.56 |
$6,736 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,645.35 |
$7,835 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$924.84 |
$4,404 |
4.3× |
| MRI breast w/o contrast unilat (77046) |
$723.87 |
$3,447 |
3.4× |
| MRI c-spine with contrast (72142) |
$1,364.79 |
$6,499 |
4.3× |
| MRI cervical spine w/o contrast (72141) |
$1,342.74 |
$6,394 |
6.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,978.62 |
$9,422 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,312.29 |
$6,249 |
6.1× |
| MRI chest with contrast (71551) |
$857.85 |
$4,085 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$998.76 |
$4,756 |
3.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,410.57 |
$6,717 |
4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,364.79 |
$6,499 |
6.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$443.31 |
$2,111 |
2.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,098.82 |
$5,232.50 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,501.08 |
$7,148 |
4.8× |
| MRI pelvis w contrast (72196) |
$1,126.02 |
$5,362 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,046.87 |
$9,747 |
6.5× |
| MRI pelvis w/o contrast (72195) |
$1,364.79 |
$6,499 |
6.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,006.34 |
$9,554 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,046.87 |
$9,747 |
6.5× |
| MRI spectroscopy (76390) |
$524.79 |
$2,499 |
6.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,046.87 |
$9,747 |
6.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,535.10 |
$7,310 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,046.87 |
$9,747 |
6.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,364.79 |
$6,499 |
4.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,012.85 |
$9,585 |
6.4× |
| MRI thoracic spine w/o contrast (72146) |
$646.28 |
$3,077.50 |
3.0× |
| MRI tmj (70336) |
$511.77 |
$2,437 |
2.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,218.21 |
$5,801 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,886.01 |
$8,981 |
6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,218.21 |
$5,801 |
5.7× |
| Myelogram Cervical (72240) |
$486.57 |
$2,317 |
0.7× |
| Myelogram Lumbar (72265) |
$455.49 |
$2,169 |
0.6× |
| Myelogram thoracic (72255) |
$467.88 |
$2,228 |
0.7× |
| Myelography 2 or more regions (72270) |
$506.10 |
$2,410 |
0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,639.49 |
$12,569 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,194.06 |
$5,686 |
1.0× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$988.68 |
$4,708 |
0.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$988.68 |
$4,708 |
0.8× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,541.82 |
$7,342 |
0.8× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,884.54 |
$8,974 |
0.9× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$1,884.54 |
$8,974 |
1.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$588.84 |
$2,804 |
0.8× |
| Neck soft tissue (70360) |
$85.26 |
$406 |
1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$250.11 |
$1,191 |
0.7× |
| Nm cisternogram (78630) |
$622.02 |
$2,962 |
1.3× |
| Nm gastric emptying study (78264) |
$600.50 |
$2,859.50 |
1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,769.67 |
$8,427 |
1.4× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$2,680.02 |
$12,762 |
2.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,320.29 |
$11,049 |
1.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$360.78 |
$1,718 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$145.11 |
$691 |
0.4× |
| Nuclear Rx Oral Admin (79005) |
$500.43 |
$2,383 |
2.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$94.92 |
$452 |
1.0× |
| Osseous survey infant (77076) |
$259.77 |
$1,237 |
2.8× |
| Osseous survey limited (77074) |
$149.94 |
$714 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$784.98 |
$3,738 |
2.2× |
| Parathyroid imaging (78070) |
$784.98 |
$3,738 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$191.31 |
$911 |
2.0× |
| PET image w/CT, skull-thigh (78815) |
$1,945.23 |
$9,263 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,286.06 |
$10,886 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,012.85 |
$9,585 |
6.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,104.60 |
$5,260 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$511.77 |
$2,437 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$839.58 |
$3,998 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$241.08 |
$1,148 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$83.37 |
$397 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$72.24 |
$344 |
0.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$137.55 |
$655 |
1.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$109.41 |
$521 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$152.88 |
$728 |
1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,766.14 |
$17,934 |
0.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$489.72 |
$2,332 |
1.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$224.28 |
$1,068 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$137.55 |
$655 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$109.83 |
$523 |
1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$214.83 |
$1,023 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$208.32 |
$992 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$266.28 |
$1,268 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$392.07 |
$1,867 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$392.28 |
$1,868 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$88.62 |
$422 |
1.1× |
| Radiological examination surgical specimen (76098) |
$409.71 |
$1,951 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,928.64 |
$9,184 |
0.7× |
| Ribs bilateral 3 views (71110) |
$149.94 |
$714 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$989.52 |
$4,712 |
2.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,126.02 |
$5,362 |
2.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$871.50 |
$4,150 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$871.50 |
$4,150 |
0.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$988.68 |
$4,708 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$133.14 |
$634 |
1.4× |
| Scanogram (77073) |
$78.12 |
$372 |
0.8× |
| Scapula complete (73010) |
$82.32 |
$392 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$22.05 |
$105 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$271.74 |
$1,294 |
2.9× |
| Simulation intermediate (77285) |
$231.63 |
$1,103 |
0.7× |
| Small bowel series (74250) |
$184.38 |
$878 |
1.2× |
| Spec medical radj physics consltj (77370) |
$483 |
$2,300 |
4.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$433.23 |
$2,063 |
1.3× |
| Special dosimetry (77331) |
$312.06 |
$1,486 |
2.6× |
| Special treatment procedure (77470) |
$1,126.44 |
$5,364 |
2.3× |
| Spine thoracic 3 views (72072) |
$111.51 |
$531 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$3,250.59 |
$15,479 |
2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$547.05 |
$2,605 |
1.6× |
| Testicular Imaging With Vascular Flow (78761) |
$313.53 |
$1,493 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$450.66 |
$2,146 |
1.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$195.09 |
$929 |
1.6× |
| Thoracolumbar 2 views (72080) |
$95.76 |
$456 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$613.83 |
$2,923 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$320.46 |
$1,526 |
0.9× |
| Thyroid uptake measurement (78012) |
$223.23 |
$1,063 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$409.50 |
$1,950 |
1.1× |
| Tmj unilateral (70328) |
$36.33 |
$173 |
0.5× |
| Treatment device intermediate (77333) |
$353.85 |
$1,685 |
2.9× |
| Treatment devices simple (77332) |
$166.95 |
$795 |
1.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,388.33 |
$11,373 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$294.63 |
$1,403 |
0.8× |
| Tx devices design & construction complex (77334) |
$611.94 |
$2,914 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$187.53 |
$893 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$118.44 |
$564 |
1.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$56.28 |
$268 |
0.7× |
| Unlisted magnetic resonance procedure (76498) |
$347.97 |
$1,657 |
4.4× |
| Upper Extremity Infant (73092) |
$59.43 |
$283 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$239.82 |
$1,142 |
1.1× |
| Urethrocystography voiding (74455) |
$187.53 |
$893 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$239.82 |
$1,142 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$84 |
$400 |
0.9× |
| Us breast unilateral complete (76641) |
$204.54 |
$974 |
2.2× |
| Us breast unilateral limited (76642) |
$204.54 |
$974 |
2.6× |
| Us chest (76604) |
$143.01 |
$681 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$177.24 |
$844 |
1.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$133.98 |
$638 |
1.4× |
| Us guided compression repair (76936) |
$203.28 |
$968 |
1.0× |
| Us infant hips dynamic (76885) |
$184.38 |
$878 |
2.3× |
| Us infant hips limited static (76886) |
$153.93 |
$733 |
2.0× |
| Us kidney transplant (76776) |
$262.92 |
$1,252 |
2.8× |
| Us ob detailed single fetus (76811) |
$427.56 |
$2,036 |
2.0× |
| Us ob transvaginal (76817) |
$149.31 |
$711 |
1.6× |
| Us pelvic non ob complete (76856) |
$269.22 |
$1,282 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$221.97 |
$1,057 |
2.4× |
| Us pregnancy ltd (76815) |
$193.52 |
$921.50 |
2.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$154.77 |
$737 |
1.6× |
| Us retroperitoneal complete (76770) |
$261.24 |
$1,244 |
2.8× |
| Us retroperitoneal limited (76775) |
$164.22 |
$782 |
1.7× |
| Us scrotum and contents (76870) |
$170.94 |
$814 |
1.8× |
| Us soft tissue head/neck (76536) |
$170.94 |
$814 |
1.8× |
| Us spinal canal and contents (76800) |
$136.50 |
$650 |
1.4× |
| Us transrectal (76872) |
$375.27 |
$1,787 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$131.25 |
$625 |
1.4× |
| Venogram extremity bilateral (75822) |
$651.84 |
$3,104 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,928.64 |
$9,184 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$677.88 |
$3,228 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$651.84 |
$3,104 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$2,122.26 |
$10,106 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$583.59 |
$2,779 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,836.66 |
$8,746 |
0.4× |
| Wrist 2 views (73100) |
$123.27 |
$587 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$375.27 |
$1,787 |
4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$102.48 |
$488 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$95.76 |
$456 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$375.27 |
$1,787 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$81.69 |
$389 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$81.48 |
$388 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$137.55 |
$655 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$69.09 |
$329 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$82.74 |
$394 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$142.80 |
$680 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$219.45 |
$1,045 |
2.3× |
| X-ray exam of femur 1 (73551) |
$85.26 |
$406 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$143.01 |
$681 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$84.42 |
$402 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$95.76 |
$456 |
1.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,251.60 |
$5,960 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$87.78 |
$418 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$45.78 |
$218 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$128.10 |
$610 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$62.16 |
$296 |
0.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$67.41 |
$321 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$173.88 |
$828 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$225.33 |
$1,073 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$118.44 |
$564 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$95.76 |
$456 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$92.40 |
$440 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$137.55 |
$655 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$133.14 |
$634 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$219.66 |
$1,046 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$149.94 |
$714 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$149.94 |
$714 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$149.94 |
$714 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$133.14 |
$634 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$149.94 |
$714 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$194.25 |
$925 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$123.27 |
$587 |
1.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$71.82 |
$342 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$143.01 |
$681 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$63.52 |
$302.50 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$49.56 |
$236 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$72.03 |
$343 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$95.76 |
$456 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$133.14 |
$634 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$117.18 |
$558 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$88.62 |
$422 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$88.62 |
$422 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$160.02 |
$762 |
1.7× |
| Xr chest 4+ views (71048) |
$212.73 |
$1,013 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$102.27 |
$487 |
1.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$255.99 |
$1,219 |
2.7× |
| Xr optic foramina (70190) |
$52.71 |
$251 |
0.7× |
| Xr shoulder 1 view (73020) |
$102.27 |
$487 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$146.79 |
$699 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$123.27 |
$587 |
1.6× |
| Xr tmj bilateral (70330) |
$91.98 |
$438 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$123.27 |
$587 |
1.6× |