| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$10,097.63 |
$10,097.63 |
7.0× |
| Acute gi blood loss imaging (78278) |
$1,728.88 |
$1,728.88 |
4.1× |
| Angio extremity unilateral (75710) |
$4,169.03 |
$4,169.03 |
1.3× |
| Angio pulmonary unilateral (75741) |
$3,645.36 |
$3,645.36 |
1.1× |
| Angiogram extremity bilateral (75716) |
$4,758.47 |
$4,758.47 |
1.4× |
| Angiogram pelvic (75736) |
$14,336 |
$14,336 |
2.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,857.42 |
$4,857.42 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$11,297.50 |
$11,297.50 |
1.9× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$4,867.72 |
$4,867.72 |
1.5× |
| Ankle 2 views (73600) |
$592.31 |
$592.31 |
6.5× |
| Arthrography knee lt (73580) |
$1,023.60 |
$1,023.60 |
2.8× |
| Arthrography wrist lt (73115) |
$995 |
$995 |
2.7× |
| Barium enema (74270) |
$1,125.42 |
$1,125.42 |
6.1× |
| Basic dosimetry (77300) |
$1,299.60 |
$1,299.60 |
9.3× |
| Bilat selctv renal venogram (75833) |
$6,763.33 |
$6,763.33 |
2.1× |
| Bone age studies (77072) |
$297.73 |
$297.73 |
2.7× |
| Bone survey complete (77075) |
$1,595.03 |
$1,595.03 |
14.6× |
| Bowel imaging (78290) |
$2,222.22 |
$2,222.22 |
5.3× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$4,430.03 |
$4,430.03 |
11.3× |
| Brain image w/flow 4 + views (78606) |
$1,978.84 |
$1,978.84 |
3.5× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$2,090.09 |
$2,090.09 |
5.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,311.60 |
$1,311.60 |
7.2× |
| Cisternogram (78630) |
$2,050.34 |
$2,050.34 |
3.6× |
| Clavicle complete (73000) |
$757.62 |
$757.62 |
8.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$5,625.50 |
$5,625.50 |
30.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,106.40 |
$1,106.40 |
7.9× |
| Contrast exam abdominl aorta (75625) |
$3,334.19 |
$3,334.19 |
1.0× |
| Contrast exam thoracic aorta (75605) |
$8,893.50 |
$8,893.50 |
1.5× |
| Csf shunt evaluation (78645) |
$2,236.52 |
$2,236.52 |
3.9× |
| CT - st neck w&wo contr (70492) |
$4,270.55 |
$4,270.55 |
23.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,574.40 |
$9,574.40 |
26.3× |
| CT abdomen and pelvis without contrast (74176) |
$7,701.78 |
$7,701.78 |
30.9× |
| CT abdomen w wo contrast (74170) |
$4,727.87 |
$4,727.87 |
25.8× |
| CT abdomen w/contrast (74160) |
$4,298.01 |
$4,298.01 |
23.5× |
| CT abdomen w/o contrast (74150) |
$4,140.14 |
$4,140.14 |
37.9× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$11,290.40 |
$11,290.40 |
31.0× |
| CT angio abdom w/o & w/dye (74175) |
$4,830.54 |
$4,830.54 |
26.4× |
| CT angio abdominal arteries (75635) |
$2,013.44 |
$2,013.44 |
11.0× |
| CT angio hrt w/3d image (75574) |
$4,087.53 |
$4,087.53 |
11.2× |
| CT angiograph pelv w/o&w/dye (72191) |
$5,044.80 |
$5,044.80 |
27.5× |
| CT cervical spine w/contrast (72126) |
$3,659.66 |
$3,659.66 |
10.0× |
| CT cervical spine w/o contrast (72125) |
$3,467.39 |
$3,467.39 |
31.8× |
| CT chest w/contrast (71260) |
$4,130.19 |
$4,130.19 |
22.5× |
| CT colonography w/o cntrst (74261) |
$3,082.20 |
$3,082.20 |
28.2× |
| CT extremity upper w & w/o contrast (73202) |
$5,266.40 |
$5,266.40 |
28.8× |
| CT head/brain with contrast (70460) |
$3,594.75 |
$3,594.75 |
19.6× |
| CT head/brain without and with contrast (70470) |
$3,965.22 |
$3,965.22 |
21.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$520 |
$520 |
1.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,178.50 |
$1,178.50 |
13.0× |
| CT lower ext w/wo contrast (73702) |
$4,868.29 |
$4,868.29 |
26.6× |
| CT lower extremity w contrast (73701) |
$4,636.63 |
$4,636.63 |
25.3× |
| CT lower extremity w/o contrast unilateral (73700) |
$4,519.37 |
$4,519.37 |
41.4× |
| CT lumbar spine w/contrast (72132) |
$3,685.97 |
$3,685.97 |
10.1× |
| CT lumbar spine w/o contrast (72131) |
$3,419.64 |
$3,419.64 |
31.3× |
| CT lumbar spine w/o then w/ con (72133) |
$4,015.44 |
$4,015.44 |
21.9× |
| CT maxillofacial area w/o contrast (70486) |
$3,311.88 |
$3,311.88 |
30.3× |
| CT maxillofacial w/contrast (70487) |
$3,674.53 |
$3,674.53 |
20.1× |
| CT maxillofacial w/o then w/ con (70488) |
$4,082.36 |
$4,082.36 |
22.3× |
| CT orbit sella ear w/o con (70480) |
$3,648.22 |
$3,648.22 |
33.4× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$4,641.04 |
$4,641.04 |
25.3× |
| CT pelvis w & w/o contrast (72194) |
$4,846.56 |
$4,846.56 |
26.5× |
| CT pelvis w/o contrast (72192) |
$3,561.27 |
$3,561.27 |
32.6× |
| CT soft tissue neck w/contrast (70491) |
$3,870.15 |
$3,870.15 |
21.1× |
| CT soft tissue neck w/o contrast (70490) |
$3,581.86 |
$3,581.86 |
32.8× |
| CT spine cervical w/wo contrast (72127) |
$4,027.45 |
$4,027.45 |
22.0× |
| CT thoracic spine w/contrast (72129) |
$3,716.30 |
$3,716.30 |
20.3× |
| CT thoracic spine w/o contrast (72128) |
$3,458.72 |
$3,458.72 |
31.7× |
| CT thoracic spine w/o then w/ con (72130) |
$3,934.79 |
$3,934.79 |
21.5× |
| CT thorax lung cancer scr c- (71271) |
$1,079.95 |
$1,079.95 |
9.9× |
| CT thorax w/o contrast (71250) |
$3,718 |
$3,718 |
34.1× |
| CT thorax w/o then w/ contrast (71270) |
$4,465.94 |
$4,465.94 |
24.4× |
| CT upper extremity w/dye (73201) |
$6,177.50 |
$6,177.50 |
17.0× |
| CT upper extremity w/o contrast rt (73200) |
$3,795.79 |
$3,795.79 |
34.8× |
| CTA chest w/wo contrast (71275) |
$4,661.23 |
$4,661.23 |
25.4× |
| CTA head w contrast (70496) |
$4,176.50 |
$4,176.50 |
22.8× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$5,040.46 |
$5,040.46 |
27.5× |
| Cta Neck (70498) |
$4,387.79 |
$4,387.79 |
24.0× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$4,894.32 |
$4,894.32 |
26.7× |
| Dilation ureters/urethra rs&i (74485) |
$2,979.55 |
$2,979.55 |
1.4× |
| Doppler echo fetal spectral display complete (76827) |
$625.50 |
$625.50 |
5.7× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$278.78 |
$278.78 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$1,247.76 |
$1,247.76 |
11.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,045 |
$1,045 |
4.2× |
| Fetal biophysical profile non-stress testing (76818) |
$298.48 |
$298.48 |
2.7× |
| Fetal biophysical profile w/o nst (76819) |
$813.77 |
$813.77 |
7.5× |
| Fetal echo complete (76825) |
$1,548.27 |
$1,548.27 |
2.7× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$1,217.79 |
$1,217.79 |
4.9× |
| Gastric emptying study (78264) |
$2,413.27 |
$2,413.27 |
5.8× |
| Gated heart planar single (78472) |
$2,163.30 |
$2,163.30 |
5.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,962.39 |
$2,962.39 |
4.1× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,696.12 |
$4,696.12 |
6.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$6,951.81 |
$6,951.81 |
9.6× |
| Heart infarct image (78466) |
$1,794 |
$1,794 |
4.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,344.48 |
$3,344.48 |
1.0× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$4,783.36 |
$4,783.36 |
1.5× |
| Hepatobiliary system imaging (78226) |
$2,617.19 |
$2,617.19 |
6.3× |
| Humerus min 2 views (73060) |
$824.54 |
$824.54 |
9.1× |
| Hysterosalpingography (74740) |
$566.57 |
$566.57 |
2.3× |
| Imrt planning (77301) |
$6,370.66 |
$6,370.66 |
4.4× |
| Infusion of radioelement (77750) |
$641 |
$641 |
1.6× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$2,885.10 |
$2,885.10 |
4.0× |
| Intracavitary radiation source applic complex (77763) |
$1,297.30 |
$1,297.30 |
1.8× |
| Intracavitary radiation source applic intermed (77762) |
$3,153.67 |
$3,153.67 |
5.5× |
| Intracavitary radiation source applic simple (77761) |
$1,832 |
$1,832 |
3.2× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$2,922.64 |
$2,922.64 |
7.5× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$3,046.93 |
$3,046.93 |
7.8× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$4,235.09 |
$4,235.09 |
10.8× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$3,396.31 |
$3,396.31 |
8.7× |
| Ivp (74400) |
$1,646.19 |
$1,646.19 |
9.0× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$2,416.42 |
$2,416.42 |
4.3× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$3,301.58 |
$3,301.58 |
5.8× |
| Liver & spleen; static only (78215) |
$1,774.92 |
$1,774.92 |
4.3× |
| Liver & spleen; w vasc flow (78216) |
$1,973.97 |
$1,973.97 |
4.7× |
| Lung perf&ventilat diferentl (78598) |
$2,957.81 |
$2,957.81 |
5.2× |
| Lung perfusion differential (78597) |
$2,957.81 |
$2,957.81 |
7.1× |
| Lung ventilat&perfus imaging (78582) |
$1,937.94 |
$1,937.94 |
3.4× |
| Lung ventilation imaging (78579) |
$2,338.34 |
$2,338.34 |
5.6× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) |
$1,592.69 |
$1,592.69 |
1.0× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) |
$1,592.69 |
$1,592.69 |
2.4× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$6,481.80 |
$6,481.80 |
2.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,555.80 |
$2,555.80 |
0.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$5,474.33 |
$5,474.33 |
15.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$5,792.94 |
$5,792.94 |
15.9× |
| Mammary ductogram single (77053) |
$402.31 |
$402.31 |
1.6× |
| Mlc device(s) for imrt (77338) |
$2,872.93 |
$2,872.93 |
7.3× |
| Mr safety determination physician/other qhp (76016) |
$220.95 |
$220.95 |
2.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$149.05 |
$149.05 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$61.45 |
$61.45 |
2.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$230.35 |
$230.35 |
2.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$606.75 |
$606.75 |
2.4× |
| MRA head w & w/o contrast (70546) |
$5,681.40 |
$5,681.40 |
15.6× |
| MRA head w/o contrast (70544) |
$5,093.95 |
$5,093.95 |
20.4× |
| MRA neck w/contrast (70548) |
$4,879.16 |
$4,879.16 |
13.4× |
| MRA neck w/o contrast (70547) |
$4,350.63 |
$4,350.63 |
17.5× |
| MRA neck w/wo contrast (70549) |
$5,464.89 |
$5,464.89 |
15.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,256.40 |
$5,256.40 |
14.4× |
| MRI abdomen w/o contrast (74181) |
$4,634.06 |
$4,634.06 |
18.6× |
| MRI any jnt lwr ext with con lt (73722) |
$4,569.71 |
$4,569.71 |
5.6× |
| MRI breast without contrast bilateral (77047) |
$6,673.24 |
$6,673.24 |
26.8× |
| MRI breast without contrast material unilateral (77046) |
$2,495.06 |
$2,495.06 |
10.0× |
| MRI cardiac w/o contrast (75557) |
$1,367.37 |
$1,367.37 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$5,313.60 |
$5,313.60 |
21.3× |
| MRI cervical spine with contrast (72142) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI chest w & w/o contrast (71552) |
$5,474.33 |
$5,474.33 |
15.0× |
| MRI chest w/o contrast (71550) |
$4,301.16 |
$4,301.16 |
17.3× |
| MRI elastography (76391) |
$1,955.75 |
$1,955.75 |
7.8× |
| MRI joint upper ext w/contrast (73222) |
$5,912.19 |
$5,912.19 |
7.2× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,770.48 |
$4,770.48 |
13.1× |
| MRI joint upr extrem w/o dye (73221) |
$5,320.17 |
$5,320.17 |
21.4× |
| Mri Lower Extremity W/O Dye (73718) |
$4,569.71 |
$4,569.71 |
18.3× |
| MRI lumbar spine with contrast (72149) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI lumbar w/wo contrast (72158) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI lwr ext w/o jnts with con rt (73719) |
$5,213.50 |
$5,213.50 |
14.3× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$5,324.75 |
$5,324.75 |
14.6× |
| MRI orbit/face/neck w/o contrast (70540) |
$4,231.08 |
$4,231.08 |
17.0× |
| MRI pelvis w/ contrast (72196) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI pelvis w/o contrast (72195) |
$4,918.78 |
$4,918.78 |
19.7× |
| MRI pelvis w/wo contrast (72197) |
$6,073.41 |
$6,073.41 |
16.7× |
| MRI spectroscopy (76390) |
$5,232.38 |
$5,232.38 |
57.6× |
| MRI spine cervical wo/w contrast (72156) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI spine thoracic w/contrast (72147) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI thoracic spine w wo contrast (72157) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI thoracic spine w/o contrast (72146) |
$5,313.60 |
$5,313.60 |
21.3× |
| MRI tmj (70336) |
$5,030.46 |
$5,030.46 |
20.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,319.60 |
$5,319.60 |
21.3× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$6,569.71 |
$6,569.71 |
18.0× |
| Myelogram thoracic (72255) |
$1,292.20 |
$1,292.20 |
1.6× |
| Myelography 2 or more regions (72270) |
$1,181.18 |
$1,181.18 |
1.4× |
| Myelography lumbosacral (72265) |
$1,413.78 |
$1,413.78 |
1.7× |
| Myocardial spect single study at rest or stress (78451) |
$6,542.63 |
$6,542.63 |
4.8× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$8,202 |
$8,202 |
9.1× |
| Nm bone 3 phase (78315) |
$4,344.34 |
$4,344.34 |
10.4× |
| Nm bone imaging whole body (78306) |
$3,169.45 |
$3,169.45 |
7.6× |
| Nm heart perfusion spect stress rest (78452) |
$7,523.50 |
$7,523.50 |
5.6× |
| Nm lymph system (78195) |
$2,180.76 |
$2,180.76 |
3.8× |
| Nm thyroid imaging only (78013) |
$1,833.12 |
$1,833.12 |
4.4× |
| Nuclear rx IV admin (79101) |
$1,246.39 |
$1,246.39 |
5.1× |
| Ob us < 14 wks single fetus (76801) |
$1,027 |
$1,027 |
9.4× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$293.28 |
$293.28 |
2.7× |
| Oral radiopharm rx (79005) |
$2,013.73 |
$2,013.73 |
8.3× |
| Parathyrd planar w/spect&CT (78072) |
$2,761.88 |
$2,761.88 |
4.9× |
| Parathyroid imaging (78070) |
$2,449.88 |
$2,449.88 |
5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,657.88 |
$2,657.88 |
6.4× |
| Peritoneogram rs&i (74190) |
$809.67 |
$809.67 |
1.4× |
| PET brain metabolic eval (78608) |
$5,329.32 |
$5,329.32 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,568 |
$6,568 |
4.4× |
| PET imaging CT for attenuation limited area (78814) |
$13,701.75 |
$13,701.75 |
9.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,923.21 |
$6,923.21 |
4.6× |
| Pulmonary perfusion imaging particulate (78580) |
$1,897.62 |
$1,897.62 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$945.52 |
$945.52 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$318 |
$318 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,017.31 |
$1,017.31 |
9.3× |
| Radex hip unilateral with pelvis 1 view (73501) |
$921.78 |
$921.78 |
10.1× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$906.62 |
$906.62 |
10.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$921.78 |
$921.78 |
8.4× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$272.43 |
$272.43 |
2.5× |
| Radex spine cervical 2 or 3 views (72040) |
$854.86 |
$854.86 |
9.4× |
| Radex spine cervical 6 or more views (72052) |
$1,096.82 |
$1,096.82 |
10.0× |
| Radiation delivery stereotactic cranial linear (77372) |
$38,751 |
$38,751 |
5.0× |
| Radiation tx delivery lvl 1 (77402) |
$617.08 |
$617.08 |
5.8× |
| Radiation tx delivery lvl 2 (77407) |
$781.48 |
$781.48 |
1.9× |
| Radiation tx delivery lvl 3 (77412) |
$1,770 |
$1,770 |
3.1× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$1,682.54 |
$1,682.54 |
15.4× |
| Radiologic exam esophagus double contrast study (74221) |
$735.31 |
$735.31 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,153.28 |
$2,153.28 |
11.8× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$1,018.02 |
$1,018.02 |
11.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,066.50 |
$1,066.50 |
11.7× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$937.51 |
$937.51 |
8.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,300.80 |
$1,300.80 |
3.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,669.80 |
$1,669.80 |
4.1× |
| Renal cyst study (74470) |
$850.28 |
$850.28 |
1.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,546.83 |
$2,546.83 |
6.1× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,395.11 |
$3,395.11 |
6.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,301.58 |
$3,301.58 |
5.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$4,274.50 |
$4,274.50 |
7.5× |
| Rp loclzj tum spect CT 2area/sep acquisj img (78832) |
$3,744 |
$3,744 |
2.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,395.11 |
$3,395.11 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$677.25 |
$677.25 |
2.8× |
| Saline infused sonohysterogram (76831) |
$609.75 |
$609.75 |
2.4× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$160.16 |
$160.16 |
6.9× |
| Selective spinal angiogram (75705) |
$6,763.33 |
$6,763.33 |
1.2× |
| Shoulder arthrogram (73040) |
$986.99 |
$986.99 |
2.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$479.34 |
$479.34 |
4.4× |
| Simulation complex (77290) |
$4,723.46 |
$4,723.46 |
12.1× |
| Simulation intermediate (77285) |
$2,030.88 |
$2,030.88 |
5.2× |
| Simulation simple (77280) |
$2,007.38 |
$2,007.38 |
14.3× |
| Small bowel series (74250) |
$1,383.39 |
$1,383.39 |
7.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,339.94 |
$2,339.94 |
6.0× |
| Special dosimetry (77331) |
$1,843.33 |
$1,843.33 |
13.1× |
| Special physics consult (77370) |
$1,362.17 |
$1,362.17 |
9.7× |
| Special treatment procedure (77470) |
$4,466.06 |
$4,466.06 |
7.7× |
| Stereotactic body radiation delivery (77373) |
$20,244.52 |
$20,244.52 |
10.8× |
| Superior sagittal sinus venogram (75870) |
$7,710.47 |
$7,710.47 |
2.3× |
| Thyroid met imaging body (78018) |
$2,626.62 |
$2,626.62 |
4.6× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$2,312.89 |
$2,312.89 |
5.5× |
| Treatment device intermediate (77333) |
$2,009.45 |
$2,009.45 |
14.3× |
| Treatment devices complex (77334) |
$2,872.93 |
$2,872.93 |
7.3× |
| Treatment devices simple (77332) |
$1,424.96 |
$1,424.96 |
10.2× |
| Ultrasound breast limited (76642) |
$782.01 |
$782.01 |
8.6× |
| Ultrasound, abdomen limited (76705) |
$1,130.27 |
$1,130.27 |
10.4× |
| Ultrasound, elastography; first target lesion (76982) |
$277.98 |
$277.98 |
2.5× |
| Unlisted procedure, clinical brachytherapy (77799) |
$1,297.30 |
$1,297.30 |
12.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,534.68 |
$1,534.68 |
6.2× |
| Urethrocystography voiding (74455) |
$1,410.27 |
$1,410.27 |
5.7× |
| Urography antegrade (74425) |
$698.98 |
$698.98 |
1.9× |
| Urography retrograde w/wo kub (74420) |
$1,436.01 |
$1,436.01 |
3.9× |
| Us abdominal aorta real time screen study aaa (76706) |
$826.53 |
$826.53 |
7.6× |
| Us breast uni real time with image complete (76641) |
$1,303.88 |
$1,303.88 |
11.9× |
| Us chest (76604) |
$705.28 |
$705.28 |
6.5× |
| Us compl joint r-t w/image documentation (76881) |
$1,010.72 |
$1,010.72 |
9.3× |
| Us elastography parenchyma (76981) |
$277.98 |
$277.98 |
2.5× |
| Us encephalogram (76506) |
$868.78 |
$868.78 |
8.0× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$410.70 |
$410.70 |
4.5× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$606.61 |
$606.61 |
5.6× |
| Us ob followup per fetus (76816) |
$480.77 |
$480.77 |
4.4× |
| Us ob limited 1 or more fetuses (76815) |
$781.38 |
$781.38 |
7.2× |
| Us obstetric transvaginal (76817) |
$1,029.89 |
$1,029.89 |
9.4× |
| Us pelvic limited or f/u non-ob (76857) |
$985.28 |
$985.28 |
9.0× |
| Us pelvis complete (76856) |
$1,253.50 |
$1,253.50 |
11.5× |
| Us retroperitoneal complete (76770) |
$1,442.30 |
$1,442.30 |
13.2× |
| Us retroperitoneal limited (76775) |
$1,291 |
$1,291 |
11.8× |
| Us scrotum (76870) |
$1,077.65 |
$1,077.65 |
9.9× |
| Us soft tissue head/neck (76536) |
$1,113.50 |
$1,113.50 |
10.2× |
| Us spinal canal (76800) |
$1,254 |
$1,254 |
11.5× |
| Us transrectal (76872) |
$1,466.04 |
$1,466.04 |
13.4× |
| Us transrectal prostate volume (76873) |
$924.92 |
$924.92 |
8.5× |
| Vascular flow imaging (78445) |
$2,236.52 |
$2,236.52 |
5.4× |
| Venogram extremity bilateral (75822) |
$3,379.38 |
$3,379.38 |
2.1× |
| Venogram ivc w serialography (75825) |
$3,344.48 |
$3,344.48 |
1.0× |
| Venogram svc w serialography (75827) |
$3,154.01 |
$3,154.01 |
1.9× |
| Venography ext unilateral (75820) |
$1,981.13 |
$1,981.13 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,344.48 |
$3,344.48 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,225.25 |
$6,225.25 |
1.9× |
| Venous sampling by catheter (75893) |
$6,116.12 |
$6,116.12 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$162 |
$162 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$921.78 |
$921.78 |
10.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$904.05 |
$904.05 |
9.9× |
| X-ray aorta leg arteries (75630) |
$4,488.20 |
$4,488.20 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,274.99 |
$1,274.99 |
7.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$716.44 |
$716.44 |
7.9× |
| X-ray exam of finger(s) (73140) |
$386.96 |
$386.96 |
4.3× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$657.52 |
$657.52 |
7.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$775.35 |
$775.35 |
8.5× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$458.17 |
$458.17 |
4.2× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$823.11 |
$823.11 |
9.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$633.50 |
$633.50 |
7.0× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$686.12 |
$686.12 |
7.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$780 |
$780 |
7.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$956.68 |
$956.68 |
8.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,593.59 |
$1,593.59 |
14.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$948.67 |
$948.67 |
10.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$420.14 |
$420.14 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$544.54 |
$544.54 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$841.98 |
$841.98 |
9.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$854.86 |
$854.86 |
9.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,166.88 |
$1,166.88 |
12.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,464.61 |
$1,464.61 |
13.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$652.65 |
$652.65 |
6.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$934.37 |
$934.37 |
10.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$408.98 |
$408.98 |
4.5× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$553.99 |
$553.99 |
6.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$826.26 |
$826.26 |
9.1× |
| Xr abdomen 1 view (74018) |
$359.34 |
$359.34 |
4.0× |
| Xr abdomen 2 views (74019) |
$851.71 |
$851.71 |
7.8× |
| Xr abdomen 3 views (74021) |
$308.88 |
$308.88 |
2.8× |
| Xr arthrogram ankle (73615) |
$1,134.57 |
$1,134.57 |
3.1× |
| Xr arthrogram elbow (73085) |
$1,134.57 |
$1,134.57 |
3.1× |
| Xr arthrogram hip (73525) |
$1,340.49 |
$1,340.49 |
3.7× |
| Xr bone density appendicular (77081) |
$230.81 |
$230.81 |
2.5× |
| Xr bone density axial (77080) |
$754.47 |
$754.47 |
6.9× |
| Xr bone length study (77073) |
$751.33 |
$751.33 |
6.9× |
| Xr bone survey limited (77074) |
$1,392.82 |
$1,392.82 |
12.8× |
| Xr chest 1 view (71045) |
$694.13 |
$694.13 |
7.6× |
| Xr chest 2 views (71046) |
$791.08 |
$791.08 |
8.7× |
| Xr chest 3 views (71047) |
$161.72 |
$161.72 |
1.8× |
| Xr cystogram 3+ views (74430) |
$1,057.06 |
$1,057.06 |
2.9× |
| Xr facial bones 3 views (70150) |
$1,050.76 |
$1,050.76 |
9.6× |
| Xr mandible 4 views (70110) |
$1,095.10 |
$1,095.10 |
10.0× |
| Xr myelogram c-spine (72240) |
$1,378.70 |
$1,378.70 |
1.7× |
| Xr nasal bones (70160) |
$832.55 |
$832.55 |
9.2× |
| Xr sternum 2 views (71120) |
$811.96 |
$811.96 |
8.9× |
| Xr surgical specimen (76098) |
$927.36 |
$927.36 |
1.6× |
| Xray elbow 2 views (73070) |
$625.49 |
$625.49 |
6.9× |
| Xray forearm 2 views (73090) |
$748.18 |
$748.18 |
8.2× |
| Xray knee 1 or 2 views rt (73560) |
$593.74 |
$593.74 |
6.5× |
| Xray neck soft tissue (70360) |
$770.48 |
$770.48 |
8.5× |
| Xray orbits complete min 4 views (70200) |
$1,186.05 |
$1,186.05 |
10.9× |
| Xray pelvis 1 or 2 views (72170) |
$749.89 |
$749.89 |
6.9× |
| Xray ribs bilateral 3 views (71110) |
$1,170.03 |
$1,170.03 |
10.7× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$1,345.06 |
$1,345.06 |
12.3× |
| Xray scapula complete (73010) |
$768.77 |
$768.77 |
7.0× |
| Xray shoulder 1 view (73020) |
$299.50 |
$299.50 |
3.3× |
| Xray spine thoracic 2 views (72070) |
$1,200.35 |
$1,200.35 |
11.0× |
| Xray spine thoracic 3 views (72072) |
$1,200.35 |
$1,200.35 |
11.0× |
| Xray tibia-fibula 2 views bil (73590) |
$776.78 |
$776.78 |
8.5× |
| Xray tmj's bilateral open-clsc (70330) |
$1,279.86 |
$1,279.86 |
14.1× |