| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,267.50 |
$3,267.50 |
2.2× |
| Abdomen 2 views (74019) |
$1,035 |
$1,035 |
9.1× |
| Acute gi blood loss imaging (78278) |
$7,733 |
$7,733 |
17.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$10,315 |
$10,315 |
7.3× |
| Angiography extremity bilateral rs&i (75716) |
$26,464 |
$26,464 |
7.7× |
| Angiography extremity unilateral rs&i (75710) |
$13,531 |
$13,531 |
3.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$21,576.50 |
$21,576.50 |
3.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$17,946 |
$17,946 |
5.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$12,988.50 |
$12,988.50 |
3.8× |
| Angiography Spinal Selective Rs&I (75705) |
$7,566 |
$7,566 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$16,007 |
$16,007 |
2.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,363 |
$3,363 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$12,995 |
$12,995 |
3.8× |
| Ankle 2 views (73600) |
$2,543 |
$2,543 |
26.7× |
| Aortogram thoracic (75605) |
$24,275 |
$24,275 |
4.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$26,464 |
$26,464 |
7.7× |
| Aortography abdominal serialography rs&i (75625) |
$26,464 |
$26,464 |
7.7× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$12,995 |
$12,995 |
3.8× |
| Arthrogram ankle (73615) |
$7,140.50 |
$7,140.50 |
18.7× |
| Arthrogram elbow (73085) |
$7,643.50 |
$7,643.50 |
20.0× |
| Arthrogram hip (73525) |
$7,643.50 |
$7,643.50 |
20.0× |
| Arthrogram knee (73580) |
$5,102 |
$5,102 |
13.4× |
| Arthrogram shoulder (73040) |
$7,643.50 |
$7,643.50 |
20.0× |
| Arthrogram wrist (73115) |
$7,643.50 |
$7,643.50 |
20.0× |
| Basic dosimetry (77300) |
$225 |
$225 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$5,579 |
$5,579 |
12.8× |
| Bone &/joint imaging whole body (78306) |
$8,852 |
$8,852 |
20.3× |
| Bone age studies (77072) |
$910 |
$910 |
8.0× |
| Bone Imaging 3 Phase (78315) |
$11,102 |
$11,102 |
25.4× |
| Bone survey complete (77075) |
$3,657 |
$3,657 |
32.0× |
| Bone survey infant (77076) |
$2,361 |
$2,361 |
20.7× |
| Bowel imaging (78290) |
$6,296 |
$6,296 |
14.4× |
| Brachytx isodose intermed (77317) |
$577 |
$577 |
1.4× |
| Brain imaging < 4 static views (78600) |
$3,385 |
$3,385 |
7.7× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$5,158 |
$5,158 |
11.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$9,613 |
$9,613 |
16.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$28,920 |
$28,920 |
18.5× |
| Brain Imaging Vascular Flow Only (78610) |
$4,987 |
$4,987 |
8.4× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$7,687 |
$7,687 |
13.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$10,406 |
$10,406 |
23.8× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$10,623 |
$10,623 |
24.3× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$5,862 |
$5,862 |
6.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,862 |
$5,862 |
15.4× |
| Cardiac shunt detection (78428) |
$8,436 |
$8,436 |
19.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$9,613 |
$9,613 |
16.2× |
| Cervical spine 2 or 3 views (72040) |
$2,228 |
$2,228 |
23.4× |
| Chest 1 view (71045) |
$1,714 |
$1,714 |
18.0× |
| Chest xray 3 views (71047) |
$2,191 |
$2,191 |
23.0× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,930 |
$1,930 |
10.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,973 |
$1,973 |
10.3× |
| Clavicle complete (73000) |
$977.50 |
$977.50 |
10.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$384 |
$384 |
3.4× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$2,641 |
$2,641 |
27.8× |
| Continuing medical physics consltj pr wk (77336) |
$500 |
$500 |
3.4× |
| Corpora cavernosography (74445) |
$5,000 |
$5,000 |
43.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$23,147 |
$23,147 |
60.7× |
| CT abdomen and pelvis without contrast (74176) |
$18,428 |
$18,428 |
70.7× |
| CT abdomen w contrast (74160) |
$11,000 |
$11,000 |
57.4× |
| CT abdomen w wo contrast (74170) |
$14,840 |
$14,840 |
77.4× |
| CT abdomen w/o contrast (74150) |
$11,106 |
$11,106 |
97.2× |
| CT angio hrt w/3d image (75574) |
$14,374.50 |
$14,374.50 |
37.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$19,395 |
$19,395 |
101.2× |
| CT angiography upper extremity lt (73206) |
$19,395 |
$19,395 |
101.2× |
| CT c-spine w/contrast (72126) |
$10,181 |
$10,181 |
26.7× |
| CT c-spine w/o contrast (72125) |
$9,539 |
$9,539 |
83.5× |
| CT cervical spine w&w/o contrast (72127) |
$14,793 |
$14,793 |
77.2× |
| CT chest w contrast (71260) |
$12,361 |
$12,361 |
64.5× |
| CT chest w/wo contrast (71270) |
$13,780 |
$13,780 |
71.9× |
| CT head/brain with contrast (70460) |
$11,076 |
$11,076 |
57.8× |
| CT head/brain without and with contrast (70470) |
$12,136 |
$12,136 |
63.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$14,840 |
$14,840 |
38.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$6,708.50 |
$6,708.50 |
70.5× |
| CT hrt w/3d image congen (75573) |
$13,909 |
$13,909 |
36.5× |
| CT iac w contrast (70481) |
$10,553 |
$10,553 |
55.0× |
| CT limited/localized follow up study (76380) |
$4,101 |
$4,101 |
43.1× |
| CT lower ext w/o (73700) |
$9,539 |
$9,539 |
83.5× |
| CT lower extremity w wo contrast (73702) |
$14,793 |
$14,793 |
77.2× |
| CT lower extremity w/contrast material (73701) |
$10,181 |
$10,181 |
53.1× |
| CT lumbar spine w & w/o contrast (72133) |
$14,793 |
$14,793 |
77.2× |
| CT lumbar spine w/contrast (72132) |
$10,181 |
$10,181 |
26.7× |
| CT lumbar spine w/o contrast (72131) |
$9,539 |
$9,539 |
83.5× |
| CT maxillofacial w contrast (70487) |
$11,076 |
$11,076 |
57.8× |
| CT maxillofacial w/wo contrast (70488) |
$14,793 |
$14,793 |
77.2× |
| CT maxillofacial wo contrast (70486) |
$9,105.50 |
$9,105.50 |
79.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$12,136 |
$12,136 |
63.3× |
| CT orbits w/o contrast (70480) |
$8,345 |
$8,345 |
73.0× |
| CT pelvis w/o contrast (72192) |
$9,539 |
$9,539 |
83.5× |
| CT pelvis w/wo contrast (72194) |
$11,080 |
$11,080 |
57.8× |
| CT scan of arm combo (73202) |
$14,793 |
$14,793 |
77.2× |
| CT soft tissue neck w contrast (70491) |
$10,576 |
$10,576 |
55.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$12,731 |
$12,731 |
66.4× |
| CT soft tissue neck w/o contrast (70490) |
$9,539 |
$9,539 |
83.5× |
| CT thoracic spine w/contrast (72129) |
$10,181 |
$10,181 |
53.1× |
| CT thoracic spine w/o contrast (72128) |
$9,539 |
$9,539 |
83.5× |
| CT thoracic spine w/wo contrast (72130) |
$14,793 |
$14,793 |
77.2× |
| CT thorax w/o contrast (71250) |
$11,410 |
$11,410 |
99.8× |
| CT upper ext wo (73200) |
$9,539 |
$9,539 |
83.5× |
| CT upper extremity with contrast (73201) |
$10,181 |
$10,181 |
26.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$8,195 |
$8,195 |
42.7× |
| Cta Abdomen (74175) |
$14,840 |
$14,840 |
77.4× |
| CTA abdomen pelvis (74174) |
$20,902 |
$20,902 |
54.8× |
| CTA chest (71275) |
$13,780 |
$13,780 |
71.9× |
| Cta Head (70496) |
$12,136 |
$12,136 |
63.3× |
| Cta Neck (70498) |
$12,731 |
$12,731 |
66.4× |
| Cta Pelvis (72191) |
$16,516 |
$16,516 |
86.1× |
| Cystography minimum 3 views rs&i (74430) |
$3,210 |
$3,210 |
8.4× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,173 |
$4,173 |
1.8× |
| Diskogram cervical (72285) |
$8,956 |
$8,956 |
4.2× |
| Diskography lumbar (72295) |
$8,956 |
$8,956 |
4.2× |
| Esophagus (74220) |
$3,359.50 |
$3,359.50 |
17.5× |
| Facial bones min 3 views (70150) |
$978 |
$978 |
8.6× |
| Fetal biophysical profile non-stress testing (76818) |
$859.50 |
$859.50 |
7.5× |
| Fluoroscopy up to 1 hr (76000) |
$2,369.50 |
$2,369.50 |
9.1× |
| Foot 2 views (73620) |
$2,395 |
$2,395 |
25.2× |
| Forearm 2 views (73090) |
$1,950.50 |
$1,950.50 |
20.5× |
| Gastric mucosa imaging (78261) |
$6,296 |
$6,296 |
14.4× |
| Hand 2 views (73120) |
$1,219 |
$1,219 |
10.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$6,003 |
$6,003 |
7.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,003 |
$6,003 |
7.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$6,003 |
$6,003 |
7.9× |
| Heart Infarct Image (78466) |
$7,926 |
$7,926 |
18.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$13,315 |
$13,315 |
3.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$14,829 |
$14,829 |
4.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$10,093 |
$10,093 |
17.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$9,722 |
$9,722 |
22.2× |
| Hysterosalpingogram (74740) |
$4,700 |
$4,700 |
18.0× |
| Interstitial radiation source applic complex (77778) |
$1,524 |
$1,524 |
2.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,323 |
$1,323 |
1.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,079 |
$1,079 |
1.8× |
| Intracavitary Radiation Source Applic Simple (77761) |
$752 |
$752 |
1.2× |
| Kidney imaging morphology (78700) |
$5,464 |
$5,464 |
12.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$7,926 |
$7,926 |
13.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$9,891 |
$9,891 |
16.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$11,647 |
$11,647 |
19.6× |
| Knee 3 views (73562) |
$2,170 |
$2,170 |
22.8× |
| Liver & spleen imaging static only (78215) |
$9,722 |
$9,722 |
22.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$10,093 |
$10,093 |
23.1× |
| Liver imaging static only (78201) |
$5,464 |
$5,464 |
9.2× |
| Liver imaging w/vascular flow (78202) |
$8,636 |
$8,636 |
14.6× |
| Lung perf&ventilat diferentl (78598) |
$12,999 |
$12,999 |
21.9× |
| Lung perfusion differential (78597) |
$8,934 |
$8,934 |
20.4× |
| Lung ventilation imaging (78579) |
$12,108 |
$12,108 |
27.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$26,464 |
$26,464 |
7.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$14,829 |
$14,829 |
4.3× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$7,286 |
$7,286 |
4.2× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$2,800 |
$2,800 |
4.1× |
| Lymphoscintigraphy (78195) |
$11,494 |
$11,494 |
19.4× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$7,657 |
$7,657 |
8.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$7,657 |
$7,657 |
20.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$9,446 |
$9,446 |
24.8× |
| Mammary ductogram or galactogram multiple (77054) |
$3,488 |
$3,488 |
13.4× |
| Mammary ductogram or galactogram single (77053) |
$2,330 |
$2,330 |
8.9× |
| MRA head w & w/o contrast (70546) |
$12,010 |
$12,010 |
31.5× |
| MRA head w/o contrast (70544) |
$9,862 |
$9,862 |
37.8× |
| MRA head with contrast (70545) |
$10,294 |
$10,294 |
27.0× |
| MRA neck w contrast (70548) |
$10,294 |
$10,294 |
27.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$12,010 |
$12,010 |
31.5× |
| MRA neck w/o contrast (70547) |
$9,862 |
$9,862 |
37.8× |
| MRI abdomen w contrast (74182) |
$9,744 |
$9,744 |
25.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$12,010 |
$12,010 |
31.5× |
| MRI abdomen w/o contrast (74181) |
$9,000 |
$9,000 |
34.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$7,657 |
$7,657 |
8.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$9,449 |
$9,449 |
24.8× |
| MRI breast w/o contrast bilateral (77047) |
$9,449 |
$9,449 |
36.2× |
| MRI breast wo contrast unilateral (77046) |
$8,989 |
$8,989 |
34.5× |
| MRI c-spine with contrast (72142) |
$10,806 |
$10,806 |
28.3× |
| MRI cardiac w/o cont stress (75559) |
$3,832 |
$3,832 |
6.4× |
| MRI cardiac w/o contrast (75557) |
$3,832 |
$3,832 |
14.7× |
| MRI cervical spine w/o contrast (72141) |
$8,180 |
$8,180 |
31.4× |
| MRI chest w/o & w/contrast material (71552) |
$12,010 |
$12,010 |
31.5× |
| MRI chest w/o contrast (71550) |
$9,000 |
$9,000 |
34.5× |
| MRI chest with contrast (71551) |
$10,294 |
$10,294 |
12.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,657 |
$7,657 |
20.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$10,489 |
$10,489 |
27.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,535 |
$6,535 |
25.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$10,374 |
$10,374 |
39.8× |
| MRI orbit face neck w contrast (70542) |
$10,275 |
$10,275 |
26.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$12,010 |
$12,010 |
31.5× |
| MRI pelvis w/contrast (72196) |
$10,806 |
$10,806 |
28.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$12,010 |
$12,010 |
31.5× |
| MRI pelvis w/o contrast (72195) |
$9,669 |
$9,669 |
37.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$11,629 |
$11,629 |
30.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$10,806 |
$10,806 |
28.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$11,629 |
$11,629 |
30.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$10,806 |
$10,806 |
28.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$11,629 |
$11,629 |
30.5× |
| MRI temporomandibular joint (70336) |
$10,883.50 |
$10,883.50 |
41.7× |
| MRI thoracic spine w/o contrast (72146) |
$8,611 |
$8,611 |
33.0× |
| MRI up ext w/o contrast (73218) |
$6,535 |
$6,535 |
25.1× |
| MRI upper ext joint w/o contrast (73221) |
$6,535 |
$6,535 |
25.1× |
| MRI, joint upper extrem combo (73223) |
$9,449 |
$9,449 |
24.8× |
| Myelogram Cervical (72240) |
$10,247 |
$10,247 |
12.0× |
| Myelogram Lumbar (72265) |
$10,121 |
$10,121 |
11.8× |
| Myelogram thoracic (72255) |
$10,247 |
$10,247 |
12.0× |
| Myelography 2 or more regions (72270) |
$11,369 |
$11,369 |
13.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$28,920 |
$28,920 |
20.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$28,920 |
$28,920 |
18.5× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$28,920 |
$28,920 |
18.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$17,534 |
$17,534 |
12.4× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$5,763 |
$5,763 |
4.1× |
| Myocardial Spect Multiple Studies (78452) |
$21,573 |
$21,573 |
15.2× |
| Myocardial spect single study at rest or stress (78451) |
$17,534 |
$17,534 |
12.4× |
| Neck soft tissue (70360) |
$2,133 |
$2,133 |
22.4× |
| Nm bone marrow wb (78104) |
$9,613 |
$9,613 |
22.0× |
| Nm cardiac blood pool multiple (78473) |
$11,647 |
$11,647 |
26.7× |
| Nm cisternogram (78630) |
$9,613 |
$9,613 |
16.2× |
| Nm csf leak detection (78650) |
$11,198 |
$11,198 |
7.9× |
| Nm gastric emptying study (78264) |
$7,995 |
$7,995 |
18.3× |
| Nm gastroesophageal reflux study (78262) |
$7,995 |
$7,995 |
18.3× |
| Nm kidney scan w/flow (78701) |
$10,093 |
$10,093 |
23.1× |
| Nm peritoneal-venous shunt patency (78291) |
$4,014 |
$4,014 |
9.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$2,023 |
$2,023 |
4.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,648 |
$1,648 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$8,436 |
$8,436 |
19.3× |
| Osseous survey limited (77074) |
$3,528 |
$3,528 |
30.9× |
| Parathyroid Planar Imaging (78070) |
$2,757 |
$2,757 |
6.3× |
| Pelvis 1 or 2 views (72170) |
$1,537 |
$1,537 |
13.4× |
| PET image w/CT, skull-thigh (78815) |
$28,920 |
$28,920 |
18.5× |
| PET imaging CT for attenuation limited area (78814) |
$28,920 |
$28,920 |
18.5× |
| PET imaging for CT attenuation whole body (78816) |
$27,603.50 |
$27,603.50 |
17.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$28,920 |
$28,920 |
20.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$13,677 |
$13,677 |
4.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$8,085 |
$8,085 |
18.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$12,999 |
$12,999 |
21.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$5,297 |
$5,297 |
8.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$2,705.50 |
$2,705.50 |
28.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$1,475 |
$1,475 |
15.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$2,606 |
$2,606 |
27.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,634 |
$1,634 |
17.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$3,111 |
$3,111 |
27.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$3,793 |
$3,793 |
33.2× |
| Radex fingr minimum 2 views (73140) |
$1,041 |
$1,041 |
10.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$2,461 |
$2,461 |
25.9× |
| Radex Hand Minimum 3 Views (73130) |
$2,303.50 |
$2,303.50 |
24.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$3,450 |
$3,450 |
36.3× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$3,907 |
$3,907 |
34.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$3,907 |
$3,907 |
34.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$3,907 |
$3,907 |
34.2× |
| Radex Humerus Minimum 2 Views (73060) |
$2,102 |
$2,102 |
22.1× |
| Radex Kne 1/2 Views (73560) |
$1,817 |
$1,817 |
19.1× |
| Radex Kne Compl 4/More Views (73564) |
$2,876 |
$2,876 |
25.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$2,528 |
$2,528 |
22.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$841 |
$841 |
8.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$4,584 |
$4,584 |
40.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$2,191 |
$2,191 |
23.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$1,449 |
$1,449 |
15.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$2,228 |
$2,228 |
19.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$2,259 |
$2,259 |
23.7× |
| Radex Toe Minimum 2 Views (73660) |
$1,459 |
$1,459 |
15.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$1,142 |
$1,142 |
10.0× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,854 |
$1,854 |
19.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$4,628 |
$4,628 |
40.5× |
| Radiation treatment delivery level 1 (77402) |
$297 |
$297 |
2.7× |
| Radiation treatment delivery level 2 (77407) |
$342 |
$342 |
0.8× |
| Radiation treatment delivery level 3 (77412) |
$1,648 |
$1,648 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$851 |
$851 |
8.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$2,682 |
$2,682 |
23.5× |
| Radiologic exam chest 2 views (71046) |
$1,714 |
$1,714 |
18.0× |
| Radiologic exam colon single contrast study (74270) |
$3,266 |
$3,266 |
17.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$876 |
$876 |
4.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$5,918 |
$5,918 |
30.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$4,107 |
$4,107 |
21.4× |
| Radiologic examination femur 1 view (73551) |
$3,669 |
$3,669 |
38.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,405 |
$1,405 |
14.8× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$1,701 |
$1,701 |
14.9× |
| Radiological examination surgical specimen (76098) |
$1,015 |
$1,015 |
1.7× |
| Ribs bilateral 3 views (71110) |
$2,330 |
$2,330 |
20.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$10,093 |
$10,093 |
23.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$13,511 |
$13,511 |
30.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$16,755 |
$16,755 |
28.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$12,064 |
$12,064 |
20.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$11,494 |
$11,494 |
19.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,723 |
$6,723 |
4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,629 |
$7,629 |
4.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,723 |
$6,723 |
4.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,335 |
$1,335 |
5.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,795 |
$2,795 |
10.7× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$9,613 |
$9,613 |
22.0× |
| Scapula (73010) |
$3,558 |
$3,558 |
31.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$1,148 |
$1,148 |
49.1× |
| Shoulder 1 view (73020) |
$1,219 |
$1,219 |
12.8× |
| Sialogram (70390) |
$3,567 |
$3,567 |
13.7× |
| Small bowel series (74250) |
$2,145 |
$2,145 |
11.2× |
| Special dosimetry (77331) |
$890 |
$890 |
6.1× |
| Special Physics Consult (77370) |
$577 |
$577 |
3.9× |
| Special treatment procedure (77470) |
$1,847 |
$1,847 |
3.1× |
| Spine thoracic 3 views (72072) |
$1,930 |
$1,930 |
16.9× |
| Spleen imaging only (78185) |
$10,093 |
$10,093 |
23.1× |
| Splenoportograpy rs&i (75810) |
$12,928 |
$12,928 |
3.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,847 |
$1,847 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$577 |
$577 |
1.4× |
| Testicular Imaging With Vascular Flow (78761) |
$5,510.50 |
$5,510.50 |
12.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,189 |
$1,189 |
2.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$577 |
$577 |
3.9× |
| Thoracolumbar 2 views (72080) |
$2,228 |
$2,228 |
23.4× |
| Thyroid imaging w/blood flow (78013) |
$3,117 |
$3,117 |
7.1× |
| Thyroid uptake measurement (78012) |
$2,757 |
$2,757 |
6.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,757 |
$2,757 |
6.3× |
| Tomogram (76100) |
$4,419 |
$4,419 |
38.7× |
| Treatment device complex (77334) |
$977 |
$977 |
2.4× |
| Ultrasound breast complete (76641) |
$5,334 |
$5,334 |
46.7× |
| Ultrasound Exam Aaa Screen (76706) |
$823 |
$823 |
7.2× |
| Ultrasound, abdomen limited (76705) |
$3,831 |
$3,831 |
33.5× |
| Urethrocystogram voiding (74455) |
$3,897 |
$3,897 |
14.9× |
| Urethrocystography retrograde rs&i (74450) |
$3,210 |
$3,210 |
12.3× |
| Us breast unilateral limited (76642) |
$1,753 |
$1,753 |
18.4× |
| Us chest (76604) |
$4,008 |
$4,008 |
35.1× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$3,186.50 |
$3,186.50 |
13.5× |
| Us compl joint r-t w/image documentation (76881) |
$3,831 |
$3,831 |
33.5× |
| Us encephalogram (76506) |
$1,147 |
$1,147 |
10.0× |
| Us hips infant static (76886) |
$1,335 |
$1,335 |
14.0× |
| Us infant hips w manipulation (76885) |
$1,679 |
$1,679 |
17.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$3,831 |
$3,831 |
33.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$3,831 |
$3,831 |
33.5× |
| Us ob limited (76815) |
$1,369.50 |
$1,369.50 |
12.0× |
| Us ob transvaginal (76817) |
$1,193 |
$1,193 |
10.4× |
| Us pelvic non ob complete (76856) |
$2,439 |
$2,439 |
21.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,416 |
$1,416 |
12.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$3,064 |
$3,064 |
26.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$1,207 |
$1,207 |
10.6× |
| Us retroperitoneal complete (76770) |
$5,334 |
$5,334 |
46.7× |
| Us retroperitoneal limited (76775) |
$4,544 |
$4,544 |
39.8× |
| Us scrotum and contents (76870) |
$5,265 |
$5,265 |
46.1× |
| Us soft tissue head/neck (76536) |
$1,744.50 |
$1,744.50 |
15.3× |
| Us spinal canal and contents (76800) |
$3,381 |
$3,381 |
29.6× |
| Us transrectal (76872) |
$5,126 |
$5,126 |
44.9× |
| Us transrectal prostate volume (76873) |
$4,871 |
$4,871 |
42.6× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,163 |
$1,163 |
10.2× |
| Venogram extremity bilateral (75822) |
$6,245 |
$6,245 |
3.6× |
| Venogram Extremity Unilateral (75820) |
$3,573 |
$3,573 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$11,557 |
$11,557 |
3.3× |
| Venography caval superior serialography rs&i (75827) |
$11,557 |
$11,557 |
6.7× |
| Venography Renal Bilateral (75833) |
$22,942 |
$22,942 |
6.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,426 |
$3,426 |
1.0× |
| Venous sampling by catheter (75893) |
$4,425.50 |
$4,425.50 |
0.7× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$4,831 |
$4,831 |
8.1× |
| Wrist 2 views (73100) |
$1,619 |
$1,619 |
17.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$2,682 |
$2,682 |
23.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,923 |
$1,923 |
20.2× |
| X-ray b.e. reductn intuss (74283) |
$5,918 |
$5,918 |
30.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$4,107 |
$4,107 |
21.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,817 |
$1,817 |
19.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$2,446 |
$2,446 |
25.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$3,907 |
$3,907 |
34.2× |
| X-ray exam of femur 2/> (73552) |
$3,669 |
$3,669 |
38.6× |
| X-ray eye for foreign body (70030) |
$575 |
$575 |
6.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,537 |
$1,537 |
16.2× |
| X-ray IV pyelogram (ivp) (74400) |
$3,954.50 |
$3,954.50 |
20.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,817 |
$1,817 |
19.1× |
| X-ray leg, infant (73592) |
$1,219 |
$1,219 |
12.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,200 |
$2,200 |
19.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$4,628 |
$4,628 |
40.5× |
| X-ray nose-rectum child f.b. (76010) |
$2,871 |
$2,871 |
30.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$2,799 |
$2,799 |
24.5× |
| X-ray retrograde pyelogram (74420) |
$4,628 |
$4,628 |
12.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$2,279 |
$2,279 |
24.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$2,279 |
$2,279 |
19.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,330 |
$2,330 |
20.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,701 |
$1,701 |
14.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$2,446 |
$2,446 |
25.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,867 |
$1,867 |
19.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$3,137 |
$3,137 |
27.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,817 |
$1,817 |
15.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$3,820 |
$3,820 |
19.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,568.50 |
$1,568.50 |
16.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$906 |
$906 |
9.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$2,133 |
$2,133 |
22.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$2,228 |
$2,228 |
19.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$3,823 |
$3,823 |
33.5× |
| Xr bone length studies (77073) |
$3,528 |
$3,528 |
30.9× |
| Xr c-spine 4 or 5 views (72050) |
$2,232 |
$2,232 |
19.5× |
| Xr c-spine 6 or more views (72052) |
$2,948 |
$2,948 |
25.8× |
| Xr chest 4+ views (71048) |
$3,032 |
$3,032 |
26.5× |
| Xr urogram antegrade (74425) |
$4,515 |
$4,515 |
11.8× |