| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,131.60 |
$10,329 |
2.6× |
| Abdomen 1 View (74018) |
$252 |
$630 |
2.5× |
| Abdomen 2 views (74019) |
$314.40 |
$786 |
2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,292.40 |
$3,231 |
2.8× |
| Angio internal mammary (75756) |
$3,564.40 |
$8,911 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,564.40 |
$8,911 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,015.20 |
$5,038 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$4,720.80 |
$11,802 |
1.3× |
Angiography extremity unilateral rs&i (75710)
range across 3 matching MRF lines |
$2,308–$4,315.20 |
$5,770–$10,788 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,564.40 |
$8,911 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,257.20 |
$5,643 |
0.6× |
| Ankle 2 views (73600) |
$270.80 |
$677 |
2.7× |
| Aortography thoracic serialography rs&i (75605) |
$5,926.80 |
$14,817 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,564.40 |
$8,911 |
1.0× |
Artery X-Rays Abdomen (75726)
range across 3 matching MRF lines |
$4,383.20–$5,668.80 |
$10,958–$14,172 |
varies |
| Artery X-Rays Adrenal Gland (75731) |
$1,769.60 |
$4,424 |
0.5× |
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines |
$2,889.20–$5,668.80 |
$7,223–$14,172 |
varies |
| Artery X-Rays Spine (75705) |
$5,926.80 |
$14,817 |
0.9× |
| Arthrogram ankle (73615) |
$733.60 |
$1,834 |
1.8× |
| Arthrogram hip (73525) |
$743.60 |
$1,859 |
1.8× |
| Arthrogram Wrist (73115) |
$649.20 |
$1,623 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$456 |
$1,140 |
2.9× |
| Bone age studies (77072) |
$256.40 |
$641 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,734.40 |
$4,336 |
3.7× |
| Bone Imaging Limited Area (78300) |
$1,116.80 |
$2,792 |
2.4× |
| Bone Imaging Multiple Areas (78305) |
$1,302.80 |
$3,257 |
2.8× |
| Bone Imaging Whole Body (78306) |
$1,444 |
$3,610 |
3.1× |
| Bone marrow imaging limited area (78102) |
$942.40 |
$2,356 |
2.0× |
| Bone marrow imaging; multiple areas (78103) |
$941.60 |
$2,354 |
2.0× |
| Bone marrow imaging; whole body (78104) |
$999.20 |
$2,498 |
2.2× |
| Bone survey infant (77076) |
$307.60 |
$769 |
2.5× |
| Brachytx isodose complex (77318) |
$1,734.40 |
$4,336 |
4.0× |
| Brachytx isodose intermed (77317) |
$1,239.20 |
$3,098 |
2.9× |
| Brachytx Isodose Plan Simple (77316) |
$1,052 |
$2,630 |
2.4× |
| Brain Flow Imaging Only (78610) |
$620 |
$1,550 |
1.0× |
| Brain Image W/Flow < 4 Views (78601) |
$1,523.60 |
$3,809 |
3.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$810.40 |
$2,026 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,288 |
$10,720 |
2.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$999.20 |
$2,498 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,542.80 |
$3,857 |
3.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,068.80 |
$5,172 |
2.3× |
| Cat Scan Follow-Up Study (76380) |
$768.40 |
$1,921 |
7.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,016.80 |
$2,542 |
1.6× |
| Cerebrospinal Fluid Scan (78630) |
$1,300 |
$3,250 |
2.1× |
| Chest 1 view (71045) |
$246.80 |
$617 |
2.4× |
| Chest 2 views (71046) |
$299.20 |
$748 |
3.0× |
| Chest 3 views (71047) |
$303.60 |
$759 |
3.0× |
| Chest 4 or more views (71048) |
$314.80 |
$787 |
2.6× |
| Cholecystography Oral Contrast (74290) |
$336.80 |
$842 |
1.7× |
| Clavicle complete (73000) |
$250 |
$625 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$265.60 |
$664 |
2.2× |
| Continuing medical physics consltj pr wk (77336) |
$661.20 |
$1,653 |
4.2× |
| Contrast Exam Abdominl Aorta (75625) |
$5,140 |
$12,850 |
1.4× |
| Contrast X-Ray Bladder (74430) |
$618.40 |
$1,546 |
1.5× |
| Contrast X-Ray Of Elbow (73085) |
$678.80 |
$1,697 |
1.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$828.40 |
$2,071 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,908.40 |
$9,771 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,480.40 |
$6,201 |
9.0× |
| CT abdomen w contrast (74160) |
$2,142.80 |
$5,357 |
10.5× |
| CT abdomen w wo contrast (74170) |
$2,366.80 |
$5,917 |
11.7× |
| CT abdomen w/o contrast (74150) |
$1,876.40 |
$4,691 |
15.5× |
| CT Angio Abdomen and Pelvis (74174) |
$2,842.40 |
$7,106 |
7.0× |
| CT Angio Chest (71275) |
$2,552.40 |
$6,381 |
12.6× |
| CT Angio Head (70496) |
$2,501.60 |
$6,254 |
12.3× |
| CT angio hrt w/3d image (75574) |
$1,006.40 |
$2,516 |
2.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,256.80 |
$5,642 |
11.1× |
| CT Angio Neck (70498) |
$2,503.20 |
$6,258 |
12.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,930.80 |
$4,827 |
9.5× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,450.40 |
$3,626 |
7.1× |
| CT cervical spine w/ contrast (72126) |
$1,937.60 |
$4,844 |
4.8× |
| CT cervical spine w/o contrast (72125) |
$1,868 |
$4,670 |
15.4× |
| CT cervical spine w/wo cont (72127) |
$2,272 |
$5,680 |
11.2× |
| CT chest w contrast (71260) |
$1,931.60 |
$4,829 |
9.5× |
| CT chest w/wo contrast (71270) |
$2,176.40 |
$5,441 |
10.7× |
| CT colonography screening (74263) |
$881.20 |
$2,203 |
3.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,177.60 |
$2,944 |
5.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$728.40 |
$1,821 |
6.0× |
| CT head/brain with contrast (70460) |
$1,722.80 |
$4,307 |
8.5× |
| CT head/brain without and with contrast (70470) |
$1,921.20 |
$4,803 |
9.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$876.80 |
$2,192 |
2.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$47.60 |
$119 |
0.5× |
| CT hrt w/3d image congen (75573) |
$911.20 |
$2,278 |
2.3× |
| CT iac w contrast (70481) |
$2,091.20 |
$5,228 |
10.3× |
| CT l-spine w&w/o contrast (72133) |
$2,304 |
$5,760 |
11.3× |
| CT lower ext w/o (73700) |
$1,470 |
$3,675 |
12.1× |
| CT lower extremity w/contrast material (73701) |
$2,686.80 |
$6,717 |
13.2× |
| CT lumbar spine w contrast (72132) |
$2,080 |
$5,200 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$1,734.40 |
$4,336 |
14.3× |
| CT maxillofacial w contrast (70487) |
$1,896.40 |
$4,741 |
9.3× |
CT maxillofacial wo contrast (70486)
range across 3 matching MRF lines |
$729.20–$1,607.60 |
$1,823–$4,019 |
varies |
| CT neck tissue combo (70492) |
$2,090.80 |
$5,227 |
10.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,522.80 |
$6,307 |
12.4× |
| CT orbits w/o contrast (70480) |
$1,900.40 |
$4,751 |
15.7× |
| CT pelvis w&w/o contrast (72194) |
$1,976 |
$4,940 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,516.40 |
$3,791 |
12.5× |
| CT scan of leg combo (73702) |
$2,924 |
$7,310 |
14.4× |
| CT scans face/jaw combo (70488) |
$2,102.80 |
$5,257 |
10.4× |
| CT soft tissue neck w contrast (70491) |
$1,734.40 |
$4,336 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,648.80 |
$4,122 |
13.6× |
| CT thoracic spine w contrast (72129) |
$1,871.20 |
$4,678 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,646.40 |
$4,116 |
13.6× |
| CT thoracic spine w/wo cont (72130) |
$1,982.40 |
$4,956 |
9.8× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$705.60–$1,672.40 |
$1,764–$4,181 |
varies |
| CT upper ext wo (73200) |
$1,416.80 |
$3,542 |
11.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,801.60 |
$7,004 |
13.8× |
| CT upper extremity with contrast (73201) |
$2,287.20 |
$5,718 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,694.80 |
$11,737 |
23.1× |
| Cta Abdomen (74175) |
$3,195.60 |
$7,989 |
15.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$5,004.80 |
$12,512 |
12.4× |
| CTA pelvis (72191) |
$2,219.20 |
$5,548 |
10.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$342 |
$855 |
1.2× |
Dilation ureters/urethra rs&i (74485)
range across 2 matching MRF lines |
$2,484.80–$3,978 |
$6,212–$9,945 |
varies |
| Discography Cerv/Thor Spine (72285) |
$2,362 |
$5,905 |
1.0× |
| Diskography lumbar (72295) |
$2,362 |
$5,905 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$249.60 |
$624 |
2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$272 |
$680 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$220 |
$550 |
1.8× |
| Dxa Bone Density Axial (77080) |
$307.60 |
$769 |
2.5× |
| Dxa bone density study (77085) |
$446 |
$1,115 |
3.7× |
| Echo exam of fetal heart (76825) |
$1,003.20 |
$2,508 |
1.6× |
| Echo exam uterus (76831) |
$302 |
$755 |
1.1× |
| Echo Guide For Artery Repair (76936) |
$403.20 |
$1,008 |
1.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$833.20 |
$2,083 |
3.0× |
| Echograp Trans R Pros Study (76873) |
$300.80 |
$752 |
2.5× |
| Esophagram (74220) |
$497.60 |
$1,244 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$336.40 |
$841 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$613.60 |
$1,534 |
5.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,336.80 |
$3,342 |
4.8× |
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines |
$342–$456.80 |
$855–$1,142 |
varies |
| Follow-Up Angiography (75898) |
$1,033.60 |
$2,584 |
0.3× |
| Foot 2 views (73620) |
$314.40 |
$786 |
3.1× |
| Forearm 2 views (73090) |
$296 |
$740 |
2.9× |
| Gastric emptying imaging study (78264) |
$1,394 |
$3,485 |
3.0× |
| Gastroesophageal Reflux Exam (78262) |
$844 |
$2,110 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,524.80 |
$3,812 |
3.3× |
| Gated Heart, Multiple (78473) |
$1,666 |
$4,165 |
3.6× |
| Hand 2 views (73120) |
$283.60 |
$709 |
2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,160 |
$5,400 |
2.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,566.80 |
$6,417 |
3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,160 |
$5,400 |
2.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,564.40 |
$8,911 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,564.40 |
$8,911 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,695.20 |
$4,238 |
2.7× |
| Hepatobiliary System Imaging (78226) |
$1,292.80 |
$3,232 |
2.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,414 |
$6,035 |
1.6× |
| Hyperthermia external generated superficial (77600) |
$1,221.20 |
$3,053 |
2.7× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) |
$2,042 |
$5,105 |
2.5× |
| Hysterosalpingogram (74740) |
$747.60 |
$1,869 |
2.7× |
| Image fusion (77399) |
$363.60 |
$909 |
2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$403.60 |
$1,009 |
4.0× |
| Infant hip ultrasound, limited static exam (76886) |
$272 |
$680 |
2.7× |
| Interstitial radiation source applic complex (77778) |
$2,522 |
$6,305 |
3.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,877.20 |
$4,693 |
2.3× |
| Joint Survey Single View (77077) |
$153.60 |
$384 |
1.3× |
| K Flow/Funct Image Multiple (78709) |
$1,281.20 |
$3,203 |
2.0× |
| K Flow/Funct Image W/Drug (78708) |
$1,475.20 |
$3,688 |
2.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,452.40 |
$3,631 |
2.3× |
| Kidney Imaging Morphol (78700) |
$482 |
$1,205 |
1.0× |
| Knee 3 Views (73562) |
$371.20 |
$928 |
3.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,236 |
$3,090 |
2.7× |
| Liver imaging static only (78201) |
$1,752.40 |
$4,381 |
2.8× |
| Liver imaging w/vascular flow (78202) |
$1,645.20 |
$4,113 |
2.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,914.40 |
$4,786 |
3.0× |
| Lung perfusion differential (78597) |
$1,148.40 |
$2,871 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,771.20 |
$4,428 |
2.8× |
| Lung Ventilation Imaging (78579) |
$971.20 |
$2,428 |
2.1× |
| Lymph System Imaging (78195) |
$1,636.80 |
$4,092 |
2.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,217.20 |
$3,043 |
1.7× |
Lymphangiography, pelvic/abdominal, unilateral (75805)
range across 2 matching MRF lines |
$1,340.80–$5,193.60 |
$3,352–$12,984 |
varies |
| Magnetic Image Jaw Joint (70336) |
$2,145.20 |
$5,363 |
7.8× |
| Mammary ductogram or galactogram multiple (77054) |
$602 |
$1,505 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$605.20 |
$1,513 |
2.2× |
| Meckels Divert Exam (78290) |
$1,161.20 |
$2,903 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$923.20 |
$2,308 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$66 |
$165 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,589.20 |
$6,473 |
6.4× |
| MRA head w/o contrast (70544) |
$2,491.20 |
$6,228 |
9.0× |
| MRA head with contrast (70545) |
$2,555.20 |
$6,388 |
6.3× |
| MRA neck w contrast (70548) |
$2,589.20 |
$6,473 |
6.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,785.20 |
$6,963 |
6.9× |
| MRA neck w/o contrast (70547) |
$2,524.40 |
$6,311 |
9.1× |
| MRI abdomen w contrast (74182) |
$1,452.40 |
$3,631 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$2,203.20 |
$5,508 |
8.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,446 |
$6,115 |
2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,842 |
$7,105 |
7.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,416.40 |
$6,041 |
2.7× |
| MRI bone marrow blood supply (77084) |
$2,493.20 |
$6,233 |
9.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,308.40 |
$5,771 |
8.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,874 |
$4,685 |
6.8× |
| MRI cardiac w/o cont stress (75559) |
$1,475.20 |
$3,688 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$1,402.80 |
$3,507 |
5.1× |
| MRI cervical spine w contrast (72142) |
$2,923.60 |
$7,309 |
7.2× |
| MRI cervical spine w/o cont (72141) |
$2,332.40 |
$5,831 |
8.4× |
| MRI chest w/o contrast (71550) |
$2,453.20 |
$6,133 |
8.9× |
| MRI chest with contrast (71551) |
$1,694 |
$4,235 |
1.9× |
| MRI chest wo w contrast (71552) |
$3,792.80 |
$9,482 |
9.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,497.20 |
$3,743 |
3.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,273.60 |
$5,684 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,118.40 |
$5,296 |
7.7× |
| MRI lumbar spine w contrast (72149) |
$2,644 |
$6,610 |
6.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,932.40 |
$9,831 |
9.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,996.80 |
$4,992 |
7.2× |
| MRI orbit face neck w contrast (70542) |
$1,996.80 |
$4,992 |
4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,369.60 |
$8,424 |
8.3× |
| MRI pelvis w contrast (72196) |
$2,733.60 |
$6,834 |
6.8× |
| MRI pelvis w/o & w contrast (72197) |
$2,990 |
$7,475 |
7.4× |
| MRI pelvis w/o contrast (72195) |
$2,253.60 |
$5,634 |
8.2× |
| MRI spectroscopy (76390) |
$859.20 |
$2,148 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,194.40 |
$5,486 |
7.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,063.20 |
$7,658 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,133.60 |
$5,334 |
7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,484 |
$8,710 |
8.6× |
| MRI, abdomen, combo (74183) |
$2,725.20 |
$6,813 |
6.7× |
| MRI, dorsal spine combo (72157) |
$3,898 |
$9,745 |
9.6× |
| MRI, dorsal spine contrast (72147) |
$2,684.80 |
$6,712 |
6.6× |
| MRI, joint upper extrem (73221) |
$2,028.80 |
$5,072 |
7.3× |
| MRI, joint upper extrem combo (73223) |
$3,745.60 |
$9,364 |
9.3× |
| MRI, lumbar spine combo (72158) |
$3,431.20 |
$8,578 |
8.5× |
| Myelogram cervical (72240) |
$1,525.20 |
$3,813 |
1.7× |
| Myelogram Lumbar (72265) |
$1,346.80 |
$3,367 |
1.5× |
| Myelography thoracic (72255) |
$1,410 |
$3,525 |
1.6× |
| Myelograpy 2/more regions rs&i (72270) |
$1,889.60 |
$4,724 |
2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,049.20 |
$5,123 |
1.4× |
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines |
$2,926.40–$3,540 |
$7,316–$8,850 |
varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$5,657.60 |
$14,144 |
2.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$6,914 |
$17,285 |
2.7× |
| N-invas est c ffr sw aly CTA (75580) |
$2,293.20 |
$5,733 |
2.3× |
| Neck soft tissue (70360) |
$258.40 |
$646 |
2.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$257.20 |
$643 |
0.6× |
| Nm csf leak detection (78650) |
$1,754 |
$4,385 |
1.2× |
| Nonvascular Shunt X-Ray (75809) |
$309.20 |
$773 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,379.20 |
$13,448 |
3.4× |
| Nuclear Rx Intra-Arterial (79445) |
$497.60 |
$1,244 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$1,326.40 |
$3,316 |
4.9× |
| Ob us nuchal meas 1 gest (76813) |
$652.80 |
$1,632 |
5.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,242.80 |
$3,107 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$1,434.40 |
$3,586 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$939.60 |
$2,349 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$294.40 |
$736 |
2.4× |
| Peritoneogram Rs&I (74190) |
$448.80 |
$1,122 |
0.7× |
| Pet Image W/Ct Lmtd (78814) |
$3,958 |
$9,895 |
2.4× |
| PET image w/CT, full body (78816) |
$5,191.60 |
$12,979 |
3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,930.40 |
$12,326 |
3.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,294.80 |
$15,737 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,057.60 |
$2,644 |
2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$439.20 |
$1,098 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$678.80 |
$1,697 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$328 |
$820 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$300.80 |
$752 |
3.0× |
| Radex elbow complete minimum 3 views (73080) |
$320.80 |
$802 |
3.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$389.60 |
$974 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$250 |
$625 |
2.5× |
| Radex foot complete minimum 3 views (73630) |
$322.40 |
$806 |
3.2× |
| Radex Hand Minimum 3 Views (73130) |
$305.20 |
$763 |
3.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$192.80 |
$482 |
1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$220.40 |
$551 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$264.80 |
$662 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$265.20 |
$663 |
2.6× |
| Radex shoulder complete minimum 2 views (73030) |
$340.40 |
$851 |
3.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$365.60 |
$914 |
3.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$673.20 |
$1,683 |
3.3× |
| Radex Spine 1 View Specify Level (72020) |
$254 |
$635 |
2.5× |
| Radex Sternum Minimum 2 Views (71120) |
$264 |
$660 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$294.80 |
$737 |
2.9× |
| Radex Toe Minimum 2 Views (73660) |
$250 |
$625 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$270 |
$675 |
2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$332 |
$830 |
3.3× |
Radiation Delivery Stereotactic Cranial Linear (77372)
range across 2 matching MRF lines |
$10,769.60–$12,774.40 |
$26,924–$31,936 |
varies |
| Radiation treatment delivery level 1 (77402) |
$915.60 |
$2,289 |
7.7× |
| Radiation treatment delivery level 2 (77407) |
$2,044.40 |
$5,111 |
4.6× |
| Radiation treatment delivery level 3 (77412) |
$2,594.80 |
$6,487 |
4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$467.20 |
$1,168 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$381.60 |
$954 |
3.2× |
| Radiologic exam colon double contrast study (74280) |
$918 |
$2,295 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$904.80 |
$2,262 |
4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$503.20 |
$1,258 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$444.80 |
$1,112 |
3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$321.20 |
$803 |
2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$571.20 |
$1,428 |
2.8× |
Radiologic exam swallow function contrast study (74230)
range across 2 matching MRF lines |
$452.80–$489.60 |
$1,132–$1,224 |
varies |
| Radiologic exam upr gi trc double contrast study (74246) |
$643.60 |
$1,609 |
3.2× |
| Radiologic examination femur 1 view (73551) |
$333.20 |
$833 |
3.3× |
| Radiologic examination femur minimum 2 views (73552) |
$333.20 |
$833 |
3.3× |
| Radiologic examination knee 1/2 views (73560) |
$306 |
$765 |
3.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$449.20 |
$1,123 |
3.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$248.40 |
$621 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$327.60 |
$819 |
3.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$2,160 |
$5,400 |
4.8× |
| Ribs bilateral 3 views (71110) |
$483.60 |
$1,209 |
4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,139.60 |
$2,849 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,206 |
$3,015 |
2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,098.40 |
$7,746 |
4.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,811.60 |
$4,529 |
2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,959.20 |
$4,898 |
3.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,318.40 |
$8,296 |
2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,877.60 |
$7,194 |
1.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$890 |
$2,225 |
3.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,008.40 |
$2,521 |
3.7× |
| Scapula (73010) |
$285.20 |
$713 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$40 |
$100 |
1.7× |
| Sella turcica (70240) |
$219.60 |
$549 |
2.2× |
| Shoulder 1 view (73020) |
$250 |
$625 |
2.5× |
| Shoulder Arthrography (73040) |
$634.80 |
$1,587 |
1.6× |
| Sialogram (70390) |
$495.20 |
$1,238 |
1.8× |
| Skull less than 4 views (70250) |
$322.80 |
$807 |
2.7× |
| Special dosimetry (77331) |
$184.40 |
$461 |
1.2× |
| Special Physics Consult (77370) |
$509.20 |
$1,273 |
3.3× |
| Special teletherapy port plan (77321) |
$890 |
$2,225 |
2.1× |
| Special treatment procedure (77470) |
$2,365.60 |
$5,914 |
3.7× |
Stereotactic Body Radiation Delivery (77373)
range across 2 matching MRF lines |
$5,080.40–$5,088.80 |
$12,701–$12,722 |
varies |
| Sternoclavicular joints (71130) |
$264.40 |
$661 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$2,257.20 |
$5,643 |
0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$328.40 |
$821 |
2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,204.80 |
$3,012 |
2.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$958.80 |
$2,397 |
2.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$540.40 |
$1,351 |
2.0× |
| Testicular Imaging W/Flow (78761) |
$634 |
$1,585 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,674.80 |
$4,187 |
3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,262 |
$3,155 |
2.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$796 |
$1,990 |
5.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$728.80 |
$1,822 |
3.6× |
| Thoracic spine 2 views (72070) |
$307.60 |
$769 |
2.5× |
| Thoracic spine 3 views (72072) |
$371.20 |
$928 |
3.1× |
| Thoracolumbar 2 views (72080) |
$286.80 |
$717 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$912 |
$2,280 |
2.0× |
| Thyroid Met Imaging Body (78018) |
$2,015.20 |
$5,038 |
3.2× |
| Thyroid Uptake Measurement (78012) |
$510.80 |
$1,277 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$943.20 |
$2,358 |
2.0× |
Tx Devices Design & Construction Complex (77334)
range across 2 matching MRF lines |
$829.60–$978.80 |
$2,074–$2,447 |
varies |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
$466.40–$538 |
$1,166–$1,345 |
varies |
Tx devices design & construction simple (77332)
range across 2 matching MRF lines |
$386.40–$394.40 |
$966–$986 |
varies |
| Ultrasound Breast Limited (76642) |
$514 |
$1,285 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$287.20 |
$718 |
2.4× |
| Ultrasound Elastography Parenchyma (76981) |
$261.60 |
$654 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$514 |
$1,285 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$582.80 |
$1,457 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$220 |
$550 |
1.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$431.20 |
$1,078 |
4.3× |
| Unlisted fluoroscopic procedure (76496) |
$220 |
$550 |
2.2× |
| Unlisted magnetic resonance procedure (76498) |
$5,513.20 |
$13,783 |
54.7× |
| Upper gi w/o kub (74240) |
$570.40 |
$1,426 |
2.8× |
| Ureteral Reflux Study (78740) |
$482 |
$1,205 |
1.0× |
| Urethrocystogram voiding (74455) |
$672.40 |
$1,681 |
2.4× |
| Urethrocystography retrograde (74450) |
$612 |
$1,530 |
2.2× |
| Us breast unilateral complete (76641) |
$438 |
$1,095 |
3.6× |
| Us chest (76604) |
$448 |
$1,120 |
3.7× |
| Us complete joint (76881) |
$616.40 |
$1,541 |
5.1× |
| Us exam, pelvic, limited (76857) |
$440.40 |
$1,101 |
3.6× |
| Us head (76506) |
$450 |
$1,125 |
3.7× |
| Us kidney transplant (76776) |
$490.40 |
$1,226 |
4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$411.60 |
$1,029 |
3.4× |
| Us ob detailed single fetus (76811) |
$565.60 |
$1,414 |
2.0× |
| Us ob limited 1 or more fetuses (76815) |
$388.80 |
$972 |
3.2× |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
$319.20–$498.80 |
$798–$1,247 |
varies |
| Us pelvic non ob complete (76856) |
$701.60 |
$1,754 |
5.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$598 |
$1,495 |
4.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$307.60 |
$769 |
2.5× |
| Us retroperitoneal complete (76770) |
$629.20 |
$1,573 |
5.2× |
| Us retroperitoneal limited (76775) |
$479.60 |
$1,199 |
4.0× |
| Us scrotum and contents (76870) |
$511.20 |
$1,278 |
4.2× |
| Us spinal canal and contents (76800) |
$312.80 |
$782 |
2.6× |
| Us thyroid (76536) |
$574 |
$1,435 |
4.7× |
| Us transrectal (76872) |
$348 |
$870 |
2.9× |
Vein X-Ray Chest (75827)
range across 2 matching MRF lines |
$2,218.40–$3,308 |
$5,546–$8,270 |
varies |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,359.20 |
$5,898 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$3,564.40 |
$8,911 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,719.60 |
$9,299 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$2,182.80 |
$5,457 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,396.80 |
$3,492 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,564.40 |
$8,911 |
1.0× |
| Venography Renal Unilateral (75831) |
$3,564.40 |
$8,911 |
1.0× |
| Venous sampling by catheter (75893) |
$5,926.80 |
$14,817 |
0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,631.20 |
$4,078 |
3.5× |
| Vertebral fracture assessment via dxa (77086) |
$177.60 |
$444 |
1.8× |
| Wrist 2 views (73100) |
$255.20 |
$638 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$344.40 |
$861 |
3.4× |
| X-ray antegrade pyelogram tube (74425) |
$678.80 |
$1,697 |
1.7× |
| X-Ray Aorta Leg Arteries (75630) |
$4,076 |
$10,190 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$339.20 |
$848 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$287.60 |
$719 |
2.9× |
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines |
$465.20–$678.80 |
$1,163–$1,697 |
varies |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$275.60 |
$689 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$410.40 |
$1,026 |
3.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$371.60 |
$929 |
3.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$487.20 |
$1,218 |
4.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$569.60 |
$1,424 |
4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$589.60 |
$1,474 |
4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$640.40 |
$1,601 |
5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$668.40 |
$1,671 |
5.5× |
X-Ray Exam L-S Spine Bending (72114)
range across 2 matching MRF lines |
$291.60–$392 |
$729–$980 |
varies |
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines |
$200.40–$357.20 |
$501–$893 |
varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$497.20 |
$1,243 |
4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$382 |
$955 |
3.2× |
| X-ray eye for foreign body (70030) |
$216.40 |
$541 |
2.1× |
| X-ray humerus (73060) |
$280.80 |
$702 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$756.40 |
$1,891 |
3.7× |
| X-ray IV pyelogram+tomography (74415) |
$529.60 |
$1,324 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$252.40 |
$631 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$357.20 |
$893 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$394.40 |
$986 |
3.3× |
| X-ray nose-rectum child f.b. (76010) |
$250 |
$625 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$441.20 |
$1,103 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$342.80 |
$857 |
2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$278 |
$695 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$342.80 |
$857 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$527.20 |
$1,318 |
5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$492.80 |
$1,232 |
4.1× |
| X-ray thoracic spine 4 vw (72074) |
$378.80 |
$947 |
3.1× |
| X-Ray Tmj Unilat (70328) |
$257.20 |
$643 |
2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,016.40 |
$2,541 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$288 |
$720 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$684.80 |
$1,712 |
5.7× |
| Xr c-spine 4 or 5 views (72050) |
$544 |
$1,360 |
4.5× |
| Xr facial bones less than 3 views (70140) |
$361.60 |
$904 |
3.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$195.20 |
$488 |
1.6× |
| Xr orbits complete 4 views (70200) |
$372.40 |
$931 |
3.1× |
| Xr Tomogram Single Plane (76100) |
$494 |
$1,235 |
4.1× |