| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,089.60 |
$5,224 |
1.7× |
| Abdomen 2 views (74019) |
$145.20 |
$363 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$428.40 |
$1,071 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$153.60 |
$384 |
1.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$225.60 |
$564 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$644.80 |
$1,612 |
1.8× |
| Bone age studies (77072) |
$115.60 |
$289 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$928.80 |
$2,322 |
2.6× |
| Bone survey complete (77075) |
$486.40 |
$1,216 |
5.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$374 |
$935 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$164 |
$410 |
2.1× |
| Chest 1 view (71045) |
$113.60 |
$284 |
1.4× |
| Chest 3 views (71047) |
$91.60 |
$229 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$267.80 |
$669.50 |
1.7× |
| Clavicle complete (73000) |
$114.40 |
$286 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$158.40 |
$396 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$176 |
$440 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,602.40 |
$4,006 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,550.20 |
$3,875.50 |
7.2× |
| CT abdomen w contrast (74160) |
$798 |
$1,995 |
5.0× |
| CT abdomen w wo contrast (74170) |
$878 |
$2,195 |
5.5× |
| CT abdomen w/o contrast (74150) |
$706 |
$1,765 |
7.5× |
| CT angio hrt w/3d image (75574) |
$899.20 |
$2,248 |
2.8× |
| CT angiography upper extremity lt (73206) |
$780 |
$1,950 |
4.9× |
| CT c-spine w/o contrast (72125) |
$672.40 |
$1,681 |
7.1× |
| CT cervical spine w&w/o contrast (72127) |
$608 |
$1,520 |
3.8× |
| CT cervical spine with contrast (72126) |
$561.20 |
$1,403 |
1.8× |
| CT chest w/wo contrast (71270) |
$875.60 |
$2,189 |
5.5× |
| CT chest with contrast (71260) |
$1,045.80 |
$2,614.50 |
6.6× |
| CT head/brain with contrast (70460) |
$694.40 |
$1,736 |
4.4× |
| CT head/brain without and with contrast (70470) |
$768 |
$1,920 |
4.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$899.20 |
$2,248 |
11.4× |
| CT hrt w/3d image congen (75573) |
$899.20 |
$2,248 |
2.8× |
| CT iac w contrast (70481) |
$652.40 |
$1,631 |
4.1× |
| CT lower ext w/o (73700) |
$890.80 |
$2,227 |
9.4× |
| CT lower extremity w wo contrast (73702) |
$810.40 |
$2,026 |
5.1× |
| CT lower extremity with contrast (73701) |
$675.60 |
$1,689 |
4.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,057.60 |
$2,644 |
6.7× |
| CT lumbar spine w/o contrast (72131) |
$930.20 |
$2,325.50 |
9.8× |
| CT lumbar spine with contrast (72132) |
$806 |
$2,015 |
2.6× |
| CT maxillofacial w contrast (70487) |
$652.40 |
$1,631 |
4.1× |
| CT maxillofacial w/o contrast (70486) |
$568 |
$1,420 |
6.0× |
| CT maxillofacial w/wo contrast (70488) |
$709.20 |
$1,773 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$986 |
$2,465 |
6.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$709.20 |
$1,773 |
4.5× |
| CT orbits w/o contrast (70480) |
$568 |
$1,420 |
6.0× |
| CT pelvis w & w/o contrast (72194) |
$777.60 |
$1,944 |
4.9× |
| CT pelvis w/o contrast (72192) |
$648.40 |
$1,621 |
6.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$719.60 |
$1,799 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$540.40 |
$1,351 |
5.7× |
| CT thoracic spine w/contrast (72129) |
$768.80 |
$1,922 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$689.20 |
$1,723 |
7.3× |
| CT thoracic spine w/wo contrast (72130) |
$777.60 |
$1,944 |
4.9× |
| CT thorax w/o contrast (71250) |
$956.40 |
$2,391 |
10.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$748.40 |
$1,871 |
4.7× |
| CT upper extremity w/o contrast rt (73200) |
$599.60 |
$1,499 |
6.3× |
| CT upper extremity with contrast (73201) |
$675.60 |
$1,689 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,019.40 |
$2,548.50 |
6.4× |
| Cta Abdomen (74175) |
$780 |
$1,950 |
4.9× |
| CTA abdomen pelvis (74174) |
$379.60 |
$949 |
1.2× |
| CTA chest (71275) |
$947.60 |
$2,369 |
6.0× |
| Cta Head (70496) |
$781.60 |
$1,954 |
4.9× |
| CTA lwr ext w&w/o contrast (73706) |
$780 |
$1,950 |
4.9× |
| Cta Neck (70498) |
$781.60 |
$1,954 |
4.9× |
| Cta Pelvis (72191) |
$780 |
$1,950 |
4.9× |
| Cystography minimum 3 views rs&i (74430) |
$224.40 |
$561 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$201.20 |
$503 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$72.80 |
$182 |
0.9× |
| Echoencephalography real time imaging (76506) |
$179.60 |
$449 |
1.9× |
| Esophagus (74220) |
$267.80 |
$669.50 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$82 |
$205 |
0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$125.20 |
$313 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$199 |
$497.50 |
0.9× |
| Forearm 2 views (73090) |
$122.80 |
$307 |
1.6× |
| Gated Heart Planar Single (78472) |
$652.40 |
$1,631 |
1.8× |
| Hand 3 views (73130) |
$122.80 |
$307 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$541.60 |
$1,354 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$514.80 |
$1,287 |
1.4× |
| Ht muscle image spect sing (78451) |
$926.40 |
$2,316 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$118.60 |
$296.50 |
1.5× |
| Hysterosalpingogram (74740) |
$299.60 |
$749 |
1.4× |
| Kidney imaging morphology (78700) |
$295.20 |
$738 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$620 |
$1,550 |
1.3× |
| Knee 3 views (73562) |
$134 |
$335 |
1.7× |
| Liver & spleen imaging static only (78215) |
$566.80 |
$1,417 |
1.6× |
| Lymphoscintigraphy (78195) |
$541.60 |
$1,354 |
1.1× |
| Meckels Diverticulum (78290) |
$258.80 |
$647 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$502 |
$1,255 |
1.5× |
| MRA head w/o contrast (70544) |
$1,268 |
$3,170 |
5.9× |
| MRA neck w contrast (70548) |
$1,168 |
$2,920 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,248.80 |
$3,122 |
4.0× |
| MRA neck w/o contrast (70547) |
$1,268 |
$3,170 |
5.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,885.20 |
$4,713 |
6.0× |
| MRI abdomen w/o contrast (74181) |
$1,451.60 |
$3,629 |
6.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,606.40 |
$4,016 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,683.20 |
$4,208 |
2.4× |
| MRI c-spine with contrast (72142) |
$1,818 |
$4,545 |
5.8× |
| MRI cervical spine w/o contrast (72141) |
$1,713.60 |
$4,284 |
7.9× |
| MRI chest w/o contrast (71550) |
$1,324.40 |
$3,311 |
6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,683.20 |
$4,208 |
5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,566.80 |
$3,917 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,407 |
$3,517.50 |
6.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,706.80 |
$4,267 |
5.4× |
| MRI pelvis w contrast (72196) |
$1,864.80 |
$4,662 |
5.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,864.80 |
$4,662 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,552.40 |
$3,881 |
7.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,814 |
$4,535 |
5.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,735.60 |
$4,339 |
5.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,351.60 |
$5,879 |
7.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,711.20 |
$4,278 |
5.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,167.20 |
$5,418 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,278.40 |
$5,696 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,347.20 |
$3,368 |
6.2× |
| MRI tmj (70336) |
$1,356 |
$3,390 |
6.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,606.60 |
$4,016.50 |
7.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,718.80 |
$4,297 |
5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,502.80 |
$3,757 |
7.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,591.60 |
$3,979 |
1.4× |
| Neck soft tissue (70360) |
$101.60 |
$254 |
1.3× |
| Nm gastric emptying study (78264) |
$428.40 |
$1,071 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,190.40 |
$5,476 |
1.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$86.20 |
$215.50 |
0.9× |
| Parathyroid imaging (78070) |
$490 |
$1,225 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$115.60 |
$289 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,814 |
$4,535 |
5.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$319.20 |
$798 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$555.60 |
$1,389 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$139.20 |
$348 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$124.40 |
$311 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$130 |
$325 |
1.4× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,056 |
$7,640 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$194.40 |
$486 |
0.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$104 |
$260 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$136.80 |
$342 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$113.60 |
$284 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$215.60 |
$539 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$339.60 |
$849 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$272.20 |
$680.50 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$126.80 |
$317 |
1.6× |
| Radiological examination surgical specimen (76098) |
$222.80 |
$557 |
0.5× |
| Ribs bilateral 3 views (71110) |
$94.20 |
$235.50 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,440.80 |
$3,602 |
2.9× |
| Scapula complete (73010) |
$115.60 |
$289 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$33.60 |
$84 |
1.4× |
| Small bowel series (74250) |
$215.60 |
$539 |
1.4× |
| Spec medical radj physics consltj (77370) |
$210 |
$525 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$347.60 |
$869 |
1.0× |
| Special dosimetry (77331) |
$209.60 |
$524 |
1.7× |
| Special treatment procedure (77470) |
$930 |
$2,325 |
1.9× |
| Spine thoracic 3 views (72072) |
$144.80 |
$362 |
1.5× |
| Stereotactic body radiation delivery (77373) |
$1,642 |
$4,105 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$300.80 |
$752 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$566 |
$1,415 |
1.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$361.20 |
$903 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$502 |
$1,255 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$478.40 |
$1,196 |
1.3× |
| Treatment device intermediate (77333) |
$136.40 |
$341 |
1.1× |
| Treatment devices simple (77332) |
$131.20 |
$328 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,023.20 |
$2,558 |
2.1× |
| Tx devices design & construction complex (77334) |
$226.60 |
$566.50 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$189.60 |
$474 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$121.40 |
$303.50 |
1.3× |
| Upper Extremity Infant (73092) |
$96.80 |
$242 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$212 |
$530 |
1.0× |
| Urethrocystography voiding (74455) |
$276.80 |
$692 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$241.40 |
$603.50 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$143.20 |
$358 |
1.5× |
| Us breast unilateral complete (76641) |
$120.40 |
$301 |
1.3× |
| Us chest (76604) |
$198.80 |
$497 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$159.60 |
$399 |
1.7× |
| Us infant hips limited static (76886) |
$100 |
$250 |
1.3× |
| Us ob detailed single fetus (76811) |
$259.60 |
$649 |
1.2× |
| Us ob transvaginal (76817) |
$86.20 |
$215.50 |
0.9× |
| Us pelvic non ob complete (76856) |
$296.20 |
$740.50 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$78.20 |
$195.50 |
0.8× |
| Us pregnancy ltd (76815) |
$86.20 |
$215.50 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$276.40 |
$691 |
2.9× |
| Us retroperitoneal complete (76770) |
$226 |
$565 |
2.4× |
| Us scrotum and contents (76870) |
$256 |
$640 |
2.7× |
| Us soft tissue head/neck (76536) |
$259.60 |
$649 |
2.7× |
| Us transrectal (76872) |
$106.40 |
$266 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$96.40 |
$241 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$222.80 |
$557 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$132 |
$330 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$111.60 |
$279 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$252.80 |
$632 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$122.80 |
$307 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$131.60 |
$329 |
1.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$164.40 |
$411 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$68.40 |
$171 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$134 |
$335 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$147.20 |
$368 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$139.60 |
$349 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$95.60 |
$239 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$132.80 |
$332 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$164.40 |
$411 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204.40 |
$511 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$105.60 |
$264 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$175.60 |
$439 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$118.80 |
$297 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$189.60 |
$474 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$190 |
$475 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$104.40 |
$261 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$204.80 |
$512 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$226.40 |
$566 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$126.40 |
$316 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$134 |
$335 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$155.20 |
$388 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$130.40 |
$326 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$156 |
$390 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$108.40 |
$271 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$133.20 |
$333 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$121.60 |
$304 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$138 |
$345 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$93.60 |
$234 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$110.80 |
$277 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$225.60 |
$564 |
2.4× |
| Xr chest 4+ views (71048) |
$132.80 |
$332 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$100.80 |
$252 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$195.60 |
$489 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$113.60 |
$284 |
1.4× |
| Xr tmj bilateral (70330) |
$132.80 |
$332 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$119.20 |
$298 |
1.5× |