| 3-D radiotherapy plan dose-volume histograms (77295) |
$477.47 |
$2,513 |
0.4× |
| Abdomen 2 views (74019) |
$88.54 |
$466 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$373.64 |
$1,966.50 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,160.14 |
$6,106 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,014.79 |
$5,341 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$913.42 |
$4,807.50 |
0.3× |
| Angiography internal mammary rs&i (75756) |
$1,126.51 |
$5,929 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,160.14 |
$6,106 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,014.79 |
$5,341 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,498.15 |
$7,885 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,242.98 |
$6,542 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,242.98 |
$6,542 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$341.05 |
$1,795 |
0.1× |
| Ankle 2 views (73600) |
$56.81 |
$299 |
0.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$230.47 |
$1,213 |
0.7× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,498.15 |
$7,885 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,014.79 |
$5,341 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$1,014.79 |
$5,341 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$850.63 |
$4,477 |
0.3× |
| Arthrogram elbow (73085) |
$185.63 |
$977 |
0.6× |
| Arthrogram hip (73525) |
$196.65 |
$1,035 |
0.6× |
| Arthrogram shoulder (73040) |
$266.76 |
$1,404 |
0.8× |
| Arthrogram wrist (73115) |
$181.64 |
$956 |
0.6× |
| Arthrography knee lt (73580) |
$400.52 |
$2,108 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$53.39 |
$281 |
0.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$392.16 |
$2,064 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$570.76 |
$3,004 |
1.5× |
| Bone age studies (77072) |
$56.24 |
$296 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$610.85 |
$3,215 |
1.6× |
| Bone Marrow Imaging Limited Area (78102) |
$300.39 |
$1,581 |
0.8× |
| Bone survey complete (77075) |
$79.99 |
$421 |
0.8× |
| Brachytx isodose complex (77318) |
$159.32 |
$838.50 |
0.5× |
| Brachytx isodose intermed (77317) |
$159.32 |
$838.50 |
0.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$131.20 |
$690.50 |
0.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,080.69 |
$10,951 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$296.78 |
$1,562 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$813.39 |
$4,281 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$118.56 |
$624 |
1.5× |
| Chest 1 view (71045) |
$85.88 |
$452 |
1.1× |
| Chest 3 views (71047) |
$214.32 |
$1,128 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$205.96 |
$1,084 |
1.3× |
| Clavicle complete (73000) |
$111.91 |
$589 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$42.18 |
$222 |
0.4× |
| Continuing medical physics consltj pr wk (77336) |
$62.89 |
$331 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,832.36 |
$9,644 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,196.24 |
$6,296 |
5.3× |
| CT abdomen w contrast (74160) |
$762.47 |
$4,013 |
4.6× |
| CT abdomen w wo contrast (74170) |
$916.56 |
$4,824 |
5.6× |
| CT abdomen w/o contrast (74150) |
$585.58 |
$3,082 |
6.0× |
| CT angio hrt w/3d image (75574) |
$895.09 |
$4,711 |
2.7× |
| CT angiography upper extremity lt (73206) |
$705.47 |
$3,713 |
4.3× |
| CT c-spine w/o contrast (72125) |
$662.15 |
$3,485 |
6.8× |
| CT cervical spine w&w/o contrast (72127) |
$794.20 |
$4,180 |
4.8× |
| CT cervical spine with contrast (72126) |
$762.47 |
$4,013 |
2.3× |
| CT chest w/wo contrast (71270) |
$916.56 |
$4,824 |
5.6× |
| CT chest with contrast (71260) |
$762.47 |
$4,013 |
4.6× |
| CT head/brain with contrast (70460) |
$724.66 |
$3,814 |
4.4× |
| CT head/brain without and with contrast (70470) |
$839.42 |
$4,418 |
5.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$792.11 |
$4,169 |
2.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$51.11 |
$269 |
0.6× |
| CT iac w contrast (70481) |
$733.21 |
$3,859 |
4.5× |
| CT limited/localized follow up study (76380) |
$283.29 |
$1,491 |
3.5× |
| CT lower ext w/o (73700) |
$610.85 |
$3,215 |
6.2× |
| CT lower extremity w wo contrast (73702) |
$872.48 |
$4,592 |
5.3× |
| CT lower extremity with contrast (73701) |
$762.47 |
$4,013 |
4.6× |
| CT lumbar spine w & w/o contrast (72133) |
$916.56 |
$4,824 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$662.15 |
$3,485 |
6.8× |
| CT lumbar spine with contrast (72132) |
$762.47 |
$4,013 |
2.3× |
| CT maxillofacial w contrast (70487) |
$490.96 |
$2,584 |
3.0× |
| CT maxillofacial w/o contrast (70486) |
$371.45 |
$1,955 |
3.8× |
| CT maxillofacial w/wo contrast (70488) |
$732.64 |
$3,856 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$762.47 |
$4,013 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$881.22 |
$4,638 |
5.4× |
| CT orbits w/o contrast (70480) |
$525.64 |
$2,766.50 |
5.4× |
| CT pelvis w & w/o contrast (72194) |
$732.64 |
$3,856 |
4.5× |
| CT pelvis w/o contrast (72192) |
$610.85 |
$3,215 |
6.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$839.04 |
$4,416 |
5.1× |
| CT soft tissue neck w/o contrast (70490) |
$427.50 |
$2,250 |
4.4× |
| CT thoracic spine w/contrast (72129) |
$762.47 |
$4,013 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$693.31 |
$3,649 |
7.1× |
| CT thoracic spine w/wo contrast (72130) |
$916.56 |
$4,824 |
5.6× |
| CT thorax w/o contrast (71250) |
$362.33 |
$1,907 |
3.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$872.48 |
$4,592 |
5.3× |
| CT upper extremity w/o contrast rt (73200) |
$366.32 |
$1,928 |
3.7× |
| CT upper extremity with contrast (73201) |
$762.47 |
$4,013 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$738.72 |
$3,888 |
4.5× |
| Cta Abdomen (74175) |
$1,018.21 |
$5,359 |
6.2× |
| CTA abdomen pelvis (74174) |
$1,934.58 |
$10,182 |
5.9× |
| CTA chest (71275) |
$916.56 |
$4,824 |
5.6× |
| Cta Head (70496) |
$1,018.21 |
$5,359 |
6.2× |
| CTA lwr ext w&w/o contrast (73706) |
$705.47 |
$3,713 |
4.3× |
| Cta Neck (70498) |
$594.13 |
$3,127 |
3.6× |
| Cta Pelvis (72191) |
$1,018.21 |
$5,359 |
6.2× |
| Cystography minimum 3 views rs&i (74430) |
$216.60 |
$1,140 |
0.7× |
| Diskogram cervical (72285) |
$790.02 |
$4,158 |
0.4× |
| Diskography lumbar (72295) |
$790.02 |
$4,158 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$35.91 |
$189 |
0.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$17.48 |
$92 |
0.2× |
| Dxa bone density study axial skeleton (77085) |
$42.75 |
$225 |
0.4× |
| Echoencephalography real time imaging (76506) |
$185.63 |
$977 |
1.9× |
| Esophagus (74220) |
$263.91 |
$1,389 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$73.15 |
$385 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$70.30 |
$370 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$64.60 |
$340 |
0.3× |
| Foot 2 views (73620) |
$57.38 |
$302 |
0.7× |
| Forearm 2 views (73090) |
$63.94 |
$336.50 |
0.8× |
| Gated Heart Planar Single (78472) |
$530.29 |
$2,791 |
1.4× |
| Hand 2 views (73120) |
$90.92 |
$478.50 |
0.9× |
| Hand 3 views (73130) |
$216.22 |
$1,138 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,895.82 |
$9,978 |
2.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,048.96 |
$10,784 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,784.10 |
$9,390 |
2.7× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$96.71 |
$509 |
0.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$96.71 |
$509 |
0.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,160.33 |
$6,107 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$529.91 |
$2,789 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$416.86 |
$2,194 |
1.1× |
| Ht muscle image spect sing (78451) |
$953.99 |
$5,021 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$74.10 |
$390 |
0.9× |
| Hysterosalpingogram (74740) |
$103.36 |
$544 |
0.5× |
| Image fusion (77399) |
$45.22 |
$238 |
0.4× |
| Interstitial radiation source applic complex (77778) |
$580.26 |
$3,054 |
0.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$199.12 |
$1,048 |
0.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$199.12 |
$1,048 |
0.4× |
| Intracavitary radiation source applic simple (77761) |
$199.12 |
$1,048 |
0.4× |
| Kidney imaging morphology (78700) |
$264.86 |
$1,394 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$361 |
$1,900 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$361 |
$1,900 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$606.67 |
$3,193 |
1.2× |
| Knee 3 views (73562) |
$130.15 |
$685 |
1.6× |
| Liver & spleen imaging static only (78215) |
$301.72 |
$1,588 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$457.14 |
$2,406 |
0.9× |
| Lung perfusion differential (78597) |
$397.48 |
$2,092 |
1.1× |
| Lung Ventilation Imaging (78579) |
$210.71 |
$1,109 |
0.6× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$587.29 |
$3,091 |
0.4× |
| Lymphoscintigraphy (78195) |
$182.97 |
$963 |
0.4× |
| Mammary ductogram or galactogram multiple (77054) |
$123.88 |
$652 |
0.6× |
| Mammary ductogram or galactogram single (77053) |
$105.83 |
$557 |
0.5× |
| Meckels Diverticulum (78290) |
$323 |
$1,700 |
0.9× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$77.33 |
$407 |
0.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$142.12 |
$748 |
0.4× |
| MRA head w & w/o contrast (70546) |
$1,730.52 |
$9,108 |
5.3× |
| MRA head w/o contrast (70544) |
$1,018.21 |
$5,359 |
4.6× |
| MRA head with contrast (70545) |
$1,527.60 |
$8,040 |
4.7× |
| MRA neck w contrast (70548) |
$1,068.56 |
$5,624 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,730.52 |
$9,108 |
5.3× |
| MRA neck w/o contrast (70547) |
$814.15 |
$4,285 |
3.6× |
| MRI abdomen w contrast (74182) |
$1,527.60 |
$8,040 |
4.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,730.52 |
$9,108 |
5.3× |
| MRI abdomen w/o contrast (74181) |
$1,018.21 |
$5,359 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,527.60 |
$8,040 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,527.60 |
$8,040 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$836.76 |
$4,404 |
3.7× |
| MRI breast w/o contrast unilat (77046) |
$654.93 |
$3,447 |
2.9× |
| MRI c-spine with contrast (72142) |
$1,527.60 |
$8,040 |
4.7× |
| MRI cardiac w/o contrast (75557) |
$674.69 |
$3,551 |
3.0× |
| MRI cervical spine w/o contrast (72141) |
$674.50 |
$3,550 |
3.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,730.52 |
$9,108 |
5.3× |
| MRI chest w/o contrast (71550) |
$1,018.21 |
$5,359 |
4.6× |
| MRI chest with contrast (71551) |
$1,527.60 |
$8,040 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,527.60 |
$8,040 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,527.60 |
$8,040 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,018.21 |
$5,359 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$878.56 |
$4,624 |
3.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,273 |
$6,700 |
3.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,527.60 |
$8,040 |
4.7× |
| MRI pelvis w contrast (72196) |
$1,527.60 |
$8,040 |
4.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,730.52 |
$9,108 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$1,018.21 |
$5,359 |
4.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,644.45 |
$8,655 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,730.52 |
$9,108 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,730.52 |
$9,108 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,527.60 |
$8,040 |
4.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,704.87 |
$8,973 |
5.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,527.60 |
$8,040 |
4.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,730.52 |
$9,108 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$666.52 |
$3,508 |
3.0× |
| MRI tmj (70336) |
$752.40 |
$3,960 |
3.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,018.21 |
$5,359 |
4.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,222.08 |
$6,432 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,018.21 |
$5,359 |
4.6× |
| Myelogram Cervical (72240) |
$364.61 |
$1,919 |
0.5× |
| Myelogram Lumbar (72265) |
$364.61 |
$1,919 |
0.5× |
| Myelogram thoracic (72255) |
$364.61 |
$1,919 |
0.5× |
| Myelography 2 or more regions (72270) |
$364.61 |
$1,919 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,844.90 |
$9,710 |
1.5× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$907.44 |
$4,776 |
0.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$907.44 |
$4,776 |
0.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,415.12 |
$7,448 |
0.7× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,729.57 |
$9,103 |
0.8× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$1,729.57 |
$9,103 |
1.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$532.76 |
$2,804 |
0.7× |
| Neck soft tissue (70360) |
$73.53 |
$387 |
0.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$87.02 |
$458 |
0.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$95.19 |
$501 |
0.3× |
| Nm cisternogram (78630) |
$453.34 |
$2,386 |
0.9× |
| Nm gastric emptying study (78264) |
$478.04 |
$2,516 |
1.3× |
| Nm gastroesophageal reflux study (78262) |
$189.81 |
$999 |
0.5× |
| Nm peritoneal-venous shunt patency (78291) |
$151.43 |
$797 |
0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$811.30 |
$4,270 |
0.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,729.57 |
$9,103 |
1.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$437.38 |
$2,302 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$118.56 |
$624 |
0.5× |
| Orthopantogram (70355) |
$97.66 |
$514 |
1.2× |
| Osseous survey infant (77076) |
$70.30 |
$370 |
0.7× |
| Parathyrd planar w/spect&CT (78072) |
$358.72 |
$1,888 |
0.7× |
| Parathyrd planar w/wo subtrj (78071) |
$335.92 |
$1,768 |
0.9× |
| Parathyroid imaging (78070) |
$283.48 |
$1,492 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$64.79 |
$341 |
0.7× |
| Peritoneogram rs&i (74190) |
$203.49 |
$1,071 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$2,347.83 |
$12,357 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,347.83 |
$12,357 |
1.8× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$764.94 |
$4,026 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,730.52 |
$9,108 |
5.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,160.14 |
$6,106 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$347.51 |
$1,829 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$397.48 |
$2,092 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$457.71 |
$2,409 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$101.84 |
$536 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$75.43 |
$397 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$83.60 |
$440 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$94.62 |
$498 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$138.32 |
$728 |
1.4× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,024.80 |
$15,920 |
0.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$97.94 |
$515.50 |
0.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$57.38 |
$302 |
0.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$78.28 |
$412 |
0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$142.12 |
$748 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$109.82 |
$578 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$198.55 |
$1,045 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$143.45 |
$755 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$110.77 |
$583 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$241.87 |
$1,273 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$237.88 |
$1,252 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$80.94 |
$426 |
1.0× |
| Radiological examination surgical specimen (76098) |
$272.94 |
$1,436.50 |
0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$286.71 |
$1,509 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,160.33 |
$6,107 |
0.4× |
| Ribs bilateral 3 views (71110) |
$137.94 |
$726 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$483.74 |
$2,546 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$475.57 |
$2,503 |
0.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$799.90 |
$4,210 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$799.90 |
$4,210 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$907.44 |
$4,776 |
0.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$105.64 |
$556 |
0.5× |
| Rp Therapy Intravenous Administration (79101) |
$118.94 |
$626 |
0.5× |
| Sacroiliac Joints < 3 Views (72200) |
$36.29 |
$191 |
0.4× |
| Scanogram (77073) |
$216.22 |
$1,138 |
2.2× |
| Scapula complete (73010) |
$95.28 |
$501.50 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$19.95 |
$105 |
0.9× |
| Simulation intermediate (77285) |
$142.12 |
$748 |
0.4× |
| Small bowel series (74250) |
$86.83 |
$457 |
0.5× |
| Spec medical radj physics consltj (77370) |
$55.86 |
$294 |
0.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$142.12 |
$748 |
0.4× |
| Special dosimetry (77331) |
$53.39 |
$281 |
0.4× |
| Special treatment procedure (77470) |
$190 |
$1,000 |
0.4× |
| Spine thoracic 3 views (72072) |
$113.05 |
$595 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$881.60 |
$4,640 |
0.5× |
| Superior sagittal sinus venogram (75870) |
$316.73 |
$1,667 |
0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$48.07 |
$253 |
0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$159.32 |
$838.50 |
0.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$87.30 |
$459.50 |
0.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$217.36 |
$1,144 |
0.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$73.91 |
$389 |
0.6× |
| Thoracolumbar 2 views (72080) |
$103.36 |
$544 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$358.72 |
$1,888 |
0.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$293.55 |
$1,545 |
0.8× |
| Thyroid uptake measurement (78012) |
$253.27 |
$1,333 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$364.99 |
$1,921 |
1.0× |
| Tomogram (76100) |
$220.97 |
$1,163 |
2.3× |
| Treatment device intermediate (77333) |
$97.85 |
$515 |
0.8× |
| Treatment devices simple (77332) |
$97.85 |
$515 |
0.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$544.73 |
$2,867 |
1.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$300.39 |
$1,581 |
0.8× |
| Tx devices design & construction complex (77334) |
$97.85 |
$515 |
0.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$90.25 |
$475 |
0.3× |
| Ultrasound, abdomen limited (76705) |
$156.84 |
$825.50 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$69.92 |
$368 |
0.9× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$132.62 |
$698 |
0.4× |
| Unlisted magnetic resonance procedure (76498) |
$239.30 |
$1,259.50 |
2.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$199.12 |
$1,048 |
2.1× |
| Upper Extremity Infant (73092) |
$90.06 |
$474 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$169.10 |
$890 |
0.8× |
| Urethrocystography voiding (74455) |
$175.56 |
$924 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$271.32 |
$1,428 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$45.22 |
$238 |
0.5× |
| Us breast unilateral complete (76641) |
$75.62 |
$398 |
0.8× |
| Us breast unilateral limited (76642) |
$75.62 |
$398 |
0.9× |
| Us chest (76604) |
$75.62 |
$398 |
0.8× |
| Us compl joint r-t w/image documentation (76881) |
$146.11 |
$769 |
1.5× |
| Us elastography parenchyma (76981) |
$74.67 |
$393 |
0.8× |
| Us guided compression repair (76936) |
$103.74 |
$546 |
0.5× |
| Us infant hips dynamic (76885) |
$85.12 |
$448 |
1.0× |
| Us infant hips limited static (76886) |
$112.48 |
$592 |
1.4× |
| Us ob detailed single fetus (76811) |
$119.70 |
$630 |
0.5× |
| Us ob transvaginal (76817) |
$125.21 |
$659 |
1.3× |
| Us pelvic non ob complete (76856) |
$249.85 |
$1,315 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$132.43 |
$697 |
1.4× |
| Us pregnancy ltd (76815) |
$87.30 |
$459.50 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$206.15 |
$1,085 |
2.1× |
| Us retroperitoneal complete (76770) |
$161.22 |
$848.50 |
1.6× |
| Us retroperitoneal limited (76775) |
$66.50 |
$350 |
0.7× |
| Us scrotum and contents (76870) |
$249.85 |
$1,315 |
2.5× |
| Us soft tissue head/neck (76536) |
$210.52 |
$1,108 |
2.1× |
| Us spinal canal and contents (76800) |
$77.14 |
$406 |
0.8× |
| Us transrectal prostate volume (76873) |
$74.86 |
$394 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$92.53 |
$487 |
0.9× |
| Venogram extremity bilateral (75822) |
$433.96 |
$2,284 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,498.15 |
$7,885 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$356.63 |
$1,877 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$400.52 |
$2,108 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,160.14 |
$6,106 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,160.14 |
$6,106 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,126.51 |
$5,929 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,241.46 |
$6,534 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$30.78 |
$162 |
0.4× |
| Wrist 2 views (73100) |
$53.58 |
$282 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$157.89 |
$831 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$143.07 |
$753 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$98.42 |
$518 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$110.77 |
$583 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$49.40 |
$260 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$103.74 |
$546 |
1.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$119.89 |
$631 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$49.97 |
$263 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$97.66 |
$514 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$108.11 |
$569 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$108.11 |
$569 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$125.21 |
$659 |
1.3× |
| X-ray exam of femur 1 (73551) |
$44.84 |
$236 |
0.5× |
| X-ray eye for foreign body (70030) |
$31.54 |
$166 |
0.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$163.40 |
$860 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$73.53 |
$387 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$125.21 |
$659 |
1.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$687.99 |
$3,621 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$95.95 |
$505 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$83.60 |
$440 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$153.90 |
$810 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$191.33 |
$1,007 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$65.74 |
$346 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$126.73 |
$667 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$214.13 |
$1,127 |
2.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$113.24 |
$596 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$98.42 |
$518 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$79.42 |
$418 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$108.87 |
$573 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$73.34 |
$386 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$175.56 |
$924 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$107.16 |
$564 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$190.95 |
$1,005 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$272.65 |
$1,435 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$111.91 |
$589 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$110.96 |
$584 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$100.51 |
$529 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$155.80 |
$820 |
1.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$48.07 |
$253 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$166.25 |
$875 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$82.27 |
$433 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$92.34 |
$486 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$100.51 |
$529 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$107.54 |
$566 |
1.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$132.24 |
$696 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$92.72 |
$488 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$106.02 |
$558 |
1.3× |
| Xr arthrogram ankle (73615) |
$211.66 |
$1,114 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$244.34 |
$1,286 |
2.5× |
| Xr chest 4+ views (71048) |
$224.96 |
$1,184 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$90.06 |
$474 |
1.1× |
| Xr optic foramina (70190) |
$22.42 |
$118 |
0.3× |
| Xr shoulder 1 view (73020) |
$80.37 |
$423 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$185.63 |
$977 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$137.56 |
$724 |
1.7× |
| Xr tmj bilateral (70330) |
$83.22 |
$438 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$116.66 |
$614 |
1.4× |