| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$20,418.97 |
$20,418.97 |
14.1× |
| Acute gi blood loss imaging (78278) |
$3,499.99 |
$3,499.99 |
8.4× |
| Angio extremity unilateral (75710) |
$4,601.98 |
$4,601.98 |
1.4× |
| Angio pulmonary unilateral (75741) |
$26,412.88 |
$26,412.88 |
8.0× |
| Angiogram extremity bilateral (75716) |
$15,855.14 |
$15,855.14 |
4.8× |
| Angiogram pelvic (75736) |
$29,340.62 |
$29,340.62 |
5.0× |
| Angiography internal mammary rs&i (75756) |
$7,806.58 |
$7,806.58 |
2.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,130.31 |
$8,130.31 |
2.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,014.62 |
$6,014.62 |
1.0× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,463.87 |
$1,463.87 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$9,275.90 |
$9,275.90 |
2.8× |
| Ankle 2 views (73600) |
$1,377.76 |
$1,377.76 |
15.2× |
| Arthrography knee lt (73580) |
$2,045.93 |
$2,045.93 |
5.6× |
| Barium enema (74270) |
$2,748.98 |
$2,748.98 |
15.0× |
| Basic dosimetry (77300) |
$2,845.99 |
$2,845.99 |
20.3× |
| Bilat selctv renal venogram (75833) |
$10,652.57 |
$10,652.57 |
3.2× |
| Bone age studies (77072) |
$632.20 |
$632.20 |
5.8× |
| Bone imaging limited area (78300) |
$5,689.80 |
$5,689.80 |
13.6× |
| Bone survey complete (77075) |
$1,957.64 |
$1,957.64 |
17.9× |
| Bowel imaging (78290) |
$2,522.26 |
$2,522.26 |
6.0× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$10,459.64 |
$10,459.64 |
26.8× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$1,529.27 |
$1,529.27 |
2.7× |
| Brain image w/flow 4 + views (78606) |
$2,502.64 |
$2,502.64 |
4.4× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$1,401.74 |
$1,401.74 |
3.4× |
| Card MRI w/stress img & dye (75563) |
$5,439.10 |
$5,439.10 |
6.6× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$9,199.60 |
$9,199.60 |
22.0× |
| Cardiac MRI w/stress img (75559) |
$4,120.20 |
$4,120.20 |
7.2× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$5,391.14 |
$5,391.14 |
14.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,218.62 |
$1,218.62 |
6.7× |
| Cisternogram (78630) |
$1,711.30 |
$1,711.30 |
3.0× |
| Clavicle complete (73000) |
$967.92 |
$967.92 |
10.7× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$8,873.37 |
$8,873.37 |
48.4× |
| Continuing medical physics consltj pr wk (77336) |
$2,575.67 |
$2,575.67 |
18.4× |
| Contrast exam abdominl aorta (75625) |
$7,907.95 |
$7,907.95 |
2.4× |
| Contrast exam thoracic aorta (75605) |
$29,340.62 |
$29,340.62 |
5.0× |
| Csf shunt evaluation (78645) |
$2,623.63 |
$2,623.63 |
4.6× |
| CT - st neck w&wo contr (70492) |
$9,896.91 |
$9,896.91 |
54.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$18,223.07 |
$18,223.07 |
50.0× |
| CT abdomen and pelvis without contrast (74176) |
$16,191.81 |
$16,191.81 |
65.0× |
| CT abdomen w wo contrast (74170) |
$11,461.62 |
$11,461.62 |
62.6× |
| CT abdomen w/contrast (74160) |
$8,534.33 |
$8,534.33 |
46.6× |
| CT abdomen w/o contrast (74150) |
$6,851.03 |
$6,851.03 |
62.8× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$5,820.45 |
$5,820.45 |
16.0× |
| CT angio abdom w/o & w/dye (74175) |
$7,861.85 |
$7,861.85 |
42.9× |
| CT angio abdominal arteries (75635) |
$7,807.14 |
$7,807.14 |
42.6× |
| CT angio hrt w/3d image (75574) |
$4,620.51 |
$4,620.51 |
12.7× |
| CT angiograph pelv w/o&w/dye (72191) |
$10,721.24 |
$10,721.24 |
58.5× |
| CT cervical spine w/contrast (72126) |
$7,667.06 |
$7,667.06 |
21.0× |
| CT cervical spine w/o contrast (72125) |
$8,908.59 |
$8,908.59 |
81.6× |
| CT chest w/contrast (71260) |
$9,061.58 |
$9,061.58 |
49.5× |
| CT extremity upper w & w/o contrast (73202) |
$10,740.86 |
$10,740.86 |
58.6× |
| CT head/brain with contrast (70460) |
$9,374 |
$9,374 |
51.2× |
| CT head/brain without and with contrast (70470) |
$11,690.56 |
$11,690.56 |
63.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,238.39 |
$3,238.39 |
8.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$2,203.98 |
$2,203.98 |
24.3× |
| CT hrt w/3d image congen (75573) |
$3,833.53 |
$3,833.53 |
10.5× |
| CT limited/localized follow up study (76380) |
$1,883.52 |
$1,883.52 |
20.7× |
| CT lower ext w/wo contrast (73702) |
$10,824.79 |
$10,824.79 |
59.1× |
| CT lower extremity w contrast (73701) |
$4,718.61 |
$4,718.61 |
25.8× |
| CT lower extremity w/o contrast unilateral (73700) |
$6,382.67 |
$6,382.67 |
58.5× |
| CT lumbar spine w/contrast (72132) |
$6,777.88 |
$6,777.88 |
18.6× |
| CT lumbar spine w/o contrast (72131) |
$8,125.30 |
$8,125.30 |
74.4× |
| CT lumbar spine w/o then w/ con (72133) |
$11,222.64 |
$11,222.64 |
61.3× |
| CT maxillofacial area w/o contrast (70486) |
$8,200.16 |
$8,200.16 |
75.1× |
| CT maxillofacial w/contrast (70487) |
$8,274.33 |
$8,274.33 |
45.2× |
| CT maxillofacial w/o then w/ con (70488) |
$13,672.96 |
$13,672.96 |
74.6× |
| CT orbit sella ear w/o con (70480) |
$8,605.15 |
$8,605.15 |
78.8× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$14,227.40 |
$14,227.40 |
77.7× |
| CT pelvis w & w/o contrast (72194) |
$17,023.62 |
$17,023.62 |
92.9× |
| CT pelvis w/o contrast (72192) |
$7,633.43 |
$7,633.43 |
69.9× |
| CT soft tissue neck w/contrast (70491) |
$9,277.18 |
$9,277.18 |
50.6× |
| CT soft tissue neck w/o contrast (70490) |
$8,103.70 |
$8,103.70 |
74.2× |
| CT spine cervical w/wo contrast (72127) |
$14,706.28 |
$14,706.28 |
80.3× |
| CT thoracic spine w/contrast (72129) |
$10,751.76 |
$10,751.76 |
58.7× |
| CT thoracic spine w/o contrast (72128) |
$7,432.08 |
$7,432.08 |
68.1× |
| CT thoracic spine w/o then w/ con (72130) |
$13,154.12 |
$13,154.12 |
71.8× |
| CT thorax lung cancer scr c- (71271) |
$1,591.40 |
$1,591.40 |
14.6× |
| CT thorax w/o contrast (71250) |
$6,306.61 |
$6,306.61 |
57.8× |
| CT thorax w/o then w/ contrast (71270) |
$7,768.43 |
$7,768.43 |
42.4× |
| CT upper extremity w/dye (73201) |
$5,439.25 |
$5,439.25 |
14.9× |
| CT upper extremity w/o contrast rt (73200) |
$8,363.57 |
$8,363.57 |
76.6× |
| CTA chest w/wo contrast (71275) |
$8,828 |
$8,828 |
48.2× |
| CTA head w contrast (70496) |
$6,118.78 |
$6,118.78 |
33.4× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$6,991.26 |
$6,991.26 |
38.2× |
| Cta Neck (70498) |
$6,782.25 |
$6,782.25 |
37.0× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$7,783.53 |
$7,783.53 |
42.5× |
| Dilation ureters/urethra rs&i (74485) |
$3,184.98 |
$3,184.98 |
1.5× |
| Doppler fetal mid cerebral artery (76821) |
$348.71 |
$348.71 |
3.2× |
| Esophogram (74220) |
$2,196.35 |
$2,196.35 |
12.0× |
| Fetal biophysical profile non-stress testing (76818) |
$2,196.35 |
$2,196.35 |
20.1× |
| Fetal biophysical profile w/o nst (76819) |
$1,335.25 |
$1,335.25 |
12.2× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$2,178.91 |
$2,178.91 |
8.7× |
| Gastric emptying study (78264) |
$8,139.03 |
$8,139.03 |
19.5× |
| Gastroesophageal reflux study (78262) |
$3,462.93 |
$3,462.93 |
8.3× |
| Gated heart planar single (78472) |
$5,615.68 |
$5,615.68 |
13.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$19,235.23 |
$19,235.23 |
26.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$17,810.60 |
$17,810.60 |
24.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$18,878.80 |
$18,878.80 |
26.0× |
| Heart infarct image (78466) |
$3,166.45 |
$3,166.45 |
7.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,897.05 |
$7,897.05 |
2.4× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$19,351.86 |
$19,351.86 |
5.9× |
| Hepatobil syst image w/drug (78227) |
$5,737.76 |
$5,737.76 |
10.1× |
| Hepatobiliary system imaging (78226) |
$5,791.17 |
$5,791.17 |
13.9× |
| Humerus min 2 views (73060) |
$2,164.74 |
$2,164.74 |
23.8× |
| Hysterosalpingography (74740) |
$3,828.08 |
$3,828.08 |
15.4× |
| Imrt planning (77301) |
$38,615.43 |
$38,615.43 |
26.7× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$9,329.31 |
$9,329.31 |
12.8× |
| Intracavitary radiation source applic intermed (77762) |
$1,850.82 |
$1,850.82 |
3.2× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$8,970.70 |
$8,970.70 |
22.9× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$6,900.79 |
$6,900.79 |
17.6× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$7,965.72 |
$7,965.72 |
20.4× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$10,178.42 |
$10,178.42 |
26.0× |
| Ivp (74400) |
$3,098.87 |
$3,098.87 |
16.9× |
| Ivp w tomography (74415) |
$2,153.84 |
$2,153.84 |
11.8× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$4,425.40 |
$4,425.40 |
7.8× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$3,649.32 |
$3,649.32 |
6.4× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$6,178.12 |
$6,178.12 |
10.9× |
| Kidney w vascular flow (78701) |
$4,333.84 |
$4,333.84 |
10.4× |
| Liver & spleen; static only (78215) |
$3,938.17 |
$3,938.17 |
9.4× |
| Liver & spleen; w vasc flow (78216) |
$4,802.54 |
$4,802.54 |
11.5× |
| Liver imaging w/vascular flow (78202) |
$3,823.72 |
$3,823.72 |
6.7× |
| Lung perf&ventilat diferentl (78598) |
$3,932.72 |
$3,932.72 |
6.9× |
| Lung perfusion differential (78597) |
$3,897.84 |
$3,897.84 |
9.3× |
| Lung ventilat&perfus imaging (78582) |
$8,464.94 |
$8,464.94 |
14.9× |
| Lung ventilation imaging (78579) |
$3,844.43 |
$3,844.43 |
9.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$14,662.68 |
$14,662.68 |
40.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$10,808.44 |
$10,808.44 |
29.7× |
| Mammary ductogram multiple ducts (77054) |
$1,883.52 |
$1,883.52 |
7.6× |
| Mammary ductogram single (77053) |
$1,745.09 |
$1,745.09 |
7.0× |
| Mlc device(s) for imrt (77338) |
$10,401.87 |
$10,401.87 |
26.6× |
| MRA head w & w/o contrast (70546) |
$8,747.25 |
$8,747.25 |
24.0× |
| MRA head w/contrast (70545) |
$8,608.82 |
$8,608.82 |
23.6× |
| MRA head w/o contrast (70544) |
$9,385.99 |
$9,385.99 |
37.7× |
| MRA neck w/contrast (70548) |
$7,899.23 |
$7,899.23 |
21.7× |
| MRA neck w/o contrast (70547) |
$5,285.41 |
$5,285.41 |
21.2× |
| MRA neck w/wo contrast (70549) |
$4,192.14 |
$4,192.14 |
11.5× |
| MRI abdomen w/contrast (74182) |
$9,728.25 |
$9,728.25 |
26.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$13,206.44 |
$13,206.44 |
36.2× |
| MRI abdomen w/o contrast (74181) |
$9,924.45 |
$9,924.45 |
39.8× |
| MRI any jnt lwr ext with con lt (73722) |
$8,903.12 |
$8,903.12 |
10.9× |
| MRI breast without contrast bilateral (77047) |
$8,564.13 |
$8,564.13 |
34.4× |
| MRI breast without contrast material unilateral (77046) |
$5,851.12 |
$5,851.12 |
23.5× |
| MRI cardiac w/o contrast (75557) |
$4,195.41 |
$4,195.41 |
16.8× |
| MRI cervical spine w/o contrast (72141) |
$11,612.86 |
$11,612.86 |
46.6× |
| MRI cervical spine with contrast (72142) |
$12,398.75 |
$12,398.75 |
34.0× |
| MRI chest w & w/o contrast (71552) |
$6,168.31 |
$6,168.31 |
16.9× |
| MRI chest w/o contrast (71550) |
$7,283.38 |
$7,283.38 |
29.2× |
| MRI joint upper ext w/contrast (73222) |
$10,733.23 |
$10,733.23 |
13.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$12,186.20 |
$12,186.20 |
33.4× |
| MRI joint upr extrem w/o dye (73221) |
$11,096.20 |
$11,096.20 |
44.5× |
| Mri Lower Extremity W/O Dye (73718) |
$9,658.49 |
$9,658.49 |
38.8× |
| MRI lumbar spine with contrast (72149) |
$9,624.70 |
$9,624.70 |
26.4× |
| MRI lumbar w/wo contrast (72158) |
$12,968.82 |
$12,968.82 |
35.6× |
| MRI lwr ext w/o jnts with con rt (73719) |
$6,535.64 |
$6,535.64 |
17.9× |
| MRI orbit/face/neck w/contrast (70542) |
$6,387.40 |
$6,387.40 |
17.5× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$7,832.74 |
$7,832.74 |
21.5× |
| MRI orbit/face/neck w/o contrast (70540) |
$8,403.90 |
$8,403.90 |
33.7× |
| MRI pelvis w/ contrast (72196) |
$11,996.54 |
$11,996.54 |
32.9× |
| MRI pelvis w/o contrast (72195) |
$8,584.84 |
$8,584.84 |
34.5× |
| MRI pelvis w/wo contrast (72197) |
$10,398.60 |
$10,398.60 |
28.5× |
| MRI spectroscopy (76390) |
$4,580.18 |
$4,580.18 |
50.4× |
| MRI spine cervical wo/w contrast (72156) |
$15,256.73 |
$15,256.73 |
41.9× |
| MRI spine thoracic w/contrast (72147) |
$10,232.92 |
$10,232.92 |
28.1× |
| MRI thoracic spine w wo contrast (72157) |
$14,560.22 |
$14,560.22 |
40.0× |
| MRI thoracic spine w/o contrast (72146) |
$8,977.24 |
$8,977.24 |
36.0× |
| MRI tmj (70336) |
$4,399.24 |
$4,399.24 |
17.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$7,673.60 |
$7,673.60 |
30.8× |
| Mri Upper Extremity W/Dye (73219) |
$11,463.53 |
$11,463.53 |
31.5× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$10,189.32 |
$10,189.32 |
28.0× |
| Myelogram thoracic (72255) |
$3,788.84 |
$3,788.84 |
4.6× |
| Myelography 2 or more regions (72270) |
$4,714.25 |
$4,714.25 |
5.8× |
| Myelography lumbosacral (72265) |
$2,246.49 |
$2,246.49 |
2.7× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$9,856.87 |
$9,856.87 |
7.3× |
| Myocardial perfusion planar multiple studies (78454) |
$20,000.41 |
$20,000.41 |
14.8× |
| Myocardial spect single study at rest or stress (78451) |
$8,559.77 |
$8,559.77 |
6.3× |
| Nm bone 3 phase (78315) |
$7,159.12 |
$7,159.12 |
17.1× |
| Nm bone imaging whole body (78306) |
$6,811.41 |
$6,811.41 |
16.3× |
| Nm bone marrow scan limited (78102) |
$5,908.89 |
$5,908.89 |
14.2× |
| Nm bone marrow scan multiple (78103) |
$11,717.50 |
$11,717.50 |
28.1× |
| Nm heart perfusion spect stress rest (78452) |
$19,073.91 |
$19,073.91 |
14.1× |
| Nm kidney function (78725) |
$5,344.27 |
$5,344.27 |
12.8× |
| Nm liver image static only (78201) |
$3,182.80 |
$3,182.80 |
5.6× |
| Nm lymph system (78195) |
$3,466.20 |
$3,466.20 |
6.1× |
| Nm myocard infarct spect (78469) |
$3,254.74 |
$3,254.74 |
5.7× |
| Nm thyroid imaging only (78013) |
$3,142.47 |
$3,142.47 |
7.5× |
| Nose to rectum for fb child (76010) |
$1,069.29 |
$1,069.29 |
11.8× |
| Nuclear rx IV admin (79101) |
$2,513.54 |
$2,513.54 |
10.3× |
| Ob us < 14 wks single fetus (76801) |
$1,461.69 |
$1,461.69 |
13.4× |
| Oral radiopharm rx (79005) |
$3,736.52 |
$3,736.52 |
15.3× |
| Parathyroid imaging (78070) |
$4,869.03 |
$4,869.03 |
11.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$6,075.66 |
$6,075.66 |
14.6× |
| Peritoneal-venous shunt patency test (78291) |
$2,623.63 |
$2,623.63 |
6.3× |
| Peritoneogram rs&i (74190) |
$816.41 |
$816.41 |
1.4× |
| Pulmonary perfusion imaging particulate (78580) |
$3,407.34 |
$3,407.34 |
8.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,964.80 |
$2,964.80 |
5.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,859.54 |
$1,859.54 |
20.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$2,718.46 |
$2,718.46 |
24.9× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$9,492.81 |
$9,492.81 |
87.0× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$13,434.25 |
$13,434.25 |
123.1× |
| Radex hip unilateral with pelvis 1 view (73501) |
$1,536.90 |
$1,536.90 |
16.9× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$2,339.14 |
$2,339.14 |
25.7× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$3,666.76 |
$3,666.76 |
33.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,443.16 |
$1,443.16 |
13.2× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$3,098.87 |
$3,098.87 |
28.4× |
| Radex spine cervical 2 or 3 views (72040) |
$1,883.52 |
$1,883.52 |
20.7× |
| Radex spine cervical 4 or 5 views (72050) |
$4,631.41 |
$4,631.41 |
42.4× |
| Radex spine cervical 6 or more views (72052) |
$2,529.89 |
$2,529.89 |
23.2× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$1,847.55 |
$1,847.55 |
20.3× |
| Radiation delivery stereotactic cranial linear (77372) |
$75,229.62 |
$75,229.62 |
9.8× |
| Radiation tx delivery lvl 1 (77402) |
$1,620.83 |
$1,620.83 |
15.2× |
| Radiation tx delivery lvl 2 (77407) |
$2,227.96 |
$2,227.96 |
5.5× |
| Radiation tx delivery lvl 3 (77412) |
$4,104.94 |
$4,104.94 |
7.1× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$573.34 |
$573.34 |
5.3× |
| Radiologic exam esophagus double contrast study (74221) |
$2,196.35 |
$2,196.35 |
12.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$3,832.44 |
$3,832.44 |
20.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$593.18 |
$593.18 |
3.2× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$688.88 |
$688.88 |
7.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,725.47 |
$1,725.47 |
19.0× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$5,054.33 |
$5,054.33 |
46.3× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$2,588.75 |
$2,588.75 |
23.7× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$2,375.11 |
$2,375.11 |
21.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,621.92 |
$1,621.92 |
4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,752.72 |
$1,752.72 |
4.4× |
| Renal cyst study (74470) |
$644.28 |
$644.28 |
1.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,980.06 |
$2,980.06 |
7.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,735.43 |
$3,735.43 |
8.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$4,790.55 |
$4,790.55 |
8.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$7,192.91 |
$7,192.91 |
12.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,942.68 |
$5,942.68 |
10.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,942.68 |
$5,942.68 |
4.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$2,060.10 |
$2,060.10 |
8.5× |
| Saline infused sonohysterogram (76831) |
$2,245.40 |
$2,245.40 |
9.0× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$172.22 |
$172.22 |
7.4× |
| Selective spinal angiogram (75705) |
$29,340.62 |
$29,340.62 |
5.0× |
| Shoulder arthrogram (73040) |
$3,747.42 |
$3,747.42 |
10.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,011.56 |
$1,011.56 |
9.3× |
| Simulation complex (77290) |
$5,200.39 |
$5,200.39 |
13.3× |
| Simulation intermediate (77285) |
$3,398.62 |
$3,398.62 |
8.7× |
| Simulation simple (77280) |
$3,315.78 |
$3,315.78 |
23.6× |
| Small bowel series (74250) |
$1,842.10 |
$1,842.10 |
10.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$4,205.22 |
$4,205.22 |
10.8× |
| Special dosimetry (77331) |
$2,206.16 |
$2,206.16 |
15.7× |
| Special physics consult (77370) |
$3,575.20 |
$3,575.20 |
25.5× |
| Special treatment procedure (77470) |
$7,379.30 |
$7,379.30 |
12.8× |
| Stereotactic body radiation delivery (77373) |
$16,832.87 |
$16,832.87 |
9.0× |
| Superior sagittal sinus venogram (75870) |
$9,169.07 |
$9,169.07 |
2.8× |
| Testicular imaging w/flow (78761) |
$3,037.83 |
$3,037.83 |
7.3× |
| Thyroid met imaging body (78018) |
$2,654.15 |
$2,654.15 |
4.7× |
| Thyroid uptake single/multiple quant measurement (78012) |
$1,870.44 |
$1,870.44 |
4.5× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$6,147.60 |
$6,147.60 |
14.7× |
| Treatment device intermediate (77333) |
$2,089.53 |
$2,089.53 |
14.9× |
| Treatment devices complex (77334) |
$2,931.01 |
$2,931.01 |
7.5× |
| Treatment devices simple (77332) |
$1,252.41 |
$1,252.41 |
8.9× |
| Ultrasound breast limited (76642) |
$1,492.21 |
$1,492.21 |
16.4× |
| Ultrasound, abdomen limited (76705) |
$3,093.42 |
$3,093.42 |
28.3× |
| Ultrasound, elastography; first target lesion (76982) |
$535.19 |
$535.19 |
4.9× |
| Umbilical-artery Doppler (OB) (76820) |
$1,193.55 |
$1,193.55 |
10.9× |
| Unlisted procedure, clinical brachytherapy (77799) |
$4,143.09 |
$4,143.09 |
38.9× |
| Urea breath test, C-14 (isotopic); acquisition for analysis Other Outpatient (78267) |
$661.63 |
$661.63 |
59.8× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$661.63 |
$661.63 |
7.0× |
| Urethrocystography retrograde rs&i (74450) |
$2,450.32 |
$2,450.32 |
9.8× |
| Urethrocystography voiding (74455) |
$3,670.03 |
$3,670.03 |
14.7× |
| Urography antegrade (74425) |
$2,051.38 |
$2,051.38 |
5.6× |
| Urography retrograde w/wo kub (74420) |
$2,744.62 |
$2,744.62 |
7.5× |
| Us abdominal aorta real time screen study aaa (76706) |
$1,159.76 |
$1,159.76 |
10.6× |
| Us breast uni real time with image complete (76641) |
$1,800.68 |
$1,800.68 |
16.5× |
| Us chest (76604) |
$1,727.65 |
$1,727.65 |
15.8× |
| Us elastography parenchyma (76981) |
$772.33 |
$772.33 |
7.1× |
| Us encephalogram (76506) |
$1,444.25 |
$1,444.25 |
13.2× |
| Us guided compression repair (76936) |
$1,183.20 |
$1,183.20 |
5.2× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$2,202.89 |
$2,202.89 |
24.2× |
| Us kidney transplanted (76776) |
$1,742.91 |
$1,742.91 |
16.0× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$2,550.60 |
$2,550.60 |
23.4× |
| Us ob detailed single fetus (76811) |
$1,982.71 |
$1,982.71 |
8.0× |
| Us ob followup per fetus (76816) |
$1,329.80 |
$1,329.80 |
12.2× |
| Us ob limited 1 or more fetuses (76815) |
$954.84 |
$954.84 |
8.7× |
| Us obstetric transvaginal (76817) |
$2,120.05 |
$2,120.05 |
19.4× |
| Us pelvic limited or f/u non-ob (76857) |
$779.35 |
$779.35 |
7.1× |
| Us pelvis complete (76856) |
$3,937.08 |
$3,937.08 |
36.1× |
| Us retroperitoneal complete (76770) |
$13,151.94 |
$13,151.94 |
120.5× |
| Us retroperitoneal limited (76775) |
$2,782.77 |
$2,782.77 |
25.5× |
| Us scrotum (76870) |
$3,001.86 |
$3,001.86 |
27.5× |
| Us soft tissue head/neck (76536) |
$3,176.26 |
$3,176.26 |
29.1× |
| Us spinal canal (76800) |
$1,189.19 |
$1,189.19 |
10.9× |
| Us transrectal (76872) |
$2,586.57 |
$2,586.57 |
23.7× |
| Us transrectal prostate volume (76873) |
$2,641.07 |
$2,641.07 |
24.2× |
| Vascular flow imaging (78445) |
$6,400.48 |
$6,400.48 |
15.3× |
| Venogram extremity bilateral (75822) |
$2,950.63 |
$2,950.63 |
1.8× |
| Venogram ivc w serialography (75825) |
$15,508.52 |
$15,508.52 |
4.7× |
| Venogram svc w serialography (75827) |
$3,628.61 |
$3,628.61 |
2.2× |
| Venography ext unilateral (75820) |
$1,391.93 |
$1,391.93 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$10,231.28 |
$10,231.28 |
3.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,073.95 |
$5,073.95 |
1.5× |
| Venous sampling by catheter (75893) |
$28,736.76 |
$28,736.76 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$805.51 |
$805.51 |
8.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$2,033.94 |
$2,033.94 |
22.4× |
| X-ray aorta leg arteries (75630) |
$10,374.62 |
$10,374.62 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,587.66 |
$2,587.66 |
14.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$2,008.87 |
$2,008.87 |
22.1× |
| X-ray exam hips bi 3-4 views (73522) |
$1,678.60 |
$1,678.60 |
15.4× |
| X-ray exam of finger(s) (73140) |
$1,726.56 |
$1,726.56 |
19.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$572.13 |
$572.13 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$259.08 |
$259.08 |
2.9× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$1,056.21 |
$1,056.21 |
11.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$2,169.10 |
$2,169.10 |
23.9× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$990.81 |
$990.81 |
9.1× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$1,932.57 |
$1,932.57 |
21.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,034.41 |
$1,034.41 |
11.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$384.77 |
$384.77 |
4.2× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$1,497.66 |
$1,497.66 |
16.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$2,922.29 |
$2,922.29 |
26.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,042.04 |
$1,042.04 |
11.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,156.02 |
$2,156.02 |
19.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$234.35 |
$234.35 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$2,604.01 |
$2,604.01 |
28.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,040.48 |
$2,040.48 |
18.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,620.83 |
$1,620.83 |
14.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$1,321.08 |
$1,321.08 |
12.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,056.21 |
$1,056.21 |
11.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$2,209.43 |
$2,209.43 |
24.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,510.74 |
$1,510.74 |
16.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,224.07 |
$1,224.07 |
11.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$945.03 |
$945.03 |
8.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$665.99 |
$665.99 |
7.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$1,381.03 |
$1,381.03 |
15.2× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$1,314.54 |
$1,314.54 |
14.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$2,213.79 |
$2,213.79 |
24.4× |
| Xr abdomen 1 view (74018) |
$1,579.41 |
$1,579.41 |
17.4× |
| Xr abdomen 2 views (74019) |
$3,264.55 |
$3,264.55 |
29.9× |
| Xr abdomen 3 views (74021) |
$4,012.29 |
$4,012.29 |
36.8× |
| Xr arthrogram hip (73525) |
$2,477.57 |
$2,477.57 |
6.8× |
| Xr bone density appendicular (77081) |
$728.12 |
$728.12 |
8.0× |
| Xr bone density axial (77080) |
$1,026.78 |
$1,026.78 |
9.4× |
| Xr bone length study (77073) |
$1,166.30 |
$1,166.30 |
10.7× |
| Xr bone survey infant (77076) |
$1,209.90 |
$1,209.90 |
11.1× |
| Xr bone survey limited (77074) |
$1,698.22 |
$1,698.22 |
15.6× |
| Xr chest 1 view (71045) |
$1,396.29 |
$1,396.29 |
15.4× |
| Xr chest 2 views (71046) |
$2,705.38 |
$2,705.38 |
29.8× |
| Xr chest 3 views (71047) |
$3,841.16 |
$3,841.16 |
42.3× |
| Xr cystogram 3+ views (74430) |
$1,439.89 |
$1,439.89 |
4.0× |
| Xr eye foreign body (70030) |
$736.84 |
$736.84 |
8.1× |
| Xr facial bones 3 views (70150) |
$1,398.47 |
$1,398.47 |
12.8× |
| Xr lower extremity 2 views infant (73592) |
$1,655.71 |
$1,655.71 |
18.2× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$1,830.11 |
$1,830.11 |
16.8× |
| Xr mandible 4 views (70110) |
$1,540.17 |
$1,540.17 |
14.1× |
| Xr myelogram c-spine (72240) |
$4,017.74 |
$4,017.74 |
4.9× |
| Xr nasal bones (70160) |
$978.82 |
$978.82 |
10.8× |
| Xr pelvis 3 views (72190) |
$417.47 |
$417.47 |
3.8× |
| Xr spine 1 view (72020) |
$759.73 |
$759.73 |
8.4× |
| Xr sternum 2 views (71120) |
$1,436.62 |
$1,436.62 |
15.8× |
| Xr stress view joint (77071) |
$247.74 |
$247.74 |
2.7× |
| Xr surgical specimen (76098) |
$913.42 |
$913.42 |
1.6× |
| Xr upper extremity 2 views infant (73092) |
$1,401.74 |
$1,401.74 |
12.8× |
| Xray elbow 2 views (73070) |
$972.28 |
$972.28 |
10.7× |
| Xray forearm 2 views (73090) |
$1,348.33 |
$1,348.33 |
14.8× |
| Xray knee 1 or 2 views rt (73560) |
$1,132.51 |
$1,132.51 |
12.5× |
| Xray neck soft tissue (70360) |
$1,899.87 |
$1,899.87 |
20.9× |
| Xray orbits complete min 4 views (70200) |
$1,243.69 |
$1,243.69 |
11.4× |
| Xray pelvis 1 or 2 views (72170) |
$1,482.40 |
$1,482.40 |
13.6× |
| Xray ribs bilateral 3 views (71110) |
$2,861.25 |
$2,861.25 |
26.2× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$2,177.82 |
$2,177.82 |
19.9× |
| Xray scapula complete (73010) |
$1,086.73 |
$1,086.73 |
10.0× |
| Xray shoulder 1 view (73020) |
$1,013.70 |
$1,013.70 |
11.2× |
| Xray sinuses paranasal <3 views (70210) |
$259.08 |
$259.08 |
2.9× |
| Xray spine thoracic 2 views (72070) |
$2,241.04 |
$2,241.04 |
20.5× |
| Xray spine thoracic 3 views (72072) |
$2,292.27 |
$2,292.27 |
21.0× |
| Xray tibia-fibula 2 views bil (73590) |
$2,112.42 |
$2,112.42 |
23.2× |
| Xray tmj open - closed unilat (70328) |
$359.08 |
$359.08 |
4.0× |
| Xray tmj's bilateral open-clsc (70330) |
$2,003.42 |
$2,003.42 |
22.0× |