| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,172.17 |
$14,954 |
2.3× |
| Abdomen 1 View (74018) |
$282.63 |
$1,013 |
2.5× |
| Abdomen 2 views (74019) |
$449.47 |
$1,611 |
3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$854.02 |
$3,061 |
1.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$945.26 |
$3,388 |
0.6× |
| Adrenal Cortex & Medulla Img (78075) |
$1,171.53 |
$4,199 |
0.7× |
| Angio internal mammary (75756) |
$1,260.53 |
$4,518 |
0.3× |
| Angio pulmonary bilat (75743) |
$2,586.06 |
$9,269 |
0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,677.01 |
$9,595 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,582.64 |
$12,841 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,319.05 |
$8,312 |
0.6× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,453.25 |
$8,793 |
0.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,361.12 |
$12,047 |
0.8× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$3,420.54 |
$12,260 |
0.5× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,230.33 |
$7,994 |
0.3× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,213.87 |
$7,935 |
0.3× |
| Basic radiation dosimetry calculation (77300) |
$291.56 |
$1,045 |
1.7× |
| Bone age studies (77072) |
$265.89 |
$953 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,223.08 |
$7,968 |
4.3× |
| Bone Imaging Limited Area (78300) |
$1,151.44 |
$4,127 |
2.2× |
| Bone Imaging Multiple Areas (78305) |
$1,471.45 |
$5,274 |
2.9× |
| Bone Imaging Whole Body (78306) |
$1,599.23 |
$5,732 |
3.1× |
| Bone marrow imaging; multiple areas (78103) |
$790.69 |
$2,834 |
1.5× |
| Bone survey infant (77076) |
$1,106.80 |
$3,967 |
8.2× |
| Brachytx isodose complex (77318) |
$1,860.10 |
$6,667 |
3.9× |
| Brachytx isodose intermed (77317) |
$1,678.47 |
$6,016 |
3.5× |
| Brachytx Isodose Plan Simple (77316) |
$1,512.18 |
$5,420 |
3.1× |
| Brain Flow Imaging Only (78610) |
$996.87 |
$3,573 |
1.4× |
| Brain Image W/Flow < 4 Views (78601) |
$1,146.14 |
$4,108 |
2.2× |
| Brain imaging < 4 static views (78600) |
$959.49 |
$3,439 |
1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,432.39 |
$5,134 |
2.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,045.42 |
$3,747 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,131.63 |
$4,056 |
0.6× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$1,497.12 |
$5,366 |
2.1× |
| Cat Scan Follow-Up Study (76380) |
$458.68 |
$1,644 |
4.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,205.84 |
$4,322 |
1.7× |
| Cerebrospinal Fluid Scan (78630) |
$811.06 |
$2,907 |
1.2× |
| Chest 1 view (71045) |
$317.79 |
$1,139 |
2.8× |
| Chest 2 views (71046) |
$397.02 |
$1,423 |
3.5× |
| Chest 3 views (71047) |
$489.09 |
$1,753 |
4.4× |
| Chest 4 or more views (71048) |
$609.90 |
$2,186 |
4.5× |
| Cholecystography Oral Contrast (74290) |
$337.59 |
$1,210 |
1.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$538.75 |
$1,931 |
0.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,181.01 |
$4,233 |
8.8× |
| Continuing medical physics consltj pr wk (77336) |
$445.29 |
$1,596 |
2.6× |
| Contrast Exam Abdominl Aorta (75625) |
$1,851.73 |
$6,637 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$425.76 |
$1,526 |
0.9× |
| Corpora cavernosography (74445) |
$726.80 |
$2,605 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,327.02 |
$15,509 |
9.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,501.24 |
$8,965 |
8.2× |
| CT abdomen w contrast (74160) |
$2,198.25 |
$7,879 |
9.7× |
| CT abdomen w wo contrast (74170) |
$2,555.09 |
$9,158 |
11.3× |
| CT abdomen w/o contrast (74150) |
$1,427.37 |
$5,116 |
10.6× |
| CT Angio Abdomen and Pelvis (74174) |
$4,210.39 |
$15,091 |
9.4× |
| CT Angio Chest (71275) |
$2,654.41 |
$9,514 |
11.8× |
| CT Angio Head (70496) |
$2,407.50 |
$8,629 |
10.7× |
| CT angio hrt w/3d image (75574) |
$1,921.20 |
$6,886 |
4.3× |
| CT Angio Neck (70498) |
$2,483.94 |
$8,903 |
11.0× |
| CT cervical spine w/ contrast (72126) |
$4,068.66 |
$14,583 |
9.1× |
| CT cervical spine w/o contrast (72125) |
$2,065.44 |
$7,403 |
15.4× |
| CT cervical spine w/wo cont (72127) |
$4,585.09 |
$16,434 |
20.3× |
| CT chest w contrast (71260) |
$2,314.59 |
$8,296 |
10.3× |
| CT chest w/wo contrast (71270) |
$2,621.77 |
$9,397 |
11.6× |
| CT head/brain with contrast (70460) |
$2,829.62 |
$10,142 |
12.5× |
| CT head/brain without and with contrast (70470) |
$3,387.06 |
$12,140 |
15.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,805.97 |
$6,473 |
4.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$211.21 |
$757 |
1.9× |
| CT hrt w/3d image congen (75573) |
$1,805.97 |
$6,473 |
4.0× |
| CT iac w contrast (70481) |
$2,323.24 |
$8,327 |
10.3× |
| CT l-spine w&w/o contrast (72133) |
$4,165.47 |
$14,930 |
18.5× |
| CT lumbar spine w contrast (72132) |
$3,696.20 |
$13,248 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$1,876.28 |
$6,725 |
14.0× |
| CT maxillofacial w contrast (70487) |
$2,644.37 |
$9,478 |
11.7× |
| CT maxillofacial wo contrast (70486) |
$2,185.41 |
$7,833 |
16.3× |
| CT neck tissue combo (70492) |
$2,350.86 |
$8,426 |
10.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,561.50 |
$9,181 |
11.4× |
| CT orbits w/o contrast (70480) |
$1,985.65 |
$7,117 |
14.8× |
| CT pelvis w&w/o contrast (72194) |
$2,273.02 |
$8,147 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,023.93 |
$3,670 |
7.6× |
| CT scans face/jaw combo (70488) |
$3,168.89 |
$11,358 |
14.0× |
| CT soft tissue neck w contrast (70491) |
$1,975.60 |
$7,081 |
8.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,639.69 |
$5,877 |
12.2× |
| CT thoracic spine w contrast (72129) |
$3,696.20 |
$13,248 |
16.4× |
| CT thoracic spine w/o contrast (72128) |
$1,876.28 |
$6,725 |
14.0× |
| CT thoracic spine w/wo cont (72130) |
$4,165.47 |
$14,930 |
18.5× |
| CT thorax w/o contrast (71250) |
$1,181.01 |
$4,233 |
8.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,672.05 |
$5,993 |
7.4× |
| Cta Abdomen (74175) |
$2,989.49 |
$10,715 |
13.3× |
| CTA pelvis (72191) |
$2,082.46 |
$7,464 |
9.2× |
| Dilation ureters/urethra rs&i (74485) |
$1,234.30 |
$4,424 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,703.86 |
$6,107 |
0.7× |
| Diskography lumbar (72295) |
$1,703.86 |
$6,107 |
0.7× |
| Dxa Bone Density Axial (77080) |
$485.74 |
$1,741 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$276.77 |
$992 |
2.5× |
| Echo exam uterus (76831) |
$672.12 |
$2,409 |
2.2× |
| Echo Guide For Artery Repair (76936) |
$578.93 |
$2,075 |
2.1× |
| Echograp Trans R Pros Study (76873) |
$955.30 |
$3,424 |
7.1× |
| Esophagram (74220) |
$454.50 |
$1,629 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$768.09 |
$2,753 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$768.09 |
$2,753 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$333.97 |
$1,197 |
1.1× |
| Follow-Up Angiography (75898) |
$2,708.26 |
$9,707 |
0.7× |
| Gastric emptying imaging study (78264) |
$1,532.55 |
$5,493 |
3.0× |
| Gastroesophageal Reflux Exam (78262) |
$805.76 |
$2,888 |
1.6× |
| Gated Heart Planar Single (78472) |
$1,516.93 |
$5,437 |
3.0× |
| Gated Heart, Multiple (78473) |
$1,911.71 |
$6,852 |
3.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,708.54 |
$9,708 |
3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,484.78 |
$8,906 |
2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,261.30 |
$8,105 |
2.5× |
| Heart first pass single,planar (78481) |
$781.20 |
$2,800 |
1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,207.45 |
$7,912 |
0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,230.33 |
$7,994 |
0.5× |
| Hepatobil Syst Image W/Drug (78227) |
$2,915.55 |
$10,450 |
4.2× |
| Hepatobiliary System Imaging (78226) |
$2,127.94 |
$7,627 |
4.1× |
| Ht Musc Image Planar Mult (78454) |
$4,782.06 |
$17,140 |
2.9× |
| Ht Muscle Image Spect Sing (78451) |
$3,969.34 |
$14,227 |
2.4× |
| Hysterosalpingogram (74740) |
$402.60 |
$1,443 |
1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$909.27 |
$3,259 |
8.1× |
| Infusion Ivp (74410) |
$1,126.89 |
$4,039 |
5.0× |
| Interstitial radiation source applic complex (77778) |
$863.51 |
$3,095 |
1.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$563.58 |
$2,020 |
0.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$528.71 |
$1,895 |
0.7× |
| Intracavitary radiation source applic simple (77761) |
$486.86 |
$1,745 |
0.7× |
| Joint Survey Single View (77077) |
$692.76 |
$2,483 |
5.2× |
| K Flow/Funct Image Multiple (78709) |
$2,535 |
$9,086 |
3.6× |
| K Flow/Funct Image W/Drug (78708) |
$1,203.33 |
$4,313 |
1.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,604.25 |
$5,750 |
2.3× |
| Kidney Imaging Morphol (78700) |
$1,203.33 |
$4,313 |
2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,492.38 |
$5,349 |
2.9× |
| Leveen/Shunt Patency Exam (78291) |
$1,101.78 |
$3,949 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,151.16 |
$4,126 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,151.16 |
$4,126 |
2.2× |
| Liver imaging static only (78201) |
$908.99 |
$3,258 |
1.3× |
| Liver imaging w/vascular flow (78202) |
$1,083.92 |
$3,885 |
1.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$978.46 |
$3,507 |
1.4× |
| Lung perfusion differential (78597) |
$636.12 |
$2,280 |
1.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,402.82 |
$5,028 |
2.0× |
| Lung Ventilation Imaging (78579) |
$785.67 |
$2,816 |
1.5× |
| Lymph System Imaging (78195) |
$1,026.17 |
$3,678 |
1.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,284.52 |
$4,604 |
0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,412.86 |
$5,064 |
0.3× |
| Magnetic Image Jaw Joint (70336) |
$2,210.24 |
$7,922 |
7.2× |
| Meckels Divert Exam (78290) |
$946.09 |
$3,391 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,100.38 |
$3,944 |
2.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,146.50 |
$14,862 |
9.2× |
| MRA head w/o contrast (70544) |
$2,482.83 |
$8,899 |
8.1× |
| MRA head with contrast (70545) |
$3,600.22 |
$12,904 |
8.0× |
| MRA neck w contrast (70548) |
$3,147.96 |
$11,283 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,647.37 |
$13,073 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,387.97 |
$8,559 |
7.8× |
| MRI abdomen w contrast (74182) |
$2,870.36 |
$10,288 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$1,979.51 |
$7,095 |
6.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,819.64 |
$6,522 |
5.9× |
| MRI cervical spine w contrast (72142) |
$3,516.52 |
$12,604 |
7.8× |
| MRI cervical spine w/o cont (72141) |
$2,425.07 |
$8,692 |
7.9× |
| MRI chest w/o contrast (71550) |
$1,205.56 |
$4,321 |
3.9× |
| MRI chest with contrast (71551) |
$1,748.22 |
$6,266 |
1.7× |
| MRI chest wo w contrast (71552) |
$2,009.36 |
$7,202 |
4.5× |
| MRI lumbar spine w contrast (72149) |
$3,517.64 |
$12,608 |
7.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,049.97 |
$14,516 |
9.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,740.13 |
$6,237 |
5.7× |
| MRI orbit face neck w contrast (70542) |
$2,775.50 |
$9,948 |
6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,899.93 |
$10,394 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,196.29 |
$7,872 |
4.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,524.40 |
$9,048 |
5.6× |
| MRI pelvis w/o contrast (72195) |
$1,514.70 |
$5,429 |
4.9× |
| MRI spectroscopy (76390) |
$2,364.25 |
$8,474 |
21.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,425.07 |
$8,692 |
7.9× |
| MRI, abdomen, combo (74183) |
$3,305.88 |
$11,849 |
7.4× |
| MRI, dorsal spine combo (72157) |
$3,273.79 |
$11,734 |
7.3× |
| MRI, dorsal spine contrast (72147) |
$2,982.79 |
$10,691 |
6.6× |
| MRI, lumbar spine combo (72158) |
$4,051.64 |
$14,522 |
9.0× |
| Myelogram cervical (72240) |
$964.23 |
$3,456 |
1.0× |
| Myelogram Lumbar (72265) |
$964.23 |
$3,456 |
1.0× |
| Myelography thoracic (72255) |
$964.23 |
$3,456 |
1.0× |
| Myelograpy 2/more regions rs&i (72270) |
$1,210.86 |
$4,340 |
1.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$910.94 |
$3,265 |
1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,267.37 |
$11,711 |
2.0× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$1,328.32 |
$4,761 |
1.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,969.34 |
$14,227 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$4,782.06 |
$17,140 |
2.9× |
| Neck soft tissue (70360) |
$281.24 |
$1,008 |
2.5× |
| Nm csf leak detection (78650) |
$1,497.12 |
$5,366 |
0.9× |
| Nm myocard infarct spect (78469) |
$1,830.80 |
$6,562 |
2.6× |
| Nonvascular Shunt X-Ray (75809) |
$115.51 |
$414 |
0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,927.92 |
$21,247 |
3.3× |
| Nuclear Rx Intra-Arterial (79445) |
$491.04 |
$1,760 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$880.25 |
$3,155 |
2.9× |
| Ob us nuchal meas 1 gest (76813) |
$277.05 |
$993 |
2.1× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$301.05 |
$1,079 |
2.2× |
| Optic foramina (70190) |
$209.25 |
$750 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$2,110.92 |
$7,566 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$264.50 |
$948 |
2.0× |
| Pet Myocardial Sngl Study (78491) |
$3,267.37 |
$11,711 |
1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,230.33 |
$7,994 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$996.03 |
$3,570 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$565.26 |
$2,026 |
4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$372.75 |
$1,336 |
0.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$459.52 |
$1,647 |
3.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$345.69 |
$1,239 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$472.63 |
$1,694 |
4.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$368.56 |
$1,321 |
3.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,728.97 |
$6,197 |
7.7× |
| Radex Spine 1 View Specify Level (72020) |
$303.56 |
$1,088 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$258.36 |
$926 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$371.35 |
$1,331 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,340.88 |
$4,806 |
10.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$5,498.26 |
$19,707 |
0.6× |
| Radiation treatment delivery level 1 (77402) |
$465.93 |
$1,670 |
3.6× |
| Radiation treatment delivery level 2 (77407) |
$540.43 |
$1,937 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$690.53 |
$2,475 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$375.54 |
$1,346 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$757.49 |
$2,715 |
5.6× |
| Radiologic exam colon double contrast study (74280) |
$908.99 |
$3,258 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$649.52 |
$2,328 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$185.54 |
$665 |
0.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$394.23 |
$1,413 |
2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$451.43 |
$1,618 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$577.53 |
$2,070 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$508.34 |
$1,822 |
2.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$734.05 |
$2,631 |
5.5× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$314.16 |
$1,126 |
0.4× |
| Radiopharm Dacryocystography (78660) |
$963.39 |
$3,453 |
1.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$2,604.47 |
$9,335 |
5.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$2,343.88 |
$8,401 |
4.7× |
| Renal Cyst Study (74470) |
$656.77 |
$2,354 |
0.9× |
| Ribs bilateral 3 views (71110) |
$466.49 |
$1,672 |
3.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$799.90 |
$2,867 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,035.09 |
$3,710 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,352.53 |
$8,432 |
3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,340.88 |
$4,806 |
1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,411.47 |
$5,059 |
2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,293.73 |
$4,637 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,458.62 |
$5,228 |
0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,293.73 |
$4,637 |
0.8× |
| Rp Therapy Intravenous Administration (79101) |
$588.42 |
$2,109 |
2.0× |
| Salivary Gland Imaging (78230) |
$449.75 |
$1,612 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$33.76 |
$121 |
1.4× |
| Sella turcica (70240) |
$120.53 |
$432 |
1.1× |
| Skull less than 4 views (70250) |
$427.43 |
$1,532 |
3.2× |
| Special dosimetry (77331) |
$291.56 |
$1,045 |
1.7× |
| Special Physics Consult (77370) |
$463.14 |
$1,660 |
2.7× |
| Special teletherapy port plan (77321) |
$1,100.38 |
$3,944 |
2.3× |
| Special treatment procedure (77470) |
$1,934.03 |
$6,932 |
2.7× |
| Stereotactic Body Radiation Delivery (77373) |
$5,372.15 |
$19,255 |
2.3× |
| Sternoclavicular joints (71130) |
$304.95 |
$1,093 |
2.7× |
| Superior sagittal sinus venogram (75870) |
$1,345.90 |
$4,824 |
0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$124.72 |
$447 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,773.33 |
$6,356 |
3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,256.34 |
$4,503 |
2.6× |
| Testicular Imaging W/Flow (78761) |
$814.41 |
$2,919 |
1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,384.96 |
$4,964 |
2.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$844.82 |
$3,028 |
1.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$692.48 |
$2,482 |
4.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$463.14 |
$1,660 |
2.1× |
| Thoracic spine 2 views (72070) |
$353.22 |
$1,266 |
2.6× |
| Thoracic spine 3 views (72072) |
$395.63 |
$1,418 |
2.9× |
| Thoracolumbar 2 views (72080) |
$256.41 |
$919 |
2.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$996.31 |
$3,571 |
1.9× |
| Thyroid Met Imaging Body (78018) |
$2,020.24 |
$7,241 |
2.9× |
| Thyroid Uptake Measurement (78012) |
$554.66 |
$1,988 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,200.26 |
$4,302 |
2.3× |
| Tx Devices Design & Construction Complex (77334) |
$1,100.38 |
$3,944 |
2.3× |
| Tx devices design & construction intermediate (77333) |
$539.03 |
$1,932 |
3.1× |
| Tx devices design & construction simple (77332) |
$297.14 |
$1,065 |
1.7× |
| Ultrasound Exam Aaa Screen (76706) |
$513.09 |
$1,839 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$739.63 |
$2,651 |
5.5× |
Unlisted Procedure Clinical Brachytherapy (77799)
range across 2 matching MRF lines |
$432.18–$578.65 |
$1,549–$2,074 |
varies |
| Upper gi w/o kub (74240) |
$496.62 |
$1,780 |
2.2× |
| Ureteral Reflux Study (78740) |
$1,076.67 |
$3,859 |
2.1× |
| Urethrocystogram voiding (74455) |
$584.23 |
$2,094 |
1.9× |
| Urethrocystography retrograde (74450) |
$584.23 |
$2,094 |
1.9× |
| Us bone density measurement (76977) |
$182.75 |
$655 |
1.4× |
| Us chest (76604) |
$547.12 |
$1,961 |
4.1× |
| Us exam, pelvic, limited (76857) |
$564.70 |
$2,024 |
4.2× |
| Us head (76506) |
$666.26 |
$2,388 |
5.0× |
| Us kidney transplant (76776) |
$709.22 |
$2,542 |
5.3× |
| Us ob detailed single fetus (76811) |
$500.25 |
$1,793 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$351.54 |
$1,260 |
2.6× |
| Us ob transvaginal (76817) |
$450.87 |
$1,616 |
3.4× |
| Us pelvic non ob complete (76856) |
$842.86 |
$3,021 |
6.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$433.57 |
$1,554 |
3.2× |
| Us retroperitoneal complete (76770) |
$671.84 |
$2,408 |
5.0× |
| Us retroperitoneal limited (76775) |
$329.22 |
$1,180 |
2.4× |
| Us scrotum and contents (76870) |
$945.54 |
$3,389 |
7.0× |
| Us spinal canal and contents (76800) |
$412.37 |
$1,478 |
3.1× |
| Us thyroid (76536) |
$785.67 |
$2,816 |
5.8× |
| Us transrectal (76872) |
$516.71 |
$1,852 |
3.8× |
| Vascular Flow Imaging (78445) |
$587.86 |
$2,107 |
1.1× |
| Vasogram (74440) |
$399.25 |
$1,431 |
1.3× |
| Vein X-Ray Chest (75827) |
$784.83 |
$2,813 |
0.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,345.90 |
$4,824 |
0.3× |
| Vein X-Ray Skull Epidural (75872) |
$1,260.53 |
$4,518 |
1.6× |
| Vein X-Ray Spleen/Liver (75810) |
$2,213.87 |
$7,935 |
0.5× |
| Venogram Sinus/Jugular (75860) |
$1,386.63 |
$4,970 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$2,230.89 |
$7,996 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$1,152.27 |
$4,130 |
0.6× |
| Venography Orbital Rs&I (75880) |
$1,260.53 |
$4,518 |
1.6× |
| Venography Renal Bilateral (75833) |
$3,320.66 |
$11,902 |
0.8× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,894.07 |
$10,373 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$194.47 |
$697 |
1.7× |
| X-Ray Aorta Leg Arteries (75630) |
$2,230.89 |
$7,996 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$434.69 |
$1,558 |
3.2× |
| X-Ray Exam Breast Specimen (76098) |
$514.20 |
$1,843 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$318.06 |
$1,140 |
2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$859.60 |
$3,081 |
6.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$1,074.43 |
$3,851 |
8.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$361.87 |
$1,297 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$453.10 |
$1,624 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$566.37 |
$2,030 |
4.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$688.30 |
$2,467 |
5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$451.98 |
$1,620 |
4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$782.04 |
$2,803 |
5.8× |
| X-ray IV pyelogram (ivp) (74400) |
$1,078.62 |
$3,866 |
4.8× |
| X-ray IV pyelogram+tomography (74415) |
$1,316.05 |
$4,717 |
5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$326.71 |
$1,171 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$360.47 |
$1,292 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$384.47 |
$1,378 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$372.47 |
$1,335 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$611.57 |
$2,192 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$473.75 |
$1,698 |
3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$399.53 |
$1,432 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$391.72 |
$1,404 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$466.21 |
$1,671 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$542.94 |
$1,946 |
4.0× |
| X-ray thoracic spine 4 vw (72074) |
$469.84 |
$1,684 |
3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$539.31 |
$1,933 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$381.12 |
$1,366 |
2.8× |
| X-Rays Bone Survey Complete (77075) |
$1,095.64 |
$3,927 |
8.1× |
| Xr c-spine 4 or 5 views (72050) |
$610.18 |
$2,187 |
4.5× |
| Xr facial bones less than 3 views (70140) |
$321.69 |
$1,153 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$331.46 |
$1,188 |
2.5× |
| Xr Tomogram Single Plane (76100) |
$520.90 |
$1,867 |
3.9× |