| 3-D radiotherapy plan dose-volume histograms (77295) |
$14,672.25 |
$19,563 |
10.4× |
| Abdomen 2 views (74019) |
$506.25 |
$675 |
4.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,954.50 |
$2,606 |
4.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,735.50 |
$6,314 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$4,463.25 |
$5,951 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$8,412 |
$11,216 |
2.6× |
| Angiography internal mammary rs&i (75756) |
$3,453.75 |
$4,605 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$10,968.75 |
$14,625 |
1.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$6,434.25 |
$8,579 |
2.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,761.50 |
$7,682 |
1.8× |
| Angiography Spinal Selective Rs&I (75705) |
$10,968.75 |
$14,625 |
1.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,741.75 |
$12,989 |
1.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,529.75 |
$3,373 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,336 |
$4,448 |
1.0× |
| Ankle 2 views (73600) |
$451.50 |
$602 |
5.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$626.25 |
$835 |
1.8× |
| Aortogram thoracic (75605) |
$4,846.50 |
$6,462 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$6,023.25 |
$8,031 |
1.9× |
| Aortography abdominal serialography rs&i (75625) |
$5,064.75 |
$6,753 |
1.6× |
| Artery X-Rays Adrenal Gland (75731) |
$4,062.75 |
$5,417 |
1.3× |
| Arthrogram elbow (73085) |
$423.75 |
$565 |
1.2× |
| Arthrogram hip (73525) |
$451.50 |
$602 |
1.3× |
| Arthrogram shoulder (73040) |
$563.25 |
$751 |
1.6× |
| Arthrogram wrist (73115) |
$916.50 |
$1,222 |
2.6× |
| Arthrography knee lt (73580) |
$582 |
$776 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$1,392.75 |
$1,857 |
10.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,506.75 |
$2,009 |
3.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,238.25 |
$1,651 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$2,216.25 |
$2,955 |
5.5× |
| Bone age studies (77072) |
$367.50 |
$490 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$2,295 |
$3,060 |
5.7× |
| Bone Marrow Imaging Limited Area (78102) |
$1,435.50 |
$1,914 |
3.5× |
| Bone survey complete (77075) |
$846 |
$1,128 |
8.0× |
| Brachytx isodose complex (77318) |
$2,992.50 |
$3,990 |
7.9× |
| Brachytx isodose intermed (77317) |
$2,184.75 |
$2,913 |
5.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,062.50 |
$2,750 |
5.4× |
| Brain image w/flow 4 + views (78606) |
$2,076 |
$2,768 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,320.75 |
$5,761 |
3.0× |
| Brain Imaging Vascular Flow Only (78610) |
$2,166.75 |
$2,889 |
3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,648.75 |
$4,865 |
10.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,947 |
$2,596 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$591.75 |
$789 |
6.7× |
| Chest 1 view (71045) |
$498 |
$664 |
5.6× |
| Chest 3 views (71047) |
$706.50 |
$942 |
8.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,125 |
$1,500 |
6.3× |
| Clavicle complete (73000) |
$384 |
$512 |
4.3× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$50,491.50 |
$67,322 |
6.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$372.75 |
$497 |
3.5× |
| Continuing medical physics consltj pr wk (77336) |
$1,322.25 |
$1,763 |
9.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,057 |
$8,076 |
17.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,633.50 |
$6,178 |
19.1× |
| CT abdomen w contrast (74160) |
$4,204.50 |
$5,606 |
23.6× |
| CT abdomen w wo contrast (74170) |
$4,519.50 |
$6,026 |
25.4× |
| CT abdomen w/o contrast (74150) |
$3,432.75 |
$4,577 |
32.3× |
| CT angio hrt w/3d image (75574) |
$2,030.25 |
$2,707 |
5.7× |
| CT angiography upper extremity lt (73206) |
$4,645.12 |
$6,193.50 |
26.1× |
| CT c-spine w/o contrast (72125) |
$3,386.25 |
$4,515 |
31.9× |
| CT cervical spine w&w/o contrast (72127) |
$3,639 |
$4,852 |
20.4× |
| CT cervical spine with contrast (72126) |
$3,492.75 |
$4,657 |
9.9× |
| CT chest w/wo contrast (71270) |
$4,011.75 |
$5,349 |
22.5× |
| CT chest with contrast (71260) |
$3,821.25 |
$5,095 |
21.4× |
| CT colonography screening (74263) |
$722.25 |
$963 |
3.0× |
| CT colonography w/dye (74262) |
$1,631.25 |
$2,175 |
9.2× |
| CT colonography w/o cntrst (74261) |
$1,070.25 |
$1,427 |
10.1× |
| CT head/brain with contrast (70460) |
$3,515.25 |
$4,687 |
19.7× |
| CT head/brain without and with contrast (70470) |
$4,034.25 |
$5,379 |
22.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,180.50 |
$1,574 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,131 |
$1,508 |
12.8× |
| CT hrt w/3d image congen (75573) |
$2,697 |
$3,596 |
7.6× |
| CT iac w contrast (70481) |
$3,168 |
$4,224 |
17.8× |
| CT limited/localized follow up study (76380) |
$1,593.75 |
$2,125 |
18.0× |
| CT lower ext w/o (73700) |
$4,168.50 |
$5,558 |
39.3× |
| CT lower extremity w wo contrast (73702) |
$4,828.12 |
$6,437.50 |
27.1× |
| CT lower extremity with contrast (73701) |
$4,437 |
$5,916 |
24.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,639 |
$4,852 |
20.4× |
| CT lumbar spine w/o contrast (72131) |
$3,318.75 |
$4,425 |
31.3× |
| CT lumbar spine with contrast (72132) |
$3,492.75 |
$4,657 |
9.9× |
| CT maxillofacial w contrast (70487) |
$3,138 |
$4,184 |
17.6× |
| CT maxillofacial w/o contrast (70486) |
$2,946 |
$3,928 |
27.7× |
| CT maxillofacial w/wo contrast (70488) |
$3,412.50 |
$4,550 |
19.2× |
| CT neck soft tissue w contrast (70491) |
$3,138 |
$4,184 |
17.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,444 |
$4,592 |
19.3× |
| CT orbits w/o contrast (70480) |
$2,974.50 |
$3,966 |
28.0× |
| CT pelvis w & w/o contrast (72194) |
$4,114.50 |
$5,486 |
23.1× |
| CT pelvis w/o contrast (72192) |
$3,408 |
$4,544 |
32.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,412.50 |
$4,550 |
19.2× |
| CT soft tissue neck w/o contrast (70490) |
$2,946 |
$3,928 |
27.7× |
| CT thoracic spine w/contrast (72129) |
$3,496.50 |
$4,662 |
19.6× |
| CT thoracic spine w/o contrast (72128) |
$3,318.75 |
$4,425 |
31.3× |
| CT thoracic spine w/wo contrast (72130) |
$3,639 |
$4,852 |
20.4× |
| CT thorax w/o contrast (71250) |
$3,112.50 |
$4,150 |
29.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,828.12 |
$6,437.50 |
27.1× |
| CT upper extremity w/o contrast rt (73200) |
$4,168.50 |
$5,558 |
39.3× |
| CT upper extremity with contrast (73201) |
$4,437 |
$5,916 |
12.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,639 |
$4,852 |
20.4× |
| Cta Abdomen (74175) |
$3,687 |
$4,916 |
20.7× |
| CTA abdomen pelvis (74174) |
$5,511 |
$7,348 |
15.6× |
| CTA chest (71275) |
$4,316.25 |
$5,755 |
24.2× |
| Cta Head (70496) |
$3,585 |
$4,780 |
20.1× |
| CTA lwr ext w&w/o contrast (73706) |
$5,017.88 |
$6,690.50 |
28.2× |
| Cta Neck (70498) |
$3,585 |
$4,780 |
20.1× |
| Cta Pelvis (72191) |
$3,543 |
$4,724 |
19.9× |
| Cystography minimum 3 views rs&i (74430) |
$521.25 |
$695 |
1.5× |
| Diskogram cervical (72285) |
$4,141.50 |
$5,522 |
2.1× |
| Diskography lumbar (72295) |
$4,682.25 |
$6,243 |
2.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$546 |
$728 |
5.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$994.50 |
$1,326 |
9.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$744.75 |
$993 |
7.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$888 |
$1,184 |
8.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$655.50 |
$874 |
7.4× |
| Dxa bone density study axial skeleton (77085) |
$848.25 |
$1,131 |
8.0× |
| Echo exam of fetal heart (76825) |
$1,915.50 |
$2,554 |
3.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,057.50 |
$1,410 |
4.4× |
| Echoencephalography real time imaging (76506) |
$1,098.75 |
$1,465 |
10.3× |
| Esophagus (74220) |
$655.50 |
$874 |
3.7× |
| Fetal biophysical profile non-stress testing (76818) |
$1,054.50 |
$1,406 |
9.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,054.50 |
$1,406 |
9.9× |
| Fluoroscopy up to 1 hr (76000) |
$807.75 |
$1,077 |
3.3× |
| Foot 2 views (73620) |
$422.25 |
$563 |
4.8× |
| Forearm 2 views (73090) |
$465.75 |
$621 |
5.3× |
| Functional MRI brain by tech (70554) |
$690.75 |
$921 |
2.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,148 |
$2,864 |
3.9× |
| Gated Heart Planar Single (78472) |
$2,837.25 |
$3,783 |
7.0× |
| Hand 2 views (73120) |
$422.25 |
$563 |
4.0× |
| Hand 3 views (73130) |
$540.75 |
$721 |
6.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$7,439.25 |
$9,919 |
10.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$8,174.25 |
$10,899 |
11.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$8,490 |
$11,320 |
12.0× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,049.75 |
$2,733 |
5.2× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,049.75 |
$2,733 |
5.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,925.50 |
$5,234 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,004 |
$2,672 |
3.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,954.50 |
$2,606 |
4.8× |
| Ht muscle image spect sing (78451) |
$6,463.50 |
$8,618 |
4.9× |
| Humerus Min 2 Views Left (73060) |
$497.25 |
$663 |
5.6× |
| Hysterosalpingogram (74740) |
$1,009.50 |
$1,346 |
4.2× |
| Interstitial radiation source applic complex (77778) |
$11,727 |
$15,636 |
16.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,960.50 |
$6,614 |
7.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,781.50 |
$5,042 |
6.7× |
| Intracavitary radiation source applic simple (77761) |
$3,042.75 |
$4,057 |
5.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$382.50 |
$510 |
3.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,653.75 |
$2,205 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,902 |
$2,536 |
3.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,397.75 |
$3,197 |
4.3× |
| Knee 3 views (73562) |
$651.75 |
$869 |
7.4× |
| Liver & spleen imaging static only (78215) |
$1,418.25 |
$1,891 |
3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,451.25 |
$1,935 |
3.6× |
| Liver imaging static only (78201) |
$1,388.25 |
$1,851 |
2.5× |
| Liver imaging w/vascular flow (78202) |
$1,451.25 |
$1,935 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$2,497.50 |
$3,330 |
4.5× |
| Lung perfusion differential (78597) |
$1,819.50 |
$2,426 |
4.5× |
| Lung Ventilation Imaging (78579) |
$1,302.75 |
$1,737 |
3.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,433.25 |
$1,911 |
0.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,130.25 |
$1,507 |
1.8× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,947.75 |
$2,597 |
1.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,269.75 |
$1,693 |
0.4× |
| Lymphoscintigraphy (78195) |
$2,737.50 |
$3,650 |
5.0× |
| Mammary ductogram or galactogram multiple (77054) |
$924.75 |
$1,233 |
3.8× |
| Mammary ductogram or galactogram single (77053) |
$754.50 |
$1,006 |
3.1× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$204.75 |
$273 |
2.3× |
| Meckels Diverticulum (78290) |
$1,593.75 |
$2,125 |
3.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,495.50 |
$5,994 |
11.8× |
| Mr elastography (76391) |
$1,320.75 |
$1,761 |
5.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$59.25 |
$79 |
2.0× |
| MRA head w & w/o contrast (70546) |
$6,133.50 |
$8,178 |
17.3× |
| MRA head w/o contrast (70544) |
$3,218.25 |
$4,291 |
13.3× |
| MRA head with contrast (70545) |
$5,654.25 |
$7,539 |
16.0× |
| MRA neck w contrast (70548) |
$5,654.25 |
$7,539 |
16.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,133.50 |
$8,178 |
17.3× |
| MRA neck w/o contrast (70547) |
$4,989.75 |
$6,653 |
20.6× |
| MRI abdomen w contrast (74182) |
$5,286 |
$7,048 |
14.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,735.25 |
$7,647 |
16.2× |
| MRI abdomen w/o contrast (74181) |
$4,665 |
$6,220 |
19.2× |
| MRI any jnt lwr ext with con lt (73722) |
$7,926.38 |
$10,568.50 |
10.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$8,001 |
$10,668 |
10.0× |
| MRI bone marrow blood supply (77084) |
$4,405.50 |
$5,874 |
18.2× |
| MRI breast w/o contrast bilateral (77047) |
$715.50 |
$954 |
3.0× |
| MRI breast w/o contrast unilat (77046) |
$715.50 |
$954 |
3.0× |
| MRI c-spine with contrast (72142) |
$5,286 |
$7,048 |
14.9× |
| MRI cardiac w/o cont stress (75559) |
$3,306.75 |
$4,409 |
6.0× |
| MRI cardiac w/o contrast (75557) |
$3,060 |
$4,080 |
12.6× |
| MRI cervical spine w/o contrast (72141) |
$4,665 |
$6,220 |
19.2× |
| MRI chest w/o & w/contrast material (71552) |
$5,735.25 |
$7,647 |
16.2× |
| MRI chest w/o contrast (71550) |
$4,665 |
$6,220 |
19.2× |
| MRI chest with contrast (71551) |
$5,286 |
$7,048 |
6.6× |
| MRI fetal sngl/1st gestation (74712) |
$984.75 |
$1,313 |
4.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$7,926.38 |
$10,568.50 |
22.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,926.38 |
$10,568.50 |
22.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,998.62 |
$9,331.50 |
28.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,665 |
$6,220 |
19.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,735.25 |
$7,647 |
16.2× |
| MRI orbit/face/neck w/contrast (70542) |
$5,286 |
$7,048 |
14.9× |
| MRI pelvis w contrast (72196) |
$5,286 |
$7,048 |
14.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,735.25 |
$7,647 |
16.2× |
| MRI pelvis w/o contrast (72195) |
$4,665 |
$6,220 |
19.2× |
| MRI scan of arm joint before and after contrast (73223) |
$8,604.75 |
$11,473 |
24.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,925.50 |
$5,234 |
4.9× |
| MRI scan of leg joint before and after contrast (73723) |
$8,604.75 |
$11,473 |
24.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,735.25 |
$7,647 |
16.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,286 |
$7,048 |
14.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,790 |
$7,720 |
16.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,286 |
$7,048 |
14.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,735.25 |
$7,647 |
16.2× |
| MRI thoracic spine w/o contrast (72146) |
$4,665 |
$6,220 |
19.2× |
| MRI tmj (70336) |
$4,619.25 |
$6,159 |
19.1× |
| MRI upper ext joint w/o contrast (73221) |
$6,998.62 |
$9,331.50 |
28.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$8,604.75 |
$11,473 |
24.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$6,998.62 |
$9,331.50 |
28.9× |
| Myelogram Cervical (72240) |
$939.75 |
$1,253 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,320.75 |
$5,761 |
3.3× |
| Myocardial Spect Multiple Studies (78452) |
$8,385.75 |
$11,181 |
6.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,267.50 |
$5,690 |
2.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,267.50 |
$5,690 |
2.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$6,657.75 |
$8,877 |
3.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$8,136.75 |
$10,849 |
3.6× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$8,136.75 |
$10,849 |
5.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$4,200.75 |
$5,601 |
4.8× |
| Neck soft tissue (70360) |
$324 |
$432 |
3.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$846.75 |
$1,129 |
2.1× |
| Nm adrenal scan (78075) |
$4,429.50 |
$5,906 |
3.4× |
| Nm bone marrow wb (78104) |
$1,435.50 |
$1,914 |
3.5× |
| Nm cisternogram (78630) |
$1,696.50 |
$2,262 |
3.1× |
| Nm csf leak detection (78650) |
$1,282.50 |
$1,710 |
1.0× |
| Nm gastric emptying study (78264) |
$1,954.50 |
$2,606 |
4.8× |
| Nm gastroesophageal reflux study (78262) |
$1,271.25 |
$1,695 |
3.1× |
| Nm peritoneal-venous shunt patency (78291) |
$1,271.25 |
$1,695 |
3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,934 |
$15,912 |
8.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$6,657.75 |
$8,877 |
4.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$7,230.75 |
$9,641 |
5.5× |
| Nuclear medicine of heart pumping function (78473) |
$3,107.25 |
$4,143 |
7.7× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$4,267.50 |
$5,690 |
2.9× |
| Nuclear medicine study of digestive tracts (78299) |
$2,599.50 |
$3,466 |
6.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$6,463.50 |
$8,618 |
4.9× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$1,466.25 |
$1,955 |
3.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,863.75 |
$2,485 |
4.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,311.75 |
$1,749 |
3.2× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,311.75 |
$1,749 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$1,590.75 |
$2,121 |
6.7× |
| Nuclr Rx Interstit Colloid (79300) |
$1,997.25 |
$2,663 |
8.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,124.25 |
$1,499 |
10.6× |
| Orthopantogram (70355) |
$258.75 |
$345 |
2.9× |
| Osseous survey infant (77076) |
$389.25 |
$519 |
3.7× |
| Osseous survey limited (77074) |
$382.50 |
$510 |
3.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,878 |
$2,504 |
3.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,547.25 |
$2,063 |
3.8× |
| Parathyroid imaging (78070) |
$1,398 |
$1,864 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$459 |
$612 |
4.3× |
| Peritoneogram rs&i (74190) |
$915.75 |
$1,221 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$7,996.50 |
$10,662 |
5.5× |
| PET imaging CT for attenuation limited area (78814) |
$7,913.25 |
$10,551 |
5.4× |
| PET imaging for CT attenuation whole body (78816) |
$8,079 |
$10,772 |
5.6× |
| Pr heart first pass single,planar (78481) |
$1,452.75 |
$1,937 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$8,604.75 |
$11,473 |
24.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,708 |
$4,944 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,335.50 |
$3,114 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,653.75 |
$2,205 |
4.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,364.75 |
$3,153 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$651.75 |
$869 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$386.25 |
$515 |
4.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$456.75 |
$609 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$584.25 |
$779 |
5.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$723 |
$964 |
6.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$850.50 |
$1,134 |
8.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$50,491.50 |
$67,322 |
6.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,325.75 |
$3,101 |
4.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,428.75 |
$1,905 |
13.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,877.25 |
$2,503 |
4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$582 |
$776 |
5.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$484.50 |
$646 |
5.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$551.25 |
$735 |
5.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$632.25 |
$843 |
7.2× |
| Radiologic exam colon single contrast study (74270) |
$990 |
$1,320 |
5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,159.50 |
$1,546 |
6.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,147.50 |
$1,530 |
6.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,159.50 |
$1,546 |
6.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$618.75 |
$825 |
7.0× |
| Radiological examination surgical specimen (76098) |
$1,305.75 |
$1,741 |
2.4× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$2,817.75 |
$3,757 |
11.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$692.25 |
$923 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,357.75 |
$4,477 |
1.0× |
| Ribs bilateral 3 views (71110) |
$588 |
$784 |
5.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,466.25 |
$1,955 |
3.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,596 |
$2,128 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,198.25 |
$2,931 |
4.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,871.50 |
$5,162 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,392.75 |
$5,857 |
3.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,871.50 |
$5,162 |
2.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$3,270.75 |
$4,361 |
13.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,590.75 |
$2,121 |
6.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,590.75 |
$2,121 |
6.7× |
| Sacroiliac Joints < 3 Views (72200) |
$381 |
$508 |
3.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$972 |
$1,296 |
4.0× |
| Salivary gland function study (78232) |
$1,575 |
$2,100 |
3.9× |
| Salivary gland imaging (78230) |
$1,271.25 |
$1,695 |
3.1× |
| Salivary gland imaging serial images (78231) |
$1,560.75 |
$2,081 |
3.8× |
| Scanogram (77073) |
$522 |
$696 |
4.9× |
| Scapula complete (73010) |
$384 |
$512 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$210 |
$280 |
9.0× |
| Sella turcica (70240) |
$489.75 |
$653 |
5.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$330.75 |
$441 |
3.1× |
| Sialogram (70390) |
$478.50 |
$638 |
2.0× |
| Simulation intermediate (77285) |
$3,324.75 |
$4,433 |
8.7× |
| Small bowel series (74250) |
$1,067.25 |
$1,423 |
6.0× |
| Spec medical radj physics consltj (77370) |
$1,534.50 |
$2,046 |
11.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,001 |
$2,668 |
5.3× |
| Special dosimetry (77331) |
$1,162.50 |
$1,550 |
8.5× |
| Special treatment procedure (77470) |
$4,881.75 |
$6,509 |
8.7× |
| Spine thoracic 3 views (72072) |
$654 |
$872 |
6.2× |
| Spleen imaging only (78185) |
$1,377 |
$1,836 |
3.4× |
| Splenoportograpy rs&i (75810) |
$7,701.75 |
$10,269 |
2.4× |
| Stereotactic body radiation delivery (77373) |
$11,625.75 |
$15,501 |
6.4× |
| Superior sagittal sinus venogram (75870) |
$2,617.50 |
$3,490 |
0.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$1,091.25 |
$1,455 |
10.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,433.75 |
$3,245 |
6.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,416 |
$1,888 |
3.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$713.25 |
$951 |
2.9× |
| Testicular Imaging With Vascular Flow (78761) |
$1,227.75 |
$1,637 |
3.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,160.25 |
$5,547 |
10.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,683.50 |
$3,578 |
19.7× |
| Therapeutic Enema (74283) |
$1,319.25 |
$1,759 |
7.4× |
| Thoracolumbar 2 views (72080) |
$655.50 |
$874 |
7.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,283.75 |
$3,045 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$707.25 |
$943 |
1.7× |
| Thyroid uptake measurement (78012) |
$707.25 |
$943 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,352.25 |
$1,803 |
3.3× |
| Tmj unilateral (70328) |
$565.50 |
$754 |
6.4× |
| Tomogram (76100) |
$828.75 |
$1,105 |
7.8× |
| Treatment device intermediate (77333) |
$1,263 |
$1,684 |
9.3× |
| Treatment devices simple (77332) |
$1,189.50 |
$1,586 |
8.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,321.50 |
$5,762 |
7.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,696.50 |
$2,262 |
4.2× |
| Tx devices design & construction complex (77334) |
$2,508.75 |
$3,345 |
6.6× |
| Ultrasound elastography first target lesion (76982) |
$1,240.50 |
$1,654 |
11.7× |
| Ultrasound, abdomen limited (76705) |
$1,072.50 |
$1,430 |
10.1× |
| Umbilical-artery Doppler (OB) (76820) |
$786 |
$1,048 |
7.4× |
| Unlisted fluoroscopic procedure (76496) |
$219 |
$292 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$3,218.25 |
$4,291 |
36.4× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$1,168.50 |
$1,558 |
2.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$7,222.50 |
$9,630 |
69.7× |
| Upper Extremity Infant (73092) |
$473.25 |
$631 |
4.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,889.25 |
$2,519 |
4.7× |
| Urethrocystography retrograde rs&i (74450) |
$396 |
$528 |
1.6× |
| Urethrocystography voiding (74455) |
$630 |
$840 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,284 |
$1,712 |
7.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,782.75 |
$2,377 |
10.0× |
| Us abdl aorta screen aaa (76706) |
$345.75 |
$461 |
3.3× |
| Us breast unilateral complete (76641) |
$1,034.25 |
$1,379 |
9.7× |
| Us breast unilateral limited (76642) |
$827.25 |
$1,103 |
9.4× |
| Us chest (76604) |
$711.75 |
$949 |
6.7× |
| Us compl joint r-t w/image documentation (76881) |
$1,002 |
$1,336 |
9.4× |
| Us elastography parenchyma (76981) |
$1,240.50 |
$1,654 |
11.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$786 |
$1,048 |
7.4× |
| Us guided compression repair (76936) |
$453 |
$604 |
2.1× |
| Us infant hips dynamic (76885) |
$989.25 |
$1,319 |
11.2× |
| Us infant hips limited static (76886) |
$771.75 |
$1,029 |
8.7× |
| Us kidney transplant (76776) |
$508.50 |
$678 |
4.8× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$279 |
$372 |
2.6× |
| Us ob detailed single fetus (76811) |
$1,403.25 |
$1,871 |
5.8× |
| Us ob transvaginal (76817) |
$1,090.50 |
$1,454 |
10.3× |
| Us pelvic non ob complete (76856) |
$1,072.50 |
$1,430 |
10.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$854.25 |
$1,139 |
8.0× |
| Us pregnancy ltd (76815) |
$1,072.50 |
$1,430 |
10.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,072.50 |
$1,430 |
10.1× |
| Us retroperitoneal complete (76770) |
$1,345.50 |
$1,794 |
12.7× |
| Us retroperitoneal limited (76775) |
$557.25 |
$743 |
5.2× |
| Us scrotum and contents (76870) |
$782.25 |
$1,043 |
7.4× |
| Us soft tissue head/neck (76536) |
$862.50 |
$1,150 |
8.1× |
| Us spinal canal and contents (76800) |
$503.25 |
$671 |
4.7× |
| Us transrectal (76872) |
$1,098.75 |
$1,465 |
10.3× |
| Us transrectal prostate volume (76873) |
$1,041 |
$1,388 |
9.8× |
| Us xtr non-vasc lmtd (76882) |
$680.25 |
$907 |
6.4× |
| Vascular flow imaging (78445) |
$1,365.75 |
$1,821 |
3.4× |
| Venogram extremity bilateral (75822) |
$2,871.75 |
$3,829 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,541.50 |
$4,722 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$2,964 |
$3,952 |
1.9× |
| Venography epidural rs&i (75872) |
$2,667.75 |
$3,557 |
4.2× |
| Venography extremity unilateral rs&i (75820) |
$2,346 |
$3,128 |
1.5× |
| Venography Renal Bilateral (75833) |
$4,302.75 |
$5,737 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$3,765.75 |
$5,021 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,759.75 |
$9,013 |
2.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$10,968.75 |
$14,625 |
1.9× |
| Vertebral fracture assessment via dxa (77086) |
$875.25 |
$1,167 |
9.9× |
| Wrist 2 views (73100) |
$422.25 |
$563 |
4.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$596.25 |
$795 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$503.25 |
$671 |
5.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$587.25 |
$783 |
6.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,445.25 |
$1,927 |
8.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$451.50 |
$602 |
5.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$587.25 |
$783 |
6.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$771.75 |
$1,029 |
7.3× |
| X-ray exam hip uni 1 view (73501) |
$465.75 |
$621 |
5.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$531 |
$708 |
6.0× |
| X-ray exam hip uni 4/> views (73503) |
$584.25 |
$779 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$618 |
$824 |
5.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$771.75 |
$1,029 |
7.3× |
| X-ray exam of femur 1 (73551) |
$563.25 |
$751 |
6.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,714.50 |
$2,286 |
9.6× |
| X-ray eye for foreign body (70030) |
$240 |
$320 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$659.25 |
$879 |
6.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$231 |
$308 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$508.50 |
$678 |
5.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$4,361.25 |
$5,815 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$351.75 |
$469 |
4.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$1,453.50 |
$1,938 |
8.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$711.75 |
$949 |
6.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$240.75 |
$321 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$429 |
$572 |
4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$539.25 |
$719 |
5.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$796.50 |
$1,062 |
7.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$690.75 |
$921 |
6.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$518.25 |
$691 |
5.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$481.50 |
$642 |
5.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$659.25 |
$879 |
6.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$599.25 |
$799 |
5.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$726.75 |
$969 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$517.50 |
$690 |
5.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$588 |
$784 |
5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$684 |
$912 |
6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$514.50 |
$686 |
4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$532.50 |
$710 |
6.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$625.50 |
$834 |
7.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$599.25 |
$799 |
6.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$499.50 |
$666 |
5.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$790.50 |
$1,054 |
7.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$579.75 |
$773 |
5.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$451.50 |
$602 |
5.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$435.75 |
$581 |
4.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$384 |
$512 |
4.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$542.25 |
$723 |
5.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$760.50 |
$1,014 |
7.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$309 |
$412 |
3.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$531 |
$708 |
6.0× |
| Xr arthrogram ankle (73615) |
$444 |
$592 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$616.50 |
$822 |
5.8× |
| Xr chest 4+ views (71048) |
$773.25 |
$1,031 |
7.3× |
| Xr Cholecystography Oral Contrast (74290) |
$405.75 |
$541 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$483.38 |
$644.50 |
5.5× |
| Xr internal auditory meati complete (70134) |
$759.75 |
$1,013 |
1.4× |
| Xr shoulder 1 view (73020) |
$429 |
$572 |
4.9× |
| Xr spine cervical 4 or 5 views (72050) |
$833.25 |
$1,111 |
7.8× |
| Xr tibia/fibula 2 views (73590) |
$497.25 |
$663 |
5.6× |
| Xr tmj bilateral (70330) |
$990 |
$1,320 |
11.2× |
| Xray knee 1 or 2 views rt (73560) |
$486 |
$648 |
5.5× |