| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,386.18 |
$15,965.43 |
4.4× |
| Acute gi blood loss imaging (78278) |
$1,308.80 |
$3,271.98 |
3.1× |
| Angiography internal mammary rs&i (75756) |
$1,720.06 |
$4,300.15 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,117.86 |
$10,294.64 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,486.04 |
$8,715.08 |
0.6× |
| Angiography, adrenal, bilateral, selective, radiological supervision and interpretation Age Under 21 (75733) |
$5,094.52 |
$12,736.30 |
1.5× |
| Angiography, adrenal, unilateral, selective, radiological supervision and interpretation Age Under 21 (75731) |
$2,547.26 |
$6,368.15 |
0.8× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$4,384.86 |
$10,962.14 |
1.3× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$2,330.60 |
$5,826.50 |
0.7× |
| Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736) |
$3,468.20 |
$8,670.50 |
0.6× |
| Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation Age Under 21 (75741) |
$2,079.66 |
$5,199.13 |
0.6× |
| Angiography, spinal, selective, radiological supervision and interpretation Age Under 21 (75705) |
$3,670.64 |
$9,176.60 |
0.6× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,824.20 |
$4,560.49 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,332.18 |
$3,330.44 |
0.4× |
| Ankle 2 views (73600) |
$341.44 |
$853.59 |
3.7× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$3,118.36 |
$7,795.88 |
0.9× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$3,659.44 |
$9,148.60 |
1.1× |
Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605)
unusually low — confirm this is the full procedure |
$2,817.90 |
$7,044.75 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$839.96 |
$2,099.88 |
5.9× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$625.77 |
$1,564.41 |
1.5× |
| Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) |
$1,176.92 |
$2,942.29 |
2.1× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$5,338.42 |
$13,346.05 |
3.5× |
| Card MRI w/stress img & dye (75563) |
$1,776.24 |
$4,440.60 |
2.1× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$2,364.10 |
$5,910.25 |
5.6× |
| Cardiac MRI morphology & function w/o contrast (75557) |
$968.08 |
$2,420.18 |
3.8× |
| Cardiac MRI w/stress img (75559) |
$1,161.69 |
$2,904.22 |
2.0× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$1,480.20 |
$3,700.50 |
4.0× |
| Cholecystography, oral contrast Age Under 21 (74290) |
$338.73 |
$846.81 |
1.8× |
| Cineradiography/videoradiography (76120) |
$977.87 |
$2,444.67 |
8.9× |
| Clavicle complete (73000) |
$452.66 |
$1,131.63 |
4.9× |
| Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) |
$758.78 |
$1,896.94 |
3.0× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$6,456.04 |
$16,140.08 |
17.5× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$3,160.88 |
$7,902.20 |
17.1× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$3,378.56 |
$8,446.38 |
18.3× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$3,306.60 |
$8,266.49 |
17.9× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$5,409.22 |
$13,523.04 |
29.2× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$3,479.72 |
$8,699.29 |
18.8× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$3,295.16 |
$8,237.90 |
17.8× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,481.68 |
$6,204.18 |
13.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,672.23 |
$6,680.56 |
14.4× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$2,248.02 |
$5,620.04 |
20.4× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$4,208.30 |
$10,520.74 |
22.7× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,546.41 |
$6,366.01 |
13.8× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$2,687.42 |
$6,718.54 |
14.5× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$2,055.55 |
$5,138.87 |
18.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,511.25 |
$6,278.11 |
13.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$2,373.70 |
$5,934.24 |
21.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,973.41 |
$7,433.52 |
16.1× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$3,341.86 |
$8,354.65 |
18.1× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$2,941.40 |
$7,353.49 |
15.9× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$3,012.54 |
$7,531.33 |
16.3× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$1,024.47 |
$2,561.17 |
7.2× |
| Corpora cavernosography, radiological supervision and interpretation Age Under 21 (74445) |
$238.83 |
$597.07 |
2.2× |
| Csf shunt evaluation (78645) |
$1,011.90 |
$2,529.75 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,185.93 |
$15,464.82 |
16.8× |
| CT abdomen and pelvis without contrast (74176) |
$4,120.54 |
$10,301.33 |
16.4× |
| CT abdomen w & w/o contrast (74170) |
$3,240.24 |
$8,100.60 |
17.5× |
| CT abdomen w/contrast (74160) |
$2,828.88 |
$7,072.20 |
15.3× |
| CT abdomen w/o contrast (74150) |
$2,167.09 |
$5,417.71 |
19.7× |
| CT angio hrt w/3d image (75574) |
$673.50 |
$1,683.73 |
1.8× |
| CT cervical spine w/contrast (72126) |
$2,580.72 |
$6,451.79 |
7.0× |
| CT cervical spine w/o contrast (72125) |
$2,306.88 |
$5,767.18 |
20.9× |
| CT chest w/contrast (71260) |
$2,957.21 |
$7,393.02 |
16.0× |
| CT extremity upper w & w/o contrast (73202) |
$3,513.71 |
$8,784.26 |
19.0× |
| CT extremity upper w/o contrast (73200) |
$2,428.60 |
$6,071.50 |
22.0× |
| CT head/brain with contrast (70460) |
$2,604.33 |
$6,510.82 |
14.1× |
| CT head/brain without and with contrast (70470) |
$3,105.14 |
$7,762.83 |
16.8× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$1,306.41 |
$3,266.01 |
3.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,924.26 |
$4,810.64 |
5.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,043.12 |
$5,107.80 |
22.3× |
| CT l-spine w/contrast (72132) |
$2,519.43 |
$6,298.56 |
6.8× |
| CT limited/localized follow up study (76380) |
$1,200.14 |
$3,000.35 |
13.1× |
| CT lower extremity w/dye (73701) |
$3,506.92 |
$8,767.29 |
19.0× |
| CT lumbar spine w/o contrast (72131) |
$2,302.23 |
$5,755.57 |
20.9× |
| CT maxillofacial w/wo contrast (70488) |
$3,224.90 |
$8,062.23 |
17.4× |
| CT neck w/contrast (70491) |
$2,978.33 |
$7,445.81 |
16.1× |
| CT neck w/o contrast (70490) |
$2,224.42 |
$5,561.03 |
20.2× |
| CT pelvis w & w/o contrast (72194) |
$2,945.70 |
$7,364.24 |
15.9× |
| CT pelvis w/o contrast (72192) |
$1,953.47 |
$4,883.67 |
17.7× |
| CT thoracic spine w/contrast (72129) |
$2,451.16 |
$6,127.89 |
13.2× |
| CT thoracic spine w/o contrast (72128) |
$2,354.46 |
$5,886.13 |
21.3× |
| CT thorax lung cancer scr c- (71271) |
$379.49 |
$948.71 |
3.4× |
| CT thorax w/o contrast (71250) |
$2,099 |
$5,247.48 |
19.0× |
| CT upper extremity w/dye (73201) |
$2,888.14 |
$7,220.35 |
7.8× |
| CTA head w contrast (70496) |
$3,283.26 |
$8,208.15 |
17.7× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$747.24 |
$1,868.09 |
2.0× |
| Dilation ureters/urethra rs&i (74485) |
$1,087.55 |
$2,718.86 |
0.5× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$2,632.15 |
$6,580.37 |
1.3× |
| Diskography lumbar s&i (72295) |
$2,632.15 |
$6,580.37 |
1.3× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Age Under 21 (76827) |
$865.70 |
$2,164.25 |
7.9× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$663.70 |
$1,659.25 |
6.0× |
| Doppler fetal mid cerebral artery (76821) |
$450.02 |
$1,125.04 |
4.1× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$391.08 |
$977.68 |
3.5× |
| Dxa bone density study axial skeleton (77085) |
$550.54 |
$1,376.34 |
5.0× |
| Dxa bone density/peripheral (77081) |
$462.40 |
$1,156 |
5.0× |
| Echo exam of eye (76516) |
$346.28 |
$865.68 |
3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76825) |
$1,962.25 |
$4,905.62 |
3.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$865.70 |
$2,164.25 |
3.4× |
| Fetal biophys profile w/o nst (76819) |
$681.67 |
$1,704.16 |
6.2× |
| Fetal biophysical profile non-stress testing (76818) |
$818 |
$2,045 |
7.4× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$614.30 |
$1,535.74 |
2.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,405.34 |
$6,013.34 |
4.2× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$1,924.27 |
$4,810.67 |
4.6× |
| Gated heart planar single (78472) |
$1,970.10 |
$4,925.23 |
4.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,723.22 |
$4,308.03 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,694.91 |
$16,737.27 |
9.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,405.59 |
$13,513.96 |
7.4× |
| Heart infarct image (78466) |
$1,186.40 |
$2,965.98 |
2.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,420.66 |
$6,051.63 |
0.7× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Age Under… (75889) |
$2,904.78 |
$7,261.95 |
0.9× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$2,141.90 |
$5,354.74 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,987.21 |
$4,968.01 |
4.7× |
| Ht muscle image spect sing (78451) |
$4,383.98 |
$10,959.95 |
3.2× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$466.09 |
$1,165.21 |
1.1× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$10,754.41 |
$26,886.02 |
7.4× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$7,965.74 |
$19,914.33 |
10.8× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,197.15 |
$2,992.86 |
2.8× |
| Intracavitary radiation source application - complex (77763) |
$4,335.69 |
$10,839.22 |
5.9× |
| Intraoperative radiation treatment delivery, electrons, single treatment session (77425) |
$4,830.29 |
$12,075.71 |
0.6× |
| Intraoperative radiation treatment delivery, x-ray, single treatment session (77424) |
$5,034.26 |
$12,585.64 |
0.6× |
| Isodose brachytherapy complex 10+ sources (77318) |
$4,074.54 |
$10,186.34 |
10.3× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$3,159.26 |
$7,898.13 |
8.0× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$2,919.60 |
$7,299 |
7.4× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$4,503.58 |
$11,258.93 |
11.4× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$4,041.62 |
$10,104.04 |
10.2× |
| Kidney function study, non-imaging radioisotopic study Age Under 21 (78725) |
$817.80 |
$2,044.50 |
1.9× |
| Kidney imaging morphology; with vascular flow Age Under 21 (78701) |
$694.70 |
$1,736.74 |
1.6× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,466.50 |
$3,666.24 |
2.6× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,906.86 |
$4,767.14 |
3.3× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$2,839.65 |
$7,099.12 |
5.0× |
| Leveen/shunt patency exam (78291) |
$830.15 |
$2,075.37 |
2.0× |
| Liver and spleen imaging (78215) |
$1,159.24 |
$2,898.10 |
2.7× |
| Liver imaging (78201) |
$1,190.20 |
$2,975.50 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$1,735.29 |
$4,338.22 |
3.0× |
| Lung perfusion imaging (78580) |
$1,363.22 |
$3,408.04 |
3.2× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Age Under 21 (75807) |
$1,686.99 |
$4,217.46 |
0.5× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$4,712.08 |
$11,780.18 |
12.8× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$4,303.39 |
$10,758.46 |
11.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$3,556.55 |
$8,891.37 |
14.1× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$5,050.22 |
$12,625.52 |
13.7× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$2,841.66 |
$7,104.14 |
7.7× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,732.12 |
$6,830.30 |
10.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$4,047.97 |
$10,119.92 |
11.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,857.56 |
$12,143.90 |
13.2× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$2,514.59 |
$6,286.47 |
6.8× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$3,630.77 |
$9,076.92 |
9.9× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$3,206.25 |
$8,015.61 |
8.7× |
| Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire… (70555) |
$5,342.88 |
$13,357.18 |
21.2× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$732.70 |
$1,831.75 |
2.9× |
| Mammary ductogram single (77053) |
$610.59 |
$1,526.46 |
2.4× |
| Mandible min 4v (70110) |
$604.07 |
$1,510.16 |
5.5× |
| Med physic dos eval rad exps (76145) |
$966.36 |
$2,415.89 |
2.5× |
| Mr safety determination physician/other qhp (76016) |
$551.20 |
$1,378 |
6.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$551.20 |
$1,378 |
8.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$551.20 |
$1,378 |
18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$551.20 |
$1,378 |
5.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$551.20 |
$1,378 |
2.2× |
| MRA head w/o contrast (70544) |
$2,372.53 |
$5,931.32 |
9.4× |
| MRA neck w/ contrast (70548) |
$2,832.46 |
$7,081.15 |
7.7× |
| MRA neck w/o contrast (70547) |
$2,458.68 |
$6,146.70 |
9.8× |
| MRI abdomen w/contrast (74182) |
$2,838.09 |
$7,095.22 |
7.7× |
| MRI abdomen w/o contrast (74181) |
$2,520.89 |
$6,302.22 |
10.0× |
| MRI abdomen w/wo contrast (74183) |
$3,157.89 |
$7,894.71 |
8.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,926.73 |
$9,816.82 |
4.7× |
| MRI breast c- bilateral (77047) |
$2,371.18 |
$5,927.94 |
9.4× |
| MRI breast without contrast material unilateral (77046) |
$1,839.94 |
$4,599.84 |
7.3× |
| MRI c-spine w&w/o cont (72156) |
$3,096.78 |
$7,741.93 |
8.4× |
| MRI cervical spine w/contrast (72142) |
$2,802.96 |
$7,007.38 |
7.6× |
| MRI chest w/contrast (71551) |
$2,663.74 |
$6,659.35 |
3.2× |
| MRI chest w/o contrast (71550) |
$2,131 |
$5,327.49 |
8.5× |
| MRI chest w/wo contrast (71552) |
$3,329.68 |
$8,324.20 |
9.0× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,663.78 |
$11,659.44 |
12.7× |
| MRI joint upr extrem w/dye (73222) |
$4,230.86 |
$10,577.12 |
5.1× |
| MRI joint upr extrem w/o dye (73221) |
$3,546.34 |
$8,865.84 |
14.1× |
| MRI lumbar spine w/contrast (72149) |
$3,078.86 |
$7,697.15 |
8.4× |
| MRI lumbar spine w/wo contrast (72158) |
$3,475.08 |
$8,687.70 |
9.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,519.55 |
$8,798.87 |
9.6× |
| MRI pelvis w & w/o contrast (72197) |
$3,132.46 |
$7,831.14 |
8.5× |
| MRI pelvis w/contrast (72196) |
$2,291.94 |
$5,729.83 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,451.40 |
$3,628.48 |
5.8× |
| MRI spectroscopy (76390) |
$3,289.91 |
$8,224.76 |
35.8× |
| MRI spine cervical w/o contrast (72141) |
$2,562.31 |
$6,405.76 |
10.2× |
| MRI t-spine w&w/o cont (72157) |
$3,267.86 |
$8,169.63 |
8.9× |
| MRI thoracic spine w/contrast (72147) |
$2,735.66 |
$6,839.13 |
7.4× |
| MRI thoracic spine w/o contrst (72146) |
$2,446.03 |
$6,115.07 |
9.7× |
| MRI tmj (70336) |
$3,602.61 |
$9,006.52 |
14.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,514.23 |
$8,785.57 |
14.0× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$12,138.33 |
$30,345.82 |
30.7× |
| Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) |
$1,309.33 |
$3,273.31 |
1.6× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78432) |
$3,278.64 |
$8,196.60 |
2.0× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$3,419.03 |
$8,547.57 |
2.3× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$4,273.78 |
$10,684.45 |
2.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78430) |
$4,435.55 |
$11,088.86 |
2.9× |
| Myocardial spect multiple studies (78452) |
$5,321.32 |
$13,303.28 |
3.9× |
| Myocrd img PET 2rtracer CT (78433) |
$4,646.50 |
$11,616.24 |
2.0× |
| Myocrd img PET metab eval single study (78459) |
$3,265.71 |
$8,164.26 |
2.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,435.55 |
$11,088.86 |
2.9× |
| Myocrd img PET rst&strs CT (78431) |
$4,435.55 |
$11,088.86 |
1.9× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$6,753.40 |
$16,883.48 |
7.5× |
| Nm adrenal imaging (78075) |
$1,954.38 |
$4,885.94 |
1.4× |
| Nm bone 3 phase (78315) |
$2,060.36 |
$5,150.88 |
4.9× |
| Nm bone imaging whole body (78306) |
$2,443.25 |
$6,108.12 |
5.8× |
| Nm bone marrow ltd (78102) |
$411.87 |
$1,029.67 |
1.0× |
| Nm bone marrow multi (78103) |
$1,398.77 |
$3,496.91 |
3.3× |
| Nm bone marrow wb (78104) |
$1,583.11 |
$3,957.76 |
3.8× |
| Nm csf cisternogram (78630) |
$2,430.50 |
$6,076.24 |
4.2× |
| Nm csf leak detection (78650) |
$1,444.07 |
$3,610.16 |
1.1× |
| Nm gastric emptying (78264) |
$1,668.34 |
$4,170.85 |
4.0× |
| Nm lung ventilation imaging (78579) |
$1,637.44 |
$4,093.58 |
3.9× |
| Nm lymph system (78195) |
$1,714.89 |
$4,287.21 |
3.0× |
| Nm myocard infarct spect (78469) |
$1,412.68 |
$3,531.68 |
2.5× |
| Nuclear medicine study for detecting heart shunt (78428) |
$1,274.56 |
$3,186.38 |
3.0× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,519.18 |
$3,797.95 |
3.6× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,823.02 |
$4,557.55 |
4.3× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$184.60 |
$461.49 |
0.4× |
| Ob us limited fetus(s) (76815) |
$577.13 |
$1,442.82 |
5.2× |
| Ob us nuchal meas 1 gest (76813) |
$663.70 |
$1,659.25 |
6.0× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Age Under 21 (76519) |
$415.54 |
$1,038.84 |
3.8× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$966.70 |
$2,416.74 |
8.8× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$966.70 |
$2,416.74 |
8.8× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter Age Under… (76510) |
$675.78 |
$1,689.42 |
4.8× |
| Panoramic X-ray of jaws (70355) |
$291.33 |
$728.32 |
3.2× |
| Parathyrd planar w/spect&CT (78072) |
$3,675.23 |
$9,188.06 |
6.4× |
| Parathyroid planar imaging (78070) |
$1,841.95 |
$4,604.86 |
4.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,809.25 |
$7,023.12 |
6.7× |
| Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation Age… (75885) |
$2,806.58 |
$7,016.44 |
0.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,111.14 |
$12,777.85 |
3.4× |
| PET imaging CT for attenuation limited area (78814) |
$4,879.11 |
$12,197.76 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,355.66 |
$13,389.14 |
3.6× |
| PET imaging whole body (78813) |
$3,702.54 |
$9,256.34 |
2.5× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$3,606.51 |
$9,016.27 |
2.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,172.37 |
$2,930.92 |
0.4× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,482.46 |
$6,206.13 |
4.3× |
| Quant differential pulm perfusion w/wo imaging (78597) |
$1,735.29 |
$4,338.22 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$820.17 |
$2,050.42 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$429.73 |
$1,074.31 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$515.68 |
$1,289.18 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$618.81 |
$1,547.01 |
5.6× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$742.56 |
$1,856.39 |
6.7× |
| Radex hip unilateral with pelvis 1 view (73501) |
$531.54 |
$1,328.85 |
5.8× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$637.85 |
$1,594.61 |
6.9× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$765.41 |
$1,913.52 |
6.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$829.20 |
$2,073 |
7.5× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$1,194.05 |
$2,985.12 |
10.8× |
| Radex spine cervical 2 or 3 views (72040) |
$456.09 |
$1,140.21 |
5.0× |
| Radex spine cervical 4 or 5 views (72050) |
$694.21 |
$1,735.51 |
6.3× |
| Radex spine cervical 6 or more views (72052) |
$850.32 |
$2,125.80 |
7.7× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$519.08 |
$1,297.69 |
5.7× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) |
$13,140.52 |
$32,851.30 |
1.7× |
| Radiation tx delivery lvl 1 (77402) |
$527.78 |
$1,319.45 |
4.9× |
| Radiation tx delivery lvl 2 (77407) |
$889.18 |
$2,222.94 |
2.2× |
| Radiation tx delivery lvl 3 (77412) |
$1,230.62 |
$3,076.53 |
2.1× |
| Radiologic exam abdomen 3+ views (74021) |
$420.98 |
$1,052.44 |
3.8× |
| Radiologic exam chest 3 views (71047) |
$470.60 |
$1,176.49 |
5.1× |
| Radiologic exam chest 4+ views (71048) |
$550.91 |
$1,377.26 |
5.0× |
| Radiologic exam colon double contrast study (74280) |
$1,100.23 |
$2,750.56 |
5.9× |
| Radiologic exam colon single contrast study (74270) |
$998.44 |
$2,496.10 |
5.4× |
| Radiologic exam esophagus double contrast study (74221) |
$607.95 |
$1,519.87 |
3.3× |
| Radiologic exam esophagus single contrast study (74220) |
$635.05 |
$1,587.62 |
3.4× |
| Radiologic exam small int single contrast study (74250) |
$683.67 |
$1,709.17 |
3.7× |
| Radiologic exam swallow function contrast study (74230) |
$725.62 |
$1,814.03 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$333.90 |
$834.73 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$701.14 |
$1,752.85 |
3.8× |
| Radiologic examination femur 1 view (73551) |
$107.39 |
$268.47 |
1.2× |
| Radiologic examination femur minimum 2 views (73552) |
$128.88 |
$322.18 |
1.4× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$338.36 |
$845.89 |
3.7× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$511.32 |
$1,278.28 |
5.6× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$507.63 |
$1,269.07 |
4.6× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$386.32 |
$965.80 |
4.2× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$434.98 |
$1,087.46 |
4.7× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$381.30 |
$953.24 |
4.2× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$463.50 |
$1,158.74 |
5.0× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$427.82 |
$1,069.54 |
4.7× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$483.49 |
$1,208.72 |
5.3× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$669.76 |
$1,674.38 |
6.1× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$539.79 |
$1,349.47 |
5.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$561.14 |
$1,402.84 |
5.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$446.36 |
$1,115.89 |
4.9× |
| Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and… (74470) |
$1,002.21 |
$2,505.51 |
1.7× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$944.40 |
$2,361 |
8.6× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$813.41 |
$2,033.52 |
7.4× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$423.91 |
$1,059.76 |
3.8× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$716.51 |
$1,791.26 |
1.9× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$525.28 |
$1,313.18 |
5.7× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) |
$614.66 |
$1,536.65 |
5.6× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$365.79 |
$914.46 |
4.0× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$429.33 |
$1,073.32 |
3.9× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$601.16 |
$1,502.88 |
5.5× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$764.76 |
$1,911.89 |
6.9× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$1,129.37 |
$2,823.41 |
10.2× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$678.34 |
$1,695.85 |
6.2× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$450.68 |
$1,126.68 |
4.9× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$758.36 |
$1,895.90 |
8.3× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$454.30 |
$1,135.74 |
4.9× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$550.22 |
$1,375.52 |
6.0× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$669.82 |
$1,674.55 |
6.1× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$449.01 |
$1,122.52 |
4.9× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$366.94 |
$917.35 |
4.0× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$907.37 |
$2,268.40 |
8.2× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$2,949.80 |
$7,374.49 |
5.2× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$1,111.21 |
$2,778.01 |
4.5× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$2,056.25 |
$5,140.62 |
8.4× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion (79403) |
$1,130.51 |
$2,826.26 |
4.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$5,169.65 |
$12,924.11 |
12.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$6,694.91 |
$16,737.27 |
16.5× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$901.15 |
$2,252.87 |
3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$771.85 |
$1,929.62 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,884.25 |
$7,210.62 |
6.8× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$2,721.36 |
$6,803.40 |
4.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,378 |
$5,944.99 |
4.2× |
| Rp loclzj tum spect 2 areas (78831) |
$3,893.74 |
$9,734.34 |
2.9× |
| Rp loclzj tum spect w/CT 1 (78830) |
$3,244.79 |
$8,111.96 |
2.4× |
| Rp loclzj tum spect w/CT 2 (78832) |
$4,283.11 |
$10,707.77 |
2.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,187.38 |
$2,968.45 |
4.8× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$865.70 |
$2,164.25 |
3.4× |
| Scapula complete (73010) |
$462.14 |
$1,155.34 |
4.2× |
| Screening digital breast tomosynthesis bi (77063) |
$16 |
$40 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$313.18 |
$782.95 |
2.8× |
| Simulation intermediate (77285) |
$1,687.63 |
$4,219.06 |
4.3× |
| Special dosimetry (77331) |
$1,260.14 |
$3,150.34 |
8.9× |
| Special physics consult (77370) |
$1,541.63 |
$3,854.06 |
10.9× |
| Special teletherapy port plan (77321) |
$2,335.77 |
$5,839.41 |
5.9× |
| Special treatment procedure (77470) |
$6,869.44 |
$17,173.60 |
11.8× |
| Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) |
$11,344.36 |
$28,360.90 |
6.0× |
| Surface application of low dose rate radionuclide source (77789) |
$1,526.12 |
$3,815.28 |
14.2× |
| Testicular imaging with vascular flow Age Under 21 (78761) |
$849.04 |
$2,122.58 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,351.70 |
$5,879.25 |
6.0× |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$565.28 |
$1,413.18 |
3.1× |
| Thyroid imaging with vascular flow (78013) |
$895.39 |
$2,238.46 |
2.1× |
| Thyroid met imaging body (78018) |
$2,532.80 |
$6,331.99 |
4.4× |
| Thyroid uptake single/multiple quant measurement (78012) |
$481.26 |
$1,203.14 |
1.1× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,658.52 |
$4,146.30 |
3.9× |
| Tr simulation simple (77280) |
$1,197.50 |
$2,993.73 |
8.4× |
| Treatment device complex (77334) |
$1,510.55 |
$3,776.36 |
3.8× |
| Treatment device intermediate (77333) |
$1,192.34 |
$2,980.84 |
8.4× |
| Treatment device simple (77332) |
$925.90 |
$2,314.75 |
6.5× |
| Ultrasound breast limited (76642) |
$519.42 |
$1,298.54 |
5.7× |
| Ultrasound, abdomen limited (76705) |
$617.54 |
$1,543.83 |
5.6× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$519.42 |
$1,298.54 |
4.7× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$692.56 |
$1,731.40 |
6.3× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$577.13 |
$1,442.82 |
2.3× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$577.13 |
$1,442.82 |
5.2× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$663.70 |
$1,659.25 |
6.0× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$663.70 |
$1,659.25 |
6.0× |
| Umbilical-artery Doppler (OB) (76820) |
$560.93 |
$1,402.31 |
5.1× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine (78499) |
$921.30 |
$2,303.23 |
2.2× |
| Unlisted fluoroscopic procedure (76496) |
$731.32 |
$1,828.29 |
8.0× |
| Unlisted gastrointestinal procedure, diagnostic nuclear medicine (78299) |
$922.86 |
$2,307.15 |
2.2× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine (78799) |
$921.30 |
$2,303.23 |
2.2× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
$922.86 |
$2,307.15 |
2.2× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$2,224.56 |
$5,561.39 |
24.2× |
| Unlisted miscellaneous procedure, diagnostic nuclear medicine (78999) |
$896.92 |
$2,242.29 |
2.1× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine (78399) |
$921.30 |
$2,303.23 |
2.2× |
| Unlisted nervous system procedure, diagnostic nuclear medicine (78699) |
$921.30 |
$2,303.23 |
2.2× |
| Unlisted procedure, clinical brachytherapy (77799) |
$3,610.73 |
$9,026.81 |
33.5× |
| Unlisted procedure, therapeutic radiology clinical treatment planning (77299) |
$186.41 |
$466.01 |
1.3× |
| Unlisted respiratory procedure, diagnostic nuclear medicine (78599) |
$921.30 |
$2,303.23 |
2.2× |
| Urea breath test, C-14 (isotopic); acquisition for analysis Other Outpatient (78267) |
$218.15 |
$545.37 |
19.7× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$546.14 |
$1,365.33 |
5.8× |
| Ureteral reflux study (78740) |
$992.87 |
$2,482.16 |
2.4× |
| Urethrocystography retrograde rs&i (74450) |
$866.64 |
$2,166.59 |
3.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$217.37 |
$543.42 |
1.2× |
| Urography antegrade rs&i (74425) |
$1,015 |
$2,537.49 |
2.8× |
| Us abdominal aorta real time screen study aaa (76706) |
$577.13 |
$1,442.82 |
5.2× |
| Us breast uni real time with image complete (76641) |
$923.41 |
$2,308.52 |
8.4× |
| Us chest (76604) |
$829.63 |
$2,074.06 |
7.5× |
| Us compl joint r-t w/image documentation (76881) |
$966.70 |
$2,416.74 |
8.8× |
| Us elastography organ (76981) |
$139.52 |
$348.80 |
1.3× |
| Us encephalogram (76506) |
$577.13 |
$1,442.82 |
5.2× |
| Us exam, pelvic, limited (76857) |
$617.54 |
$1,543.83 |
5.6× |
| Us guided compression repair (76936) |
$761.25 |
$1,903.12 |
3.3× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$346.28 |
$865.68 |
3.8× |
| US OB Follow-Up/Repeat (76816) |
$577.13 |
$1,442.82 |
5.2× |
| Us ob transvaginal (76817) |
$577.13 |
$1,442.82 |
5.2× |
| Us retroperitoneal complete (76770) |
$853.74 |
$2,134.34 |
7.7× |
| Us retroperitoneal ltd (76775) |
$682.99 |
$1,707.47 |
6.2× |
| Us scrotum (76870) |
$663.70 |
$1,659.25 |
6.0× |
| Us soft tissue head/neck (76536) |
$577.13 |
$1,442.82 |
5.2× |
| Us spinal canal (76800) |
$346.28 |
$865.68 |
3.1× |
| Us transrectal (76872) |
$577.13 |
$1,442.82 |
5.2× |
| Us unlstd proc (76999) |
$1,017.23 |
$2,543.06 |
11.1× |
| Use 1st target lesion (76982) |
$139.52 |
$348.80 |
1.3× |
| Venogram sinus/jugular (75860) |
$11,509.58 |
$28,773.93 |
3.5× |
| Venography adrenal unilateral selective rs&i (75840) |
$3,734.82 |
$9,337.04 |
1.1× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$3,793.67 |
$9,484.17 |
41.3× |
| Venography renal unilateral selective rs&i (75831) |
$2,885.93 |
$7,214.82 |
0.9× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$2,302.01 |
$5,755.01 |
0.7× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$2,297.17 |
$5,742.91 |
1.4× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$2,216.15 |
$5,540.37 |
1.3× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,100.47 |
$2,751.17 |
0.7× |
| Venography, orbital, radiological supervision and interpretation Age Under 21 (75880) |
$1,026.22 |
$2,565.53 |
1.6× |
| Venography, superior sagittal sinus, radiological supervision and interpretation Age Under 21 (75870) |
$1,616.37 |
$4,040.92 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low — confirm this is the full procedure |
$2,687.39 |
$6,718.46 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$64.08 |
$160.18 |
0.7× |
| X-ray exam hips bi 3-4 views (73522) |
$995.03 |
$2,487.57 |
9.0× |
| X-ray exam of finger(s) (73140) |
$395.37 |
$988.41 |
4.3× |
| X-ray exam of knee 1 or 2 (73560) |
$454.06 |
$1,135.15 |
4.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,227.62 |
$3,069.03 |
6.6× |
| X-ray exam ribs bil 3 views (71110) |
$903.20 |
$2,257.98 |
8.2× |
| X-ray exam ribs uni 2 views (71100) |
$649.24 |
$1,623.10 |
7.1× |
| X-ray heel (73650) |
$402.71 |
$1,006.76 |
4.4× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$515.81 |
$1,289.51 |
4.7× |
| X-ray retrograde pyelogram (74420) |
$606.56 |
$1,516.38 |
1.6× |
| Xr abdomen 1 view (74018) |
$284.41 |
$711.02 |
3.1× |
| Xr abdomen 2 views (74019) |
$413.94 |
$1,034.84 |
3.8× |
| Xr arthrogram ankle (73615) |
$584.90 |
$1,462.24 |
1.6× |
| Xr arthrogram elbow (73085) |
$783.48 |
$1,958.70 |
2.1× |
| Xr arthrogram hip (73525) |
$559.38 |
$1,398.44 |
1.5× |
| Xr arthrogram knee (73580) |
$929.58 |
$2,323.94 |
2.5× |
| Xr arthrogram wrist (73115) |
$1,074.48 |
$2,686.20 |
2.9× |
| Xr bone age studies (77072) |
$262.04 |
$655.09 |
2.4× |
| Xr bone length study (77073) |
$105.17 |
$262.91 |
1.0× |
| Xr bone survey infant (77076) |
$548.58 |
$1,371.45 |
5.0× |
| Xr bone survey ltd (77074) |
$303.72 |
$759.30 |
2.8× |
| Xr chest 1 view (71045) |
$322.32 |
$805.78 |
3.5× |
| Xr chest 2 views (71046) |
$392.56 |
$981.38 |
4.3× |
| Xr eye foreign body (70030) |
$622.41 |
$1,556.02 |
6.8× |
| Xr facial bones 3+ views (70150) |
$578.90 |
$1,447.25 |
5.2× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$347.74 |
$869.34 |
3.8× |
| Xr forearm 2 views (73090) |
$401.43 |
$1,003.56 |
4.4× |
| Xr hand 2v (73120) |
$400.16 |
$1,000.40 |
3.6× |
| Xr hysterosalpingogram (74740) |
$750.81 |
$1,877.02 |
3.0× |
| Xr joint survey 1 view (77077) |
$287.75 |
$719.37 |
2.6× |
| Xr myelogram c-spine (72240) |
$1,151.42 |
$2,878.53 |
1.4× |
| Xr myelogram l-spine (72265) |
$1,129.78 |
$2,824.44 |
1.4× |
| Xr myelogram t-spine (72255) |
$885.96 |
$2,214.88 |
1.1× |
| Xr neck soft tissue (70360) |
$361.47 |
$903.66 |
3.9× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$477.18 |
$1,192.96 |
5.2× |
| Xr osseous survey complete (77075) |
$817.86 |
$2,044.65 |
7.4× |
| Xr pelvis 1-2 views (72170) |
$340.48 |
$851.19 |
3.1× |
| Xr pelvis min 3 view (72190) |
$395.16 |
$987.88 |
3.6× |
| Xr peritoneogram (74190) |
$1,250.50 |
$3,126.24 |
2.2× |
| Xr sacrum/coccyx 2+ views (72220) |
$443.31 |
$1,108.27 |
4.8× |
| Xr sella turcica (70240) |
$323.82 |
$809.53 |
3.5× |
| Xr shoulder 1 view (73020) |
$285.78 |
$714.44 |
3.1× |
| Xr sialogram (70390) |
$292.17 |
$730.41 |
1.2× |
| Xr sinuses 3+ views (70220) |
$593.62 |
$1,484.05 |
6.5× |
| Xr skull min 4 view (70260) |
$853.28 |
$2,133.19 |
7.7× |
| Xr spine 1 view (72020) |
$356.07 |
$890.16 |
3.9× |
| Xr spine thoracic 3v (72072) |
$565.28 |
$1,413.19 |
5.1× |
| Xr sternum 2+ views (71120) |
$447.70 |
$1,119.24 |
4.9× |
| Xr stress view joint (77071) |
$315.80 |
$789.51 |
3.4× |
| Xr surgical specimen (76098) |
$348.62 |
$871.54 |
0.6× |
| Xr t-spine 2 views (72070) |
$471.07 |
$1,177.67 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$439.57 |
$1,098.92 |
4.8× |
| Xr tmj bilateral (70330) |
$701.72 |
$1,754.29 |
7.6× |
| Xr tmj unilateral (70328) |
$539.79 |
$1,349.47 |
5.9× |
| Xr venogram renal bilat (75833) |
$5,771.86 |
$14,429.64 |
1.7× |
| Xr wrist 2 views (73100) |
$385.29 |
$963.22 |
4.2× |