| 3-D radiotherapy plan dose-volume histograms (77295) |
$697.26 |
$6,972.63 |
0.5× |
| Abdomen 2 views (74019) |
$13.09 |
$130.94 |
0.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$49.12 |
$491.21 |
0.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$379.63 |
$3,796.26 |
0.1× |
| Angiography extremity bilateral rs&i (75716) |
$379.63 |
$3,796.26 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$758.70 |
$7,587 |
0.2× |
| Angiography internal mammary rs&i (75756) |
$379.63 |
$3,796.26 |
0.1× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$700.40 |
$7,004 |
0.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$379.63 |
$3,796.26 |
0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$433.62 |
$4,336.13 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,443.40 |
$14,434 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,226.60 |
$12,266 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$314.75 |
$3,147.50 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$441.02 |
$4,410.13 |
0.1× |
| Ankle 2 views (73600) |
$70.80 |
$708 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$45.80 |
$458.03 |
0.1× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$977.30 |
$9,772.95 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$613.52 |
$6,135.13 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$379.63 |
$3,796.26 |
0.1× |
| Artery X-Rays Adrenal Gland (75731) |
$379.63 |
$3,796.26 |
0.1× |
| Arthrogram elbow (73085) |
$45.80 |
$458.03 |
0.1× |
| Arthrogram hip (73525) |
$109.45 |
$1,094.52 |
0.3× |
| Arthrogram shoulder (73040) |
$256.40 |
$2,564.02 |
0.8× |
| Arthrogram wrist (73115) |
$75.55 |
$755.52 |
0.2× |
| Arthrography knee lt (73580) |
$45.80 |
$458.03 |
0.1× |
| Basic radiation dosimetry calculation (77300) |
$225 |
$2,250 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$49.12 |
$491.21 |
0.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$49.12 |
$491.21 |
0.1× |
| Bone &/joint imaging whole body (78306) |
$49.12 |
$491.21 |
0.1× |
| Bone age studies (77072) |
$35.30 |
$352.97 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$49.12 |
$491.21 |
0.1× |
| Bone Marrow Imaging Limited Area (78102) |
$49.12 |
$491.21 |
0.1× |
| Bone survey complete (77075) |
$38.44 |
$384.47 |
0.4× |
| Brachytx isodose complex (77318) |
$297.90 |
$2,979 |
0.8× |
| Brachytx isodose intermed (77317) |
$106.20 |
$1,062.03 |
0.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$79 |
$790.03 |
0.2× |
| Brain image w/flow 4 + views (78606) |
$64.37 |
$643.74 |
0.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$49.12 |
$491.21 |
0.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$64.37 |
$643.74 |
0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$186.33 |
$1,863.25 |
0.1× |
| Brain Imaging Vascular Flow Only (78610) |
$64.37 |
$643.74 |
0.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$49.12 |
$491.21 |
0.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$186.95 |
$1,869.52 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$64.37 |
$643.74 |
0.1× |
| Cervical spine 2 or 3 views (72040) |
$10.82 |
$108.23 |
0.1× |
| Chest 1 view (71045) |
$10.84 |
$108.42 |
0.1× |
| Chest 3 views (71047) |
$10.82 |
$108.23 |
0.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$21.88 |
$218.83 |
0.1× |
| Clavicle complete (73000) |
$89.10 |
$891 |
1.1× |
Complete single session course of cranial lesion surgery using radiation (77371)
likely a partial charge, not the full procedure |
$927.46 |
$9,274.55 |
0.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$15.60 |
$155.97 |
0.2× |
| Continuing medical physics consltj pr wk (77336) |
$16.16 |
$161.60 |
0.1× |
| Corpora cavernosography (74445) |
$13.09 |
$130.94 |
0.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$45.80 |
$458.03 |
0.1× |
| CT abdomen and pelvis without contrast (74176) |
$29.18 |
$291.84 |
0.1× |
| CT abdomen w contrast (74160) |
$21.88 |
$218.83 |
0.1× |
| CT abdomen w wo contrast (74170) |
$21.88 |
$218.83 |
0.1× |
| CT abdomen w/o contrast (74150) |
$13.09 |
$130.94 |
0.1× |
| CT angio hrt w/3d image (75574) |
$47.50 |
$475.06 |
0.1× |
| CT angiography upper extremity lt (73206) |
$509 |
$5,090 |
3.0× |
| CT c-spine w/o contrast (72125) |
$13.09 |
$130.94 |
0.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$557.10 |
$5,571 |
3.3× |
| CT cervical spine w&w/o contrast (72127) |
$21.88 |
$218.83 |
0.1× |
| CT cervical spine with contrast (72126) |
$45.80 |
$458.03 |
0.1× |
| CT chest w/wo contrast (71270) |
$21.88 |
$218.83 |
0.1× |
| CT chest with contrast (71260) |
$21.88 |
$218.83 |
0.1× |
| CT colonography screening (74263) |
$27.18 |
$271.86 |
0.1× |
| CT head/brain with contrast (70460) |
$21.88 |
$218.83 |
0.1× |
| CT head/brain without and with contrast (70470) |
$21.88 |
$218.83 |
0.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$39.10 |
$391.06 |
0.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$10.82 |
$108.23 |
0.1× |
| CT hrt w/3d image congen (75573) |
$264.36 |
$2,643.56 |
0.8× |
| CT iac w contrast (70481) |
$21.88 |
$218.83 |
0.1× |
| CT limited/localized follow up study (76380) |
$10.82 |
$108.23 |
0.1× |
| CT lower ext w/o (73700) |
$236.70 |
$2,366.97 |
2.4× |
| CT lower extremity w wo contrast (73702) |
$473.19 |
$4,731.92 |
2.8× |
| CT lower extremity with contrast (73701) |
$500 |
$5,000 |
3.0× |
| CT lumbar spine w & w/o contrast (72133) |
$21.88 |
$218.83 |
0.1× |
| CT lumbar spine w/o contrast (72131) |
$13.09 |
$130.94 |
0.1× |
| CT lumbar spine with contrast (72132) |
$45.80 |
$458.03 |
0.1× |
| CT maxillofacial w contrast (70487) |
$21.88 |
$218.83 |
0.1× |
| CT maxillofacial w/o contrast (70486) |
$13.09 |
$130.94 |
0.1× |
| CT maxillofacial w/wo contrast (70488) |
$380.24 |
$3,802.42 |
2.3× |
| CT neck soft tissue w contrast (70491) |
$21.88 |
$218.83 |
0.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$21.88 |
$218.83 |
0.1× |
| CT orbits w/o contrast (70480) |
$13.09 |
$130.94 |
0.1× |
| CT pelvis w & w/o contrast (72194) |
$21.88 |
$218.83 |
0.1× |
| CT pelvis w/o contrast (72192) |
$13.09 |
$130.94 |
0.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$21.88 |
$218.83 |
0.1× |
| CT soft tissue neck w/o contrast (70490) |
$13.09 |
$130.94 |
0.1× |
| CT thoracic spine w/contrast (72129) |
$21.88 |
$218.83 |
0.1× |
| CT thoracic spine w/o contrast (72128) |
$13.09 |
$130.94 |
0.1× |
| CT thoracic spine w/wo contrast (72130) |
$21.88 |
$218.83 |
0.1× |
| CT thorax w/o contrast (71250) |
$13.09 |
$130.94 |
0.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$184.69 |
$1,846.92 |
1.1× |
| CT upper extremity w/o contrast rt (73200) |
$311 |
$3,110 |
3.1× |
| CT upper extremity with contrast (73201) |
$356.20 |
$3,562 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$21.88 |
$218.83 |
0.1× |
| Cta Abdomen (74175) |
$286.94 |
$2,869.42 |
1.7× |
| CTA abdomen pelvis (74174) |
$170.90 |
$1,709 |
0.5× |
| CTA chest (71275) |
$21.88 |
$218.83 |
0.1× |
| Cta Head (70496) |
$21.88 |
$218.83 |
0.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,024.70 |
$10,247 |
3.1× |
| CTA lwr ext w&w/o contrast (73706) |
$539.20 |
$5,392 |
3.2× |
| Cta Neck (70498) |
$21.88 |
$218.83 |
0.1× |
| Cta Pelvis (72191) |
$21.88 |
$218.83 |
0.1× |
| Cystography minimum 3 views rs&i (74430) |
$45.80 |
$458.03 |
0.1× |
| Diskogram cervical (72285) |
$557.30 |
$5,573 |
0.3× |
| Diskography lumbar (72295) |
$557.30 |
$5,573 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$63.80 |
$637.97 |
0.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$78.14 |
$781.47 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$13.09 |
$130.94 |
0.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$13.09 |
$130.94 |
0.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$15.76 |
$157.62 |
0.2× |
| Dxa bone density study axial skeleton (77085) |
$22.64 |
$226.47 |
0.2× |
| Echo exam of fetal heart (76825) |
$247.55 |
$2,475.52 |
0.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$133.14 |
$1,331.42 |
0.6× |
| Echoencephalography real time imaging (76506) |
$102.34 |
$1,023.47 |
1.0× |
| Esophageal motility (78258) |
$82.86 |
$828.60 |
0.2× |
| Esophagus (74220) |
$21.88 |
$218.83 |
0.1× |
| Fetal biophysical profile non-stress testing (76818) |
$13.09 |
$130.94 |
0.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$39.50 |
$394.97 |
0.4× |
| Fluoroscopy up to 1 hr (76000) |
$29.18 |
$291.84 |
0.1× |
| Foot 2 views (73620) |
$70.10 |
$701 |
0.8× |
| Forearm 2 views (73090) |
$73.20 |
$732 |
0.9× |
| Functional MRI brain by tech (70554) |
$263.99 |
$2,639.92 |
1.2× |
| Gated Heart Planar Single (78472) |
$206.26 |
$2,062.60 |
0.5× |
| Hand 2 views (73120) |
$54.10 |
$541 |
0.5× |
| Hand 3 views (73130) |
$76.70 |
$767 |
0.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$85.39 |
$853.91 |
0.1× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$282.24 |
$2,822.46 |
0.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$318.20 |
$3,181.96 |
0.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$609.46 |
$6,094.63 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$64.37 |
$643.74 |
0.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$49.12 |
$491.21 |
0.1× |
| Ht muscle image spect sing (78451) |
$288.21 |
$2,882.08 |
0.2× |
| Humerus Min 2 Views Left (73060) |
$77.40 |
$774 |
0.9× |
| Hysterosalpingogram (74740) |
$120.39 |
$1,203.92 |
0.5× |
| Interstitial radiation source applic complex (77778) |
$85.39 |
$853.91 |
0.1× |
| Kidney imaging morphology (78700) |
$286.41 |
$2,864.10 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$64.37 |
$643.74 |
0.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$64.37 |
$643.74 |
0.1× |
| Knee 3 views (73562) |
$111.30 |
$1,113 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$49.12 |
$491.21 |
0.1× |
| Liver imaging w/vascular flow (78202) |
$64.37 |
$643.74 |
0.1× |
| Lung perf&ventilat diferentl (78598) |
$150.98 |
$1,509.87 |
0.3× |
| Lung perfusion differential (78597) |
$89.71 |
$897.10 |
0.2× |
| Lung Ventilation Imaging (78579) |
$49.12 |
$491.21 |
0.1× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$379.63 |
$3,796.26 |
0.1× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$190.74 |
$1,907.41 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$379.63 |
$3,796.26 |
0.1× |
| Lymphoscintigraphy (78195) |
$64.37 |
$643.74 |
0.1× |
| Mammary ductogram or galactogram multiple (77054) |
$29.18 |
$291.84 |
0.1× |
| Mammary ductogram or galactogram single (77053) |
$29.18 |
$291.84 |
0.1× |
| Meckels Diverticulum (78290) |
$232.86 |
$2,328.60 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$507.30 |
$5,073 |
1.4× |
| Mr safety determination physician/other qhp (76016) |
$11 |
$110 |
0.1× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$7.40 |
$74 |
0.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$3.10 |
$31 |
0.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$11.50 |
$115 |
0.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$30.20 |
$302 |
0.1× |
| MRA head w & w/o contrast (70546) |
$45.80 |
$458.03 |
0.1× |
| MRA head w/o contrast (70544) |
$29.18 |
$291.84 |
0.1× |
| MRA head with contrast (70545) |
$45.80 |
$458.03 |
0.1× |
| MRA neck w contrast (70548) |
$45.80 |
$458.03 |
0.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$45.80 |
$458.03 |
0.1× |
| MRA neck w/o contrast (70547) |
$29.18 |
$291.84 |
0.1× |
| MRI abdomen w contrast (74182) |
$45.80 |
$458.03 |
0.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$45.80 |
$458.03 |
0.1× |
| MRI abdomen w/o contrast (74181) |
$29.18 |
$291.84 |
0.1× |
| MRI any jnt lwr ext with con lt (73722) |
$385.68 |
$3,856.80 |
0.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$411.68 |
$4,116.80 |
0.5× |
| MRI breast w/o contrast bilateral (77047) |
$224.59 |
$2,245.92 |
1.0× |
| MRI breast w/o contrast unilat (77046) |
$29.18 |
$291.84 |
0.1× |
| MRI c-spine with contrast (72142) |
$494.75 |
$4,947.52 |
1.5× |
| MRI cardiac w/o cont stress (75559) |
$65.70 |
$657.04 |
0.1× |
| MRI cardiac w/o contrast (75557) |
$414.79 |
$4,147.92 |
1.8× |
| MRI cervical spine w/o contrast (72141) |
$29.18 |
$291.84 |
0.1× |
| MRI chest w/o & w/contrast material (71552) |
$45.80 |
$458.03 |
0.1× |
| MRI chest w/o contrast (71550) |
$29.18 |
$291.84 |
0.1× |
| MRI chest with contrast (71551) |
$95.36 |
$953.60 |
0.1× |
| MRI fetal sngl/1st gestation (74712) |
$281.94 |
$2,819.42 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$45.80 |
$458.03 |
0.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$45.80 |
$458.03 |
0.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$499.90 |
$4,999 |
2.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$29.18 |
$291.84 |
0.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$45.80 |
$458.03 |
0.1× |
| MRI orbit/face/neck w/contrast (70542) |
$116.20 |
$1,162 |
0.3× |
| MRI pelvis w contrast (72196) |
$401 |
$4,010.02 |
1.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$45.80 |
$458.03 |
0.1× |
| MRI pelvis w/o contrast (72195) |
$29.18 |
$291.84 |
0.1× |
| MRI scan of arm joint before and after contrast (73223) |
$396.90 |
$3,969.02 |
1.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$176.03 |
$1,760.30 |
0.2× |
| MRI scan of leg joint before and after contrast (73723) |
$45.80 |
$458.03 |
0.1× |
| MRI spectroscopy (76390) |
$415.36 |
$4,153.62 |
5.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$45.80 |
$458.03 |
0.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$539.30 |
$5,393.02 |
1.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$45.80 |
$458.03 |
0.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$556.50 |
$5,565.02 |
1.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$45.80 |
$458.03 |
0.1× |
| MRI thoracic spine w/o contrast (72146) |
$29.18 |
$291.84 |
0.1× |
| MRI tmj (70336) |
$29.18 |
$291.84 |
0.1× |
| MRI upper ext joint w/o contrast (73221) |
$602.40 |
$6,024 |
2.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$730.80 |
$7,308 |
2.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$295.89 |
$2,958.92 |
1.3× |
| Myelogram Cervical (72240) |
$95.36 |
$953.60 |
0.1× |
| Myelogram Lumbar (72265) |
$95.36 |
$953.60 |
0.1× |
| Myelogram thoracic (72255) |
$95.36 |
$953.60 |
0.1× |
| Myelography 2 or more regions (72270) |
$95.36 |
$953.60 |
0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$459.61 |
$4,596.08 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$450.81 |
$4,508.08 |
0.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$441.70 |
$4,417 |
0.3× |
| Neck soft tissue (70360) |
$10.82 |
$108.23 |
0.1× |
| Nm adrenal scan (78075) |
$169.12 |
$1,691.16 |
0.1× |
| Nm bone marrow multiple (78103) |
$49.12 |
$491.21 |
0.1× |
| Nm bone marrow wb (78104) |
$49.12 |
$491.21 |
0.1× |
| Nm cisternogram (78630) |
$64.37 |
$643.74 |
0.1× |
| Nm csf leak detection (78650) |
$169.12 |
$1,691.16 |
0.1× |
| Nm gastric emptying study (78264) |
$49.12 |
$491.21 |
0.1× |
| Nm gastroesophageal reflux study (78262) |
$49.12 |
$491.21 |
0.1× |
| Nm peritoneal-venous shunt patency (78291) |
$49.12 |
$491.21 |
0.1× |
| Nm whole blood volume (78122) |
$64.37 |
$643.74 |
0.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,135.75 |
$11,357.50 |
0.9× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$169.12 |
$1,691.16 |
0.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$110.31 |
$1,103.10 |
0.3× |
| Nuclear Rx Oral Admin (79005) |
$115.56 |
$1,155.65 |
0.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$58.80 |
$587.97 |
0.6× |
| Orthopantogram (70355) |
$10.82 |
$108.23 |
0.1× |
| Osseous survey infant (77076) |
$68.50 |
$685 |
0.7× |
| Osseous survey limited (77074) |
$13.09 |
$130.94 |
0.1× |
| Parathyrd planar w/spect&CT (78072) |
$134.28 |
$1,342.87 |
0.3× |
| Parathyrd planar w/wo subtrj (78071) |
$49.12 |
$491.21 |
0.1× |
| Parathyroid imaging (78070) |
$49.12 |
$491.21 |
0.1× |
| Pelvis 1 or 2 views (72170) |
$13.09 |
$130.94 |
0.1× |
| PET image w/CT, skull-thigh (78815) |
$186.33 |
$1,863.25 |
0.1× |
| PET imaging CT for attenuation limited area (78814) |
$186.33 |
$1,863.25 |
0.1× |
| PET imaging for CT attenuation whole body (78816) |
$186.33 |
$1,863.25 |
0.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$408.10 |
$4,081.02 |
1.2× |
| Proton tx delivery intermediate (77523) |
$533.20 |
$5,332 |
0.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$837.30 |
$8,373 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$475.42 |
$4,754.13 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$49.12 |
$491.21 |
0.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$64.37 |
$643.74 |
0.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$65.70 |
$657.04 |
0.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$10.82 |
$108.23 |
0.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$13.09 |
$130.94 |
0.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$13.09 |
$130.94 |
0.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$33.14 |
$331.47 |
0.3× |
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure |
$1,763.80 |
$17,638 |
0.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$161.30 |
$1,613 |
0.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$296.70 |
$2,967 |
3.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$483 |
$4,830 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$13.09 |
$130.94 |
0.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$71.60 |
$716 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$10.82 |
$108.23 |
0.1× |
| Radiologic exam colon single contrast study (74270) |
$21.88 |
$218.83 |
0.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$21.88 |
$218.83 |
0.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$21.88 |
$218.83 |
0.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$62.06 |
$620.62 |
0.7× |
| Radiological examination surgical specimen (76098) |
$65.70 |
$657.04 |
0.1× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$29.63 |
$296.30 |
0.1× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$29.63 |
$296.30 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$379.63 |
$3,796.26 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$504.06 |
$5,040.63 |
0.2× |
| Ribs bilateral 3 views (71110) |
$13.09 |
$130.94 |
0.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$49.12 |
$491.21 |
0.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$323.96 |
$3,239.58 |
0.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$169.12 |
$1,691.16 |
0.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$169.12 |
$1,691.16 |
0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$540.70 |
$5,407 |
0.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$169.12 |
$1,691.16 |
0.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$73.62 |
$736.15 |
0.3× |
| Rp Therapy Intravenous Administration (79101) |
$29.63 |
$296.30 |
0.1× |
| Sacroiliac Joints < 3 Views (72200) |
$38.20 |
$381.97 |
0.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$59.29 |
$592.92 |
0.3× |
| Salivary gland function study (78232) |
$49.12 |
$491.21 |
0.1× |
| Scanogram (77073) |
$66.44 |
$664.47 |
0.7× |
| Scapula complete (73010) |
$52.84 |
$528.47 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$8.90 |
$89 |
0.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$23.20 |
$231.97 |
0.2× |
| Sialogram (70390) |
$29.18 |
$291.84 |
0.1× |
| Small bowel series (74250) |
$21.88 |
$218.83 |
0.1× |
| Spec medical radj physics consltj (77370) |
$16.16 |
$161.60 |
0.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$44.01 |
$440.06 |
0.1× |
| Special dosimetry (77331) |
$128.88 |
$1,288.80 |
1.0× |
| Special treatment procedure (77470) |
$70.11 |
$701.09 |
0.1× |
| Speech evaluation complex (70371) |
$82.34 |
$823.42 |
0.4× |
| Spine thoracic 3 views (72072) |
$13.09 |
$130.94 |
0.1× |
| Spleen imaging only (78185) |
$49.12 |
$491.21 |
0.1× |
| Splenoportograpy rs&i (75810) |
$379.63 |
$3,796.26 |
0.1× |
| Stereotactic body radiation delivery (77373) |
$212.52 |
$2,125.15 |
0.1× |
| Superior sagittal sinus venogram (75870) |
$331.90 |
$3,319 |
0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$34.64 |
$346.40 |
0.4× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$562.10 |
$5,621 |
5.7× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$573.20 |
$5,732 |
16.0× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$562.10 |
$5,621 |
5.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$357.40 |
$3,574 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$44.01 |
$440.06 |
0.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$44.01 |
$440.06 |
0.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$16.16 |
$161.60 |
0.1× |
| Therapeutic Enema (74283) |
$129.84 |
$1,298.42 |
0.8× |
| Thoracolumbar 2 views (72080) |
$24 |
$240 |
0.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$64.37 |
$643.74 |
0.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$49.12 |
$491.21 |
0.1× |
| Thyroid uptake measurement (78012) |
$49.12 |
$491.21 |
0.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$49.12 |
$491.21 |
0.1× |
| Tmj unilateral (70328) |
$31.11 |
$311.12 |
0.4× |
| Treatment device intermediate (77333) |
$16.16 |
$161.60 |
0.1× |
| Treatment devices simple (77332) |
$161.70 |
$1,617 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$169.12 |
$1,691.16 |
0.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$49.12 |
$491.21 |
0.1× |
| Tx devices design & construction complex (77334) |
$489.45 |
$4,894.50 |
1.4× |
| Ultrasound elastography first target lesion (76982) |
$13.09 |
$130.94 |
0.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$58.69 |
$586.92 |
0.2× |
| Ultrasound, abdomen limited (76705) |
$13.09 |
$130.94 |
0.1× |
| Umbilical-artery Doppler (OB) (76820) |
$25.34 |
$253.47 |
0.3× |
| Unlisted fluoroscopic procedure (76496) |
$10.82 |
$108.23 |
0.1× |
| Unlisted magnetic resonance procedure (76498) |
$10.82 |
$108.23 |
0.1× |
| Unlisted Ultrasound Procedure (76999) |
$28.30 |
$283 |
0.3× |
| Upper Extremity Infant (73092) |
$73.10 |
$731 |
0.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$172.31 |
$1,723.10 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$29.18 |
$291.84 |
0.1× |
| Urethrocystography voiding (74455) |
$29.18 |
$291.84 |
0.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$21.88 |
$218.83 |
0.1× |
| Us abdl aorta screen aaa (76706) |
$27.14 |
$271.47 |
0.3× |
| Us breast unilateral complete (76641) |
$36.69 |
$366.90 |
0.4× |
| Us breast unilateral limited (76642) |
$22.18 |
$221.76 |
0.3× |
| Us chest (76604) |
$38.70 |
$386.97 |
0.4× |
| Us compl joint r-t w/image documentation (76881) |
$13.09 |
$130.94 |
0.1× |
| Us elastography parenchyma (76981) |
$33.90 |
$338.97 |
0.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$13.09 |
$130.94 |
0.1× |
| Us guided compression repair (76936) |
$37.38 |
$373.83 |
0.2× |
| Us infant hips dynamic (76885) |
$23.41 |
$234.12 |
0.3× |
| Us infant hips limited static (76886) |
$10.82 |
$108.23 |
0.1× |
| Us kidney transplant (76776) |
$13.09 |
$130.94 |
0.1× |
| Us ob detailed single fetus (76811) |
$121.19 |
$1,211.92 |
0.5× |
| Us ob transvaginal (76817) |
$13.50 |
$134.96 |
0.1× |
| Us pelvic non ob complete (76856) |
$13.09 |
$130.94 |
0.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$41 |
$410 |
0.4× |
| Us pregnancy ltd (76815) |
$65 |
$649.97 |
0.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$64.10 |
$640.97 |
0.6× |
| Us retroperitoneal complete (76770) |
$13.09 |
$130.94 |
0.1× |
| Us retroperitoneal limited (76775) |
$13.09 |
$130.94 |
0.1× |
| Us scrotum and contents (76870) |
$13.09 |
$130.94 |
0.1× |
| Us soft tissue head/neck (76536) |
$13.09 |
$130.94 |
0.1× |
| Us spinal canal and contents (76800) |
$108.60 |
$1,085.97 |
1.1× |
| Us transrectal (76872) |
$116.10 |
$1,161 |
1.2× |
| Us transrectal prostate volume (76873) |
$13.09 |
$130.94 |
0.1× |
| Us xtr non-vasc lmtd (76882) |
$96.40 |
$964 |
1.0× |
| Vasogram (74440) |
$29.18 |
$291.84 |
0.1× |
| Venogram extremity bilateral (75822) |
$347.52 |
$3,475.20 |
0.2× |
| Venogram orbital (75880) |
$74.82 |
$748.19 |
0.1× |
| Venography caval inferior serialography rs&i (75825) |
$486.06 |
$4,860.63 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$190.74 |
$1,907.41 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$245.27 |
$2,452.70 |
0.2× |
| Venography Renal Bilateral (75833) |
$425.86 |
$4,258.63 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$491.20 |
$4,912 |
0.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$692.40 |
$6,924 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,349.25 |
$13,492.50 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$10.82 |
$108.23 |
0.1× |
| Wrist 2 views (73100) |
$75.70 |
$757 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$70.51 |
$705.12 |
0.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$119.60 |
$1,196 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$21.88 |
$218.83 |
0.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$122.75 |
$1,227.50 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$102.30 |
$1,023 |
1.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$87.20 |
$871.97 |
0.9× |
| X-ray exam hip uni 1 view (73501) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$51.86 |
$518.62 |
0.6× |
| X-ray exam hip uni 4/> views (73503) |
$117.95 |
$1,179.50 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$65.94 |
$659.47 |
0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$76.50 |
$764.97 |
0.8× |
| X-ray exam of femur 1 (73551) |
$86.60 |
$866 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$21.88 |
$218.83 |
0.1× |
| X-ray eye for foreign body (70030) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$79.60 |
$795.97 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$102.30 |
$1,023 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$145.60 |
$1,456 |
1.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$242.58 |
$2,425.83 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.10 |
$901 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$121.65 |
$1,216.50 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$27.81 |
$278.12 |
0.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$73.70 |
$737 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$68.10 |
$681 |
0.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$22.14 |
$221.47 |
0.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$47.91 |
$479.12 |
0.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$78 |
$780 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$64.24 |
$642.47 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$45.80 |
$458.03 |
0.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$119.40 |
$1,194 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$39.66 |
$396.62 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$32.26 |
$322.62 |
0.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$29.06 |
$290.62 |
0.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$10.82 |
$108.23 |
0.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$13.09 |
$130.94 |
0.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$132.30 |
$1,323 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$87.90 |
$879 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$80.10 |
$801 |
1.0× |
| Xr arthrogram ankle (73615) |
$45.80 |
$458.03 |
0.1× |
| Xr c-spine 6 or more views (72052) |
$13.09 |
$130.94 |
0.1× |
| Xr chest 4+ views (71048) |
$46.14 |
$461.47 |
0.5× |
| Xr finger(s) 2+ views (73140) |
$66.70 |
$667 |
0.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$22.50 |
$224.97 |
0.2× |
| Xr optic foramina (70190) |
$80.56 |
$805.62 |
1.0× |
| Xr shoulder 1 view (73020) |
$102.20 |
$1,022 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$13.09 |
$130.94 |
0.1× |
| Xr tibia/fibula 2 views (73590) |
$115.55 |
$1,155.50 |
1.4× |
| Xr tmj bilateral (70330) |
$10.82 |
$108.23 |
0.1× |
| Xray knee 1 or 2 views rt (73560) |
$96.90 |
$969 |
1.2× |