| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,108 |
$4,216 |
1.7× |
| Abdomen 2 views (74019) |
$220.50 |
$441 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$796 |
$1,592 |
2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,517 |
$3,034 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,868 |
$5,736 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,103.50 |
$4,207 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$1,585 |
$3,170 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,994.50 |
$3,989 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,579.50 |
$5,159 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,280 |
$4,560 |
0.8× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,888 |
$3,776 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,101.50 |
$4,203 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,153 |
$2,306 |
0.4× |
| Ankle 2 views (73600) |
$102 |
$204 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$790.50 |
$1,581 |
2.5× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,232.50 |
$4,465 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,897 |
$5,794 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,707.50 |
$5,415 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$1,659.50 |
$3,319 |
0.6× |
| Arthrogram elbow (73085) |
$650 |
$1,300 |
2.1× |
| Arthrogram hip (73525) |
$875.50 |
$1,751 |
2.8× |
| Arthrogram shoulder (73040) |
$708 |
$1,416 |
2.2× |
| Arthrogram wrist (73115) |
$684 |
$1,368 |
2.2× |
| Arthrography knee lt (73580) |
$684.50 |
$1,369 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$139 |
$278 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$505.50 |
$1,011 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$692.50 |
$1,385 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$911 |
$1,822 |
2.5× |
| Bone age studies (77072) |
$232.50 |
$465 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,017 |
$2,034 |
2.8× |
| Bone survey complete (77075) |
$253 |
$506 |
2.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$624 |
$1,248 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,563 |
$7,126 |
2.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,697 |
$3,394 |
5.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$792.50 |
$1,585 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$271 |
$542 |
3.4× |
| Chest 1 view (71045) |
$130 |
$260 |
1.6× |
| Chest 3 views (71047) |
$191.50 |
$383 |
2.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$267 |
$534 |
1.7× |
| Clavicle complete (73000) |
$209 |
$418 |
2.7× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$30,579.50 |
$61,159 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$159.50 |
$319 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$309.50 |
$619 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,784.50 |
$5,569 |
8.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,193.50 |
$4,387 |
10.2× |
| CT abdomen w contrast (74160) |
$1,329.50 |
$2,659 |
8.4× |
| CT abdomen w wo contrast (74170) |
$1,529 |
$3,058 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,156 |
$2,312 |
12.2× |
| CT angiography upper extremity lt (73206) |
$640 |
$1,280 |
4.0× |
| CT c-spine w/o contrast (72125) |
$930 |
$1,860 |
9.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,509.50 |
$3,019 |
9.5× |
| CT cervical spine with contrast (72126) |
$1,363 |
$2,726 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,661.50 |
$3,323 |
10.5× |
| CT chest with contrast (71260) |
$1,468 |
$2,936 |
9.2× |
| CT colonography screening (74263) |
$527 |
$1,054 |
2.4× |
| CT colonography w/o cntrst (74261) |
$278 |
$556 |
2.9× |
| CT head/brain with contrast (70460) |
$1,139 |
$2,278 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,229 |
$2,458 |
7.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$50.50 |
$101 |
0.6× |
| CT iac w contrast (70481) |
$1,319 |
$2,638 |
8.3× |
| CT lower ext w/o (73700) |
$1,006.50 |
$2,013 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,331 |
$2,662 |
8.4× |
| CT lower extremity with contrast (73701) |
$1,157.50 |
$2,315 |
7.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,781 |
$3,562 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$1,332.50 |
$2,665 |
14.1× |
| CT lumbar spine with contrast (72132) |
$1,685 |
$3,370 |
5.3× |
| CT maxillofacial w contrast (70487) |
$1,181 |
$2,362 |
7.4× |
| CT maxillofacial w/o contrast (70486) |
$1,012.50 |
$2,025 |
10.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,349.50 |
$2,699 |
8.5× |
| CT neck soft tissue w contrast (70491) |
$1,306 |
$2,612 |
8.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,396.50 |
$2,793 |
8.8× |
| CT orbits w/o contrast (70480) |
$987.50 |
$1,975 |
10.4× |
| CT pelvis w & w/o contrast (72194) |
$1,561 |
$3,122 |
9.8× |
| CT pelvis w/o contrast (72192) |
$1,125.50 |
$2,251 |
11.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,382.50 |
$2,765 |
8.7× |
| CT soft tissue neck w/o contrast (70490) |
$864 |
$1,728 |
9.1× |
| CT thoracic spine w/contrast (72129) |
$1,088.50 |
$2,177 |
6.9× |
| CT thoracic spine w/o contrast (72128) |
$946.50 |
$1,893 |
10.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,251.50 |
$2,503 |
7.9× |
| CT thorax w/o contrast (71250) |
$1,069 |
$2,138 |
11.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$698 |
$1,396 |
4.4× |
| CT upper extremity w/o contrast rt (73200) |
$527.50 |
$1,055 |
5.6× |
| CT upper extremity with contrast (73201) |
$607 |
$1,214 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,592.50 |
$3,185 |
10.0× |
| Cta Abdomen (74175) |
$1,825.50 |
$3,651 |
11.5× |
| CTA abdomen pelvis (74174) |
$3,591 |
$7,182 |
11.4× |
| CTA chest (71275) |
$1,455.50 |
$2,911 |
9.2× |
| Cta Head (70496) |
$1,340 |
$2,680 |
8.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,133 |
$2,266 |
7.1× |
| Cta Neck (70498) |
$1,361 |
$2,722 |
8.6× |
| Cta Pelvis (72191) |
$2,039.50 |
$4,079 |
12.8× |
| Cystography minimum 3 views rs&i (74430) |
$662 |
$1,324 |
2.1× |
| Diskogram cervical (72285) |
$1,505 |
$3,010 |
0.9× |
| Diskography lumbar (72295) |
$1,565.50 |
$3,131 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$396.50 |
$793 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$350 |
$700 |
4.4× |
| Dxa bone density study axial skeleton (77085) |
$301 |
$602 |
3.2× |
| Echoencephalography real time imaging (76506) |
$364.50 |
$729 |
3.9× |
| Esophagus (74220) |
$147.50 |
$295 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$343.50 |
$687 |
1.6× |
| Foot 2 views (73620) |
$183 |
$366 |
2.3× |
| Forearm 2 views (73090) |
$202 |
$404 |
2.6× |
| Gated Heart Planar Single (78472) |
$579.50 |
$1,159 |
1.6× |
| Hand 2 views (73120) |
$108.50 |
$217 |
1.1× |
| Hand 3 views (73130) |
$203.50 |
$407 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,216.50 |
$6,433 |
5.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,648.50 |
$3,297 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,070 |
$2,140 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,070 |
$2,140 |
3.0× |
| Ht muscle image spect sing (78451) |
$1,184 |
$2,368 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$184 |
$368 |
2.3× |
| Hysterosalpingogram (74740) |
$737.50 |
$1,475 |
3.4× |
| Interstitial radiation source applic complex (77778) |
$2,086 |
$4,172 |
3.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,232.50 |
$2,465 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,473 |
$2,946 |
3.0× |
| Knee 3 views (73562) |
$239.50 |
$479 |
3.0× |
| Liver & spleen imaging static only (78215) |
$836 |
$1,672 |
2.3× |
| Liver imaging static only (78201) |
$1,716 |
$3,432 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$2,061 |
$4,122 |
4.2× |
| Lung perfusion differential (78597) |
$2,061 |
$4,122 |
5.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,181.50 |
$2,363 |
0.4× |
| Lymphoscintigraphy (78195) |
$896.50 |
$1,793 |
1.8× |
| Meckels Diverticulum (78290) |
$586 |
$1,172 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$333 |
$666 |
1.0× |
| Mr elastography (76391) |
$344 |
$688 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,430.50 |
$2,861 |
4.5× |
| MRA head w/o contrast (70544) |
$1,137.50 |
$2,275 |
5.3× |
| MRA neck w contrast (70548) |
$1,285.50 |
$2,571 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,478.50 |
$2,957 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,118 |
$2,236 |
5.2× |
| MRI abdomen w contrast (74182) |
$1,655 |
$3,310 |
5.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,321 |
$4,642 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$1,433 |
$2,866 |
6.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,616.50 |
$3,233 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,607.50 |
$3,215 |
2.3× |
| MRI c-spine with contrast (72142) |
$1,484 |
$2,968 |
4.7× |
| MRI cardiac w/o contrast (75557) |
$1,130 |
$2,260 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$1,133 |
$2,266 |
5.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,647 |
$3,294 |
5.2× |
| MRI chest w/o contrast (71550) |
$1,246.50 |
$2,493 |
5.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,379 |
$2,758 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,279.50 |
$2,559 |
4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,244 |
$2,488 |
5.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,282.50 |
$2,565 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,035 |
$4,070 |
6.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,809 |
$3,618 |
5.7× |
| MRI pelvis w contrast (72196) |
$1,385.50 |
$2,771 |
4.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,593.50 |
$3,187 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,205 |
$2,410 |
5.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,931 |
$3,862 |
6.1× |
| MRI scan of leg joint before and after contrast (73723) |
$2,107 |
$4,214 |
6.7× |
| MRI spectroscopy (76390) |
$1,347.50 |
$2,695 |
17.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,467.50 |
$4,935 |
7.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,455.50 |
$2,911 |
4.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,078.50 |
$4,157 |
6.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,229.50 |
$2,459 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,203 |
$4,406 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,106 |
$2,212 |
5.1× |
| MRI tmj (70336) |
$1,209.50 |
$2,419 |
5.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,573 |
$3,146 |
7.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,586 |
$3,172 |
5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,199 |
$2,398 |
5.5× |
| Myelogram Cervical (72240) |
$1,334.50 |
$2,669 |
1.9× |
| Myelogram Lumbar (72265) |
$1,122.50 |
$2,245 |
1.6× |
| Myelogram thoracic (72255) |
$1,419 |
$2,838 |
2.0× |
| Myelography 2 or more regions (72270) |
$2,520.50 |
$5,041 |
3.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,312.50 |
$10,625 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,842.50 |
$5,685 |
2.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$5,065.50 |
$10,131 |
3.9× |
| Neck soft tissue (70360) |
$190.50 |
$381 |
2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$349.50 |
$699 |
1.0× |
| Nm bone marrow multiple (78103) |
$314 |
$628 |
0.9× |
| Nm bone marrow wb (78104) |
$404.50 |
$809 |
1.1× |
| Nm cisternogram (78630) |
$911 |
$1,822 |
1.9× |
| Nm gastric emptying study (78264) |
$881 |
$1,762 |
2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,656 |
$5,312 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$588.50 |
$1,177 |
2.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$203 |
$406 |
2.1× |
| Orthopantogram (70355) |
$263 |
$526 |
3.3× |
| Osseous survey infant (77076) |
$92 |
$184 |
1.0× |
| Osseous survey limited (77074) |
$153.50 |
$307 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$673 |
$1,346 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$510 |
$1,020 |
1.4× |
| Parathyroid imaging (78070) |
$364.50 |
$729 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$167.50 |
$335 |
1.8× |
| Peritoneogram rs&i (74190) |
$528.50 |
$1,057 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$3,229 |
$6,458 |
2.5× |
| PET imaging CT for attenuation limited area (78814) |
$3,212.50 |
$6,425 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$4,247.50 |
$8,495 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,690 |
$3,380 |
5.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,763 |
$3,526 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,737 |
$3,474 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$698 |
$1,396 |
1.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,513 |
$3,026 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$587 |
$1,174 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$254 |
$508 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$541.50 |
$1,083 |
5.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$265 |
$530 |
2.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$226 |
$452 |
2.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,007 |
$20,014 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$390.50 |
$781 |
4.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$474.50 |
$949 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$287.50 |
$575 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$212.50 |
$425 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$247.50 |
$495 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$191.50 |
$383 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$418 |
$836 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$275 |
$550 |
1.7× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$100 |
$200 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$527 |
$1,054 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$428.50 |
$857 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$184.50 |
$369 |
2.3× |
| Radiological examination surgical specimen (76098) |
$199.50 |
$399 |
0.4× |
| Radiopharm Dacryocystography (78660) |
$506 |
$1,012 |
1.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,716 |
$3,432 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,714.50 |
$3,429 |
0.6× |
| Ribs bilateral 3 views (71110) |
$227 |
$454 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,151 |
$2,302 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,695 |
$3,390 |
3.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,206.50 |
$2,413 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,170.50 |
$2,341 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,031.50 |
$2,063 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$404.50 |
$809 |
1.9× |
| Scanogram (77073) |
$399.50 |
$799 |
4.2× |
| Scapula complete (73010) |
$244.50 |
$489 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$28 |
$56 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$363.50 |
$727 |
3.8× |
| Sialogram (70390) |
$752 |
$1,504 |
3.5× |
| Small bowel series (74250) |
$410 |
$820 |
2.6× |
| Spec medical radj physics consltj (77370) |
$404 |
$808 |
3.3× |
| Special treatment procedure (77470) |
$639 |
$1,278 |
1.3× |
| Spine thoracic 3 views (72072) |
$297.50 |
$595 |
3.1× |
| Stereotactic body radiation delivery (77373) |
$2,670 |
$5,340 |
1.6× |
| Superior sagittal sinus venogram (75870) |
$1,018.50 |
$2,037 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$886.50 |
$1,773 |
2.6× |
| Testicular Imaging With Vascular Flow (78761) |
$1,027 |
$2,054 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$516 |
$1,032 |
1.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$262 |
$524 |
2.2× |
| Thoracolumbar 2 views (72080) |
$436 |
$872 |
5.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,208 |
$2,416 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$633 |
$1,266 |
1.7× |
| Tmj unilateral (70328) |
$174 |
$348 |
2.2× |
| Treatment device intermediate (77333) |
$488 |
$976 |
4.0× |
| Treatment devices simple (77332) |
$199 |
$398 |
1.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,847.50 |
$9,695 |
9.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$591.50 |
$1,183 |
1.6× |
| Tx devices design & construction complex (77334) |
$527.50 |
$1,055 |
1.6× |
| Ultrasound scan of cornea to determine thickness (76514) |
$85.50 |
$171 |
3.3× |
| Ultrasound scan to determine eye length and lens power (76519) |
$268 |
$536 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$545.50 |
$1,091 |
5.8× |
| Unlisted magnetic resonance procedure (76498) |
$387 |
$774 |
4.9× |
| Upper Extremity Infant (73092) |
$98.50 |
$197 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$720 |
$1,440 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$1,029 |
$2,058 |
4.8× |
| Urethrocystography voiding (74455) |
$571 |
$1,142 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$837 |
$1,674 |
5.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$2,153 |
$4,306 |
13.6× |
| Us abdl aorta screen aaa (76706) |
$278 |
$556 |
2.9× |
| Us breast unilateral complete (76641) |
$289 |
$578 |
3.1× |
| Us breast unilateral limited (76642) |
$289 |
$578 |
3.7× |
| Us chest (76604) |
$272.50 |
$545 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$399.50 |
$799 |
4.2× |
| Us elastography parenchyma (76981) |
$252.50 |
$505 |
2.7× |
| Us guided compression repair (76936) |
$459 |
$918 |
2.3× |
| Us infant hips dynamic (76885) |
$484 |
$968 |
6.1× |
| Us kidney transplant (76776) |
$143.50 |
$287 |
1.5× |
| Us ob transvaginal (76817) |
$124 |
$248 |
1.3× |
| Us pelvic non ob complete (76856) |
$517.50 |
$1,035 |
5.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$399.50 |
$799 |
4.2× |
| Us pregnancy ltd (76815) |
$103.50 |
$207 |
1.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$406.50 |
$813 |
4.3× |
| Us retroperitoneal complete (76770) |
$423.50 |
$847 |
4.5× |
| Us retroperitoneal limited (76775) |
$419 |
$838 |
4.4× |
| Us scrotum and contents (76870) |
$532 |
$1,064 |
5.6× |
| Us soft tissue head/neck (76536) |
$491.50 |
$983 |
5.2× |
| Us spinal canal and contents (76800) |
$226 |
$452 |
2.4× |
| Us transrectal (76872) |
$636.50 |
$1,273 |
6.7× |
| Us transrectal prostate volume (76873) |
$348.50 |
$697 |
3.7× |
| Us xtr non-vasc lmtd (76882) |
$375 |
$750 |
4.0× |
| Us, eye b-scan (76512) |
$300 |
$600 |
3.2× |
| Venogram extremity bilateral (75822) |
$1,213.50 |
$2,427 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$1,634.50 |
$3,269 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,603.50 |
$3,207 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$802.50 |
$1,605 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,869.50 |
$3,739 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,714.50 |
$3,429 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,044 |
$4,088 |
0.7× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,681 |
$3,362 |
0.3× |
| Wrist 2 views (73100) |
$92.50 |
$185 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$251 |
$502 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$289 |
$578 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$220.50 |
$441 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$576 |
$1,152 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$95.50 |
$191 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$206 |
$412 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$157 |
$314 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$188.50 |
$377 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$219.50 |
$439 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$296 |
$592 |
3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$327.50 |
$655 |
3.5× |
| X-ray exam of femur 1 (73551) |
$68 |
$136 |
0.9× |
| X-ray eye for foreign body (70030) |
$153.50 |
$307 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$341 |
$682 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$214.50 |
$429 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$217 |
$434 |
2.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,009.50 |
$2,019 |
0.5× |
| X-ray head for orthodontia (70350) |
$424 |
$848 |
5.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$177.50 |
$355 |
2.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$727 |
$1,454 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$195.50 |
$391 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$287.50 |
$575 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$102 |
$204 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$98.50 |
$197 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$287.50 |
$575 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$335.50 |
$671 |
3.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$280.50 |
$561 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$202 |
$404 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$213 |
$426 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$329 |
$658 |
3.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$846 |
$1,692 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$259 |
$518 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$259 |
$518 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$330 |
$660 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$223.50 |
$447 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$219.50 |
$439 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$225 |
$450 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$281.50 |
$563 |
3.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$193.50 |
$387 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$335.50 |
$671 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$204 |
$408 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$208.50 |
$417 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$252.50 |
$505 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$280.50 |
$561 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$253 |
$506 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$157.50 |
$315 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$202 |
$404 |
2.6× |
| Xr arthrogram ankle (73615) |
$743 |
$1,486 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$339 |
$678 |
3.6× |
| Xr chest 4+ views (71048) |
$396 |
$792 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$153 |
$306 |
1.9× |
| Xr optic foramina (70190) |
$233 |
$466 |
3.0× |
| Xr shoulder 1 view (73020) |
$144 |
$288 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$317.50 |
$635 |
3.4× |
| Xr tibia/fibula 2 views (73590) |
$202 |
$404 |
2.6× |
| Xr tmj bilateral (70330) |
$357.50 |
$715 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$196 |
$392 |
2.5× |