| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,355.40 |
$4,518 |
1.1× |
| Abdomen 2 views (74019) |
$183 |
$610 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$976.80 |
$3,256 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,674.30 |
$5,581 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,495.20 |
$4,984 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,854.30 |
$6,181 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$702.30 |
$2,341 |
0.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$1,354.20 |
$4,514 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,074.90 |
$3,583 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,068.90 |
$3,563 |
0.4× |
| Angiography Spinal Selective Rs&I (75705) |
$1,062.60 |
$3,542 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$1,228.50 |
$4,095 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$305.70 |
$1,019 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$631.80 |
$2,106 |
0.2× |
| Ankle 2 views (73600) |
$127.80 |
$426 |
1.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$319.50 |
$1,065 |
1.0× |
| Aortogram thoracic (75605) |
$1,365 |
$4,550 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,699.70 |
$8,999 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,046 |
$6,820 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,407.90 |
$4,693 |
0.5× |
| Arthrogram elbow (73085) |
$206.10 |
$687 |
0.7× |
| Arthrogram hip (73525) |
$180.90 |
$603 |
0.6× |
| Arthrogram shoulder (73040) |
$366.90 |
$1,223 |
1.2× |
| Arthrogram wrist (73115) |
$138.60 |
$462 |
0.4× |
| Arthrography knee lt (73580) |
$277.50 |
$925 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$525.15 |
$1,750.50 |
4.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$508.80 |
$1,696 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$614.10 |
$2,047 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$867.30 |
$2,891 |
2.4× |
| Bone age studies (77072) |
$128.10 |
$427 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$971.10 |
$3,237 |
2.7× |
| Bone Marrow Imaging Limited Area (78102) |
$305.40 |
$1,018 |
0.9× |
| Bone survey complete (77075) |
$558.15 |
$1,860.50 |
6.0× |
| Brachytx isodose complex (77318) |
$877.50 |
$2,925 |
2.6× |
| Brachytx isodose intermed (77317) |
$634.20 |
$2,114 |
1.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$402.90 |
$1,343 |
1.2× |
| Brain image w/flow 4 + views (78606) |
$433.80 |
$1,446 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,917.60 |
$6,392 |
1.5× |
| Brain Imaging Vascular Flow Only (78610) |
$430.50 |
$1,435 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$392.70 |
$1,309 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$171.30 |
$571 |
2.2× |
| Chest 1 view (71045) |
$101.10 |
$337 |
1.3× |
| Chest 3 views (71047) |
$193.50 |
$645 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$306.90 |
$1,023 |
2.0× |
| Cineradiography/videoradiography (76120) |
$54.90 |
$183 |
0.6× |
| Clavicle complete (73000) |
$148.20 |
$494 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$93.75 |
$312.50 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$476.70 |
$1,589 |
4.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$160.20 |
$534 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,623 |
$5,410 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,125.30 |
$3,751 |
5.3× |
| CT abdomen w contrast (74160) |
$961.50 |
$3,205 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,191.60 |
$3,972 |
7.6× |
| CT abdomen w/o contrast (74150) |
$796.20 |
$2,654 |
8.5× |
| CT angio hrt w/3d image (75574) |
$285 |
$950 |
0.9× |
| CT angiography upper extremity lt (73206) |
$825.60 |
$2,752 |
5.3× |
| CT c-spine w/o contrast (72125) |
$825.30 |
$2,751 |
8.8× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$141.60 |
$472 |
0.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,028.10 |
$3,427 |
6.5× |
| CT cervical spine with contrast (72126) |
$876.90 |
$2,923 |
2.8× |
| CT chest w/wo contrast (71270) |
$1,235.40 |
$4,118 |
7.9× |
| CT chest with contrast (71260) |
$988.50 |
$3,295 |
6.3× |
| CT head/brain with contrast (70460) |
$789.60 |
$2,632 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,902.45 |
$6,341.50 |
12.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$140.40 |
$468 |
0.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$24.75 |
$82.50 |
0.3× |
| CT hrt w/3d image congen (75573) |
$163.80 |
$546 |
0.5× |
| CT iac w contrast (70481) |
$789.60 |
$2,632 |
5.0× |
| CT limited/localized follow up study (76380) |
$321.90 |
$1,073 |
4.1× |
| CT lower ext w/o (73700) |
$692.70 |
$2,309 |
7.4× |
| CT lower extremity w wo contrast (73702) |
$1,036.80 |
$3,456 |
6.6× |
| CT lower extremity with contrast (73701) |
$820.80 |
$2,736 |
5.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,028.10 |
$3,427 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$577.65 |
$1,925.50 |
6.2× |
| CT lumbar spine with contrast (72132) |
$876.90 |
$2,923 |
2.8× |
| CT maxillofacial w contrast (70487) |
$789.60 |
$2,632 |
5.0× |
| CT maxillofacial w/o contrast (70486) |
$659.70 |
$2,199 |
7.0× |
| CT maxillofacial w/wo contrast (70488) |
$876.60 |
$2,922 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$789.90 |
$2,633 |
5.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$876.60 |
$2,922 |
5.6× |
| CT orbits w/o contrast (70480) |
$659.70 |
$2,199 |
7.0× |
| CT pelvis w & w/o contrast (72194) |
$1,182.60 |
$3,942 |
7.5× |
| CT pelvis w/o contrast (72192) |
$825.30 |
$2,751 |
8.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$876.90 |
$2,923 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$660.30 |
$2,201 |
7.0× |
| CT thoracic spine w/contrast (72129) |
$876.90 |
$2,923 |
5.6× |
| CT thoracic spine w/o contrast (72128) |
$577.65 |
$1,925.50 |
6.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,028.10 |
$3,427 |
6.5× |
| CT thorax w/o contrast (71250) |
$1,739.10 |
$5,797 |
18.6× |
| CT unlisted procedure (76497) |
$193.80 |
$646 |
2.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,036.80 |
$3,456 |
6.6× |
| CT upper extremity w/o contrast rt (73200) |
$692.70 |
$2,309 |
7.4× |
| CT upper extremity with contrast (73201) |
$820.80 |
$2,736 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$962.40 |
$3,208 |
6.1× |
| Cta Abdomen (74175) |
$928.80 |
$3,096 |
5.9× |
| CTA abdomen pelvis (74174) |
$1,961.55 |
$6,538.50 |
6.3× |
| CTA chest (71275) |
$1,163.70 |
$3,879 |
7.4× |
| Cta Head (70496) |
$1,201.05 |
$4,003.50 |
7.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$281.40 |
$938 |
0.9× |
| CTA lwr ext w&w/o contrast (73706) |
$925.20 |
$3,084 |
5.9× |
| Cta Neck (70498) |
$1,423.20 |
$4,744 |
9.1× |
| Cta Pelvis (72191) |
$884.40 |
$2,948 |
5.6× |
| Cystography minimum 3 views rs&i (74430) |
$254.70 |
$849 |
0.8× |
| Diskogram cervical (72285) |
$392.70 |
$1,309 |
0.2× |
| Diskography lumbar (72295) |
$392.70 |
$1,309 |
0.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$147 |
$490 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$230.70 |
$769 |
3.0× |
| Dxa bone density study axial skeleton (77085) |
$315 |
$1,050 |
3.4× |
| Echoencephalography real time imaging (76506) |
$231.90 |
$773 |
2.5× |
| Esophagus (74220) |
$283.80 |
$946 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$223.80 |
$746 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$175.20 |
$584 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$214.05 |
$713.50 |
1.0× |
| Foot 2 views (73620) |
$152.70 |
$509 |
2.0× |
| Forearm 2 views (73090) |
$148.20 |
$494 |
1.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$493.50 |
$1,645 |
1.0× |
| Gastrointestinal Protein Loss (78282) |
$278.10 |
$927 |
0.8× |
| Gated Heart Planar Single (78472) |
$1,105.80 |
$3,686 |
3.1× |
| Hand 2 views (73120) |
$108.30 |
$361 |
1.2× |
| Hand 3 views (73130) |
$117.60 |
$392 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$711.30 |
$2,371 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$711.30 |
$2,371 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$711.30 |
$2,371 |
1.1× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$279.60 |
$932 |
0.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$194.70 |
$649 |
0.6× |
| Heart Infarct Image (78466) |
$326.70 |
$1,089 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,001.40 |
$3,338 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$545.10 |
$1,817 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$466.80 |
$1,556 |
1.3× |
| Ht muscle image spect sing (78451) |
$1,093.80 |
$3,646 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$141.60 |
$472 |
1.8× |
| Hysterosalpingogram (74740) |
$469.80 |
$1,566 |
2.2× |
| Image fusion (77399) |
$109.80 |
$366 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$2,417.70 |
$8,059 |
3.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,391.90 |
$7,973 |
3.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,959.60 |
$6,532 |
4.0× |
| Intracavitary radiation source applic simple (77761) |
$868.20 |
$2,894 |
1.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$155.10 |
$517 |
1.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$245.40 |
$818 |
0.7× |
| Kidney imaging morphology (78700) |
$390.90 |
$1,303 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$717 |
$2,390 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$553.50 |
$1,845 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$688.50 |
$2,295 |
1.4× |
| Knee 3 views (73562) |
$164.10 |
$547 |
2.1× |
| Liver & spleen imaging static only (78215) |
$749.40 |
$2,498 |
2.1× |
| Liver imaging w/vascular flow (78202) |
$611.70 |
$2,039 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$344.40 |
$1,148 |
0.7× |
| Lung perfusion differential (78597) |
$220.20 |
$734 |
0.6× |
| Lung Ventilation Imaging (78579) |
$257.40 |
$858 |
0.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,931.70 |
$6,439 |
0.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$914.10 |
$3,047 |
0.3× |
| Lymphoscintigraphy (78195) |
$556.50 |
$1,855 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$185.10 |
$617 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$132.30 |
$441 |
0.6× |
| Meckels Diverticulum (78290) |
$530.10 |
$1,767 |
1.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$110.10 |
$367 |
0.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,501.60 |
$11,672 |
10.4× |
| MRA head w & w/o contrast (70546) |
$1,466.40 |
$4,888 |
4.7× |
| MRA head w/o contrast (70544) |
$1,216.50 |
$4,055 |
5.7× |
| MRA head with contrast (70545) |
$1,460.70 |
$4,869 |
4.7× |
| MRA neck w contrast (70548) |
$1,460.70 |
$4,869 |
4.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,466.40 |
$4,888 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,216.50 |
$4,055 |
5.7× |
| MRI abdomen w contrast (74182) |
$1,497.60 |
$4,992 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,961.70 |
$6,539 |
6.3× |
| MRI abdomen w/o contrast (74181) |
$1,438.20 |
$4,794 |
6.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,452.60 |
$4,842 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,452.60 |
$4,842 |
2.1× |
| MRI bone marrow blood supply (77084) |
$1,015.80 |
$3,386 |
4.7× |
| MRI breast w/o contrast bilateral (77047) |
$807 |
$2,690 |
3.8× |
| MRI breast w/o contrast unilat (77046) |
$704.70 |
$2,349 |
3.3× |
| MRI c-spine with contrast (72142) |
$1,530.90 |
$5,103 |
4.9× |
| MRI cervical spine w/o contrast (72141) |
$1,471.20 |
$4,904 |
6.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,423.20 |
$4,744 |
4.6× |
| MRI chest w/o contrast (71550) |
$1,050.60 |
$3,502 |
4.9× |
| MRI chest with contrast (71551) |
$1,209 |
$4,030 |
1.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,497.60 |
$4,992 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,497.60 |
$4,992 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,438.20 |
$4,794 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,453.20 |
$4,844 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,970.40 |
$6,568 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,532.10 |
$5,107 |
4.9× |
| MRI pelvis w contrast (72196) |
$984.30 |
$3,281 |
3.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,093.20 |
$3,644 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$950.70 |
$3,169 |
4.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,639.20 |
$5,464 |
5.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,190.30 |
$7,301 |
7.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,642.50 |
$5,475 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,530.90 |
$5,103 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,642.50 |
$5,475 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,530.90 |
$5,103 |
4.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,642.50 |
$5,475 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,471.20 |
$4,904 |
6.9× |
| MRI tmj (70336) |
$1,015.80 |
$3,386 |
4.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,434.90 |
$4,783 |
6.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,961.70 |
$6,539 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,438.20 |
$4,794 |
6.7× |
| Myelogram Lumbar (72265) |
$745.80 |
$2,486 |
1.1× |
| Myelography 2 or more regions (72270) |
$644.40 |
$2,148 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,186.10 |
$7,287 |
1.9× |
| Myocardial infarct spect (78469) |
$649.80 |
$2,166 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,719.65 |
$9,065.50 |
2.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$829.80 |
$2,766 |
1.1× |
| Neck soft tissue (70360) |
$142.50 |
$475 |
1.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$582.30 |
$1,941 |
1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$279.90 |
$933 |
0.8× |
| Nm adrenal scan (78075) |
$696 |
$2,320 |
0.6× |
| Nm bone marrow wb (78104) |
$313.20 |
$1,044 |
0.9× |
| Nm cisternogram (78630) |
$575.10 |
$1,917 |
1.2× |
| Nm csf leak detection (78650) |
$529.50 |
$1,765 |
0.5× |
| Nm gastric emptying study (78264) |
$828.30 |
$2,761 |
2.3× |
| Nm gastroesophageal reflux study (78262) |
$711.60 |
$2,372 |
2.0× |
| Nm peritoneal-venous shunt patency (78291) |
$423 |
$1,410 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,280.60 |
$7,602 |
1.8× |
| Nuclear medicine study of endocrine organs (78099) |
$331.20 |
$1,104 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$456.90 |
$1,523 |
1.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$371.70 |
$1,239 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$678.60 |
$2,262 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$450 |
$1,500 |
0.9× |
| Nuclear Rx Oral Admin (79005) |
$335.10 |
$1,117 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$162 |
$540 |
1.7× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$178.80 |
$596 |
1.9× |
| Orthopantogram (70355) |
$112.20 |
$374 |
1.4× |
| Osseous survey infant (77076) |
$118.20 |
$394 |
1.3× |
| Osseous survey limited (77074) |
$130.80 |
$436 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$317.40 |
$1,058 |
0.9× |
| Parathyroid imaging (78070) |
$229.50 |
$765 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$84.60 |
$282 |
0.9× |
| Peritoneogram rs&i (74190) |
$216 |
$720 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$1,917.60 |
$6,392 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$1,615.50 |
$5,385 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$1,917.60 |
$6,392 |
1.5× |
| Pr csf ventriculography (78635) |
$291 |
$970 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,961.70 |
$6,539 |
6.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,025.70 |
$3,419 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$471 |
$1,570 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$500.10 |
$1,667 |
1.0× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$750.60 |
$2,502 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$215.40 |
$718 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$67.80 |
$226 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$112.50 |
$375 |
1.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$112.50 |
$375 |
1.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$158.10 |
$527 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$214.80 |
$716 |
2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,110 |
$23,700 |
1.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$395.40 |
$1,318 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$204.90 |
$683 |
2.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$204.90 |
$683 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$153 |
$510 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$195.90 |
$653 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$183 |
$610 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$140.40 |
$468 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$418.50 |
$1,395 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$162.90 |
$543 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$115.50 |
$385 |
0.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$130.20 |
$434 |
0.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$67.80 |
$226 |
0.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$111 |
$370 |
1.4× |
| Radiological examination surgical specimen (76098) |
$329.70 |
$1,099 |
0.7× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,751.10 |
$5,837 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,317.20 |
$7,724 |
0.8× |
| Ribs bilateral 3 views (71110) |
$217.20 |
$724 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$329.10 |
$1,097 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$548.40 |
$1,828 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$540.30 |
$1,801 |
1.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$727.50 |
$2,425 |
3.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$198.90 |
$663 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$167.10 |
$557 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$134.10 |
$447 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$171.30 |
$571 |
0.8× |
| Salivary gland imaging (78230) |
$272.70 |
$909 |
0.8× |
| Scanogram (77073) |
$121.20 |
$404 |
1.3× |
| Scapula complete (73010) |
$156.90 |
$523 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$38.70 |
$129 |
1.7× |
| Sella turcica (70240) |
$56.10 |
$187 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$219.90 |
$733 |
2.3× |
| Sialogram (70390) |
$171.30 |
$571 |
0.8× |
| Simulation intermediate (77285) |
$642.60 |
$2,142 |
1.9× |
| Small bowel series (74250) |
$312.30 |
$1,041 |
2.0× |
| Spec medical radj physics consltj (77370) |
$434.40 |
$1,448 |
3.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$739.80 |
$2,466 |
2.2× |
| Special dosimetry (77331) |
$470.40 |
$1,568 |
3.9× |
| Special treatment procedure (77470) |
$1,184.70 |
$3,949 |
2.4× |
| Spine thoracic 3 views (72072) |
$292.20 |
$974 |
3.1× |
| Stereotactic body radiation delivery (77373) |
$1,574.70 |
$5,249 |
1.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$105 |
$350 |
1.1× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$96 |
$320 |
1.0× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$82.50 |
$275 |
0.9× |
| Tbs Technical Calculation Only (77091) |
$80.70 |
$269 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$878.10 |
$2,927 |
2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$391.50 |
$1,305 |
1.2× |
| Testicular Imaging With Vascular Flow (78761) |
$441.30 |
$1,471 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$993.60 |
$3,312 |
3.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$536.10 |
$1,787 |
4.5× |
| Therapeutic Enema (74283) |
$516.30 |
$1,721 |
3.3× |
| Thoracolumbar 2 views (72080) |
$257.70 |
$859 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,067.70 |
$3,559 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$315.30 |
$1,051 |
0.9× |
| Thyroid uptake measurement (78012) |
$195.30 |
$651 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$452.10 |
$1,507 |
1.3× |
| Tomogram (76100) |
$186.90 |
$623 |
2.0× |
| Treatment device intermediate (77333) |
$437.10 |
$1,457 |
3.6× |
| Treatment devices simple (77332) |
$339.30 |
$1,131 |
2.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$783.30 |
$2,611 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$281.70 |
$939 |
0.8× |
| Tx devices design & construction complex (77334) |
$760.20 |
$2,534 |
2.3× |
| Ultrasound elastography first target lesion (76982) |
$102.90 |
$343 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$322.50 |
$1,075 |
3.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$54.90 |
$183 |
0.7× |
| Unlisted fluoroscopic procedure (76496) |
$124.80 |
$416 |
1.6× |
| Unlisted magnetic resonance procedure (76498) |
$506.10 |
$1,687 |
6.5× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$327.60 |
$1,092 |
0.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$128.10 |
$427 |
1.4× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$358.20 |
$1,194 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$173.40 |
$578 |
2.2× |
| Upper Extremity Infant (73092) |
$199.05 |
$663.50 |
2.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$293.10 |
$977 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$278.10 |
$927 |
1.3× |
| Urethrocystography voiding (74455) |
$299.70 |
$999 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$518.70 |
$1,729 |
3.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$539.70 |
$1,799 |
3.4× |
| Us abdl aorta screen aaa (76706) |
$248.70 |
$829 |
2.7× |
| Us breast unilateral complete (76641) |
$169.50 |
$565 |
1.8× |
| Us breast unilateral limited (76642) |
$203.40 |
$678 |
2.6× |
| Us chest (76604) |
$334.50 |
$1,115 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$221.10 |
$737 |
2.4× |
| Us elastography parenchyma (76981) |
$144.60 |
$482 |
1.5× |
| Us guided compression repair (76936) |
$987.60 |
$3,292 |
5.1× |
| Us infant hips limited static (76886) |
$195.90 |
$653 |
2.5× |
| Us kidney transplant (76776) |
$324.60 |
$1,082 |
3.5× |
| Us ob transvaginal (76817) |
$239.10 |
$797 |
2.6× |
| Us pelvic non ob complete (76856) |
$370.50 |
$1,235 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$232.50 |
$775 |
2.5× |
| Us pregnancy ltd (76815) |
$189.30 |
$631 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$301.50 |
$1,005 |
3.2× |
| Us retroperitoneal complete (76770) |
$403.20 |
$1,344 |
4.3× |
| Us retroperitoneal limited (76775) |
$336.60 |
$1,122 |
3.6× |
| Us scrotum and contents (76870) |
$314.40 |
$1,048 |
3.4× |
| Us soft tissue head/neck (76536) |
$277.50 |
$925 |
3.0× |
| Us spinal canal and contents (76800) |
$360.90 |
$1,203 |
3.9× |
| Us transrectal (76872) |
$475.80 |
$1,586 |
5.1× |
| Us transrectal prostate volume (76873) |
$103.50 |
$345 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$206.10 |
$687 |
2.2× |
| Us, eye b-scan (76512) |
$90.90 |
$303 |
1.0× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$205.20 |
$684 |
0.6× |
| Vascular flow imaging (78445) |
$257.70 |
$859 |
0.7× |
| Venogram extremity bilateral (75822) |
$471.30 |
$1,571 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$795.30 |
$2,651 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$674.10 |
$2,247 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$344.40 |
$1,148 |
0.2× |
| Venography Renal Bilateral (75833) |
$1,248.30 |
$4,161 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,141.50 |
$3,805 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$708.30 |
$2,361 |
0.3× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$1,205.70 |
$4,019 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$96.90 |
$323 |
1.2× |
| Wrist 2 views (73100) |
$148.20 |
$494 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$328.80 |
$1,096 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$103.50 |
$345 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$166.80 |
$556 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$413.40 |
$1,378 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$129 |
$430 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$141.60 |
$472 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$214.80 |
$716 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$67.80 |
$226 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$67.80 |
$226 |
0.9× |
| X-ray exam hip uni 4/> views (73503) |
$112.50 |
$375 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$112.50 |
$375 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$214.80 |
$716 |
2.3× |
| X-ray exam of femur 1 (73551) |
$67.80 |
$226 |
0.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$261.60 |
$872 |
1.7× |
| X-ray eye for foreign body (70030) |
$62.40 |
$208 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$213.90 |
$713 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$166.50 |
$555 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$166.20 |
$554 |
2.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$303 |
$1,010 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$135.30 |
$451 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$80.70 |
$269 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$171.30 |
$571 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$121.20 |
$404 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$93.60 |
$312 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$188.10 |
$627 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$311.40 |
$1,038 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$228.60 |
$762 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$175.80 |
$586 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$105.30 |
$351 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$130.80 |
$436 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$105.30 |
$351 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$120.30 |
$401 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$362.40 |
$1,208 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$160.80 |
$536 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$204.90 |
$683 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$259.20 |
$864 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$155.10 |
$517 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$167.70 |
$559 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$175.80 |
$586 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$210 |
$700 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$163.50 |
$545 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$222 |
$740 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$114.90 |
$383 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$142.50 |
$475 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$132.90 |
$443 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$156.60 |
$522 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$247.20 |
$824 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$130.20 |
$434 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$161.40 |
$538 |
2.1× |
| Xr arthrogram ankle (73615) |
$201 |
$670 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$294 |
$980 |
3.1× |
| Xr chest 4+ views (71048) |
$203.40 |
$678 |
2.2× |
| Xr Cholecystography Oral Contrast (74290) |
$124.20 |
$414 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$145.20 |
$484 |
1.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$85.80 |
$286 |
0.9× |
| Xr shoulder 1 view (73020) |
$142.20 |
$474 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$240.30 |
$801 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$147.60 |
$492 |
1.9× |
| Xr tmj bilateral (70330) |
$136.80 |
$456 |
1.8× |
| Xray knee 1 or 2 views rt (73560) |
$147.90 |
$493 |
1.9× |