| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,985.01 |
$13,283.37 |
3.3× |
| Abdomen 2 views (74019) |
$207.36 |
$691.20 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$598.67 |
$1,995.58 |
1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,034.91 |
$10,116.37 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,358.98 |
$7,863.27 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,010.41 |
$6,701.38 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$1,471.76 |
$4,905.87 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,865.81 |
$9,552.69 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,363.14 |
$7,877.15 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,706.41 |
$5,688.05 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$1,735.15 |
$5,783.82 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,472.27 |
$8,240.91 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$635.06 |
$2,116.86 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$956.66 |
$3,188.86 |
0.3× |
| Ankle 2 views (73600) |
$179.63 |
$598.76 |
2.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$736.50 |
$2,455 |
2.4× |
| Aortogram thoracic (75605) |
$1,651.71 |
$5,505.71 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,573.19 |
$8,577.30 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$1,518.60 |
$5,062 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,685.95 |
$5,619.82 |
0.6× |
| Arthrogram elbow (73085) |
$377.83 |
$1,259.43 |
1.2× |
| Arthrogram hip (73525) |
$389.53 |
$1,298.44 |
1.3× |
| Arthrogram shoulder (73040) |
$418.28 |
$1,394.28 |
1.4× |
| Arthrogram wrist (73115) |
$284.40 |
$948 |
0.9× |
| Arthrography knee lt (73580) |
$287.50 |
$958.35 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$353.20 |
$1,177.32 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$522.34 |
$1,741.15 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$794.08 |
$2,646.92 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$983.62 |
$3,278.75 |
2.8× |
| Bone age studies (77072) |
$115 |
$383.34 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$983.62 |
$3,278.75 |
2.8× |
| Bone Marrow Imaging Limited Area (78102) |
$443.47 |
$1,478.24 |
1.3× |
| Bone survey complete (77075) |
$443.47 |
$1,478.24 |
4.8× |
| Brachytx isodose complex (77318) |
$1,279.21 |
$4,264.02 |
3.9× |
| Brachytx isodose intermed (77317) |
$1,129.61 |
$3,765.37 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$674.82 |
$2,249.39 |
2.1× |
| Brain image w/flow 4 + views (78606) |
$673.48 |
$2,244.92 |
1.4× |
| Brain imaging < 4 static views (78600) |
$349.96 |
$1,166.52 |
1.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$384.95 |
$1,283.18 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$503.54 |
$1,678.47 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,228.04 |
$7,426.81 |
1.8× |
| Brain Imaging Vascular Flow Only (78610) |
$389.97 |
$1,299.91 |
0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,349.24 |
$4,497.47 |
4.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$372.80 |
$1,242.66 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$220.33 |
$734.45 |
2.9× |
| Chest 1 view (71045) |
$95.48 |
$318.27 |
1.3× |
| Chest 3 views (71047) |
$127.96 |
$426.52 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$251.38 |
$837.92 |
1.6× |
| Cineradiography/videoradiography (76120) |
$140.10 |
$467 |
1.5× |
| Clavicle complete (73000) |
$185.99 |
$619.96 |
2.4× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$28,775.08 |
$95,916.93 |
4.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$193.87 |
$646.25 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$354.40 |
$1,181.32 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,999.99 |
$6,666.64 |
6.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,419.30 |
$4,731.01 |
6.8× |
| CT abdomen w contrast (74160) |
$1,076.86 |
$3,589.54 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,182.75 |
$3,942.51 |
7.7× |
| CT abdomen w/o contrast (74150) |
$898.60 |
$2,995.34 |
9.8× |
| CT angio hrt w/3d image (75574) |
$455.43 |
$1,518.10 |
1.5× |
| CT angiography upper extremity lt (73206) |
$799.16 |
$2,663.88 |
5.2× |
| CT c-spine w/o contrast (72125) |
$916.71 |
$3,055.70 |
10.0× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$405.82 |
$1,352.72 |
2.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,063.01 |
$3,543.36 |
6.9× |
| CT cervical spine with contrast (72126) |
$1,027.13 |
$3,423.78 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,171.39 |
$3,904.65 |
7.6× |
| CT chest with contrast (71260) |
$986.04 |
$3,286.81 |
6.4× |
| CT head/brain with contrast (70460) |
$867.61 |
$2,892.02 |
5.6× |
| CT head/brain without and with contrast (70470) |
$979.56 |
$3,265.19 |
6.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$521.83 |
$1,739.45 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$90 |
$300 |
1.2× |
| CT hrt w/3d image congen (75573) |
$444.74 |
$1,482.48 |
1.5× |
| CT iac w contrast (70481) |
$1,059.95 |
$3,533.18 |
6.9× |
| CT limited/localized follow up study (76380) |
$570.18 |
$1,900.59 |
7.5× |
| CT lower ext w/o (73700) |
$632.26 |
$2,107.53 |
6.9× |
| CT lower extremity w wo contrast (73702) |
$697.14 |
$2,323.79 |
4.5× |
| CT lower extremity with contrast (73701) |
$664.06 |
$2,213.54 |
4.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,245.69 |
$4,152.30 |
8.1× |
| CT lumbar spine w/o contrast (72131) |
$702.99 |
$2,343.30 |
7.7× |
| CT lumbar spine with contrast (72132) |
$806.80 |
$2,689.33 |
2.6× |
| CT maxillofacial w contrast (70487) |
$955.39 |
$3,184.62 |
6.2× |
| CT maxillofacial w/o contrast (70486) |
$665.08 |
$2,216.93 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,003.47 |
$3,344.91 |
6.5× |
| CT neck soft tissue w contrast (70491) |
$814.43 |
$2,714.77 |
5.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,329.65 |
$4,432.17 |
8.7× |
| CT orbits w/o contrast (70480) |
$871.88 |
$2,906.28 |
9.5× |
| CT pelvis w & w/o contrast (72194) |
$1,124.95 |
$3,749.84 |
7.3× |
| CT pelvis w/o contrast (72192) |
$817.48 |
$2,724.95 |
8.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$956.91 |
$3,189.70 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$706.55 |
$2,355.17 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$994.06 |
$3,313.53 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$885.92 |
$2,953.08 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,103.21 |
$3,677.36 |
7.2× |
| CT thorax w/o contrast (71250) |
$774.58 |
$2,581.92 |
8.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$709.86 |
$2,366.20 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$605.54 |
$2,018.48 |
6.6× |
| CT upper extremity with contrast (73201) |
$636.07 |
$2,120.25 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,391.99 |
$4,639.96 |
9.1× |
| Cta Abdomen (74175) |
$1,242.01 |
$4,140.04 |
8.1× |
| CTA abdomen pelvis (74174) |
$1,747.41 |
$5,824.71 |
5.7× |
| CTA chest (71275) |
$1,142.39 |
$3,807.97 |
7.4× |
| Cta Head (70496) |
$1,217.45 |
$4,058.16 |
7.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,515.55 |
$8,385.17 |
8.2× |
| CTA lwr ext w&w/o contrast (73706) |
$698.96 |
$2,329.88 |
4.5× |
| Cta Neck (70498) |
$1,298.10 |
$4,327.01 |
8.4× |
| Cta Pelvis (72191) |
$1,105.52 |
$3,685.07 |
7.2× |
| Cystography minimum 3 views rs&i (74430) |
$262.83 |
$876.09 |
0.9× |
| Diskography lumbar (72295) |
$677.02 |
$2,256.72 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$110.40 |
$368 |
1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$104.78 |
$349.26 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$297.17 |
$990.58 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$134.59 |
$448.64 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$69.90 |
$233 |
0.8× |
| Echo exam of fetal heart (76825) |
$382.75 |
$1,275.85 |
0.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$305.08 |
$1,016.95 |
1.5× |
| Echoencephalography real time imaging (76506) |
$752.60 |
$2,508.68 |
8.2× |
| Esophagus (74220) |
$264.86 |
$882.87 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$498.94 |
$1,663.12 |
5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$448.30 |
$1,494.35 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$331.10 |
$1,103.67 |
1.6× |
| Foot 2 views (73620) |
$139.17 |
$463.91 |
1.8× |
| Forearm 2 views (73090) |
$166.14 |
$553.81 |
2.2× |
| Functional MRI brain by tech (70554) |
$1,011.90 |
$3,373 |
4.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$838.23 |
$2,794.10 |
1.8× |
| Gated Heart Planar Single (78472) |
$845.72 |
$2,819.08 |
2.4× |
| Hand 2 views (73120) |
$158.76 |
$529.21 |
1.7× |
| Hand 3 views (73130) |
$153.97 |
$513.25 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,401.15 |
$4,670.49 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,898.72 |
$6,329.06 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,584.57 |
$8,615.23 |
4.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,044.23 |
$6,814.10 |
6.0× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,807.38 |
$6,024.59 |
5.3× |
| Heart Infarct Image (78466) |
$263.22 |
$877.40 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,659 |
$5,530 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$987.19 |
$3,290.63 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$987.19 |
$3,290.63 |
2.8× |
| Ht muscle image spect sing (78451) |
$1,588.41 |
$5,294.69 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$188.79 |
$629.29 |
2.5× |
| Hysterosalpingogram (74740) |
$425.41 |
$1,418.02 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$2,455.12 |
$8,183.73 |
4.0× |
| Intracavitary radiation source applic simple (77761) |
$1,032.46 |
$3,441.55 |
2.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$97.19 |
$323.97 |
1.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$290.06 |
$966.87 |
0.8× |
| Kidney imaging morphology (78700) |
$610.40 |
$2,034.67 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$848.27 |
$2,827.57 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$859.97 |
$2,866.58 |
1.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$946.22 |
$3,154.08 |
2.0× |
| Knee 3 views (73562) |
$181.66 |
$605.54 |
2.4× |
| Liver & spleen imaging static only (78215) |
$544.73 |
$1,815.78 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$532.20 |
$1,774 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$845.72 |
$2,819.08 |
1.8× |
| Lung perfusion differential (78597) |
$845.72 |
$2,819.08 |
2.4× |
| Lung Ventilation Imaging (78579) |
$550.84 |
$1,836.14 |
1.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,827.31 |
$6,091.05 |
0.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$787.37 |
$2,624.56 |
0.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,827.31 |
$6,091.05 |
0.7× |
| Lymphoscintigraphy (78195) |
$653.38 |
$2,177.92 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$236.40 |
$788 |
1.1× |
| Meckels Diverticulum (78290) |
$519.04 |
$1,730.12 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,433.07 |
$11,443.57 |
10.5× |
| Mr elastography (76391) |
$448.50 |
$1,495 |
2.1× |
| MRA head w & w/o contrast (70546) |
$1,466.53 |
$4,888.45 |
4.8× |
| MRA head w/o contrast (70544) |
$1,186.92 |
$3,956.39 |
5.7× |
| MRA head with contrast (70545) |
$1,282.07 |
$4,273.58 |
4.2× |
| MRA neck w contrast (70548) |
$1,318.20 |
$4,394.01 |
4.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,479.51 |
$4,931.70 |
4.8× |
| MRA neck w/o contrast (70547) |
$981.08 |
$3,270.27 |
4.7× |
| MRI abdomen w contrast (74182) |
$1,365.02 |
$4,550.06 |
4.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,612.32 |
$5,374.41 |
5.3× |
| MRI abdomen w/o contrast (74181) |
$1,172.16 |
$3,907.20 |
5.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,316.93 |
$4,389.77 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,166.82 |
$3,889.39 |
1.7× |
| MRI bone marrow blood supply (77084) |
$1,174.80 |
$3,916 |
5.6× |
| MRI breast w/o contrast bilateral (77047) |
$1,407.76 |
$4,692.54 |
6.7× |
| MRI breast w/o contrast unilat (77046) |
$1,278 |
$4,260 |
6.1× |
| MRI c-spine with contrast (72142) |
$1,443.64 |
$4,812.12 |
4.7× |
| MRI cardiac w/o cont stress (75559) |
$1,466.10 |
$4,887 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$1,443.89 |
$4,812.97 |
6.9× |
| MRI cervical spine w/o contrast (72141) |
$1,173.18 |
$3,910.59 |
5.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,729.61 |
$5,765.38 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,193.79 |
$3,979.29 |
5.7× |
| MRI chest with contrast (71551) |
$1,159.50 |
$3,865 |
1.7× |
| MRI fetal sngl/1st gestation (74712) |
$478.20 |
$1,594 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,218.30 |
$4,061 |
4.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,466.28 |
$4,887.60 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,223.05 |
$4,076.82 |
5.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,140.35 |
$3,801.18 |
5.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,517.93 |
$5,059.76 |
5.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,352.04 |
$4,506.80 |
4.4× |
| MRI pelvis w contrast (72196) |
$1,198.80 |
$3,996 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,491.47 |
$4,971.56 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,253.32 |
$4,177.74 |
6.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,746.41 |
$5,821.36 |
5.7× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,614.87 |
$5,382.89 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,934.18 |
$6,447.26 |
6.3× |
| MRI spectroscopy (76390) |
$374.10 |
$1,247 |
4.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,756.33 |
$5,854.43 |
5.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,451.52 |
$4,838.41 |
4.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,629.88 |
$5,432.93 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,277.24 |
$4,257.46 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,666.01 |
$5,553.36 |
5.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,238.05 |
$4,126.85 |
5.9× |
| MRI tmj (70336) |
$1,020.90 |
$3,403 |
4.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,088.20 |
$3,627.32 |
5.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,356.62 |
$4,522.07 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,092.27 |
$3,640.89 |
5.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,928.70 |
$6,429 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,881.76 |
$6,272.55 |
1.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,928.70 |
$6,429 |
1.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,390.50 |
$4,635 |
1.1× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,547.40 |
$5,158 |
0.8× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,124.24 |
$7,080.79 |
1.1× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$1,928.70 |
$6,429 |
1.5× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$849.54 |
$2,831.81 |
1.1× |
| Neck soft tissue (70360) |
$162.83 |
$542.78 |
2.1× |
| Nm adrenal scan (78075) |
$889.50 |
$2,965 |
0.8× |
| Nm bone marrow multiple (78103) |
$431.61 |
$1,438.69 |
1.2× |
| Nm bone marrow wb (78104) |
$459.59 |
$1,531.98 |
1.3× |
| Nm cisternogram (78630) |
$553.89 |
$1,846.31 |
1.2× |
| Nm csf leak detection (78650) |
$346.28 |
$1,154.26 |
0.3× |
| Nm gastric emptying study (78264) |
$778.30 |
$2,594.34 |
2.2× |
| Nm peritoneal-venous shunt patency (78291) |
$227.14 |
$757.12 |
0.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,782.36 |
$15,941.20 |
3.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,470.60 |
$4,902 |
1.2× |
| Nuclear medicine of heart pumping function (78473) |
$790.58 |
$2,635.28 |
2.3× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,327.20 |
$4,424 |
1.1× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$782.02 |
$2,606.75 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$973.70 |
$3,245.68 |
4.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$225.43 |
$751.42 |
2.5× |
| Orthopantogram (70355) |
$164.70 |
$549 |
2.2× |
| Osseous survey infant (77076) |
$136.12 |
$453.73 |
1.5× |
| Osseous survey limited (77074) |
$286.49 |
$954.96 |
3.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,989.64 |
$6,632.14 |
4.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,627.59 |
$5,425.30 |
4.6× |
| Parathyroid imaging (78070) |
$672.46 |
$2,241.53 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$159.53 |
$531.76 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$2,262.14 |
$7,540.46 |
1.8× |
| PET imaging CT for attenuation limited area (78814) |
$2,262.14 |
$7,540.46 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,262.14 |
$7,540.46 |
1.8× |
| Pr csf ventriculography (78635) |
$503.54 |
$1,678.47 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,675.68 |
$5,585.59 |
5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$963.90 |
$3,213 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$813.92 |
$2,713.07 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$550.84 |
$1,836.14 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$845.72 |
$2,819.08 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$280.89 |
$936.30 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$140.44 |
$468.15 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$227.97 |
$759.90 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$176.83 |
$589.43 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$107.40 |
$358 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$267.60 |
$892 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,040.94 |
$43,469.79 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$913.63 |
$3,045.45 |
1.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$499.61 |
$1,665.36 |
5.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$860.44 |
$2,868.12 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$229.24 |
$764.14 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$165.89 |
$552.96 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$214.23 |
$714.10 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$119.35 |
$397.84 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$415.99 |
$1,386.64 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$517.76 |
$1,725.88 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$517.76 |
$1,725.88 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$285.98 |
$953.26 |
1.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$226.95 |
$756.51 |
3.0× |
| Radiological examination surgical specimen (76098) |
$143.75 |
$479.18 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,051.49 |
$3,504.97 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,659 |
$5,530 |
0.6× |
| Ribs bilateral 3 views (71110) |
$185.99 |
$619.96 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$497.16 |
$1,657.19 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$667.88 |
$2,226.26 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$992.53 |
$3,308.44 |
2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,056.49 |
$6,854.96 |
1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,262.14 |
$7,540.46 |
1.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,001.95 |
$3,339.82 |
0.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$645.49 |
$2,151.63 |
3.2× |
| Rp Therapy Intravenous Administration (79101) |
$433.29 |
$1,444.31 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$112.46 |
$374.86 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$323.10 |
$1,077 |
1.5× |
| Salivary gland imaging (78230) |
$519.27 |
$1,730.90 |
1.5× |
| Scanogram (77073) |
$115 |
$383.34 |
1.3× |
| Scapula complete (73010) |
$164.36 |
$547.87 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$29 |
$96.68 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$200.49 |
$668.30 |
2.2× |
| Simulation intermediate (77285) |
$488.45 |
$1,628.16 |
1.5× |
| Small bowel series (74250) |
$386.23 |
$1,287.42 |
2.5× |
| Spec medical radj physics consltj (77370) |
$365.86 |
$1,219.53 |
3.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$709.60 |
$2,365.34 |
2.2× |
| Special dosimetry (77331) |
$341.93 |
$1,139.76 |
2.9× |
| Special treatment procedure (77470) |
$1,705.11 |
$5,683.69 |
3.5× |
| Spine thoracic 3 views (72072) |
$213.72 |
$712.40 |
2.3× |
| Splenoportograpy rs&i (75810) |
$947.70 |
$3,159 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$7,031.46 |
$23,438.21 |
4.5× |
| Superior sagittal sinus venogram (75870) |
$827.40 |
$2,758 |
0.3× |
| Tbs Technical Calculation Only (77091) |
$121.20 |
$404 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,050.74 |
$3,502.46 |
3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$405.64 |
$1,352.14 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$983.89 |
$3,279.64 |
3.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$681.82 |
$2,272.72 |
5.8× |
| Thoracolumbar 2 views (72080) |
$205.83 |
$686.11 |
2.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$962.76 |
$3,209.21 |
2.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$742.93 |
$2,476.45 |
2.1× |
| Thyroid uptake measurement (78012) |
$644.47 |
$2,148.24 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$815.45 |
$2,718.16 |
2.3× |
| Tmj unilateral (70328) |
$182.68 |
$608.94 |
2.4× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$121.20 |
$404 |
1.6× |
| Treatment device intermediate (77333) |
$672.39 |
$2,241.30 |
5.7× |
| Treatment devices simple (77332) |
$368.98 |
$1,229.94 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$958.18 |
$3,193.94 |
2.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$377.32 |
$1,257.73 |
1.1× |
| Tx devices design & construction complex (77334) |
$716.89 |
$2,389.62 |
2.2× |
| Ultrasound elastography first target lesion (76982) |
$468 |
$1,560 |
5.1× |
| Ultrasound, abdomen limited (76705) |
$354.93 |
$1,183.10 |
3.9× |
| Umbilical-artery Doppler (OB) (76820) |
$270.46 |
$901.53 |
3.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$398.99 |
$1,329.98 |
5.2× |
| Unlisted magnetic resonance procedure (76498) |
$526.50 |
$1,755 |
6.9× |
| Unlisted Ultrasound Procedure (76999) |
$251.10 |
$837 |
3.3× |
| Upper Extremity Infant (73092) |
$115 |
$383.34 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$268.17 |
$893.90 |
1.3× |
| Urethrocystography voiding (74455) |
$413.45 |
$1,378.16 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$563.70 |
$1,879 |
3.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$366 |
$1,220 |
2.4× |
| Us abdl aorta screen aaa (76706) |
$128.74 |
$429.14 |
1.4× |
| Us breast unilateral complete (76641) |
$357.98 |
$1,193.28 |
3.9× |
| Us breast unilateral limited (76642) |
$256.22 |
$854.08 |
3.4× |
| Us chest (76604) |
$230.26 |
$767.53 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$429.99 |
$1,433.29 |
4.7× |
| Us elastography parenchyma (76981) |
$515.47 |
$1,718.25 |
5.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$83.50 |
$278.33 |
0.9× |
| Us guided compression repair (76936) |
$418.20 |
$1,394 |
2.2× |
| Us infant hips dynamic (76885) |
$322.36 |
$1,074.54 |
4.2× |
| Us infant hips limited static (76886) |
$222.37 |
$741.24 |
2.9× |
| Us kidney transplant (76776) |
$65.70 |
$219 |
0.7× |
| Us ob detailed single fetus (76811) |
$244.51 |
$815.02 |
1.2× |
| Us ob transvaginal (76817) |
$297.43 |
$991.43 |
3.2× |
| Us pelvic non ob complete (76856) |
$371.47 |
$1,238.23 |
4.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$256.21 |
$854.04 |
2.8× |
| Us pregnancy ltd (76815) |
$158.51 |
$528.37 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$332.03 |
$1,106.77 |
3.6× |
| Us retroperitoneal complete (76770) |
$385.72 |
$1,285.72 |
4.2× |
| Us retroperitoneal limited (76775) |
$379.61 |
$1,265.37 |
4.1× |
| Us scrotum and contents (76870) |
$462.55 |
$1,541.85 |
5.0× |
| Us soft tissue head/neck (76536) |
$473.75 |
$1,579.16 |
5.2× |
| Us spinal canal and contents (76800) |
$72.51 |
$241.71 |
0.8× |
| Us transrectal (76872) |
$447 |
$1,490 |
4.9× |
| Us transrectal prostate volume (76873) |
$357 |
$1,190 |
3.9× |
| Us xtr non-vasc lmtd (76882) |
$429.99 |
$1,433.29 |
4.7× |
| Venogram extremity bilateral (75822) |
$774.74 |
$2,582.46 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,427.61 |
$4,758.69 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,128.65 |
$3,762.17 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$523.11 |
$1,743.69 |
0.4× |
| Venography Renal Bilateral (75833) |
$2,570.50 |
$8,568.35 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$1,285.12 |
$4,283.75 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,126.87 |
$3,756.23 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$1,667.56 |
$5,558.56 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$76.84 |
$256.13 |
1.0× |
| Wrist 2 views (73100) |
$140.70 |
$469 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$309.64 |
$1,032.14 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$181.41 |
$604.70 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$208.86 |
$696.21 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$497.16 |
$1,657.19 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$155.96 |
$519.88 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$177.59 |
$591.97 |
2.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$257.23 |
$857.43 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$149.10 |
$496.99 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$158 |
$526.67 |
2.1× |
| X-ray exam hip uni 4/> views (73503) |
$174.79 |
$582.64 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$194.13 |
$647.10 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$210.92 |
$703.07 |
2.3× |
| X-ray exam of femur 1 (73551) |
$218.56 |
$728.52 |
2.9× |
| X-ray eye for foreign body (70030) |
$123.91 |
$413.02 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$236.36 |
$787.88 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$176.83 |
$589.43 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$175.05 |
$583.49 |
2.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$468.30 |
$1,561 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$146.31 |
$487.70 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$102.53 |
$341.78 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$199.73 |
$665.76 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$156.73 |
$522.43 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$115 |
$383.34 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$274.53 |
$915.10 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$373.50 |
$1,245.01 |
4.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$279.62 |
$932.06 |
3.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$181.41 |
$604.70 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$114.49 |
$381.65 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$192.35 |
$641.16 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$160.54 |
$535.15 |
1.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$359.10 |
$1,197 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$357.90 |
$1,193 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$176.32 |
$587.73 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$231.28 |
$770.92 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$285.73 |
$952.42 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$181.15 |
$603.85 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$202.53 |
$675.09 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$167.58 |
$558.59 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$259.01 |
$863.37 |
3.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$165.89 |
$552.96 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$230.51 |
$768.38 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$163.85 |
$546.18 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$180.13 |
$600.45 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$115 |
$383.34 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$172 |
$573.32 |
2.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$41.10 |
$137 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$205.83 |
$686.11 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$215.50 |
$718.34 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$143.24 |
$477.48 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$159.02 |
$530.06 |
2.1× |
| Xr arthrogram ankle (73615) |
$213.60 |
$712 |
0.7× |
| Xr c-spine 6 or more views (72052) |
$304.04 |
$1,013.48 |
3.3× |
| Xr chest 4+ views (71048) |
$143.77 |
$479.25 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$152.15 |
$507.16 |
2.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$104.40 |
$348 |
1.1× |
| Xr optic foramina (70190) |
$100.80 |
$336 |
1.3× |
| Xr shoulder 1 view (73020) |
$151.64 |
$505.47 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$270.71 |
$902.38 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$165.39 |
$551.30 |
2.2× |
| Xr tmj bilateral (70330) |
$271.22 |
$904.07 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$156.40 |
$521.35 |
2.1× |