| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,168.62 |
$17,228.75 |
4.2× |
| Abdomen 2 views (74019) |
$268.95 |
$896.50 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$776.49 |
$2,588.30 |
2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,373.70 |
$14,579 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,059.64 |
$10,198.80 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,607.54 |
$8,691.80 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,908.90 |
$6,363 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,013.70 |
$13,379 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,065.04 |
$10,216.80 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,213.25 |
$7,377.50 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$2,142.30 |
$7,141 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,206.58 |
$10,688.60 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$748.80 |
$2,496 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,240.80 |
$4,136 |
0.4× |
| Ankle 2 views (73600) |
$232.98 |
$776.60 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$956.40 |
$3,188 |
3.1× |
| Aortogram thoracic (75605) |
$2,142.30 |
$7,141 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,337.47 |
$11,124.90 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$1,969.65 |
$6,565.50 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,186.70 |
$7,289 |
0.8× |
| Arthrogram elbow (73085) |
$490.05 |
$1,633.50 |
1.6× |
| Arthrogram hip (73525) |
$505.23 |
$1,684.10 |
1.6× |
| Arthrogram shoulder (73040) |
$542.52 |
$1,808.40 |
1.7× |
| Arthrogram wrist (73115) |
$406.23 |
$1,354.10 |
1.3× |
| Arthrography knee lt (73580) |
$372.90 |
$1,243 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$458.10 |
$1,527 |
3.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$677.49 |
$2,258.30 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$936.30 |
$3,121 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,275.78 |
$4,252.60 |
3.6× |
| Bone age studies (77072) |
$135.60 |
$452 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,275.78 |
$4,252.60 |
3.6× |
| Bone Marrow Imaging Limited Area (78102) |
$522.90 |
$1,743 |
1.5× |
| Bone survey complete (77075) |
$575.19 |
$1,917.30 |
6.1× |
| Brachytx isodose complex (77318) |
$1,659.15 |
$5,530.50 |
4.9× |
| Brachytx isodose intermed (77317) |
$1,465.12 |
$4,883.75 |
4.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$875.25 |
$2,917.50 |
2.6× |
| Brain image w/flow 4 + views (78606) |
$794.10 |
$2,647 |
1.6× |
| Brain imaging < 4 static views (78600) |
$453.90 |
$1,513 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$499.29 |
$1,664.30 |
1.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$653.10 |
$2,177 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,627.10 |
$8,757 |
2.1× |
| Brain Imaging Vascular Flow Only (78610) |
$505.80 |
$1,686 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,590.90 |
$5,303 |
5.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$460.50 |
$1,535 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$285.78 |
$952.60 |
3.7× |
| Chest 1 view (71045) |
$123.84 |
$412.80 |
1.6× |
| Chest 3 views (71047) |
$165.96 |
$553.20 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$326.04 |
$1,086.80 |
2.1× |
| Cineradiography/videoradiography (76120) |
$181.80 |
$606 |
1.9× |
| Clavicle complete (73000) |
$241.23 |
$804.10 |
3.1× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$37,321.76 |
$124,405.88 |
5.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$251.46 |
$838.20 |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$459.66 |
$1,532.19 |
3.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,594.02 |
$8,646.75 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,840.86 |
$6,136.20 |
8.6× |
| CT abdomen w contrast (74160) |
$1,396.71 |
$4,655.70 |
8.9× |
| CT abdomen w wo contrast (74170) |
$1,534.05 |
$5,113.50 |
9.8× |
| CT abdomen w/o contrast (74150) |
$1,165.50 |
$3,885 |
12.4× |
| CT angio hrt w/3d image (75574) |
$1,945.80 |
$6,486 |
6.2× |
| CT angiography upper extremity lt (73206) |
$1,036.53 |
$3,455.10 |
6.6× |
| CT c-spine w/o contrast (72125) |
$1,188.99 |
$3,963.30 |
12.7× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$526.35 |
$1,754.50 |
3.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,378.74 |
$4,595.80 |
8.8× |
| CT cervical spine with contrast (72126) |
$1,332.21 |
$4,440.70 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,519.32 |
$5,064.40 |
9.7× |
| CT chest with contrast (71260) |
$1,278.91 |
$4,263.05 |
8.1× |
| CT head/brain with contrast (70460) |
$1,125.30 |
$3,751 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,270.50 |
$4,235 |
8.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,961.40 |
$6,538 |
6.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$90 |
$300 |
1.2× |
| CT hrt w/3d image congen (75573) |
$1,943.10 |
$6,477 |
6.2× |
| CT iac w contrast (70481) |
$1,374.78 |
$4,582.60 |
8.7× |
| CT limited/localized follow up study (76380) |
$739.53 |
$2,465.10 |
9.5× |
| CT lower ext w/o (73700) |
$820.05 |
$2,733.50 |
8.8× |
| CT lower extremity w wo contrast (73702) |
$904.20 |
$3,014 |
5.8× |
| CT lower extremity with contrast (73701) |
$861.30 |
$2,871 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,615.68 |
$5,385.60 |
10.3× |
| CT lumbar spine w/o contrast (72131) |
$911.79 |
$3,039.30 |
9.7× |
| CT lumbar spine with contrast (72132) |
$1,046.43 |
$3,488.10 |
3.3× |
| CT maxillofacial w contrast (70487) |
$1,239.15 |
$4,130.50 |
7.9× |
| CT maxillofacial w/o contrast (70486) |
$862.62 |
$2,875.40 |
9.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,301.52 |
$4,338.40 |
8.3× |
| CT neck soft tissue w contrast (70491) |
$1,056.33 |
$3,521.10 |
6.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,724.58 |
$5,748.60 |
11.0× |
| CT orbits w/o contrast (70480) |
$1,319.55 |
$4,398.50 |
14.1× |
| CT pelvis w & w/o contrast (72194) |
$1,459.08 |
$4,863.60 |
9.3× |
| CT pelvis w/o contrast (72192) |
$1,060.29 |
$3,534.30 |
11.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,241.13 |
$4,137.10 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$916.41 |
$3,054.70 |
9.8× |
| CT thoracic spine w/contrast (72129) |
$1,289.31 |
$4,297.70 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,149.06 |
$3,830.20 |
12.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,430.88 |
$4,769.60 |
9.1× |
| CT thorax w/o contrast (71250) |
$1,004.64 |
$3,348.80 |
10.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$920.70 |
$3,069 |
5.9× |
| CT upper extremity w/o contrast rt (73200) |
$785.40 |
$2,618 |
8.4× |
| CT upper extremity with contrast (73201) |
$825 |
$2,750 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,805.43 |
$6,018.10 |
11.5× |
| Cta Abdomen (74175) |
$1,610.91 |
$5,369.70 |
10.3× |
| CTA abdomen pelvis (74174) |
$2,266.42 |
$7,554.75 |
7.3× |
| CTA chest (71275) |
$1,481.70 |
$4,939 |
9.4× |
| Cta Head (70496) |
$1,579.05 |
$5,263.50 |
10.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,262.71 |
$10,875.70 |
10.4× |
| CTA lwr ext w&w/o contrast (73706) |
$906.57 |
$3,021.90 |
5.8× |
| Cta Neck (70498) |
$1,683.66 |
$5,612.20 |
10.7× |
| Cta Pelvis (72191) |
$1,433.88 |
$4,779.60 |
9.1× |
| Cystography minimum 3 views rs&i (74430) |
$340.89 |
$1,136.30 |
1.1× |
| Diskography lumbar (72295) |
$878.10 |
$2,927 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$143.40 |
$478 |
1.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$135.90 |
$453 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$385.44 |
$1,284.80 |
4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$158.70 |
$529 |
2.0× |
| Dxa bone density study axial skeleton (77085) |
$90.60 |
$302 |
1.0× |
| Echo exam of fetal heart (76825) |
$472.80 |
$1,576 |
1.0× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$395.70 |
$1,319 |
1.9× |
| Echoencephalography real time imaging (76506) |
$976.14 |
$3,253.80 |
10.4× |
| Esophagus (74220) |
$343.53 |
$1,145.10 |
2.2× |
| Fetal biophysical profile non-stress testing (76818) |
$588.30 |
$1,961 |
6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$581.46 |
$1,938.20 |
6.2× |
| Fluoroscopy up to 1 hr (76000) |
$429.44 |
$1,431.47 |
2.0× |
| Foot 2 views (73620) |
$180.51 |
$601.70 |
2.3× |
| Forearm 2 views (73090) |
$215.49 |
$718.30 |
2.8× |
| Functional MRI brain by tech (70554) |
$1,314.30 |
$4,381 |
6.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,087.20 |
$3,624 |
2.2× |
| Gated Heart Planar Single (78472) |
$1,096.92 |
$3,656.40 |
3.1× |
| Hand 2 views (73120) |
$205.92 |
$686.40 |
2.2× |
| Hand 3 views (73130) |
$199.71 |
$665.70 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,652.10 |
$5,507 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,345.40 |
$7,818 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,192.60 |
$10,642 |
5.1× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,651.40 |
$8,838 |
7.7× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,344.20 |
$7,814 |
6.8× |
| Heart Infarct Image (78466) |
$341.40 |
$1,138 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,154.60 |
$7,182 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,280.40 |
$4,268 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,280.40 |
$4,268 |
3.6× |
| Ht muscle image spect sing (78451) |
$1,872.90 |
$6,243 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$244.86 |
$816.20 |
3.1× |
| Hysterosalpingogram (74740) |
$551.76 |
$1,839.20 |
2.6× |
| Interstitial radiation source applic complex (77778) |
$3,184.33 |
$10,614.44 |
5.1× |
| Intracavitary radiation source applic simple (77761) |
$1,339.12 |
$4,463.75 |
2.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$114.60 |
$382 |
1.2× |
| Kidney funcj study non-img radioisotopic study (78725) |
$391.20 |
$1,304 |
1.1× |
| Kidney imaging morphology (78700) |
$791.70 |
$2,639 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,100.22 |
$3,667.40 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,115.40 |
$3,718 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,115.70 |
$3,719 |
2.3× |
| Knee 3 views (73562) |
$235.62 |
$785.40 |
3.0× |
| Liver & spleen imaging static only (78215) |
$706.53 |
$2,355.10 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$691.20 |
$2,304 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$997.20 |
$3,324 |
2.1× |
| Lung perfusion differential (78597) |
$997.20 |
$3,324 |
2.8× |
| Lung Ventilation Imaging (78579) |
$649.50 |
$2,165 |
1.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,154.60 |
$7,182 |
0.8× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$972.60 |
$3,242 |
0.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,154.60 |
$7,182 |
0.8× |
| Lymphoscintigraphy (78195) |
$770.40 |
$2,568 |
1.6× |
| Mammary ductogram or galactogram multiple (77054) |
$307.20 |
$1,024 |
1.4× |
| Meckels Diverticulum (78290) |
$612 |
$2,040 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,452.75 |
$14,842.50 |
13.3× |
| Mr elastography (76391) |
$582.60 |
$1,942 |
2.7× |
| MRA head w & w/o contrast (70546) |
$1,902.12 |
$6,340.40 |
6.1× |
| MRA head w/o contrast (70544) |
$1,539.45 |
$5,131.50 |
7.2× |
| MRA head with contrast (70545) |
$1,662.87 |
$5,542.90 |
5.3× |
| MRA neck w contrast (70548) |
$1,554.30 |
$5,181 |
5.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,918.95 |
$6,396.50 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,272.48 |
$4,241.60 |
6.0× |
| MRI abdomen w contrast (74182) |
$1,770.45 |
$5,901.50 |
5.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,091.21 |
$6,970.70 |
6.7× |
| MRI abdomen w/o contrast (74181) |
$1,520.31 |
$5,067.70 |
7.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,708.08 |
$5,693.60 |
2.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,513.38 |
$5,044.60 |
2.2× |
| MRI bone marrow blood supply (77084) |
$1,525.80 |
$5,086 |
7.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,825.89 |
$6,086.30 |
8.5× |
| MRI breast w/o contrast unilat (77046) |
$1,659.90 |
$5,533 |
7.8× |
| MRI c-spine with contrast (72142) |
$1,872.42 |
$6,241.40 |
6.0× |
| MRI cardiac w/o cont stress (75559) |
$1,904.10 |
$6,347 |
3.9× |
| MRI cardiac w/o contrast (75557) |
$1,702.50 |
$5,675 |
8.0× |
| MRI cervical spine w/o contrast (72141) |
$1,521.63 |
$5,072.10 |
7.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,243.34 |
$7,477.80 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,548.36 |
$5,161.20 |
7.2× |
| MRI chest with contrast (71551) |
$1,506 |
$5,020 |
2.1× |
| MRI fetal sngl/1st gestation (74712) |
$621 |
$2,070 |
2.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,582.20 |
$5,274 |
5.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,901.79 |
$6,339.30 |
6.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,586.31 |
$5,287.70 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,479.06 |
$4,930.20 |
6.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,968.78 |
$6,562.60 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,753.62 |
$5,845.40 |
5.6× |
| MRI pelvis w contrast (72196) |
$1,712.37 |
$5,707.90 |
5.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,934.46 |
$6,448.20 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,625.58 |
$5,418.60 |
7.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,265.12 |
$7,550.40 |
7.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,904.10 |
$6,347 |
2.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,508.66 |
$8,362.20 |
8.0× |
| MRI spectroscopy (76390) |
$485.70 |
$1,619 |
6.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,277.99 |
$7,593.30 |
7.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,882.65 |
$6,275.50 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,113.98 |
$7,046.60 |
6.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,656.60 |
$5,522 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,160.84 |
$7,202.80 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,605.78 |
$5,352.60 |
7.5× |
| MRI tmj (70336) |
$1,326 |
$4,420 |
6.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,411.41 |
$4,704.70 |
6.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,759.56 |
$5,865.20 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,416.69 |
$4,722.30 |
6.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,504.70 |
$8,349 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,440.68 |
$8,135.60 |
2.1× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,504.70 |
$8,349 |
2.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,805.70 |
$6,019 |
1.4× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,009.70 |
$6,699 |
1.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,504.70 |
$8,349 |
1.3× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$2,504.70 |
$8,349 |
1.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,001.70 |
$3,339 |
1.3× |
| Neck soft tissue (70360) |
$211.20 |
$704 |
2.7× |
| Nm adrenal scan (78075) |
$1,155.30 |
$3,851 |
1.0× |
| Nm bone marrow multiple (78103) |
$559.80 |
$1,866 |
1.6× |
| Nm bone marrow wb (78104) |
$596.10 |
$1,987 |
1.7× |
| Nm cisternogram (78630) |
$653.10 |
$2,177 |
1.3× |
| Nm csf leak detection (78650) |
$408.30 |
$1,361 |
0.4× |
| Nm gastric emptying study (78264) |
$1,009.47 |
$3,364.90 |
2.8× |
| Nm gastroesophageal reflux study (78262) |
$777.60 |
$2,592 |
2.2× |
| Nm peritoneal-venous shunt patency (78291) |
$294.60 |
$982 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,202.80 |
$20,676 |
5.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,909.80 |
$6,366 |
1.5× |
| Nuclear medicine of heart pumping function (78473) |
$1,025.40 |
$3,418 |
2.9× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,723.50 |
$5,745 |
1.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,142.40 |
$3,808 |
3.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,014.30 |
$3,381 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$1,262.91 |
$4,209.70 |
6.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$279.09 |
$930.30 |
3.0× |
| Orthopantogram (70355) |
$213.90 |
$713 |
2.7× |
| Osseous survey infant (77076) |
$160.50 |
$535 |
1.7× |
| Osseous survey limited (77074) |
$337.80 |
$1,126 |
3.6× |
| Parathyrd planar w/spect&CT (78072) |
$2,346 |
$7,820 |
4.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,111.01 |
$7,036.70 |
5.9× |
| Parathyroid imaging (78070) |
$872.19 |
$2,907.30 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$206.91 |
$689.70 |
2.2× |
| PET image w/CT, skull-thigh (78815) |
$2,667.30 |
$8,891 |
2.1× |
| PET imaging CT for attenuation limited area (78814) |
$2,667.30 |
$8,891 |
2.1× |
| PET imaging for CT attenuation whole body (78816) |
$2,667.30 |
$8,891 |
2.1× |
| Pr csf ventriculography (78635) |
$653.10 |
$2,177 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,173.38 |
$7,244.60 |
7.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,251.90 |
$4,173 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$959.70 |
$3,199 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$714.45 |
$2,381.50 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,096.92 |
$3,656.40 |
2.3× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,052.37 |
$3,507.90 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$364.32 |
$1,214.40 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$182.16 |
$607.20 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$295.68 |
$985.60 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$229.35 |
$764.50 |
2.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$139.50 |
$465 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$347.70 |
$1,159 |
3.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,914.31 |
$56,381.05 |
2.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,185 |
$3,950 |
2.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$648 |
$2,160 |
7.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,116 |
$3,720 |
3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.33 |
$991.10 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$215.16 |
$717.20 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$252.60 |
$842 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$154.80 |
$516 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$539.55 |
$1,798.50 |
3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$610.50 |
$2,035 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$671.55 |
$2,238.50 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$370.92 |
$1,236.40 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$294.36 |
$981.20 |
3.8× |
| Radiological examination surgical specimen (76098) |
$186.45 |
$621.50 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,363.80 |
$4,546 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,154.60 |
$7,182 |
0.8× |
| Ribs bilateral 3 views (71110) |
$241.23 |
$804.10 |
2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$586.20 |
$1,954 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$866.25 |
$2,887.50 |
1.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,287.33 |
$4,291.10 |
2.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,667.30 |
$8,891 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,667.30 |
$8,891 |
2.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,181.40 |
$3,938 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$761.10 |
$2,537 |
3.6× |
| Rp Therapy Intravenous Administration (79101) |
$510.90 |
$1,703 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$145.86 |
$486.20 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$419.70 |
$1,399 |
2.0× |
| Salivary gland imaging (78230) |
$673.50 |
$2,245 |
1.9× |
| Scanogram (77073) |
$149.16 |
$497.20 |
1.6× |
| Scapula complete (73010) |
$213.18 |
$710.60 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$37.62 |
$125.40 |
1.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$260.04 |
$866.80 |
2.8× |
| Simulation intermediate (77285) |
$633.52 |
$2,111.75 |
1.9× |
| Small bowel series (74250) |
$500.94 |
$1,669.80 |
3.2× |
| Spec medical radj physics consltj (77370) |
$474.52 |
$1,581.75 |
3.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$920.36 |
$3,067.88 |
2.7× |
| Special dosimetry (77331) |
$443.49 |
$1,478.29 |
3.7× |
| Special treatment procedure (77470) |
$2,211.55 |
$7,371.84 |
4.5× |
| Spine thoracic 3 views (72072) |
$277.20 |
$924 |
3.0× |
| Splenoportograpy rs&i (75810) |
$1,230.60 |
$4,102 |
0.4× |
| Stereotactic body radiation delivery (77373) |
$9,119.92 |
$30,399.75 |
5.7× |
| Superior sagittal sinus venogram (75870) |
$1,074.60 |
$3,582 |
0.4× |
| Tbs Technical Calculation Only (77091) |
$461.70 |
$1,539 |
5.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,362.82 |
$4,542.75 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$526.12 |
$1,753.75 |
1.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,276.12 |
$4,253.75 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$884.32 |
$2,947.75 |
7.3× |
| Thoracolumbar 2 views (72080) |
$266.97 |
$889.90 |
3.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,248.72 |
$4,162.40 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$876 |
$2,920 |
2.4× |
| Thyroid uptake measurement (78012) |
$835.89 |
$2,786.30 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,057.65 |
$3,525.50 |
3.0× |
| Tmj unilateral (70328) |
$236.94 |
$789.80 |
3.0× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$461.70 |
$1,539 |
5.9× |
| Treatment device intermediate (77333) |
$872.10 |
$2,907 |
7.2× |
| Treatment devices simple (77332) |
$478.57 |
$1,595.25 |
4.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,242.78 |
$4,142.60 |
2.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$489.39 |
$1,631.30 |
1.4× |
| Tx devices design & construction complex (77334) |
$929.81 |
$3,099.38 |
2.8× |
| Ultrasound elastography first target lesion (76982) |
$607.80 |
$2,026 |
6.5× |
| Ultrasound, abdomen limited (76705) |
$460.35 |
$1,534.50 |
4.9× |
| Umbilical-artery Doppler (OB) (76820) |
$318.90 |
$1,063 |
3.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$517.50 |
$1,725 |
6.6× |
| Unlisted magnetic resonance procedure (76498) |
$683.70 |
$2,279 |
8.8× |
| Unlisted Ultrasound Procedure (76999) |
$326.10 |
$1,087 |
4.2× |
| Upper Extremity Infant (73092) |
$135.60 |
$452 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$347.82 |
$1,159.40 |
1.6× |
| Urethrocystography voiding (74455) |
$536.25 |
$1,787.50 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$768.60 |
$2,562 |
4.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$475.50 |
$1,585 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$166.98 |
$556.60 |
1.8× |
| Us breast unilateral complete (76641) |
$464.31 |
$1,547.70 |
5.0× |
| Us breast unilateral limited (76642) |
$332.32 |
$1,107.75 |
4.3× |
| Us chest (76604) |
$298.65 |
$995.50 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$557.70 |
$1,859 |
6.0× |
| Us elastography parenchyma (76981) |
$668.58 |
$2,228.60 |
7.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$108.30 |
$361 |
1.2× |
| Us guided compression repair (76936) |
$597.30 |
$1,991 |
3.1× |
| Us infant hips dynamic (76885) |
$380.10 |
$1,267 |
4.9× |
| Us infant hips limited static (76886) |
$262.20 |
$874 |
3.4× |
| Us kidney transplant (76776) |
$94.05 |
$313.50 |
1.0× |
| Us ob detailed single fetus (76811) |
$317.13 |
$1,057.10 |
1.5× |
| Us ob transvaginal (76817) |
$385.77 |
$1,285.90 |
4.1× |
| Us pelvic non ob complete (76856) |
$481.80 |
$1,606 |
5.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$332.31 |
$1,107.70 |
3.5× |
| Us pregnancy ltd (76815) |
$205.59 |
$685.30 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$430.65 |
$1,435.50 |
4.6× |
| Us retroperitoneal complete (76770) |
$500.28 |
$1,667.60 |
5.3× |
| Us retroperitoneal limited (76775) |
$492.36 |
$1,641.20 |
5.3× |
| Us scrotum and contents (76870) |
$599.94 |
$1,999.80 |
6.4× |
| Us soft tissue head/neck (76536) |
$614.46 |
$2,048.20 |
6.6× |
| Us spinal canal and contents (76800) |
$85.50 |
$285 |
0.9× |
| Us transrectal (76872) |
$580.50 |
$1,935 |
6.2× |
| Us transrectal prostate volume (76873) |
$463.50 |
$1,545 |
4.9× |
| Us xtr non-vasc lmtd (76882) |
$557.70 |
$1,859 |
6.0× |
| Venogram extremity bilateral (75822) |
$1,004.85 |
$3,349.50 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$1,851.63 |
$6,172.10 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,463.88 |
$4,879.60 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$678.48 |
$2,261.60 |
0.5× |
| Venography Renal Bilateral (75833) |
$3,030.90 |
$10,103 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$1,515.30 |
$5,051 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,395.13 |
$4,650.45 |
0.5× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$2,142.30 |
$7,141 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$90.60 |
$302 |
1.2× |
| Wrist 2 views (73100) |
$182.49 |
$608.30 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$401.61 |
$1,338.70 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$224.59 |
$748.65 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$270.90 |
$903 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$586.20 |
$1,954 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$193.19 |
$643.98 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$230.34 |
$767.80 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$333.63 |
$1,112.10 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$193.38 |
$644.60 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$204.93 |
$683.10 |
2.6× |
| X-ray exam hip uni 4/> views (73503) |
$226.71 |
$755.70 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$251.79 |
$839.30 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$248.70 |
$829 |
2.7× |
| X-ray exam of femur 1 (73551) |
$283.47 |
$944.90 |
3.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$642.90 |
$2,143 |
4.1× |
| X-ray eye for foreign body (70030) |
$146.10 |
$487 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$306.57 |
$1,021.90 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$229.35 |
$764.50 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$227.04 |
$756.80 |
2.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$608.10 |
$2,027 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$189.94 |
$633.15 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$132.99 |
$443.30 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$259.05 |
$863.50 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$203.28 |
$677.60 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$149.16 |
$497.20 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$356.07 |
$1,186.90 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$484.44 |
$1,614.80 |
5.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$346.18 |
$1,153.95 |
3.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$235.29 |
$784.30 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$148.50 |
$495 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$226.80 |
$756 |
2.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$208.23 |
$694.10 |
2.2× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$466.50 |
$1,555 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$511.17 |
$1,703.90 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$228.69 |
$762.30 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$299.97 |
$999.90 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$370.59 |
$1,235.30 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$234.96 |
$783.20 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$262.68 |
$875.60 |
3.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$217.35 |
$724.50 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$335.94 |
$1,119.80 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$195.60 |
$652 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$298.98 |
$996.60 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$212.52 |
$708.40 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$233.64 |
$778.80 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$135.60 |
$452 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$223.08 |
$743.60 |
2.9× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$53.10 |
$177 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$266.97 |
$889.90 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$279.51 |
$931.70 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$185.79 |
$619.30 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$206.25 |
$687.50 |
2.6× |
| Xr arthrogram ankle (73615) |
$277.50 |
$925 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$394.35 |
$1,314.50 |
4.2× |
| Xr chest 4+ views (71048) |
$186.48 |
$621.60 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$197.34 |
$657.80 |
2.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$135.60 |
$452 |
1.4× |
| Xr optic foramina (70190) |
$130.80 |
$436 |
1.7× |
| Xr shoulder 1 view (73020) |
$196.68 |
$655.60 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$351.12 |
$1,170.40 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$214.51 |
$715.05 |
2.8× |
| Xr tmj bilateral (70330) |
$319.80 |
$1,066 |
4.1× |
| Xray knee 1 or 2 views rt (73560) |
$202.86 |
$676.20 |
2.6× |