| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,168.62 |
$17,228.75 |
4.2× |
| Abdomen 1 View (74018) |
$215.16 |
$717.20 |
2.8× |
| Abdomen 2 views (74019) |
$268.95 |
$896.50 |
2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$776.49 |
$2,588.30 |
2.2× |
| Adrenal Cortex & Medulla Img (78075) |
$1,155.30 |
$3,851 |
1.0× |
| Angio internal mammary (75756) |
$1,908.90 |
$6,363 |
0.7× |
| Angio pulmonary bilat (75743) |
$3,065.04 |
$10,216.80 |
1.1× |
| 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 pulmonary unilateral slctv rs&i (75741) |
$2,213.25 |
$7,377.50 |
0.8× |
| 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× |
| Aortography thoracic serialography rs&i (75605) |
$2,142.30 |
$7,141 |
0.4× |
| Artery X-Rays Abdomen (75726) |
$3,206.58 |
$10,688.60 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$2,186.70 |
$7,289 |
0.8× |
| Artery X-Rays Pelvis (75736) |
$4,013.70 |
$13,379 |
0.8× |
| Artery X-Rays Spine (75705) |
$2,142.30 |
$7,141 |
0.4× |
| Arthrogram ankle (73615) |
$277.50 |
$925 |
0.9× |
| Arthrogram hip (73525) |
$505.23 |
$1,684.10 |
1.6× |
| Arthrogram Wrist (73115) |
$406.23 |
$1,354.10 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$458.10 |
$1,527 |
3.8× |
| Bone age studies (77072) |
$135.60 |
$452 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,275.78 |
$4,252.60 |
3.6× |
| Bone Imaging Limited Area (78300) |
$677.49 |
$2,258.30 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$936.30 |
$3,121 |
2.6× |
| Bone Imaging Whole Body (78306) |
$1,275.78 |
$4,252.60 |
3.6× |
| Bone marrow imaging limited area (78102) |
$522.90 |
$1,743 |
1.5× |
| Bone marrow imaging; multiple areas (78103) |
$559.80 |
$1,866 |
1.6× |
| Bone marrow imaging; whole body (78104) |
$596.10 |
$1,987 |
1.7× |
| Bone survey infant (77076) |
$160.50 |
$535 |
1.7× |
| 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 Plan Simple (77316) |
$875.25 |
$2,917.50 |
2.6× |
| Brain Flow Imaging Only (78610) |
$505.80 |
$1,686 |
1.0× |
| Brain Image W/Flow < 4 Views (78601) |
$499.29 |
$1,664.30 |
1.4× |
| Brain imaging < 4 static views (78600) |
$453.90 |
$1,513 |
1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$794.10 |
$2,647 |
1.6× |
| 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× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,590.90 |
$5,303 |
5.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$1,904.10 |
$6,347 |
2.7× |
| Cat Scan Follow-Up Study (76380) |
$739.53 |
$2,465.10 |
9.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$460.50 |
$1,535 |
0.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$653.10 |
$2,177 |
1.3× |
| Cerebrospinal Fluid Scan (78630) |
$653.10 |
$2,177 |
1.3× |
| Chest 1 view (71045) |
$123.84 |
$412.80 |
1.6× |
| Chest 2 views (71046) |
$154.80 |
$516 |
2.0× |
| Chest 3 views (71047) |
$165.96 |
$553.20 |
2.1× |
| Chest 4 or more views (71048) |
$186.48 |
$621.60 |
2.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$181.80 |
$606 |
1.9× |
| Clavicle complete (73000) |
$241.23 |
$804.10 |
3.1× |
| 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× |
| Contrast Exam Abdominl Aorta (75625) |
$1,969.65 |
$6,565.50 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$340.89 |
$1,136.30 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$490.05 |
$1,633.50 |
1.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$372.90 |
$1,243 |
1.2× |
| 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 Abdomen and Pelvis (74174) |
$2,266.42 |
$7,554.75 |
7.3× |
| CT Angio Chest (71275) |
$1,481.70 |
$4,939 |
9.4× |
| CT Angio Head (70496) |
$1,579.05 |
$5,263.50 |
10.0× |
| CT angio hrt w/3d image (75574) |
$1,945.80 |
$6,486 |
6.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$906.57 |
$3,021.90 |
5.8× |
| CT Angio Neck (70498) |
$1,683.66 |
$5,612.20 |
10.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,036.53 |
$3,455.10 |
6.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$526.35 |
$1,754.50 |
3.3× |
| CT cervical spine w/ contrast (72126) |
$1,332.21 |
$4,440.70 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$1,188.99 |
$3,963.30 |
12.7× |
| CT cervical spine w/wo cont (72127) |
$1,378.74 |
$4,595.80 |
8.8× |
| CT chest w contrast (71260) |
$1,278.91 |
$4,263.05 |
8.1× |
| CT chest w/wo contrast (71270) |
$1,519.32 |
$5,064.40 |
9.7× |
| 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 l-spine w&w/o contrast (72133) |
$1,615.68 |
$5,385.60 |
10.3× |
| CT lower ext w/o (73700) |
$820.05 |
$2,733.50 |
8.8× |
| CT lower extremity w/contrast material (73701) |
$861.30 |
$2,871 |
5.5× |
| CT lumbar spine w contrast (72132) |
$1,046.43 |
$3,488.10 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$911.79 |
$3,039.30 |
9.7× |
| CT maxillofacial w contrast (70487) |
$1,239.15 |
$4,130.50 |
7.9× |
| CT maxillofacial wo contrast (70486) |
$862.62 |
$2,875.40 |
9.2× |
| CT neck tissue combo (70492) |
$1,241.13 |
$4,137.10 |
7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,724.58 |
$5,748.60 |
11.0× |
CT orbits w/o contrast (70480)
range across 2 matching MRF lines |
$1,184.70–$1,454.40 |
$3,949–$4,848 |
varies |
| 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 scan of leg combo (73702) |
$904.20 |
$3,014 |
5.8× |
| CT scans face/jaw combo (70488) |
$1,301.52 |
$4,338.40 |
8.3× |
| CT soft tissue neck w contrast (70491) |
$1,056.33 |
$3,521.10 |
6.7× |
| 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 cont (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 ext wo (73200) |
$785.40 |
$2,618 |
8.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$920.70 |
$3,069 |
5.9× |
| 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 head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,262.71 |
$10,875.70 |
10.4× |
| CTA pelvis (72191) |
$1,433.88 |
$4,779.60 |
9.1× |
| Dilation ureters/urethra rs&i (74485) |
$608.10 |
$2,027 |
0.3× |
| 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 Axial (77080) |
$385.44 |
$1,284.80 |
4.1× |
| Dxa bone density study (77085) |
$90.60 |
$302 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$158.70 |
$529 |
2.0× |
| Echo exam of fetal heart (76825) |
$472.80 |
$1,576 |
1.0× |
| Echo exam uterus (76831) |
$419.70 |
$1,399 |
2.0× |
| Echo Guide For Artery Repair (76936) |
$597.30 |
$1,991 |
3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$395.70 |
$1,319 |
1.9× |
| Echograp Trans R Pros Study (76873) |
$463.50 |
$1,545 |
4.9× |
| Esophagram (74220) |
$343.53 |
$1,145.10 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$588.30 |
$1,961 |
6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$581.46 |
$1,938.20 |
6.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$621 |
$2,070 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$429.44 |
$1,431.47 |
2.0× |
| Follow-Up Angiography (75898) |
$748.80 |
$2,496 |
0.3× |
| Foot 2 views (73620) |
$180.51 |
$601.70 |
2.3× |
| Forearm 2 views (73090) |
$215.49 |
$718.30 |
2.8× |
| Gastric emptying imaging study (78264) |
$1,009.47 |
$3,364.90 |
2.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,014.30 |
$3,381 |
2.8× |
| Gastroesophageal Reflux Exam (78262) |
$777.60 |
$2,592 |
2.2× |
| Gated Heart Planar Single (78472) |
$1,096.92 |
$3,656.40 |
3.1× |
| Gated Heart, Multiple (78473) |
$1,025.40 |
$3,418 |
2.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,087.20 |
$3,624 |
2.2× |
| Hand 2 views (73120) |
$205.92 |
$686.40 |
2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,192.60 |
$10,642 |
5.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,345.40 |
$7,818 |
3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,652.10 |
$5,507 |
2.6× |
| Heart Image (Pet) Multiple (78492) |
$1,909.80 |
$6,366 |
1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,154.60 |
$7,182 |
0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,154.60 |
$7,182 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,280.40 |
$4,268 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,280.40 |
$4,268 |
3.6× |
| Ht Muscle Image Spect Sing (78451) |
$1,872.90 |
$6,243 |
1.6× |
| Hysterosalpingogram (74740) |
$551.76 |
$1,839.20 |
2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$380.10 |
$1,267 |
4.9× |
| Infant hip ultrasound, limited static exam (76886) |
$262.20 |
$874 |
3.4× |
| 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 (77077) |
$114.60 |
$382 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$1,115.70 |
$3,719 |
2.3× |
| K Flow/Funct Image W/Drug (78708) |
$1,115.40 |
$3,718 |
2.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,100.22 |
$3,667.40 |
2.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$391.20 |
$1,304 |
1.1× |
| Kidney Imaging Morphol (78700) |
$791.70 |
$2,639 |
2.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,142.40 |
$3,808 |
3.2× |
| Knee 3 Views (73562) |
$235.62 |
$785.40 |
3.0× |
| Leveen/Shunt Patency Exam (78291) |
$294.60 |
$982 |
0.8× |
| 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 Ventilat&Perfus Imaging (78582) |
$1,096.92 |
$3,656.40 |
2.3× |
| Lung Ventilation Imaging (78579) |
$649.50 |
$2,165 |
1.8× |
| Lymph System Imaging (78195) |
$770.40 |
$2,568 |
1.6× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$972.60 |
$3,242 |
0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,154.60 |
$7,182 |
0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,154.60 |
$7,182 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$1,326 |
$4,420 |
6.2× |
| Magnetic Resonance Elastography (76391) |
$582.60 |
$1,942 |
2.7× |
| Mammary ductogram or galactogram multiple (77054) |
$307.20 |
$1,024 |
1.4× |
| Meckels Divert Exam (78290) |
$612 |
$2,040 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,452.75 |
$14,842.50 |
13.3× |
| Mra Head W/O & W/Contrast Material (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 contrast (74181) |
$1,520.31 |
$5,067.70 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,708.08 |
$5,693.60 |
2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,508.66 |
$8,362.20 |
8.0× |
| 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 brain functional w/o physician admnistration (70554) |
$1,314.30 |
$4,381 |
6.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,825.89 |
$6,086.30 |
8.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,659.90 |
$5,533 |
7.8× |
| 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 contrast (72142) |
$1,872.42 |
$6,241.40 |
6.0× |
| MRI cervical spine w/o cont (72141) |
$1,521.63 |
$5,072.10 |
7.1× |
| 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 chest wo w contrast (71552) |
$2,243.34 |
$7,477.80 |
7.2× |
| 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 & w/contr matr (73720) |
$2,173.38 |
$7,244.60 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,586.31 |
$5,287.70 |
7.4× |
| MRI lumbar spine w contrast (72149) |
$1,882.65 |
$6,275.50 |
6.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,277.99 |
$7,593.30 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,479.06 |
$4,930.20 |
6.9× |
| MRI orbit face neck w contrast (70542) |
$1,753.62 |
$5,845.40 |
5.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,968.78 |
$6,562.60 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,712.37 |
$5,707.90 |
5.5× |
| MRI pelvis w/o & w contrast (72197) |
$1,934.46 |
$6,448.20 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,625.58 |
$5,418.60 |
7.6× |
| MRI spectroscopy (76390) |
$485.70 |
$1,619 |
6.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,605.78 |
$5,352.60 |
7.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,582.20 |
$5,274 |
5.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,416.69 |
$4,722.30 |
6.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,759.56 |
$5,865.20 |
5.6× |
| MRI, abdomen, combo (74183) |
$2,091.21 |
$6,970.70 |
6.7× |
| MRI, dorsal spine combo (72157) |
$2,160.84 |
$7,202.80 |
6.9× |
| MRI, dorsal spine contrast (72147) |
$1,656.60 |
$5,522 |
5.3× |
| MRI, joint upper extrem (73221) |
$1,411.41 |
$4,704.70 |
6.6× |
| MRI, joint upper extrem combo (73223) |
$2,265.12 |
$7,550.40 |
7.2× |
| MRI, lumbar spine combo (72158) |
$2,113.98 |
$7,046.60 |
6.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$341.40 |
$1,138 |
1.0× |
| 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 sw aly CTA (75580) |
$1,001.70 |
$3,339 |
1.3× |
| Neck soft tissue (70360) |
$211.20 |
$704 |
2.7× |
| Nm csf leak detection (78650) |
$408.30 |
$1,361 |
0.4× |
| Nonvascular Shunt X-Ray (75809) |
$260.04 |
$866.80 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,202.80 |
$20,676 |
5.0× |
| Nuclear Rx Intra-Arterial (79445) |
$761.10 |
$2,537 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$1,262.91 |
$4,209.70 |
6.0× |
| Ob us nuchal meas 1 gest (76813) |
$108.30 |
$361 |
1.2× |
| Optic foramina (70190) |
$130.80 |
$436 |
1.7× |
| Panoramic X-ray of jaws (70355) |
$213.90 |
$713 |
2.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,346 |
$7,820 |
4.8× |
| Parathyroid Planar Imaging (78070) |
$872.19 |
$2,907.30 |
2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,111.01 |
$7,036.70 |
5.9× |
| Pelvis 1 or 2 views (72170) |
$206.91 |
$689.70 |
2.2× |
| Pet Image W/Ct Lmtd (78814) |
$2,667.30 |
$8,891 |
2.1× |
| PET image w/CT, full body (78816) |
$2,667.30 |
$8,891 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,667.30 |
$8,891 |
2.1× |
| Pet Myocardial Sngl Study (78491) |
$1,723.50 |
$5,745 |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,251.90 |
$4,173 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$714.45 |
$2,381.50 |
2.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,052.37 |
$3,507.90 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$401.61 |
$1,338.70 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$364.32 |
$1,214.40 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$270.90 |
$903 |
3.5× |
Radex Calcaneus Minimum 2 Views (73650)
range across 2 matching MRF lines |
$180.90–$198.99 |
$603–$663.30 |
varies |
| Radex elbow complete minimum 3 views (73080) |
$230.34 |
$767.80 |
3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$306.57 |
$1,021.90 |
3.3× |
| Radex fingr minimum 2 views (73140) |
$197.34 |
$657.80 |
2.5× |
| Radex foot complete minimum 3 views (73630) |
$227.04 |
$756.80 |
2.9× |
| Radex Hand Minimum 3 Views (73130) |
$199.71 |
$665.70 |
2.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$149.16 |
$497.20 |
1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$139.50 |
$465 |
1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$235.29 |
$784.30 |
3.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$228.69 |
$762.30 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$217.35 |
$724.50 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$195.60 |
$652 |
2.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$642.90 |
$2,143 |
4.1× |
| Radex Spine 1 View Specify Level (72020) |
$233.64 |
$778.80 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$223.08 |
$743.60 |
2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$319.80 |
$1,066 |
4.1× |
| Radex Toe Minimum 2 Views (73660) |
$185.79 |
$619.30 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$135.60 |
$452 |
1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$206.25 |
$687.50 |
2.6× |
| 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 level 1 (77402) |
$648 |
$2,160 |
7.1× |
| Radiation treatment delivery level 2 (77407) |
$1,116 |
$3,720 |
3.2× |
| Radiation treatment delivery level 3 (77412) |
$1,185 |
$3,950 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.33 |
$991.10 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$252.60 |
$842 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$586.20 |
$1,954 |
3.7× |
| 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 knee complete 4/more views (73564) |
$259.05 |
$863.50 |
2.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$208.23 |
$694.10 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$500.94 |
$1,669.80 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$326.04 |
$1,086.80 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$671.55 |
$2,238.50 |
4.3× |
| Radiologic examination femur 1 view (73551) |
$283.47 |
$944.90 |
3.6× |
| Radiologic examination femur minimum 2 views (73552) |
$294.36 |
$981.20 |
3.8× |
| Radiologic examination knee 1/2 views (73560) |
$202.86 |
$676.20 |
2.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$337.80 |
$1,126 |
3.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$214.51 |
$715.05 |
2.8× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$53.10 |
$177 |
0.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$2,651.40 |
$8,838 |
7.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$2,344.20 |
$7,814 |
6.8× |
| Renal Cyst Study (74470) |
$466.50 |
$1,555 |
1.0× |
| Ribs bilateral 3 views (71110) |
$241.23 |
$804.10 |
2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$489.39 |
$1,631.30 |
1.4× |
| 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 2+ Days Imaging (78804) |
$1,242.78 |
$4,142.60 |
2.6× |
| 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/acquisj 1day img (78830) |
$1,181.40 |
$3,938 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$510.90 |
$1,703 |
2.4× |
| Salivary Gland Imaging (78230) |
$673.50 |
$2,245 |
1.9× |
| Scapula (73010) |
$213.18 |
$710.60 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$37.62 |
$125.40 |
1.6× |
| Shoulder 1 view (73020) |
$196.68 |
$655.60 |
2.5× |
| Shoulder Arthrography (73040) |
$542.52 |
$1,808.40 |
1.7× |
| Skull less than 4 views (70250) |
$212.52 |
$708.40 |
2.3× |
| Special dosimetry (77331) |
$443.49 |
$1,478.29 |
3.7× |
| Special Physics Consult (77370) |
$474.52 |
$1,581.75 |
3.9× |
| Special teletherapy port plan (77321) |
$920.36 |
$3,067.88 |
2.7× |
| Special treatment procedure (77470) |
$2,211.55 |
$7,371.84 |
4.5× |
| Srs Multisource (77371) |
$37,321.76 |
$124,405.88 |
5.7× |
| Stereotactic Body Radiation Delivery (77373) |
$9,119.92 |
$30,399.75 |
5.7× |
| Sternoclavicular joints (71130) |
$135.60 |
$452 |
1.7× |
| Superior sagittal sinus venogram (75870) |
$1,074.60 |
$3,582 |
0.4× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$461.70 |
$1,539 |
5.9× |
| 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 Intermed (77285) |
$633.52 |
$2,111.75 |
1.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$884.32 |
$2,947.75 |
7.3× |
| Thoracic spine 2 views (72070) |
$266.97 |
$889.90 |
2.9× |
| Thoracic spine 3 views (72072) |
$277.20 |
$924 |
3.0× |
| Thoracolumbar 2 views (72080) |
$266.97 |
$889.90 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$876 |
$2,920 |
2.4× |
| Thyroid Met Imaging Body (78018) |
$1,248.72 |
$4,162.40 |
2.6× |
| 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× |
| Tx Devices Design & Construction Complex (77334) |
$929.81 |
$3,099.38 |
2.8× |
| Tx devices design & construction intermediate (77333) |
$872.10 |
$2,907 |
7.2× |
| Tx devices design & construction simple (77332) |
$478.57 |
$1,595.25 |
4.0× |
| Ultrasound Breast Limited (76642) |
$332.32 |
$1,107.75 |
4.3× |
| Ultrasound elastography first target lesion (76982) |
$607.80 |
$2,026 |
6.5× |
| Ultrasound Elastography Parenchyma (76981) |
$668.58 |
$2,228.60 |
7.1× |
| Ultrasound Exam Aaa Screen (76706) |
$166.98 |
$556.60 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$460.35 |
$1,534.50 |
4.9× |
| Umbilical-artery Doppler (OB) (76820) |
$318.90 |
$1,063 |
3.4× |
| Unlisted Dx Radiographic Procedure (76499) |
$517.50 |
$1,725 |
6.6× |
| Unlisted magnetic resonance procedure (76498) |
$683.70 |
$2,279 |
8.8× |
| Unlisted us procedure (76999) |
$326.10 |
$1,087 |
4.2× |
| Upper gi w/o kub (74240) |
$370.92 |
$1,236.40 |
2.4× |
| Urethrocystogram voiding (74455) |
$536.25 |
$1,787.50 |
2.5× |
| Urethrocystography retrograde (74450) |
$347.82 |
$1,159.40 |
1.6× |
| Us breast unilateral complete (76641) |
$464.31 |
$1,547.70 |
5.0× |
| Us chest (76604) |
$298.65 |
$995.50 |
3.2× |
| Us complete joint (76881) |
$557.70 |
$1,859 |
6.0× |
| Us exam, pelvic, limited (76857) |
$332.31 |
$1,107.70 |
3.5× |
| Us head (76506) |
$976.14 |
$3,253.80 |
10.4× |
| Us kidney transplant (76776) |
$94.05 |
$313.50 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$557.70 |
$1,859 |
6.0× |
| Us ob detailed single fetus (76811) |
$317.13 |
$1,057.10 |
1.5× |
| Us ob limited 1 or more fetuses (76815) |
$205.59 |
$685.30 |
2.2× |
| Us ob transvaginal (76817) |
$385.77 |
$1,285.90 |
4.1× |
| Us pelvic non ob complete (76856) |
$481.80 |
$1,606 |
5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$430.65 |
$1,435.50 |
4.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$279.09 |
$930.30 |
3.0× |
| 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 spinal canal and contents (76800) |
$85.50 |
$285 |
0.9× |
| Us thyroid (76536) |
$614.46 |
$2,048.20 |
6.6× |
| Us transrectal (76872) |
$580.50 |
$1,935 |
6.2× |
| Vein X-Ray Chest (75827) |
$1,463.88 |
$4,879.60 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$959.70 |
$3,199 |
0.3× |
| Vein X-Ray Spleen/Liver (75810) |
$1,230.60 |
$4,102 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$1,395.13 |
$4,650.45 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$1,363.80 |
$4,546 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,851.63 |
$6,172.10 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,004.85 |
$3,349.50 |
0.7× |
| 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 (75831) |
$1,515.30 |
$5,051 |
0.5× |
| Venous sampling by catheter (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 Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$224.59 |
$748.65 |
2.9× |
| X-ray antegrade pyelogram tube (74425) |
$956.40 |
$3,188 |
3.1× |
| X-Ray Aorta Leg Arteries (75630) |
$3,337.47 |
$11,124.90 |
1.2× |
| X-Ray Bend Only L-S Spine (72120) |
$346.18 |
$1,153.95 |
3.7× |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines |
$179.47–$206.91 |
$598.25–$689.70 |
varies |
| X-Ray Exam Breast Specimen (76098) |
$186.45 |
$621.50 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$182.16 |
$607.20 |
2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$295.68 |
$985.60 |
3.2× |
| 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 2 Views (73521) |
$229.35 |
$764.50 |
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 L-S Spine Bending (72114) |
$484.44 |
$1,614.80 |
5.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$285.78 |
$952.60 |
3.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$394.35 |
$1,314.50 |
4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$299.97 |
$999.90 |
3.2× |
| X-ray eye for foreign body (70030) |
$146.10 |
$487 |
1.9× |
| X-ray humerus (73060) |
$244.86 |
$816.20 |
3.1× |
| X-ray IV pyelogram (ivp) (74400) |
$768.60 |
$2,562 |
4.9× |
| X-ray IV pyelogram+tomography (74415) |
$475.50 |
$1,585 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$132.99 |
$443.30 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$203.28 |
$677.60 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$356.07 |
$1,186.90 |
3.8× |
| X-ray nose-rectum child f.b. (76010) |
$148.50 |
$495 |
1.9× |
| 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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$145.86 |
$486.20 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$262.68 |
$875.60 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$335.94 |
$1,119.80 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$298.98 |
$996.60 |
3.2× |
| X-ray thoracic spine 4 vw (72074) |
$279.51 |
$931.70 |
3.0× |
| X-Ray Tmj Unilat (70328) |
$236.94 |
$789.80 |
3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$511.17 |
$1,703.90 |
1.6× |
| X-Rays Bone Length Studies (77073) |
$149.16 |
$497.20 |
1.6× |
| X-Rays Bone Survey Complete (77075) |
$575.19 |
$1,917.30 |
6.1× |
| Xr c-spine 4 or 5 views (72050) |
$351.12 |
$1,170.40 |
3.7× |
| Xr facial bones less than 3 views (70140) |
$229.35 |
$764.50 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$135.60 |
$452 |
1.4× |
| Xr orbits complete 4 views (70200) |
$226.80 |
$756 |
2.4× |