| 3-D radiotherapy plan dose-volume histograms (77295) |
$15,517 |
$15,517 |
10.4× |
| Abdomen 2 views (74019) |
$642 |
$642 |
5.7× |
| Acute gi blood loss imaging (78278) |
$2,317 |
$2,317 |
5.4× |
| Angio Adrenal Bilat Select (75733) |
$6,529 |
$6,529 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$6,520 |
$6,520 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$5,880 |
$5,880 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$8,702 |
$8,702 |
2.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,922 |
$7,922 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$11,666 |
$11,666 |
3.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,880 |
$5,880 |
1.7× |
| Angiography Spinal Selective Rs&I (75705) |
$20,310 |
$20,310 |
3.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$12,628 |
$12,628 |
2.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$12,614 |
$12,614 |
3.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,702 |
$8,702 |
2.6× |
| Ankle 2 views (73600) |
$289 |
$289 |
3.1× |
| Aortogram thoracic (75605) |
$14,962 |
$14,962 |
2.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$14,962 |
$14,962 |
4.4× |
| Aortography abdominal serialography rs&i (75625) |
$14,962 |
$14,962 |
4.4× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$12,192 |
$12,192 |
3.6× |
| Artery X-Rays Adrenal Gland (75731) |
$12,628 |
$12,628 |
3.7× |
| Arthrogram ankle (73615) |
$8,005 |
$8,005 |
21.3× |
| Arthrogram elbow (73085) |
$3,566 |
$3,566 |
9.5× |
| Arthrogram hip (73525) |
$2,571 |
$2,571 |
6.8× |
| Arthrogram knee (73580) |
$3,943 |
$3,943 |
10.5× |
| Arthrogram shoulder (73040) |
$1,293 |
$1,293 |
3.4× |
| Arthrogram wrist (73115) |
$4,048 |
$4,048 |
10.8× |
| Basic dosimetry (77300) |
$1,341 |
$1,341 |
9.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$3,520 |
$3,520 |
8.2× |
| Bone &/joint imaging whole body (78306) |
$3,064 |
$3,064 |
7.1× |
| Bone age studies (77072) |
$1,058 |
$1,058 |
9.4× |
| Bone Imaging 3 Phase (78315) |
$4,625 |
$4,625 |
10.7× |
| Bone survey complete (77075) |
$2,818 |
$2,818 |
25.0× |
| Bone survey infant (77076) |
$462 |
$462 |
4.1× |
| Bowel imaging (78290) |
$2,966 |
$2,966 |
6.9× |
| Brachytx isodose complex (77318) |
$3,519 |
$3,519 |
8.7× |
| Brachytx isodose intermed (77317) |
$2,860 |
$2,860 |
7.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,008 |
$2,008 |
5.0× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,766 |
$1,766 |
4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,948 |
$1,948 |
3.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$16,286 |
$16,286 |
10.6× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,548 |
$1,548 |
2.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$4,993 |
$4,993 |
11.6× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$6,807 |
$6,807 |
8.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$6,807 |
$6,807 |
18.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,548 |
$1,548 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$1,177 |
$1,177 |
12.6× |
| Chest 1 view (71045) |
$335 |
$335 |
3.6× |
| Chest xray 3 views (71047) |
$335 |
$335 |
3.6× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,732 |
$1,732 |
9.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,751 |
$1,751 |
9.3× |
| Clavicle complete (73000) |
$1,074 |
$1,074 |
11.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$577 |
$577 |
5.1× |
| Continuing medical physics consltj pr wk (77336) |
$2,177 |
$2,177 |
15.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$14,436 |
$14,436 |
38.4× |
| CT abdomen and pelvis without contrast (74176) |
$8,838 |
$8,838 |
34.4× |
| CT abdomen w contrast (74160) |
$9,869 |
$9,869 |
52.2× |
| CT abdomen w wo contrast (74170) |
$10,399 |
$10,399 |
55.0× |
| CT abdomen w/o contrast (74150) |
$6,395 |
$6,395 |
56.8× |
| CT angio hrt w/3d image (75574) |
$12,827 |
$12,827 |
34.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$11,541 |
$11,541 |
61.1× |
| CT angiography upper extremity lt (73206) |
$11,541 |
$11,541 |
61.1× |
| CT c-spine w/contrast (72126) |
$9,869 |
$9,869 |
26.3× |
| CT c-spine w/o contrast (72125) |
$8,182 |
$8,182 |
72.6× |
| CT cervical spine w&w/o contrast (72127) |
$10,399 |
$10,399 |
55.0× |
| CT chest w contrast (71260) |
$9,328 |
$9,328 |
49.4× |
| CT chest w/wo contrast (71270) |
$10,048 |
$10,048 |
53.2× |
| CT colonography screening (74263) |
$6,093 |
$6,093 |
23.7× |
| CT colonography w/dye (74262) |
$7,390 |
$7,390 |
39.1× |
| CT colonography w/o cntrst (74261) |
$5,919 |
$5,919 |
52.5× |
| CT head/brain with contrast (70460) |
$10,036 |
$10,036 |
53.1× |
| CT head/brain without and with contrast (70470) |
$11,206 |
$11,206 |
59.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$12,461 |
$12,461 |
33.1× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$12,827 |
$12,827 |
136.8× |
| CT hrt w/3d image congen (75573) |
$12,827 |
$12,827 |
34.1× |
| CT iac w contrast (70481) |
$8,851 |
$8,851 |
46.8× |
| CT limited/localized follow up study (76380) |
$4,870 |
$4,870 |
51.9× |
| CT lower ext w/o (73700) |
$6,707 |
$6,707 |
59.5× |
| CT lower extremity w wo contrast (73702) |
$10,279 |
$10,279 |
54.4× |
| CT lower extremity w/contrast material (73701) |
$9,789 |
$9,789 |
51.8× |
| CT lumbar spine w & w/o contrast (72133) |
$10,703 |
$10,703 |
56.6× |
| CT lumbar spine w/contrast (72132) |
$9,869 |
$9,869 |
26.3× |
| CT lumbar spine w/o contrast (72131) |
$7,983 |
$7,983 |
70.9× |
| CT maxillofacial w contrast (70487) |
$9,552 |
$9,552 |
50.5× |
| CT maxillofacial w/wo contrast (70488) |
$10,399 |
$10,399 |
55.0× |
| CT maxillofacial wo contrast (70486) |
$7,415 |
$7,415 |
65.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$10,703 |
$10,703 |
56.6× |
| CT orbits w/o contrast (70480) |
$5,829 |
$5,829 |
51.7× |
| CT pelvis w/o contrast (72192) |
$6,162 |
$6,162 |
54.7× |
| CT pelvis w/wo contrast (72194) |
$10,399 |
$10,399 |
55.0× |
| CT scan of arm combo (73202) |
$11,541 |
$11,541 |
61.1× |
| CT soft tissue neck w contrast (70491) |
$9,552 |
$9,552 |
50.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$10,399 |
$10,399 |
55.0× |
| CT soft tissue neck w/o contrast (70490) |
$6,191 |
$6,191 |
55.0× |
| CT thoracic spine w/contrast (72129) |
$7,464 |
$7,464 |
39.5× |
| CT thoracic spine w/o contrast (72128) |
$7,464 |
$7,464 |
66.3× |
| CT thoracic spine w/wo contrast (72130) |
$10,703 |
$10,703 |
56.6× |
| CT thorax w/o contrast (71250) |
$6,690 |
$6,690 |
59.4× |
| CT upper ext wo (73200) |
$6,575 |
$6,575 |
58.4× |
| CT upper extremity with contrast (73201) |
$9,095 |
$9,095 |
24.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$10,194 |
$10,194 |
53.9× |
| Cta Abdomen (74175) |
$11,214 |
$11,214 |
59.3× |
| CTA abdomen pelvis (74174) |
$15,358 |
$15,358 |
40.9× |
| CTA chest (71275) |
$11,214 |
$11,214 |
59.3× |
| Cta Head (70496) |
$7,981 |
$7,981 |
42.2× |
| Cta Neck (70498) |
$7,981 |
$7,981 |
42.2× |
| Cta Pelvis (72191) |
$11,214 |
$11,214 |
59.3× |
| Cystography minimum 3 views rs&i (74430) |
$915 |
$915 |
2.4× |
| Diskography lumbar (72295) |
$16,493 |
$16,493 |
7.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,414 |
$1,414 |
12.6× |
| Esophagus (74220) |
$1,662 |
$1,662 |
8.8× |
| Facial bones min 3 views (70150) |
$1,109 |
$1,109 |
9.8× |
| Fetal biophysical profile non-stress testing (76818) |
$2,211 |
$2,211 |
19.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,686 |
$1,686 |
15.0× |
| Fluoroscopy up to 1 hr (76000) |
$1,629 |
$1,629 |
6.3× |
| Foot 2 views (73620) |
$289 |
$289 |
3.1× |
| Forearm 2 views (73090) |
$1,099 |
$1,099 |
11.7× |
| Hand 2 views (73120) |
$289 |
$289 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$6,417 |
$6,417 |
8.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$9,495 |
$9,495 |
12.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,268 |
$4,268 |
5.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$10,372 |
$10,372 |
3.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$6,529 |
$6,529 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,839 |
$1,839 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,839 |
$1,839 |
4.3× |
| Hysterosalpingogram (74740) |
$2,279 |
$2,279 |
8.9× |
| Image fusion (77399) |
$1,420 |
$1,420 |
9.8× |
| Interstitial radiation source applic complex (77778) |
$23,290 |
$23,290 |
31.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,580 |
$2,580 |
3.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,047 |
$2,047 |
3.4× |
| Intracavitary Radiation Source Applic Simple (77761) |
$2,047 |
$2,047 |
3.4× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$27,020 |
$27,020 |
3.4× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$2,041 |
$2,041 |
4.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,948 |
$1,948 |
3.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,162 |
$2,162 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,084 |
$3,084 |
5.3× |
| Knee 3 views (73562) |
$500 |
$500 |
5.3× |
| Liver & spleen imaging static only (78215) |
$4,317 |
$4,317 |
10.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$4,317 |
$4,317 |
10.0× |
| Liver imaging static only (78201) |
$2,687 |
$2,687 |
4.6× |
| Liver imaging w/vascular flow (78202) |
$2,687 |
$2,687 |
4.6× |
| Lung perf&ventilat diferentl (78598) |
$1,983 |
$1,983 |
3.4× |
| Lung perfusion differential (78597) |
$1,269 |
$1,269 |
2.9× |
| Lung ventilation imaging (78579) |
$1,269 |
$1,269 |
2.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$12,192 |
$12,192 |
3.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$12,192 |
$12,192 |
3.6× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$5,990 |
$5,990 |
3.5× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$2,303 |
$2,303 |
3.4× |
| Lymphoscintigraphy (78195) |
$2,776 |
$2,776 |
4.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$6,891 |
$6,891 |
8.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$6,891 |
$6,891 |
18.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$8,458 |
$8,458 |
22.5× |
| Mammary ductogram or galactogram single (77053) |
$1,296 |
$1,296 |
5.0× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$948 |
$948 |
10.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$7,288 |
$7,288 |
18.1× |
| Mr safety determination physician/other qhp (76016) |
$290 |
$290 |
3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$81 |
$81 |
2.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$302 |
$302 |
2.9× |
| Mr safety implt pos&/immoblj (76019) |
$196 |
$196 |
3.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$796 |
$796 |
3.1× |
| MRA head w & w/o contrast (70546) |
$8,286 |
$8,286 |
22.0× |
| MRA head w/o contrast (70544) |
$6,769 |
$6,769 |
26.3× |
| MRA head with contrast (70545) |
$8,286 |
$8,286 |
22.0× |
| MRA neck w contrast (70548) |
$7,613 |
$7,613 |
20.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$8,286 |
$8,286 |
22.0× |
| MRA neck w/o contrast (70547) |
$6,769 |
$6,769 |
26.3× |
| MRI abdomen w contrast (74182) |
$9,630 |
$9,630 |
25.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$9,630 |
$9,630 |
25.6× |
| MRI abdomen w/o contrast (74181) |
$8,172 |
$8,172 |
31.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$6,891 |
$6,891 |
8.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$8,458 |
$8,458 |
22.5× |
| MRI breast w/o contrast bilateral (77047) |
$4,083 |
$4,083 |
15.9× |
| MRI breast wo contrast unilateral (77046) |
$3,328 |
$3,328 |
12.9× |
| MRI c-spine with contrast (72142) |
$7,613 |
$7,613 |
20.3× |
| MRI cardiac w/o cont stress (75559) |
$6,338 |
$6,338 |
10.8× |
| MRI cardiac w/o contrast (75557) |
$6,338 |
$6,338 |
24.7× |
| MRI cervical spine w/o contrast (72141) |
$7,613 |
$7,613 |
29.6× |
| MRI chest w/o & w/contrast material (71552) |
$9,630 |
$9,630 |
25.6× |
| MRI chest w/o contrast (71550) |
$8,172 |
$8,172 |
31.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$6,891 |
$6,891 |
18.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$8,458 |
$8,458 |
22.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,891 |
$6,891 |
26.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$6,891 |
$6,891 |
26.8× |
| MRI orbit face neck w contrast (70542) |
$8,458 |
$8,458 |
22.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$8,458 |
$8,458 |
22.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$9,630 |
$9,630 |
25.6× |
| MRI pelvis w/o contrast (72195) |
$8,172 |
$8,172 |
31.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$9,146 |
$9,146 |
24.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$7,613 |
$7,613 |
20.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$9,146 |
$9,146 |
24.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$7,613 |
$7,613 |
20.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$9,146 |
$9,146 |
24.3× |
| MRI temporomandibular joint (70336) |
$6,891 |
$6,891 |
26.8× |
| MRI thoracic spine w/o contrast (72146) |
$7,613 |
$7,613 |
29.6× |
| MRI up ext w/o contrast (73218) |
$6,891 |
$6,891 |
26.8× |
| MRI upper ext joint w/o contrast (73221) |
$6,891 |
$6,891 |
26.8× |
| MRI, joint upper extrem combo (73223) |
$8,458 |
$8,458 |
22.5× |
| Myelogram Cervical (72240) |
$5,327 |
$5,327 |
6.3× |
| Myelogram Lumbar (72265) |
$5,342 |
$5,342 |
6.3× |
| Myelogram thoracic (72255) |
$5,342 |
$5,342 |
6.3× |
| Myelography 2 or more regions (72270) |
$5,342 |
$5,342 |
6.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$16,286 |
$16,286 |
11.7× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$16,286 |
$16,286 |
10.6× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$16,286 |
$16,286 |
10.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$5,642 |
$5,642 |
4.0× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$5,642 |
$5,642 |
4.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,642 |
$5,642 |
4.0× |
| Myocardial spect single study at rest or stress (78451) |
$5,642 |
$5,642 |
4.0× |
| Neck soft tissue (70360) |
$1,025 |
$1,025 |
10.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$940 |
$940 |
2.3× |
| Nm adrenal scan (78075) |
$5,977 |
$5,977 |
4.3× |
| Nm cisternogram (78630) |
$2,225 |
$2,225 |
3.8× |
| Nm gastric emptying study (78264) |
$2,468 |
$2,468 |
5.7× |
| Nm gastroesophageal reflux study (78262) |
$2,596 |
$2,596 |
6.0× |
| Nm peritoneal-venous shunt patency (78291) |
$2,624 |
$2,624 |
6.1× |
| Nonvascular shunt X-ray (75809) |
$1,922 |
$1,922 |
17.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$23,125 |
$23,125 |
15.5× |
| Nuclear Rx Oral Admin (79005) |
$3,613 |
$3,613 |
14.4× |
| Ob us nuchal meas 1 gest (76813) |
$960 |
$960 |
8.5× |
| Osseous survey limited (77074) |
$463 |
$463 |
4.1× |
| Parathyroid Planar Imaging (78070) |
$1,548 |
$1,548 |
3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,605 |
$1,605 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$1,085 |
$1,085 |
9.6× |
| PET image w/CT, skull-thigh (78815) |
$16,286 |
$16,286 |
10.6× |
| PET imaging CT for attenuation limited area (78814) |
$16,286 |
$16,286 |
10.6× |
| PET imaging for CT attenuation whole body (78816) |
$16,286 |
$16,286 |
10.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$10,372 |
$10,372 |
3.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$6,529 |
$6,529 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,238 |
$3,238 |
7.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,983 |
$1,983 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,120 |
$2,120 |
3.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,041 |
$1,041 |
11.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$883 |
$883 |
9.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,024 |
$1,024 |
10.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$391 |
$391 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$647 |
$647 |
5.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,236 |
$1,236 |
11.0× |
| Radex fingr minimum 2 views (73140) |
$819 |
$819 |
8.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,104 |
$1,104 |
11.8× |
| Radex Hand Minimum 3 Views (73130) |
$1,085 |
$1,085 |
11.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$704 |
$704 |
7.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$850 |
$850 |
7.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$850 |
$850 |
7.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$997 |
$997 |
8.9× |
| Radex Humerus Minimum 2 Views (73060) |
$804 |
$804 |
8.6× |
| Radex Kne 1/2 Views (73560) |
$1,099 |
$1,099 |
11.7× |
| Radex Kne Compl 4/More Views (73564) |
$581 |
$581 |
5.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,514 |
$1,514 |
13.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$1,076 |
$1,076 |
11.5× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$1,475 |
$1,475 |
13.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$948 |
$948 |
10.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$1,172 |
$1,172 |
12.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$1,209 |
$1,209 |
10.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,645 |
$1,645 |
17.5× |
| Radex Toe Minimum 2 Views (73660) |
$883 |
$883 |
9.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$429 |
$429 |
3.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,083 |
$1,083 |
11.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,236 |
$1,236 |
11.0× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$28,006 |
$28,006 |
3.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$35,097 |
$35,097 |
4.4× |
| Radiation treatment delivery level 1 (77402) |
$1,782 |
$1,782 |
16.2× |
| Radiation treatment delivery level 2 (77407) |
$2,966 |
$2,966 |
7.1× |
| Radiation treatment delivery level 3 (77412) |
$2,834 |
$2,834 |
4.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$335 |
$335 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$642 |
$642 |
5.7× |
| Radiologic exam chest 2 views (71046) |
$335 |
$335 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$2,439 |
$2,439 |
12.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,604 |
$2,604 |
13.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,026 |
$2,026 |
10.7× |
| Radiologic examination femur 1 view (73551) |
$1,413 |
$1,413 |
15.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$1,192 |
$1,192 |
12.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,104 |
$1,104 |
11.8× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$348 |
$348 |
3.1× |
| Radiological examination surgical specimen (76098) |
$2,571 |
$2,571 |
4.4× |
| Radiopharm Dacryocystography (78660) |
$1,396 |
$1,396 |
3.2× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$1,779 |
$1,779 |
7.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$2,534 |
$2,534 |
6.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,995 |
$1,995 |
4.8× |
| Ribs bilateral 3 views (71110) |
$2,528 |
$2,528 |
22.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$3,208 |
$3,208 |
7.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,624 |
$2,624 |
6.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,319 |
$6,319 |
10.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$6,152 |
$6,152 |
10.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,979 |
$3,979 |
6.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,572 |
$1,572 |
6.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,612 |
$1,612 |
6.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,974 |
$1,974 |
7.7× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$1,853 |
$1,853 |
4.3× |
| Scapula (73010) |
$1,074 |
$1,074 |
9.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$52 |
$52 |
2.2× |
| Shoulder 1 view (73020) |
$515 |
$515 |
5.5× |
| Simulation intermediate (77285) |
$3,297 |
$3,297 |
8.2× |
| Small bowel series (74250) |
$792 |
$792 |
4.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,138 |
$2,138 |
5.3× |
| Special dosimetry (77331) |
$1,406 |
$1,406 |
9.7× |
| Special Physics Consult (77370) |
$2,012 |
$2,012 |
13.9× |
| Special treatment procedure (77470) |
$7,239 |
$7,239 |
12.2× |
| Spine thoracic 3 views (72072) |
$1,434 |
$1,434 |
12.7× |
| Splenoportograpy rs&i (75810) |
$10,372 |
$10,372 |
3.0× |
| Stereotactic Body Radiation Delivery (77373) |
$20,474 |
$20,474 |
10.6× |
| Superior sagittal sinus venogram (75870) |
$12,192 |
$12,192 |
3.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$971 |
$971 |
8.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$7,685 |
$7,685 |
19.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,965 |
$2,965 |
7.3× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$5,986 |
$5,986 |
23.3× |
| Testicular Imaging With Vascular Flow (78761) |
$2,041 |
$2,041 |
4.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$5,484 |
$5,484 |
13.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,642 |
$2,642 |
18.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,930 |
$4,930 |
8.4× |
| Thyroid imaging w/blood flow (78013) |
$2,831 |
$2,831 |
6.6× |
| Thyroid uptake measurement (78012) |
$2,010 |
$2,010 |
4.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,084 |
$3,084 |
7.2× |
| Tomogram (76100) |
$943 |
$943 |
8.4× |
| Treatment device complex (77334) |
$4,038 |
$4,038 |
10.0× |
| Treatment device intermediate (77333) |
$1,685 |
$1,685 |
11.6× |
| Treatment devices simple (77332) |
$1,349 |
$1,349 |
9.3× |
| Ultrasound breast complete (76641) |
$1,247 |
$1,247 |
11.1× |
| Ultrasound Exam Aaa Screen (76706) |
$646 |
$646 |
5.7× |
| Ultrasound, abdomen limited (76705) |
$801 |
$801 |
7.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$437 |
$437 |
4.0× |
| Ureteral reflux study (78740) |
$1,548 |
$1,548 |
3.6× |
| Urethrocystogram voiding (74455) |
$2,235 |
$2,235 |
8.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,361 |
$1,361 |
5.3× |
| Us breast unilateral limited (76642) |
$1,247 |
$1,247 |
13.3× |
| Us chest (76604) |
$2,097 |
$2,097 |
18.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,875 |
$1,875 |
8.1× |
| Us compl joint r-t w/image documentation (76881) |
$1,555 |
$1,555 |
13.8× |
| Us encephalogram (76506) |
$664 |
$664 |
5.9× |
| Us hips infant static (76886) |
$1,875 |
$1,875 |
20.0× |
| Us infant hips w manipulation (76885) |
$1,875 |
$1,875 |
20.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,243 |
$1,243 |
11.0× |
| Us ob limited (76815) |
$542 |
$542 |
4.8× |
| Us ob transvaginal (76817) |
$1,338 |
$1,338 |
11.9× |
| Us pelvic non ob complete (76856) |
$1,974 |
$1,974 |
17.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,345 |
$1,345 |
11.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$686 |
$686 |
6.1× |
| Us retroperitoneal limited (76775) |
$1,974 |
$1,974 |
17.5× |
| Us scrotum and contents (76870) |
$2,074 |
$2,074 |
18.4× |
| Us soft tissue head/neck (76536) |
$1,887 |
$1,887 |
16.8× |
| Us spinal canal and contents (76800) |
$693 |
$693 |
6.2× |
| Us transrectal prostate volume (76873) |
$382 |
$382 |
3.4× |
| Us,transplanted kidney, real time/ doppler (76776) |
$463 |
$463 |
4.1× |
| Venogram adrenal unilat (75840) |
$12,628 |
$12,628 |
3.7× |
| Venogram extremity bilateral (75822) |
$7,217 |
$7,217 |
4.3× |
| Venogram Extremity Unilateral (75820) |
$4,507 |
$4,507 |
2.7× |
| Venography caval inferior serialography rs&i (75825) |
$11,666 |
$11,666 |
3.4× |
| Venography caval superior serialography rs&i (75827) |
$11,666 |
$11,666 |
6.9× |
| Venography Orbital Rs&I (75880) |
$2,303 |
$2,303 |
3.4× |
| Venography Renal Bilateral (75833) |
$12,628 |
$12,628 |
3.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,110 |
$6,110 |
1.8× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$2,211 |
$2,211 |
3.3× |
| Venous sampling by catheter (75893) |
$22,458 |
$22,458 |
3.7× |
| Wrist 2 views (73100) |
$337 |
$337 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$2,091 |
$2,091 |
18.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,143 |
$1,143 |
12.2× |
| X-ray b.e. reductn intuss (74283) |
$760 |
$760 |
4.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$3,009 |
$3,009 |
15.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$954 |
$954 |
10.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$850 |
$850 |
9.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$850 |
$850 |
7.5× |
| X-ray exam of femur 2/> (73552) |
$1,413 |
$1,413 |
15.1× |
| X-ray eye for foreign body (70030) |
$788 |
$788 |
8.4× |
| X-ray IV pyelogram (ivp) (74400) |
$4,346 |
$4,346 |
23.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,418 |
$1,418 |
15.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$933 |
$933 |
9.9× |
| X-ray leg, infant (73592) |
$429 |
$429 |
4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,209 |
$1,209 |
10.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,024 |
$1,024 |
9.1× |
| X-ray nose-rectum child f.b. (76010) |
$2,439 |
$2,439 |
26.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,238 |
$1,238 |
11.0× |
| X-ray retrograde pyelogram (74420) |
$2,074 |
$2,074 |
5.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,817 |
$1,817 |
16.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,293 |
$1,293 |
11.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,164 |
$1,164 |
12.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,542 |
$1,542 |
16.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,254 |
$1,254 |
11.1× |
| X-Ray Small Bowel Enteroclysis (74251) |
$2,239 |
$2,239 |
11.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$943 |
$943 |
10.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,200 |
$1,200 |
12.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,036 |
$1,036 |
11.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$691 |
$691 |
6.1× |
| Xr bone length studies (77073) |
$1,153 |
$1,153 |
10.2× |
| Xr c-spine 4 or 5 views (72050) |
$888 |
$888 |
7.9× |
| Xr c-spine 6 or more views (72052) |
$1,904 |
$1,904 |
16.9× |
| Xr chest 4+ views (71048) |
$642 |
$642 |
5.7× |
| Xr urogram antegrade (74425) |
$2,571 |
$2,571 |
6.8× |