| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,992.01 |
$12,097 |
2.7× |
| Abdomen 1 View (74018) |
$181.50 |
$550 |
1.9× |
| Abdomen 2 views (74019) |
$199.65 |
$605 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$282.48 |
$856 |
0.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$964.92 |
$2,924 |
0.7× |
| Angio internal mammary (75756) |
$1,067.22 |
$3,234 |
0.3× |
| Angio pulmonary bilat (75743) |
$1,718.97 |
$5,209 |
0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,964.16 |
$5,952 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$3,683.46 |
$11,162 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,098.24 |
$3,328 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,154.67 |
$3,499 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,734.94 |
$11,318 |
1.1× |
| Ankle 2 views (73600) |
$85.47 |
$259 |
0.9× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,455.53 |
$7,441 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,681.35 |
$5,095 |
0.5× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$2,730.75 |
$8,275 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,585.65 |
$4,805 |
0.5× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,455.53 |
$7,441 |
0.4× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,730.75 |
$8,275 |
0.5× |
| Arthrogram ankle (73615) |
$375.54 |
$1,138 |
1.0× |
| Arthrogram hip (73525) |
$508.53 |
$1,541 |
1.4× |
| Arthrogram Wrist (73115) |
$528.33 |
$1,601 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$477.51 |
$1,447 |
3.3× |
| Bone age studies (77072) |
$110.22 |
$334 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$930.27 |
$2,819 |
2.2× |
| Bone Imaging Limited Area (78300) |
$469.92 |
$1,424 |
1.1× |
| Bone Imaging Multiple Areas (78305) |
$508.53 |
$1,541 |
1.2× |
| Bone Imaging Whole Body (78306) |
$658.35 |
$1,995 |
1.5× |
| Bone marrow imaging; whole body (78104) |
$396 |
$1,200 |
0.9× |
| Bone survey infant (77076) |
$119.46 |
$362 |
1.1× |
| Brachytx isodose complex (77318) |
$827.64 |
$2,508 |
2.1× |
| Brachytx isodose intermed (77317) |
$671.22 |
$2,034 |
1.7× |
| Brachytx Isodose Plan Simple (77316) |
$242.55 |
$735 |
0.6× |
| Brain Flow Imaging Only (78610) |
$290.07 |
$879 |
0.5× |
| Brain Image W/Flow < 4 Views (78601) |
$421.08 |
$1,276 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$666.27 |
$2,019 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,058.54 |
$6,238 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,622.28 |
$4,916 |
4.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,468.73 |
$7,481 |
2.9× |
| Cardiac Shunt Detection (78428) |
$336.60 |
$1,020 |
0.8× |
| Cat Scan Follow-Up Study (76380) |
$347.49 |
$1,053 |
3.7× |
| Cerebrospinal Fluid Scan (78630) |
$649.77 |
$1,969 |
1.1× |
| Chest 1 view (71045) |
$181.50 |
$550 |
1.9× |
| Chest 2 views (71046) |
$199.65 |
$605 |
2.1× |
| Chest 3 views (71047) |
$220.11 |
$667 |
2.4× |
| Chest 4 or more views (71048) |
$242.22 |
$734 |
2.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$132.66 |
$402 |
1.2× |
| Cholecystography Oral Contrast (74290) |
$166.32 |
$504 |
0.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$114.51 |
$347 |
1.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$383.79 |
$1,163 |
0.5× |
| Clavicle complete (73000) |
$244.86 |
$742 |
2.6× |
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271)
range across 2 matching MRF lines |
$32.67–$37.29 |
$99–$113 |
varies |
| Continuing medical physics consltj pr wk (77336) |
$562.98 |
$1,706 |
3.9× |
| Contrast Exam Abdominl Aorta (75625) |
$1,573.44 |
$4,768 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$605.22 |
$1,834 |
1.6× |
| Contrast X-Ray Of Elbow (73085) |
$817.41 |
$2,477 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$719.40 |
$2,180 |
1.9× |
| Corpora cavernosography (74445) |
$298.32 |
$904 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,318.58 |
$7,026 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,288.32 |
$3,904 |
5.0× |
| CT abdomen w contrast (74160) |
$1,866.15 |
$5,655 |
9.9× |
| CT abdomen w wo contrast (74170) |
$2,053.59 |
$6,223 |
10.9× |
| CT abdomen w/o contrast (74150) |
$1,213.74 |
$3,678 |
10.8× |
| CT Angio Abdomen and Pelvis (74174) |
$1,327.26 |
$4,022 |
3.6× |
| CT Angio Chest (71275) |
$995.28 |
$3,016 |
5.3× |
| CT Angio Head (70496) |
$693.99 |
$2,103 |
3.7× |
| CT angio hrt w/3d image (75574) |
$880.44 |
$2,668 |
2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,399.20 |
$4,240 |
7.4× |
| CT Angio Neck (70498) |
$825.66 |
$2,502 |
4.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$736.89 |
$2,233 |
3.9× |
| CT bone density (77078) |
$135.63 |
$411 |
1.5× |
| CT cervical spine w/ contrast (72126) |
$649.11 |
$1,967 |
1.7× |
| CT cervical spine w/o contrast (72125) |
$591.69 |
$1,793 |
5.3× |
| CT cervical spine w/wo cont (72127) |
$954.36 |
$2,892 |
5.1× |
| CT chest w contrast (71260) |
$813.12 |
$2,464 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,001.88 |
$3,036 |
5.3× |
| CT colonography screening (74263) |
$275.22 |
$834 |
1.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$368.61 |
$1,117 |
2.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$275.88 |
$836 |
2.5× |
| CT head/brain with contrast (70460) |
$1,479.72 |
$4,484 |
7.9× |
| CT head/brain without and with contrast (70470) |
$1,627.56 |
$4,932 |
8.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$554.40 |
$1,680 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$503.58 |
$1,526 |
5.4× |
| CT hrt w/3d image congen (75573) |
$609.84 |
$1,848 |
1.6× |
| CT iac w contrast (70481) |
$740.85 |
$2,245 |
3.9× |
| CT l-spine w&w/o contrast (72133) |
$773.85 |
$2,345 |
4.1× |
| CT lower ext w/o (73700) |
$578.16 |
$1,752 |
5.2× |
| CT lower extremity w/contrast material (73701) |
$609.84 |
$1,848 |
3.2× |
| CT lumbar spine w contrast (72132) |
$759.99 |
$2,303 |
2.0× |
| CT lumbar spine w/o contrast (72131) |
$500.28 |
$1,516 |
4.5× |
| CT maxillofacial w contrast (70487) |
$763.62 |
$2,314 |
4.1× |
| CT maxillofacial wo contrast (70486) |
$693.99 |
$2,103 |
6.2× |
| CT neck tissue combo (70492) |
$825.66 |
$2,502 |
4.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,042.80 |
$3,160 |
5.5× |
| CT orbits w/o contrast (70480) |
$523.38 |
$1,586 |
4.7× |
| CT pelvis w&w/o contrast (72194) |
$751.74 |
$2,278 |
4.0× |
| CT pelvis w/o contrast (72192) |
$551.43 |
$1,671 |
4.9× |
| CT scan of leg combo (73702) |
$773.52 |
$2,344 |
4.1× |
| CT scans face/jaw combo (70488) |
$969.54 |
$2,938 |
5.2× |
| CT soft tissue neck w contrast (70491) |
$668.25 |
$2,025 |
3.6× |
| CT soft tissue neck w/o contrast (70490) |
$509.52 |
$1,544 |
4.5× |
| CT thoracic spine w contrast (72129) |
$571.56 |
$1,732 |
3.0× |
| CT thoracic spine w/o contrast (72128) |
$411.18 |
$1,246 |
3.7× |
| CT thoracic spine w/wo cont (72130) |
$664.95 |
$2,015 |
3.5× |
| CT thorax w/o contrast (71250) |
$602.25 |
$1,825 |
5.4× |
| CT unlisted procedure (76497) |
$438.57 |
$1,329 |
4.7× |
| CT upper ext wo (73200) |
$787.71 |
$2,387 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$951.72 |
$2,884 |
5.1× |
| CT upper extremity with contrast (73201) |
$866.91 |
$2,627 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$557.04 |
$1,688 |
3.0× |
| Cta Abdomen (74175) |
$967.89 |
$2,933 |
5.1× |
| CTA pelvis (72191) |
$520.74 |
$1,578 |
2.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$298.32 |
$904 |
1.2× |
| Dilation ureters/urethra rs&i (74485) |
$1,086.03 |
$3,291 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,043.79 |
$3,163 |
0.5× |
| Diskography lumbar (72295) |
$2,455.53 |
$7,441 |
1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$217.47 |
$659 |
1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$466.62 |
$1,414 |
4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$123.75 |
$375 |
1.1× |
| Dxa Bone Density Axial (77080) |
$434.61 |
$1,317 |
3.9× |
| Dxa bone density study (77085) |
$568.92 |
$1,724 |
5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$110.55 |
$335 |
1.2× |
| Echo exam of fetal heart (76825) |
$1,966.80 |
$5,960 |
3.4× |
| Echo exam uterus (76831) |
$687.72 |
$2,084 |
2.7× |
| Echo Guide For Artery Repair (76936) |
$637.56 |
$1,932 |
2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,408.44 |
$4,268 |
5.5× |
| Echograp Trans R Pros Study (76873) |
$381.48 |
$1,156 |
3.4× |
| Esophagram (74220) |
$377.52 |
$1,144 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$256.41 |
$777 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$233.31 |
$707 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$403.26 |
$1,222 |
1.6× |
| Follow-Up Angiography (75898) |
$629.31 |
$1,907 |
0.2× |
| Foot 2 views (73620) |
$205.92 |
$624 |
2.2× |
| Forearm 2 views (73090) |
$215.82 |
$654 |
2.3× |
| Gastric emptying imaging study (78264) |
$1,130.25 |
$3,425 |
2.6× |
| Gastroesophageal Reflux Exam (78262) |
$418.77 |
$1,269 |
1.0× |
| Gated Heart Planar Single (78472) |
$573.54 |
$1,738 |
1.3× |
| Gated Heart, Multiple (78473) |
$630.30 |
$1,910 |
1.5× |
| Hand 2 views (73120) |
$110.22 |
$334 |
1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,895.19 |
$5,743 |
2.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,722.60 |
$5,220 |
2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,566.18 |
$4,746 |
2.1× |
| Heart first pass single,planar (78481) |
$511.50 |
$1,550 |
0.9× |
| Heart Image (Pet) Multiple (78492) |
$1,679.70 |
$5,090 |
1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,403.49 |
$4,253 |
0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,266.21 |
$3,837 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,405.80 |
$4,260 |
2.4× |
| Hepatobiliary System Imaging (78226) |
$315.81 |
$957 |
0.7× |
| Ht Musc Image Planar Mult (78454) |
$964.92 |
$2,924 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$964.92 |
$2,924 |
0.7× |
| Hysterosalpingogram (74740) |
$638.88 |
$1,936 |
2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$195.03 |
$591 |
2.1× |
| Infant hip ultrasound, limited static exam (76886) |
$160.71 |
$487 |
1.7× |
| Infusion Ivp (74410) |
$371.58 |
$1,126 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$1,529.88 |
$4,636 |
2.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$669.24 |
$2,028 |
0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$464.97 |
$1,409 |
0.8× |
| Intracavitary radiation source applic simple (77761) |
$440.55 |
$1,335 |
0.7× |
| Joint Survey Single View (77077) |
$88.11 |
$267 |
0.8× |
| K Flow/Funct Image Multiple (78709) |
$632.28 |
$1,916 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$472.23 |
$1,431 |
0.8× |
| K Flow/Funct Image W/O Drug (78707) |
$571.23 |
$1,731 |
1.0× |
| Kidney Imaging Morphol (78700) |
$519.09 |
$1,573 |
1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$575.19 |
$1,743 |
1.3× |
| Knee 3 Views (73562) |
$264 |
$800 |
2.8× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$732.93 |
$2,221 |
1.7× |
| Leveen/Shunt Patency Exam (78291) |
$336.60 |
$1,020 |
0.8× |
| Liver & Spleen Imaging Static Only (78215) |
$468.60 |
$1,420 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$402.60 |
$1,220 |
0.9× |
| Liver imaging static only (78201) |
$769.89 |
$2,333 |
1.3× |
| Liver imaging w/vascular flow (78202) |
$549.45 |
$1,665 |
0.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$763.62 |
$2,314 |
1.3× |
| Lung perfusion differential (78597) |
$314.49 |
$953 |
0.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$515.46 |
$1,562 |
0.9× |
| Lung Ventilation Imaging (78579) |
$402.93 |
$1,221 |
0.9× |
| Lymph System Imaging (78195) |
$1,451.34 |
$4,398 |
2.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$549.12 |
$1,664 |
0.3× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$367.62 |
$1,114 |
0.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,681.35 |
$5,095 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$549.12 |
$1,664 |
0.2× |
| Magnetic Image Jaw Joint (70336) |
$1,239.48 |
$3,756 |
4.8× |
| Magnetic Resonance Elastography (76391) |
$238.92 |
$724 |
0.9× |
| Mammary ductogram or galactogram multiple (77054) |
$340.23 |
$1,031 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$253.11 |
$767 |
1.0× |
| Meckels Divert Exam (78290) |
$361.35 |
$1,095 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,750.65 |
$5,305 |
4.4× |
| Mr safety determination physician/other qhp (76016) |
$101.64 |
$308 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$27.72 |
$84 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$106.26 |
$322 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$68.31 |
$207 |
1.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$279.51 |
$847 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,667.49 |
$5,053 |
4.5× |
| MRA head w/o contrast (70544) |
$715.11 |
$2,167 |
2.8× |
| MRA head with contrast (70545) |
$1,077.12 |
$3,264 |
2.9× |
| MRA neck w contrast (70548) |
$964.92 |
$2,924 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,107.48 |
$3,356 |
3.0× |
| MRA neck w/o contrast (70547) |
$777.15 |
$2,355 |
3.0× |
| MRI abdomen w contrast (74182) |
$1,846.35 |
$5,595 |
4.9× |
| MRI abdomen w/o contrast (74181) |
$911.46 |
$2,762 |
3.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,203.08 |
$6,676 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,315.61 |
$7,017 |
6.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,228.16 |
$6,752 |
2.7× |
| MRI bone marrow blood supply (77084) |
$884.07 |
$2,679 |
3.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,600.83 |
$4,851 |
6.3× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,277.10 |
$3,870 |
5.0× |
| MRI cardiac w/o cont stress (75559) |
$955.68 |
$2,896 |
1.6× |
| MRI cardiac w/o contrast (75557) |
$848.43 |
$2,571 |
3.3× |
| MRI cervical spine w contrast (72142) |
$1,133.22 |
$3,434 |
3.0× |
| MRI cervical spine w/o cont (72141) |
$1,029.93 |
$3,121 |
4.0× |
| MRI chest w/o contrast (71550) |
$1,661.55 |
$5,035 |
6.5× |
| MRI chest with contrast (71551) |
$2,028.18 |
$6,146 |
2.4× |
| MRI chest wo w contrast (71552) |
$2,541 |
$7,700 |
6.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,975.71 |
$5,987 |
5.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,173.71 |
$6,587 |
5.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,720.29 |
$5,213 |
6.7× |
| MRI lumbar spine w contrast (72149) |
$1,299.54 |
$3,938 |
3.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,485.33 |
$4,501 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$880.44 |
$2,668 |
3.4× |
| MRI orbit face neck w contrast (70542) |
$1,072.50 |
$3,250 |
2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,285.68 |
$3,896 |
3.4× |
| MRI pelvis w contrast (72196) |
$2,181.30 |
$6,610 |
5.8× |
| MRI pelvis w/o & w contrast (72197) |
$2,629.11 |
$7,967 |
7.0× |
| MRI pelvis w/o contrast (72195) |
$1,687.95 |
$5,115 |
6.6× |
| MRI spectroscopy (76390) |
$446.82 |
$1,354 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$949.41 |
$2,877 |
3.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,963.17 |
$5,949 |
5.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,626.90 |
$4,930 |
6.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,159.85 |
$6,545 |
5.8× |
| MRI, abdomen, combo (74183) |
$2,031.15 |
$6,155 |
5.4× |
| MRI, dorsal spine combo (72157) |
$1,287 |
$3,900 |
3.4× |
| MRI, dorsal spine contrast (72147) |
$1,043.46 |
$3,162 |
2.8× |
| MRI, joint upper extrem (73221) |
$2,087.25 |
$6,325 |
8.2× |
| MRI, joint upper extrem combo (73223) |
$2,489.19 |
$7,543 |
6.7× |
| MRI, lumbar spine combo (72158) |
$1,430.88 |
$4,336 |
3.8× |
| Myelogram cervical (72240) |
$617.76 |
$1,872 |
0.7× |
| Myelogram Lumbar (72265) |
$620.73 |
$1,881 |
0.7× |
| Myelography thoracic (72255) |
$566.28 |
$1,716 |
0.7× |
| Myelograpy 2/more regions rs&i (72270) |
$518.43 |
$1,571 |
0.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$488.73 |
$1,481 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,346.40 |
$4,080 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,861.10 |
$8,670 |
2.1× |
| Neck soft tissue (70360) |
$223.08 |
$676 |
2.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$373.89 |
$1,133 |
0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$271.26 |
$822 |
0.6× |
| Nm csf leak detection (78650) |
$1,044.12 |
$3,164 |
0.8× |
| Nm myocard infarct spect (78469) |
$561.66 |
$1,702 |
1.0× |
| Nm red cell survival study (78130) |
$290.07 |
$879 |
0.7× |
| Nonvascular Shunt X-Ray (75809) |
$150.81 |
$457 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,591.95 |
$13,915 |
3.1× |
| Nuclear Rx Intra-Arterial (79445) |
$302.61 |
$917 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$1,056.33 |
$3,201 |
4.2× |
| Ob us nuchal meas 1 gest (76813) |
$275.22 |
$834 |
2.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$189.75 |
$575 |
1.7× |
| Optic foramina (70190) |
$53.13 |
$161 |
0.6× |
| Panoramic X-ray of jaws (70355) |
$137.28 |
$416 |
1.5× |
| Parathyroid Planar Imaging (78070) |
$1,073.82 |
$3,254 |
2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,323.96 |
$4,012 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$93.39 |
$283 |
0.8× |
| Perineogram (74775) |
$275.55 |
$835 |
1.1× |
| Peritoneogram Rs&I (74190) |
$298.32 |
$904 |
0.5× |
| Pet Image Skull-Thigh (78812) |
$1,411.08 |
$4,276 |
0.9× |
| Pet Image W/Ct Lmtd (78814) |
$1,135.86 |
$3,442 |
0.7× |
| PET image w/CT, full body (78816) |
$5,273.40 |
$15,980 |
3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,227.20 |
$15,840 |
3.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$750.75 |
$2,275 |
0.5× |
| Pet Myocardial Sngl Study (78491) |
$1,526.25 |
$4,625 |
1.0× |
| PET whole body (78813) |
$1,552.32 |
$4,704 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,608.75 |
$4,875 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$495.66 |
$1,502 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$187.77 |
$569 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$459.03 |
$1,391 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$263.01 |
$797 |
2.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$183.81 |
$557 |
2.0× |
| Radex elbow complete minimum 3 views (73080) |
$280.50 |
$850 |
3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$198.66 |
$602 |
1.8× |
| Radex fingr minimum 2 views (73140) |
$200.97 |
$609 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$291.06 |
$882 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$270.60 |
$820 |
2.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$71.28 |
$216 |
0.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$79.86 |
$242 |
0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$198.66 |
$602 |
2.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$245.85 |
$745 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$110.55 |
$335 |
1.2× |
| Radex shoulder complete minimum 2 views (73030) |
$304.26 |
$922 |
3.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$109.56 |
$332 |
1.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$341.55 |
$1,035 |
1.8× |
| Radex Spine 1 View Specify Level (72020) |
$88.77 |
$269 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$117.48 |
$356 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$283.47 |
$859 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$198.99 |
$603 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$238.26 |
$722 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$273.24 |
$828 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$435.93 |
$1,321 |
3.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,228.25 |
$34,025 |
1.4× |
| Radiation treatment delivery level 1 (77402) |
$202.62 |
$614 |
1.9× |
| Radiation treatment delivery level 2 (77407) |
$312.84 |
$948 |
0.8× |
| Radiation treatment delivery level 3 (77412) |
$782.10 |
$2,370 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$340.23 |
$1,031 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$220.11 |
$667 |
2.0× |
| Radiologic exam colon double contrast study (74280) |
$264.66 |
$802 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$175.89 |
$533 |
0.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$252.12 |
$764 |
1.3× |
| Radiologic exam knee complete 4/more views (73564) |
$365.31 |
$1,107 |
3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$322.08 |
$976 |
2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$166.65 |
$505 |
0.9× |
| Radiologic exam swallow function contrast study (74230) |
$108.24 |
$328 |
0.6× |
| Radiologic exam teeth complete full mouth (70320) |
$217.14 |
$658 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$467.94 |
$1,418 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$66.33 |
$201 |
0.7× |
| Radiologic examination femur minimum 2 views (73552) |
$99 |
$300 |
1.1× |
| Radiologic examination knee 1/2 views (73560) |
$71.28 |
$216 |
0.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$116.82 |
$354 |
1.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$53.13 |
$161 |
0.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$53.13 |
$161 |
0.6× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$118.14 |
$358 |
0.2× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$572.88 |
$1,736 |
2.3× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$290.07 |
$879 |
0.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$252.45 |
$765 |
0.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$208.56 |
$632 |
0.5× |
| Renal Cyst Study (74470) |
$298.32 |
$904 |
0.5× |
| Ribs bilateral 3 views (71110) |
$382.47 |
$1,159 |
3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$392.37 |
$1,189 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$515.13 |
$1,561 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,028.84 |
$6,148 |
3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,122.33 |
$3,401 |
1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,234.53 |
$3,741 |
2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,757.25 |
$5,325 |
1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$479.49 |
$1,453 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$523.38 |
$1,586 |
2.1× |
| Salivary Gland Imaging Serial Images (78231) |
$418.77 |
$1,269 |
1.0× |
| Scapula (73010) |
$266.97 |
$809 |
2.4× |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines |
$30.69–$61.38 |
$93–$186 |
varies |
| Sella turcica (70240) |
$53.13 |
$161 |
0.6× |
| Shoulder 1 view (73020) |
$53.13 |
$161 |
0.6× |
| Shoulder Arthrography (73040) |
$876.81 |
$2,657 |
2.3× |
| Sialogram (70390) |
$166.32 |
$504 |
0.7× |
| Skull less than 4 views (70250) |
$71.61 |
$217 |
0.6× |
| Special dosimetry (77331) |
$596.97 |
$1,809 |
4.1× |
| Special Physics Consult (77370) |
$688.05 |
$2,085 |
4.8× |
| Special teletherapy port plan (77321) |
$1,050.06 |
$3,182 |
2.6× |
| Special treatment procedure (77470) |
$1,767.15 |
$5,355 |
3.0× |
| Speech evaluation, complex (70371) |
$173.25 |
$525 |
0.7× |
| Spleen Imaging (78185) |
$529.65 |
$1,605 |
1.2× |
| Stereotactic Body Radiation Delivery (77373) |
$3,623.73 |
$10,981 |
1.9× |
| Sternoclavicular joints (71130) |
$260.70 |
$790 |
2.8× |
| Superior sagittal sinus venogram (75870) |
$781.44 |
$2,368 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$805.86 |
$2,442 |
7.4× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$107.91 |
$327 |
1.2× |
| Tbs technical calculation only (77091) |
$107.91 |
$327 |
1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,362.24 |
$4,128 |
3.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$228.36 |
$692 |
0.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$307.23 |
$931 |
1.2× |
| Testicular Imaging W/Flow (78761) |
$563.31 |
$1,707 |
1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,137.84 |
$3,448 |
2.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$640.86 |
$1,942 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$583.11 |
$1,767 |
4.0× |
| Thoracic spine 2 views (72070) |
$89.76 |
$272 |
0.8× |
| Thoracic spine 3 views (72072) |
$152.79 |
$463 |
1.4× |
| Thoracolumbar 2 views (72080) |
$121.77 |
$369 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$251.79 |
$763 |
0.6× |
| Thyroid Met Imaging Body (78018) |
$1,222.32 |
$3,704 |
2.1× |
| Thyroid Uptake Measurement (78012) |
$223.41 |
$677 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$791.01 |
$2,397 |
1.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,125.96 |
$3,412 |
2.8× |
| Tx devices design & construction intermediate (77333) |
$724.35 |
$2,195 |
5.0× |
| Tx devices design & construction simple (77332) |
$544.83 |
$1,651 |
3.8× |
| Ultrasound Breast Limited (76642) |
$321.75 |
$975 |
3.5× |
| Ultrasound elastography first target lesion (76982) |
$310.53 |
$941 |
2.8× |
| Ultrasound Elastography Parenchyma (76981) |
$310.53 |
$941 |
2.8× |
| Ultrasound Exam Aaa Screen (76706) |
$403.26 |
$1,222 |
3.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$325.38 |
$986 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$574.53 |
$1,741 |
5.1× |
| Umbilical-artery Doppler (OB) (76820) |
$112.86 |
$342 |
1.0× |
| Unlis px ther radiol clinical tx planning (77299) |
$141.24 |
$428 |
1.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$277.53 |
$841 |
3.0× |
| Unlisted fluoroscopic procedure (76496) |
$70.29 |
$213 |
0.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,105.83 |
$3,351 |
11.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$826.65 |
$2,505 |
7.6× |
| Unlisted us procedure (76999) |
$72.93 |
$221 |
0.8× |
| Upper gi w/o kub (74240) |
$214.17 |
$649 |
1.1× |
| Ureteral Reflux Study (78740) |
$402.60 |
$1,220 |
0.9× |
| Urethrocystogram voiding (74455) |
$563.64 |
$1,708 |
2.2× |
| Urethrocystography retrograde (74450) |
$430.65 |
$1,305 |
1.7× |
| Us breast unilateral complete (76641) |
$354.09 |
$1,073 |
3.2× |
| Us chest (76604) |
$192.72 |
$584 |
1.7× |
| Us complete joint (76881) |
$568.59 |
$1,723 |
5.1× |
| Us exam, pelvic, limited (76857) |
$397.32 |
$1,204 |
3.5× |
| Us head (76506) |
$109.23 |
$331 |
1.0× |
| Us kidney transplant (76776) |
$428.34 |
$1,298 |
3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$219.12 |
$664 |
2.0× |
| Us ob detailed single fetus (76811) |
$383.79 |
$1,163 |
1.5× |
| Us ob limited 1 or more fetuses (76815) |
$372.90 |
$1,130 |
3.3× |
| Us ob transvaginal (76817) |
$471.57 |
$1,429 |
4.2× |
| Us pelvic non ob complete (76856) |
$679.80 |
$2,060 |
6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$475.20 |
$1,440 |
4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$259.71 |
$787 |
2.3× |
| Us retroperitoneal complete (76770) |
$589.71 |
$1,787 |
5.3× |
| Us retroperitoneal limited (76775) |
$536.58 |
$1,626 |
4.8× |
| Us scrotum and contents (76870) |
$555.72 |
$1,684 |
5.0× |
| Us spinal canal and contents (76800) |
$168.63 |
$511 |
1.5× |
| Us thyroid (76536) |
$571.56 |
$1,732 |
5.1× |
| Us transrectal (76872) |
$347.16 |
$1,052 |
3.1× |
| Vascular Flow Imaging (78445) |
$351.78 |
$1,066 |
0.8× |
| Vasogram (74440) |
$273.90 |
$830 |
1.1× |
| Vein X-Ray Chest (75827) |
$812.13 |
$2,461 |
0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,223.31 |
$3,707 |
0.4× |
| Vein X-Ray Skull Epidural (75872) |
$1,964.16 |
$5,952 |
2.9× |
| Vein X-Ray Spleen/Liver (75810) |
$1,964.16 |
$5,952 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$1,681.35 |
$5,095 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$1,964.16 |
$5,952 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,681.35 |
$5,095 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$1,185.69 |
$3,593 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$481.80 |
$1,460 |
0.3× |
| Venography Orbital Rs&I (75880) |
$1,964.16 |
$5,952 |
2.9× |
| Venography Renal Bilateral (75833) |
$1,679.37 |
$5,089 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,541.10 |
$4,670 |
0.5× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,730.75 |
$8,275 |
0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$290.07 |
$879 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$56.10 |
$170 |
0.6× |
Wrist 2 views (73100)
range across 2 matching MRF lines |
$221.43–$331.32 |
$671–$1,004 |
varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$118.47 |
$359 |
1.3× |
| X-ray antegrade pyelogram tube (74425) |
$197.34 |
$598 |
0.5× |
| X-Ray Aorta Leg Arteries (75630) |
$1,765.83 |
$5,351 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$61.05 |
$185 |
0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$71.28 |
$216 |
0.8× |
| X-Ray Exam Breast Specimen (76098) |
$372.90 |
$1,130 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$118.47 |
$359 |
1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$309.21 |
$937 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$363.33 |
$1,101 |
3.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$64.68 |
$196 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$107.58 |
$326 |
1.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$240.24 |
$728 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$130.68 |
$396 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$166.65 |
$505 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$386.76 |
$1,172 |
3.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$463.98 |
$1,406 |
4.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$291.06 |
$882 |
3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$502.26 |
$1,522 |
4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$121.77 |
$369 |
1.1× |
| X-ray eye for foreign body (70030) |
$79.86 |
$242 |
0.9× |
| X-ray head for orthodontia (70350) |
$53.13 |
$161 |
0.6× |
| X-ray humerus (73060) |
$108.57 |
$329 |
1.2× |
| X-ray IV pyelogram (ivp) (74400) |
$166.32 |
$504 |
0.9× |
| X-ray IV pyelogram+tomography (74415) |
$660.66 |
$2,002 |
3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$153.45 |
$465 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$224.40 |
$680 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$142.23 |
$431 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$166.32 |
$504 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$516.12 |
$1,564 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$240.24 |
$728 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$170.61 |
$517 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$101.64 |
$308 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$363.66 |
$1,102 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$198 |
$600 |
1.8× |
| X-ray thoracic spine 4 vw (72074) |
$167.97 |
$509 |
1.5× |
| X-Ray Tmj Unilat (70328) |
$79.86 |
$242 |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$520.41 |
$1,577 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$120.78 |
$366 |
1.1× |
| X-Rays Bone Survey Complete (77075) |
$315.48 |
$956 |
2.8× |
| Xr c-spine 4 or 5 views (72050) |
$428.67 |
$1,299 |
3.8× |
| Xr facial bones less than 3 views (70140) |
$53.13 |
$161 |
0.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$61.38 |
$186 |
0.5× |
| Xr orbits complete 4 views (70200) |
$228.36 |
$692 |
2.0× |
| Xr Tomogram Single Plane (76100) |
$88.11 |
$267 |
0.8× |