| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,015 |
$6,500 |
1.5× |
| Abdomen 2 views (74019) |
$157.17 |
$507 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$590.86 |
$1,906 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,006.94 |
$6,474 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,792.17 |
$9,007 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,228.53 |
$3,963 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,214.08 |
$10,368 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,268.27 |
$7,317 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,160.39 |
$6,969 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,892.86 |
$6,106 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,268.02 |
$10,542 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,097.09 |
$3,539 |
0.4× |
| Ankle 2 views (73600) |
$82.15 |
$265 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$254.82 |
$822 |
0.8× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,806.99 |
$5,829 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,358.23 |
$10,833 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$2,001.36 |
$6,456 |
0.7× |
| Arthrogram elbow (73085) |
$399.59 |
$1,289 |
1.2× |
| Arthrogram hip (73525) |
$174.84 |
$564 |
0.5× |
| Arthrogram shoulder (73040) |
$266.60 |
$860 |
0.8× |
| Arthrogram wrist (73115) |
$279 |
$900 |
0.8× |
| Arthrography knee lt (73580) |
$266.60 |
$860 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$155 |
$500 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$382.85 |
$1,235 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$466.24 |
$1,504 |
1.2× |
| Bone age studies (77072) |
$196.85 |
$635 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$572.57 |
$1,847 |
1.5× |
| Bone survey complete (77075) |
$290.16 |
$936 |
2.9× |
| Brachytx isodose complex (77318) |
$1,280.61 |
$4,131 |
3.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$642.94 |
$2,074 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,514.66 |
$4,886 |
1.1× |
| Brain Imaging Vascular Flow Only (78610) |
$305.04 |
$984 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,251.78 |
$4,038 |
3.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$461.59 |
$1,489 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$110.67 |
$357 |
1.3× |
| Chest 1 view (71045) |
$125.24 |
$404 |
1.5× |
| Chest 3 views (71047) |
$179.49 |
$579 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$118.11 |
$381 |
0.7× |
| Clavicle complete (73000) |
$120.90 |
$390 |
1.5× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$23,064 |
$74,400 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$449.19 |
$1,449 |
4.5× |
| Continuing medical physics consltj pr wk (77336) |
$215.45 |
$695 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,059.02 |
$6,642 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,611.38 |
$5,198 |
7.1× |
| CT abdomen w contrast (74160) |
$732.84 |
$2,364 |
4.4× |
| CT abdomen w wo contrast (74170) |
$1,145.14 |
$3,694 |
6.8× |
| CT abdomen w/o contrast (74150) |
$499.41 |
$1,611 |
5.0× |
| CT angio hrt w/3d image (75574) |
$870.79 |
$2,809 |
2.6× |
| CT angiography upper extremity lt (73206) |
$563.27 |
$1,817 |
3.4× |
| CT c-spine w/o contrast (72125) |
$851.57 |
$2,747 |
8.5× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$970.61 |
$3,131 |
5.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,318.74 |
$4,254 |
7.9× |
| CT cervical spine with contrast (72126) |
$562.34 |
$1,814 |
1.7× |
| CT chest w/wo contrast (71270) |
$845.68 |
$2,728 |
5.1× |
| CT chest with contrast (71260) |
$820.88 |
$2,648 |
4.9× |
| CT colonography screening (74263) |
$442.68 |
$1,428 |
1.9× |
| CT colonography w/o cntrst (74261) |
$678.90 |
$2,190 |
6.8× |
| CT head/brain with contrast (70460) |
$506.85 |
$1,635 |
3.0× |
| CT head/brain without and with contrast (70470) |
$895.90 |
$2,890 |
5.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$985.49 |
$3,179 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$37.20 |
$120 |
0.4× |
| CT hrt w/3d image congen (75573) |
$938.68 |
$3,028 |
2.8× |
| CT iac w contrast (70481) |
$697.50 |
$2,250 |
4.2× |
| CT limited/localized follow up study (76380) |
$317.75 |
$1,025 |
3.8× |
| CT lower ext w/o (73700) |
$662.78 |
$2,138 |
6.6× |
| CT lower extremity w wo contrast (73702) |
$666.50 |
$2,150 |
4.0× |
| CT lower extremity with contrast (73701) |
$568.85 |
$1,835 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,089.03 |
$3,513 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$811.27 |
$2,617 |
8.1× |
| CT lumbar spine with contrast (72132) |
$562.34 |
$1,814 |
1.7× |
| CT maxillofacial w contrast (70487) |
$581.25 |
$1,875 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$708.66 |
$2,286 |
7.1× |
| CT maxillofacial w/wo contrast (70488) |
$585.28 |
$1,888 |
3.5× |
| CT neck soft tissue w contrast (70491) |
$718.27 |
$2,317 |
4.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$763.22 |
$2,462 |
4.6× |
| CT orbits w/o contrast (70480) |
$542.50 |
$1,750 |
5.4× |
| CT pelvis w & w/o contrast (72194) |
$708.04 |
$2,284 |
4.2× |
| CT pelvis w/o contrast (72192) |
$576.91 |
$1,861 |
5.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$942.71 |
$3,041 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$559.55 |
$1,805 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$555.83 |
$1,793 |
3.3× |
| CT thoracic spine w/o contrast (72128) |
$799.18 |
$2,578 |
8.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,138.01 |
$3,671 |
6.8× |
| CT thorax w/o contrast (71250) |
$779.96 |
$2,516 |
7.8× |
| CT unlisted procedure (76497) |
$813.75 |
$2,625 |
9.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$638.29 |
$2,059 |
3.8× |
| CT upper extremity w/o contrast rt (73200) |
$516.77 |
$1,667 |
5.2× |
| CT upper extremity with contrast (73201) |
$619.38 |
$1,998 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,109.49 |
$3,579 |
6.6× |
| Cta Abdomen (74175) |
$1,005.95 |
$3,245 |
6.0× |
| CTA abdomen pelvis (74174) |
$2,008.49 |
$6,479 |
6.0× |
| CTA chest (71275) |
$957.90 |
$3,090 |
5.7× |
| Cta Head (70496) |
$1,134.29 |
$3,659 |
6.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,984 |
$6,400 |
6.0× |
| CTA lwr ext w&w/o contrast (73706) |
$667.74 |
$2,154 |
4.0× |
| Cta Neck (70498) |
$1,040.98 |
$3,358 |
6.2× |
| Cta Pelvis (72191) |
$1,038.50 |
$3,350 |
6.2× |
| Cystography minimum 3 views rs&i (74430) |
$266.60 |
$860 |
0.8× |
| Diskography lumbar (72295) |
$787.71 |
$2,541 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$130.20 |
$420 |
1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$186.31 |
$601 |
1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$182.90 |
$590 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$186 |
$600 |
1.9× |
| Echo exam of fetal heart (76825) |
$365.02 |
$1,177.50 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$278.38 |
$898 |
1.2× |
| Echoencephalography real time imaging (76506) |
$230.02 |
$742 |
2.3× |
| Esophagus (74220) |
$127.41 |
$411 |
0.8× |
| Fetal biophysical profile non-stress testing (76818) |
$285.20 |
$920 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$240.87 |
$777 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$162.44 |
$524 |
0.7× |
| Foot 2 views (73620) |
$96.10 |
$310 |
1.2× |
| Forearm 2 views (73090) |
$117.18 |
$378 |
1.4× |
| Functional MRI brain by tech (70554) |
$952.32 |
$3,072 |
4.2× |
| Gated Heart Planar Single (78472) |
$916.67 |
$2,957 |
2.4× |
| Hand 2 views (73120) |
$120.28 |
$388 |
1.2× |
| Hand 3 views (73130) |
$124 |
$400 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,331.76 |
$4,296 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,468.47 |
$4,737 |
2.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$203.98 |
$658 |
0.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$203.98 |
$658 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,814.80 |
$9,080 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,058.03 |
$3,413 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$376.03 |
$1,213 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,042.84 |
$3,364 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$114.70 |
$370 |
1.4× |
| Hysterosalpingogram (74740) |
$540.33 |
$1,743 |
2.4× |
| Interstitial radiation source applic complex (77778) |
$2,623.84 |
$8,464 |
3.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$66.96 |
$216 |
0.7× |
| Kidney imaging morphology (78700) |
$461.90 |
$1,490 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,360.59 |
$4,389 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$643.25 |
$2,075 |
1.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$609.77 |
$1,967 |
1.2× |
| Knee 3 views (73562) |
$154.38 |
$498 |
1.9× |
| Liver & spleen imaging static only (78215) |
$446.09 |
$1,439 |
1.2× |
| Lung perfusion differential (78597) |
$307.83 |
$993 |
0.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,510.32 |
$4,872 |
0.5× |
| Lymphoscintigraphy (78195) |
$548.70 |
$1,770 |
1.1× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$105.71 |
$341 |
1.3× |
| Meckels Diverticulum (78290) |
$345.96 |
$1,116 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$320.23 |
$1,033 |
0.9× |
| Mr elastography (76391) |
$641.70 |
$2,070 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$68.20 |
$220 |
0.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$46.19 |
$149 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$18.91 |
$61 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$70.99 |
$229 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$187.24 |
$604 |
0.8× |
| MRA head w & w/o contrast (70546) |
$931.86 |
$3,006 |
2.8× |
| MRA head w/o contrast (70544) |
$775 |
$2,500 |
3.4× |
| MRA head with contrast (70545) |
$361.77 |
$1,167 |
1.1× |
| MRA neck w contrast (70548) |
$1,103.60 |
$3,560 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,322.15 |
$4,265 |
4.0× |
| MRA neck w/o contrast (70547) |
$697.19 |
$2,249 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,367.10 |
$4,410 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$814.37 |
$2,627 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,127.16 |
$3,636 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,345.40 |
$4,340 |
1.8× |
| MRI bone marrow blood supply (77084) |
$863.35 |
$2,785 |
3.8× |
| MRI breast w/o contrast bilateral (77047) |
$861.18 |
$2,778 |
3.8× |
| MRI c-spine with contrast (72142) |
$1,121.27 |
$3,617 |
3.4× |
| MRI cardiac w/o contrast (75557) |
$690.68 |
$2,228 |
3.0× |
| MRI cervical spine w/o contrast (72141) |
$1,129.64 |
$3,644 |
5.0× |
| MRI chest w/o & w/contrast material (71552) |
$918.84 |
$2,964 |
2.8× |
| MRI chest w/o contrast (71550) |
$759.50 |
$2,450 |
3.3× |
| MRI fetal sngl/1st gestation (74712) |
$281.48 |
$908 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,243.10 |
$4,010 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$546.84 |
$1,764 |
1.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$975.88 |
$3,148 |
4.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,066.40 |
$3,440 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,209 |
$3,900 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,134.91 |
$3,661 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$904.27 |
$2,917 |
4.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,162.19 |
$3,749 |
3.5× |
| MRI scan of leg joint before and after contrast (73723) |
$929.07 |
$2,997 |
2.8× |
| MRI spectroscopy (76390) |
$810.03 |
$2,613 |
9.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,458.24 |
$4,704 |
4.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,306.34 |
$4,214 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,441.50 |
$4,650 |
4.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$409.20 |
$1,320 |
1.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,483.04 |
$4,784 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,108.87 |
$3,577 |
4.9× |
| MRI tmj (70336) |
$1,108.87 |
$3,577 |
4.9× |
| MRI upper ext joint w/o contrast (73221) |
$984.25 |
$3,175 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,050.59 |
$3,389 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$970.61 |
$3,131 |
4.3× |
| Myelogram Cervical (72240) |
$602.33 |
$1,943 |
0.8× |
| Myelogram Lumbar (72265) |
$467.79 |
$1,509 |
0.6× |
| Myelogram thoracic (72255) |
$620.62 |
$2,002 |
0.8× |
| Myelography 2 or more regions (72270) |
$1,105.46 |
$3,566 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,172.42 |
$3,782 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,498.85 |
$4,835 |
1.2× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,651.12 |
$8,552 |
1.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,550 |
$5,000 |
1.9× |
| Neck soft tissue (70360) |
$77.50 |
$250 |
0.9× |
| Nm cisternogram (78630) |
$712.69 |
$2,299 |
1.4× |
| Nm gastric emptying study (78264) |
$641.39 |
$2,069 |
1.7× |
| Nm gastroesophageal reflux study (78262) |
$926.59 |
$2,989 |
2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,170 |
$7,000 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$568.23 |
$1,833 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$119.66 |
$386 |
1.2× |
| Orthopantogram (70355) |
$129.27 |
$417 |
1.6× |
| Osseous survey infant (77076) |
$125.86 |
$406 |
1.3× |
| Parathyrd planar w/spect&CT (78072) |
$753.61 |
$2,431 |
1.5× |
| Parathyroid imaging (78070) |
$765.08 |
$2,468 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$112.84 |
$364 |
1.1× |
| Peritoneogram rs&i (74190) |
$185.07 |
$597 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$2,262.38 |
$7,298 |
1.7× |
| PET imaging CT for attenuation limited area (78814) |
$1,792.73 |
$5,783 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$1,793.97 |
$5,787 |
1.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,258.91 |
$4,061 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,151.34 |
$3,714 |
3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,304.48 |
$4,208 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,439.39 |
$7,869 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$342.86 |
$1,106 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$644.49 |
$2,079 |
1.2× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,705 |
$5,500 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$336.35 |
$1,085 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$55.80 |
$180 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$180.73 |
$583 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$217.31 |
$701 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$199.33 |
$643 |
2.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,934.70 |
$22,370 |
1.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,087.79 |
$3,509 |
2.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$949.53 |
$3,063 |
9.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,087.79 |
$3,509 |
3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$88.35 |
$285 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$111.60 |
$360 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$203.98 |
$658 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$116.25 |
$375 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$259.16 |
$836 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,226.67 |
$3,957 |
7.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$285.20 |
$920 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$216.38 |
$698 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$112.22 |
$362 |
1.4× |
| Radiological examination surgical specimen (76098) |
$305.66 |
$986 |
0.6× |
| Radiopharm Dacryocystography (78660) |
$136.40 |
$440 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,148.36 |
$10,156 |
1.0× |
| Ribs bilateral 3 views (71110) |
$230.33 |
$743 |
2.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$466.24 |
$1,504 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$500.03 |
$1,613 |
1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$566.37 |
$1,827 |
0.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$524.83 |
$1,693 |
0.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$408.89 |
$1,319 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$408.89 |
$1,319 |
1.8× |
| Sacroiliac Joints < 3 Views (72200) |
$76.88 |
$248 |
0.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$291.71 |
$941 |
1.3× |
| Scanogram (77073) |
$131.13 |
$423 |
1.3× |
| Scapula complete (73010) |
$78.12 |
$252 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$34.10 |
$110 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$82.46 |
$266 |
0.8× |
| Simulation intermediate (77285) |
$419.74 |
$1,354 |
1.2× |
| Small bowel series (74250) |
$168.02 |
$542 |
1.0× |
| Spec medical radj physics consltj (77370) |
$456.94 |
$1,474 |
3.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$376.03 |
$1,213 |
1.1× |
| Special dosimetry (77331) |
$128.96 |
$416 |
1.0× |
| Special treatment procedure (77470) |
$655.65 |
$2,115 |
1.2× |
| Speech evaluation complex (70371) |
$163.37 |
$527 |
0.7× |
| Spine thoracic 3 views (72072) |
$161.20 |
$520 |
1.6× |
| Stereotactic body radiation delivery (77373) |
$2,291.83 |
$7,393 |
1.3× |
| Superior sagittal sinus venogram (75870) |
$1,113.52 |
$3,592 |
0.4× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$80.91 |
$261 |
0.8× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$29.45 |
$95 |
0.8× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$80.91 |
$261 |
0.8× |
| Tbs Technical Calculation Only (77091) |
$68.20 |
$220 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$713 |
$2,300 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$151.59 |
$489 |
0.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$465 |
$1,500 |
1.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$200.88 |
$648 |
1.6× |
| Therapeutic Enema (74283) |
$372.31 |
$1,201 |
2.2× |
| Thoracolumbar 2 views (72080) |
$115.32 |
$372 |
1.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$686.96 |
$2,216 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$286.13 |
$923 |
0.8× |
| Thyroid uptake measurement (78012) |
$180.73 |
$583 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$235.29 |
$759 |
0.6× |
| Treatment device intermediate (77333) |
$299.77 |
$967 |
2.3× |
| Treatment devices simple (77332) |
$275.59 |
$889 |
2.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$422.84 |
$1,364 |
1.1× |
| Tx devices design & construction complex (77334) |
$425.48 |
$1,372.50 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$249.24 |
$804 |
2.5× |
| Umbilical-artery Doppler (OB) (76820) |
$172.98 |
$558 |
1.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$254.82 |
$822 |
3.1× |
| Unlisted fluoroscopic procedure (76496) |
$69.75 |
$225 |
0.8× |
| Unlisted magnetic resonance procedure (76498) |
$788.95 |
$2,545 |
9.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$311.55 |
$1,005 |
0.8× |
| Upper Extremity Infant (73092) |
$83.39 |
$269 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$291.40 |
$940 |
1.3× |
| Urethrocystography voiding (74455) |
$319.92 |
$1,032 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$457.25 |
$1,475 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$123.07 |
$397 |
1.2× |
| Us breast unilateral complete (76641) |
$337.59 |
$1,089 |
3.4× |
| Us breast unilateral limited (76642) |
$208.63 |
$673 |
2.5× |
| Us chest (76604) |
$170.81 |
$551 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$346.89 |
$1,119 |
3.5× |
| Us elastography parenchyma (76981) |
$170.81 |
$551 |
1.7× |
| Us guided compression repair (76936) |
$296.36 |
$956 |
1.4× |
| Us infant hips dynamic (76885) |
$274.04 |
$884 |
3.3× |
| Us infant hips limited static (76886) |
$266.91 |
$861 |
3.2× |
| Us kidney transplant (76776) |
$229.71 |
$741 |
2.3× |
| Us ob detailed single fetus (76811) |
$481.12 |
$1,552 |
2.1× |
| Us ob transvaginal (76817) |
$230.64 |
$744 |
2.3× |
| Us pelvic non ob complete (76856) |
$200.88 |
$648 |
2.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$108.19 |
$349 |
1.1× |
| Us pregnancy ltd (76815) |
$105.09 |
$339 |
1.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$218.55 |
$705 |
2.2× |
| Us retroperitoneal complete (76770) |
$181.35 |
$585 |
1.8× |
| Us retroperitoneal limited (76775) |
$145.08 |
$468 |
1.5× |
| Us scrotum and contents (76870) |
$189.10 |
$610 |
1.9× |
| Us soft tissue head/neck (76536) |
$229.40 |
$740 |
2.3× |
| Us spinal canal and contents (76800) |
$226.92 |
$732 |
2.3× |
| Us transrectal (76872) |
$496.93 |
$1,603 |
5.0× |
| Us transrectal prostate volume (76873) |
$256.68 |
$828 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$179.49 |
$579 |
1.8× |
| Us, eye b-scan (76512) |
$202.12 |
$652 |
2.0× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$506.85 |
$1,635 |
0.8× |
| Venogram extremity bilateral (75822) |
$1,033.54 |
$3,334 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$586.52 |
$1,892 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$1,113.52 |
$3,592 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$439.89 |
$1,419 |
0.3× |
| Venography Renal Bilateral (75833) |
$3,305.53 |
$10,663 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$3,148.36 |
$10,156 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,439.39 |
$7,869 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,358.23 |
$10,833 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$80.60 |
$260 |
1.0× |
| Wrist 2 views (73100) |
$82.46 |
$266 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$259.16 |
$836 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$82.77 |
$267 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$145.08 |
$468 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$443.92 |
$1,432 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$84.94 |
$274 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$117.80 |
$380 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$189.72 |
$612 |
1.9× |
| X-ray exam hip uni 1 view (73501) |
$163.68 |
$528 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$266.29 |
$859 |
3.2× |
| X-ray exam hip uni 4/> views (73503) |
$172.05 |
$555 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$223.51 |
$721 |
2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$234.67 |
$757 |
2.4× |
| X-ray exam of femur 1 (73551) |
$92.07 |
$297 |
1.1× |
| X-ray eye for foreign body (70030) |
$131.13 |
$423 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$108.50 |
$350 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$64.17 |
$207 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$142.29 |
$459 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$76.26 |
$246 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$83.39 |
$269 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$147.56 |
$476 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$144.77 |
$467 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$84.01 |
$271 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$115.32 |
$372 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$190.03 |
$613 |
1.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$86.49 |
$279 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$143.22 |
$462 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$158.10 |
$510 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$232.50 |
$750 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$188.48 |
$608 |
1.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$354.95 |
$1,145 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$124 |
$400 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$130.51 |
$421 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$187.55 |
$605 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$87.11 |
$281 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$108.50 |
$350 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$130.82 |
$422 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$81.22 |
$262 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$97.03 |
$313 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$188.48 |
$608 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$111.91 |
$361 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$64.17 |
$207 |
0.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$83.39 |
$269 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$158.41 |
$511 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$138.57 |
$447 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$304.42 |
$982 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$107.26 |
$346 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.69 |
$399 |
1.5× |
| Xr arthrogram ankle (73615) |
$276.83 |
$893 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$224.75 |
$725 |
2.3× |
| Xr chest 4+ views (71048) |
$214.52 |
$692 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$113.15 |
$365 |
1.4× |
| Xr shoulder 1 view (73020) |
$95.79 |
$309 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$217 |
$700 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$111.60 |
$360 |
1.3× |
| Xr tmj bilateral (70330) |
$85.56 |
$276 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$75.95 |
$245 |
0.9× |