| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,300 |
$13,125 |
3.5× |
| Abdomen 1 View (74018) |
$329.76 |
$687 |
2.9× |
| Abdomen 2 views (74019) |
$429.60 |
$895 |
3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,023.36 |
$2,132 |
2.0× |
| Adrenal Cortex & Medulla Img (78075) |
$2,327.52 |
$4,849 |
1.4× |
| Angio internal mammary (75756) |
$3,535.68 |
$7,366 |
0.9× |
| Angio pulmonary bilat (75743) |
$3,705.12 |
$7,719 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$3,535.68 |
$7,366 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,091.36 |
$4,357 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,535.68 |
$7,366 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,535.68 |
$7,366 |
0.9× |
| Ankle 2 views (73600) |
$350.88 |
$731 |
3.1× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$3,098.40 |
$6,455 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,753.76 |
$5,737 |
0.7× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$3,242.88 |
$6,756 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$2,565.12 |
$5,344 |
0.6× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$3,535.68 |
$7,366 |
0.5× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$3,535.68 |
$7,366 |
0.5× |
| Arthrogram ankle (73615) |
$577.92 |
$1,204 |
1.3× |
| Arthrogram hip (73525) |
$597.12 |
$1,244 |
1.3× |
| Arthrogram Wrist (73115) |
$732.48 |
$1,526 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$556.80 |
$1,160 |
3.2× |
| Bone age studies (77072) |
$213.60 |
$445 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,606.08 |
$3,346 |
3.1× |
| Bone Imaging Limited Area (78300) |
$1,165.44 |
$2,428 |
2.3× |
| Bone Imaging Multiple Areas (78305) |
$1,446.72 |
$3,014 |
2.8× |
| Bone Imaging Whole Body (78306) |
$1,554.72 |
$3,239 |
3.0× |
| Bone marrow imaging; multiple areas (78103) |
$695.52 |
$1,449 |
1.4× |
| Bone survey infant (77076) |
$210.72 |
$439 |
1.6× |
| Brachytx isodose complex (77318) |
$6,884.64 |
$14,343 |
14.3× |
| Brachytx isodose intermed (77317) |
$6,439.68 |
$13,416 |
13.4× |
| Brachytx Isodose Plan Simple (77316) |
$251.04 |
$523 |
0.5× |
| Brain Image W/Flow < 4 Views (78601) |
$699.36 |
$1,457 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,517.92 |
$7,329 |
1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,120.16 |
$4,417 |
4.7× |
| Cat Scan Follow-Up Study (76380) |
$487.68 |
$1,016 |
4.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,424.64 |
$2,968 |
2.0× |
| Chest 1 view (71045) |
$116.16 |
$242 |
1.0× |
| Chest 2 views (71046) |
$443.04 |
$923 |
4.0× |
| Chest 3 views (71047) |
$497.76 |
$1,037 |
4.4× |
| Chest 4 or more views (71048) |
$554.88 |
$1,156 |
4.1× |
| Cholecystography Oral Contrast (74290) |
$354.24 |
$738 |
1.6× |
| Clavicle complete (73000) |
$350.88 |
$731 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$190.08 |
$396 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$523.68 |
$1,091 |
3.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,098.40 |
$6,455 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$350.40 |
$730 |
0.8× |
| Contrast X-Ray Of Elbow (73085) |
$662.88 |
$1,381 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$660.96 |
$1,377 |
1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$409.44 |
$853 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,513.28 |
$5,236 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,794.72 |
$3,739 |
5.8× |
| CT abdomen w contrast (74160) |
$1,356 |
$2,825 |
6.0× |
| CT abdomen w wo contrast (74170) |
$1,647.36 |
$3,432 |
7.3× |
| CT abdomen w/o contrast (74150) |
$1,242.72 |
$2,589 |
9.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,455.20 |
$5,115 |
5.5× |
| CT Angio Chest (71275) |
$2,192.16 |
$4,567 |
9.7× |
| CT Angio Head (70496) |
$1,017.60 |
$2,120 |
4.5× |
| CT angio hrt w/3d image (75574) |
$1,189.92 |
$2,479 |
2.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,138.88 |
$4,456 |
9.5× |
| CT Angio Neck (70498) |
$1,139.04 |
$2,373 |
5.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,252.16 |
$4,692 |
10.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$2,628 |
$5,475 |
11.6× |
| CT cervical spine w/ contrast (72126) |
$1,479.84 |
$3,083 |
3.3× |
| CT cervical spine w/o contrast (72125) |
$1,213.92 |
$2,529 |
9.0× |
| CT cervical spine w/wo cont (72127) |
$1,950.24 |
$4,063 |
8.6× |
| CT chest w contrast (71260) |
$1,897.92 |
$3,954 |
8.4× |
| CT chest w/wo contrast (71270) |
$1,897.92 |
$3,954 |
8.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$194.40 |
$405 |
1.4× |
| CT head/brain with contrast (70460) |
$1,093.44 |
$2,278 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,123.20 |
$2,340 |
5.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$886.08 |
$1,846 |
2.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$95.52 |
$199 |
0.9× |
| CT hrt w/3d image congen (75573) |
$653.28 |
$1,361 |
1.5× |
| CT iac w contrast (70481) |
$1,139.04 |
$2,373 |
5.0× |
| CT l-spine w&w/o contrast (72133) |
$2,455.20 |
$5,115 |
10.9× |
| CT lower ext w/o (73700) |
$1,514.40 |
$3,155 |
11.3× |
| CT lower extremity w/contrast material (73701) |
$2,138.88 |
$4,456 |
9.5× |
| CT lumbar spine w contrast (72132) |
$1,862.88 |
$3,881 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$1,528.32 |
$3,184 |
11.4× |
| CT maxillofacial w contrast (70487) |
$1,139.04 |
$2,373 |
5.0× |
| CT maxillofacial wo contrast (70486) |
$1,093.44 |
$2,278 |
8.1× |
| CT neck tissue combo (70492) |
$1,548 |
$3,225 |
6.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,548 |
$3,225 |
6.9× |
| CT orbits w/o contrast (70480) |
$1,093.44 |
$2,278 |
8.1× |
| CT pelvis w&w/o contrast (72194) |
$1,627.20 |
$3,390 |
7.2× |
| CT pelvis w/o contrast (72192) |
$1,242.72 |
$2,589 |
9.2× |
| CT scan of leg combo (73702) |
$2,294.40 |
$4,780 |
10.2× |
| CT scans face/jaw combo (70488) |
$1,548 |
$3,225 |
6.9× |
| CT soft tissue neck w contrast (70491) |
$1,139.04 |
$2,373 |
5.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,093.44 |
$2,278 |
8.1× |
| CT thoracic spine w contrast (72129) |
$1,862.88 |
$3,881 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,528.32 |
$3,184 |
11.4× |
| CT thoracic spine w/wo cont (72130) |
$2,455.20 |
$5,115 |
10.9× |
| CT thorax w/o contrast (71250) |
$1,638.24 |
$3,413 |
12.2× |
| CT unlisted procedure (76497) |
$2,418.24 |
$5,038 |
21.6× |
| CT upper ext wo (73200) |
$1,514.40 |
$3,155 |
11.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,973.28 |
$4,111 |
8.7× |
| CT upper extremity with contrast (73201) |
$1,822.56 |
$3,797 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,025.12 |
$4,219 |
9.0× |
| Cta Abdomen (74175) |
$1,511.04 |
$3,148 |
6.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,628 |
$5,475 |
5.9× |
| CTA pelvis (72191) |
$1,392 |
$2,900 |
6.2× |
| Diskography lumbar (72295) |
$2,149.44 |
$4,478 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$351.84 |
$733 |
2.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$351.84 |
$733 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$305.76 |
$637 |
2.3× |
| Dxa Bone Density Axial (77080) |
$520.80 |
$1,085 |
3.9× |
| Dxa bone density study (77085) |
$445.92 |
$929 |
3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$444 |
$925 |
4.0× |
| Echo exam of fetal heart (76825) |
$1,242.72 |
$2,589 |
1.8× |
| Echo exam uterus (76831) |
$238.08 |
$496 |
0.8× |
| Echo Guide For Artery Repair (76936) |
$614.88 |
$1,281 |
2.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$839.52 |
$1,749 |
2.7× |
| Echograp Trans R Pros Study (76873) |
$415.68 |
$866 |
3.1× |
| Esophagram (74220) |
$279.36 |
$582 |
1.2× |
| Fetal Biophys Profile W/Nst (76818) |
$700.80 |
$1,460 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$336.48 |
$701 |
2.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,535.36 |
$5,282 |
8.3× |
| Fluoroscopy up to 1 hr (76000) |
$468 |
$975 |
1.5× |
| Follow-Up Angiography (75898) |
$1,713.60 |
$3,570 |
0.4× |
| Foot 2 views (73620) |
$350.88 |
$731 |
3.1× |
| Forearm 2 views (73090) |
$131.52 |
$274 |
1.2× |
| Gastric emptying imaging study (78264) |
$1,554.72 |
$3,239 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,009.92 |
$2,104 |
2.0× |
| Gated Heart, Multiple (78473) |
$1,400.64 |
$2,918 |
2.7× |
| Hand 2 views (73120) |
$125.28 |
$261 |
0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$10,508.64 |
$21,893 |
11.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$8,927.52 |
$18,599 |
10.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$7,345.92 |
$15,304 |
8.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,565.12 |
$5,344 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,565.12 |
$5,344 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,572.96 |
$3,277 |
2.3× |
| Hepatobiliary System Imaging (78226) |
$1,572.96 |
$3,277 |
3.1× |
| Ht Musc Image Planar Mult (78454) |
$1,507.68 |
$3,141 |
0.9× |
| Ht Muscle Image Spect Sing (78451) |
$1,217.28 |
$2,536 |
0.7× |
| Hysterosalpingogram (74740) |
$765.12 |
$1,594 |
2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$424.32 |
$884 |
3.8× |
| Infant hip ultrasound, limited static exam (76886) |
$353.76 |
$737 |
3.2× |
| Interstitial radiation source applic complex (77778) |
$1,714.08 |
$3,571 |
1.9× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$5,956.80 |
$12,410 |
0.6× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$5,956.80 |
$12,410 |
0.6× |
| K Flow/Funct Image Multiple (78709) |
$1,424.64 |
$2,968 |
2.0× |
| K Flow/Funct Image W/Drug (78708) |
$1,356.48 |
$2,826 |
1.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,217.28 |
$2,536 |
1.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$544.80 |
$1,135 |
1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$668.64 |
$1,393 |
1.3× |
| Knee 3 Views (73562) |
$144.48 |
$301 |
1.3× |
| Liver & Spleen Imaging Static Only (78215) |
$728.16 |
$1,517 |
1.4× |
| Liver imaging static only (78201) |
$1,009.92 |
$2,104 |
1.4× |
| Liver imaging w/vascular flow (78202) |
$1,896 |
$3,950 |
2.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,410.72 |
$2,939 |
2.0× |
| Lung perfusion differential (78597) |
$987.84 |
$2,058 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,528.32 |
$3,184 |
2.2× |
| Lung Ventilation Imaging (78579) |
$768.96 |
$1,602 |
1.5× |
| Lymph System Imaging (78195) |
$1,513.92 |
$3,154 |
2.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,512.32 |
$5,234 |
1.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,973.76 |
$10,362 |
1.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,565.12 |
$5,344 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$1,661.76 |
$3,462 |
5.4× |
| Meckels Divert Exam (78290) |
$958.08 |
$1,996 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,800.48 |
$3,751 |
3.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$44.64 |
$93 |
1.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,865.44 |
$8,053 |
8.6× |
| MRA head w/o contrast (70544) |
$1,966.56 |
$4,097 |
6.4× |
| MRA head with contrast (70545) |
$2,529.12 |
$5,269 |
5.6× |
| MRA neck w contrast (70548) |
$2,529.12 |
$5,269 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,865.44 |
$8,053 |
8.6× |
| MRA neck w/o contrast (70547) |
$1,966.56 |
$4,097 |
6.4× |
| MRI abdomen w contrast (74182) |
$2,066.40 |
$4,305 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$1,604.64 |
$3,343 |
5.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,062.08 |
$4,296 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,618.72 |
$7,539 |
8.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,062.08 |
$4,296 |
2.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,642.56 |
$3,422 |
5.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,432.80 |
$2,985 |
4.7× |
| MRI cardiac w/o contrast (75557) |
$1,452 |
$3,025 |
4.7× |
| MRI cervical spine w contrast (72142) |
$2,142.24 |
$4,463 |
4.8× |
| MRI cervical spine w/o cont (72141) |
$1,594.08 |
$3,321 |
5.2× |
| MRI chest w/o contrast (71550) |
$1,797.60 |
$3,745 |
5.9× |
| MRI chest with contrast (71551) |
$2,066.40 |
$4,305 |
2.0× |
| MRI chest wo w contrast (71552) |
$2,897.28 |
$6,036 |
6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,948.80 |
$4,060 |
4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,066.40 |
$4,305 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,826.40 |
$3,805 |
6.0× |
| MRI lumbar spine w contrast (72149) |
$2,156.16 |
$4,492 |
4.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,136.32 |
$6,534 |
7.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,593.12 |
$3,319 |
5.2× |
| MRI orbit face neck w contrast (70542) |
$2,174.88 |
$4,531 |
4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,594.72 |
$7,489 |
8.0× |
| MRI pelvis w contrast (72196) |
$2,073.12 |
$4,319 |
4.6× |
| MRI pelvis w/o & w contrast (72197) |
$4,349.76 |
$9,062 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$1,962.72 |
$4,089 |
6.4× |
| MRI spectroscopy (76390) |
$1,623.36 |
$3,382 |
14.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,779.84 |
$3,708 |
5.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,965.12 |
$4,094 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,826.40 |
$3,805 |
6.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,066.40 |
$4,305 |
4.6× |
| MRI, abdomen, combo (74183) |
$3,624.96 |
$7,552 |
8.1× |
| MRI, dorsal spine combo (72157) |
$3,156.96 |
$6,577 |
7.0× |
| MRI, dorsal spine contrast (72147) |
$2,156.16 |
$4,492 |
4.8× |
| MRI, joint upper extrem (73221) |
$1,917.12 |
$3,994 |
6.2× |
| MRI, joint upper extrem combo (73223) |
$3,618.72 |
$7,539 |
8.1× |
| MRI, lumbar spine combo (72158) |
$3,157.44 |
$6,578 |
7.0× |
| Myelogram cervical (72240) |
$1,277.76 |
$2,662 |
1.3× |
| Myelogram Lumbar (72265) |
$1,237.44 |
$2,578 |
1.2× |
| Myelograpy 2/more regions rs&i (72270) |
$1,656.48 |
$3,451 |
1.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,102.56 |
$8,547 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,204.80 |
$8,760 |
2.5× |
| N-invas est c ffr sw aly CTA (75580) |
$1,726.08 |
$3,596 |
1.6× |
| Neck soft tissue (70360) |
$174.72 |
$364 |
1.6× |
| Nonvascular Shunt X-Ray (75809) |
$180.96 |
$377 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,299.68 |
$11,041 |
3.0× |
| Nuclear Rx Intra-Arterial (79445) |
$496.32 |
$1,034 |
1.7× |
| Nuclear Rx Oral Admin (79005) |
$1,171.68 |
$2,441 |
3.9× |
| Ob us nuchal meas 1 gest (76813) |
$322.08 |
$671 |
2.4× |
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 2 matching MRF lines |
$127.68–$135.84 |
$266–$283 |
varies |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,511.04 |
$3,148 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$1,217.28 |
$2,536 |
2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,511.04 |
$3,148 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$131.52 |
$274 |
1.0× |
| Peritoneogram Rs&I (74190) |
$1,500.96 |
$3,127 |
2.1× |
| Pet Image Skull-Thigh (78812) |
$4,021.92 |
$8,379 |
2.2× |
| Pet Image W/Ct Lmtd (78814) |
$3,772.80 |
$7,860 |
2.1× |
| PET image w/CT, full body (78816) |
$5,439.36 |
$11,332 |
3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,570.08 |
$9,521 |
2.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,727.20 |
$7,765 |
2.2× |
| PET whole body (78813) |
$4,508.16 |
$9,392 |
2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,565.12 |
$5,344 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$750.72 |
$1,564 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$481.92 |
$1,004 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$340.32 |
$709 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$133.44 |
$278 |
1.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$350.88 |
$731 |
3.1× |
| Radex elbow complete minimum 3 views (73080) |
$144.48 |
$301 |
1.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$491.04 |
$1,023 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$350.88 |
$731 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$133.44 |
$278 |
1.2× |
| Radex Hand Minimum 3 Views (73130) |
$434.88 |
$906 |
3.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$360.96 |
$752 |
3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$504 |
$1,050 |
3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$320.16 |
$667 |
2.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$177.60 |
$370 |
1.6× |
| Radex shoulder complete minimum 2 views (73030) |
$474.72 |
$989 |
4.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$304.32 |
$634 |
2.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$931.68 |
$1,941 |
4.1× |
| Radex Spine 1 View Specify Level (72020) |
$295.68 |
$616 |
2.6× |
| Radex Sternum Minimum 2 Views (71120) |
$350.88 |
$731 |
3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$241.92 |
$504 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$350.88 |
$731 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$503.04 |
$1,048 |
3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$383.52 |
$799 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$696.96 |
$1,452 |
5.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,183.52 |
$35,799 |
1.8× |
| Radiation treatment delivery level 1 (77402) |
$92.16 |
$192 |
0.7× |
| Radiation treatment delivery level 2 (77407) |
$887.04 |
$1,848 |
1.8× |
| Radiation treatment delivery level 3 (77412) |
$1,107.36 |
$2,307 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$491.04 |
$1,023 |
3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$481.92 |
$1,004 |
3.6× |
| Radiologic exam colon double contrast study (74280) |
$778.56 |
$1,622 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$660.48 |
$1,376 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$680.16 |
$1,417 |
3.0× |
| Radiologic exam knee complete 4/more views (73564) |
$156.96 |
$327 |
1.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$434.88 |
$906 |
3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$456 |
$950 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$328.32 |
$684 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$345.60 |
$720 |
1.5× |
| Radiologic examination femur 1 view (73551) |
$153.12 |
$319 |
1.4× |
| Radiologic examination femur minimum 2 views (73552) |
$237.60 |
$495 |
2.1× |
| Radiologic examination knee 1/2 views (73560) |
$347.52 |
$724 |
3.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$327.84 |
$683 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$350.88 |
$731 |
3.1× |
| Ribs bilateral 3 views (71110) |
$516.96 |
$1,077 |
3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$866.40 |
$1,805 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,182.72 |
$2,464 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,896 |
$3,950 |
2.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,217.28 |
$2,536 |
1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,896 |
$3,950 |
2.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,579.04 |
$5,373 |
1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,273.76 |
$4,737 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$740.16 |
$1,542 |
2.5× |
| Scapula (73010) |
$350.88 |
$731 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$217.92 |
$454 |
9.3× |
| Shoulder 1 view (73020) |
$350.88 |
$731 |
3.1× |
| Shoulder Arthrography (73040) |
$438.72 |
$914 |
1.0× |
| Skull less than 4 views (70250) |
$326.40 |
$680 |
2.4× |
| Special dosimetry (77331) |
$312 |
$650 |
1.8× |
| Special Physics Consult (77370) |
$844.32 |
$1,759 |
4.9× |
| Special teletherapy port plan (77321) |
$1,922.88 |
$4,006 |
4.0× |
| Special treatment procedure (77470) |
$1,932.96 |
$4,027 |
2.7× |
| Stereotactic Body Radiation Delivery (77373) |
$3,825.12 |
$7,969 |
1.7× |
| Sternoclavicular joints (71130) |
$205.44 |
$428 |
1.8× |
| Superior sagittal sinus venogram (75870) |
$2,926.56 |
$6,097 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,611.20 |
$5,440 |
5.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,258.56 |
$2,622 |
2.6× |
| Testicular Imaging W/Flow (78761) |
$668.64 |
$1,393 |
1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,021.28 |
$4,211 |
4.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,871.04 |
$3,898 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,801.44 |
$3,753 |
10.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$333.60 |
$695 |
1.5× |
| Thoracic spine 2 views (72070) |
$153.12 |
$319 |
1.1× |
| Thoracic spine 3 views (72072) |
$242.40 |
$505 |
1.8× |
| Thoracolumbar 2 views (72080) |
$350.88 |
$731 |
3.1× |
| Thyroid Met Imaging Body (78018) |
$1,087.68 |
$2,266 |
1.6× |
| Thyroid Uptake Measurement (78012) |
$421.44 |
$878 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,172.64 |
$2,443 |
2.3× |
| Tx Devices Design & Construction Complex (77334) |
$1,313.76 |
$2,737 |
2.7× |
| Tx devices design & construction intermediate (77333) |
$530.88 |
$1,106 |
3.1× |
| Tx devices design & construction simple (77332) |
$530.88 |
$1,106 |
3.1× |
| Ultrasound Breast Limited (76642) |
$398.40 |
$830 |
3.6× |
| Ultrasound Elastography Parenchyma (76981) |
$277.44 |
$578 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$218.40 |
$455 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$576.48 |
$1,201 |
4.3× |
| Umbilical-artery Doppler (OB) (76820) |
$305.76 |
$637 |
2.3× |
| Unlisted Dx Radiographic Procedure (76499) |
$122.88 |
$256 |
1.1× |
| Unlisted fluoroscopic procedure (76496) |
$1,269.60 |
$2,645 |
11.3× |
| Unlisted magnetic resonance procedure (76498) |
$1,608 |
$3,350 |
14.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,758.72 |
$3,664 |
13.4× |
| Unlisted us procedure (76999) |
$107.04 |
$223 |
1.0× |
| Upper gi w/o kub (74240) |
$345.60 |
$720 |
1.5× |
| Urethrocystogram voiding (74455) |
$350.40 |
$730 |
1.1× |
| Urethrocystography retrograde (74450) |
$350.40 |
$730 |
1.1× |
| Us breast unilateral complete (76641) |
$446.40 |
$930 |
3.3× |
| Us chest (76604) |
$445.44 |
$928 |
3.3× |
| Us complete joint (76881) |
$538.56 |
$1,122 |
4.0× |
| Us exam, pelvic, limited (76857) |
$184.32 |
$384 |
1.4× |
| Us head (76506) |
$278.40 |
$580 |
2.1× |
| Us kidney transplant (76776) |
$292.32 |
$609 |
2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$443.04 |
$923 |
3.3× |
| Us ob detailed single fetus (76811) |
$558.72 |
$1,164 |
1.8× |
| Us ob limited 1 or more fetuses (76815) |
$378.24 |
$788 |
2.8× |
| Us ob transvaginal (76817) |
$462.24 |
$963 |
3.4× |
| Us pelvic non ob complete (76856) |
$707.04 |
$1,473 |
5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$523.68 |
$1,091 |
3.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$514.08 |
$1,071 |
3.8× |
| Us retroperitoneal complete (76770) |
$837.60 |
$1,745 |
6.2× |
| Us retroperitoneal limited (76775) |
$221.76 |
$462 |
1.6× |
| Us scrotum and contents (76870) |
$707.04 |
$1,473 |
5.3× |
| Us spinal canal and contents (76800) |
$278.40 |
$580 |
2.1× |
| Us thyroid (76536) |
$601.92 |
$1,254 |
4.5× |
| Us transrectal (76872) |
$548.64 |
$1,143 |
4.1× |
| Vein X-Ray Chest (75827) |
$2,553.60 |
$5,320 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,565.12 |
$5,344 |
0.6× |
| Vein X-Ray Spleen/Liver (75810) |
$2,342.88 |
$4,881 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,565.12 |
$5,344 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,553.60 |
$5,320 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$2,624.16 |
$5,467 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,269.60 |
$2,645 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,565.12 |
$5,344 |
0.6× |
| Venography Renal Unilateral (75831) |
$2,400.96 |
$5,002 |
0.6× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,623.20 |
$5,465 |
0.4× |
| Wrist 2 views (73100) |
$125.28 |
$261 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$319.20 |
$665 |
2.9× |
| X-ray antegrade pyelogram tube (74425) |
$586.08 |
$1,221 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$3,098.40 |
$6,455 |
0.8× |
| X-Ray Bend Only L-S Spine (72120) |
$350.88 |
$731 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$350.88 |
$731 |
3.1× |
| X-Ray Exam Breast Specimen (76098) |
$349.92 |
$729 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$319.20 |
$665 |
2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$371.04 |
$773 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$450.24 |
$938 |
3.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$350.88 |
$731 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$516.96 |
$1,077 |
4.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$516.96 |
$1,077 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$292.80 |
$610 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$516.96 |
$1,077 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$526.56 |
$1,097 |
3.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$595.68 |
$1,241 |
4.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$151.68 |
$316 |
1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$611.52 |
$1,274 |
4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$489.60 |
$1,020 |
3.6× |
| X-ray eye for foreign body (70030) |
$250.08 |
$521 |
2.2× |
| X-ray humerus (73060) |
$434.88 |
$906 |
3.9× |
| X-ray IV pyelogram (ivp) (74400) |
$762.24 |
$1,588 |
3.4× |
| X-ray IV pyelogram+tomography (74415) |
$1,100.64 |
$2,293 |
4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$311.04 |
$648 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$217.44 |
$453 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$169.44 |
$353 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$520.80 |
$1,085 |
4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$581.76 |
$1,212 |
4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$156.48 |
$326 |
1.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$350.88 |
$731 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$459.36 |
$957 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$369.12 |
$769 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$540 |
$1,125 |
4.0× |
| X-ray thoracic spine 4 vw (72074) |
$595.68 |
$1,241 |
4.4× |
| X-Ray Tmj Unilat (70328) |
$217.44 |
$453 |
1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$762.24 |
$1,588 |
1.7× |
| X-Rays Bone Length Studies (77073) |
$319.20 |
$665 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$883.68 |
$1,841 |
6.6× |
| Xr c-spine 4 or 5 views (72050) |
$595.68 |
$1,241 |
4.4× |
| Xr facial bones less than 3 views (70140) |
$491.04 |
$1,023 |
4.4× |
| Xr orbits complete 4 views (70200) |
$199.20 |
$415 |
1.5× |