| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,679 |
$7,572 |
4.3× |
| Abdomen 1 View (74018) |
$220.50 |
$294 |
2.7× |
| Abdomen 2 views (74019) |
$350.25 |
$467 |
3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,595.25 |
$2,127 |
4.2× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$684 |
$912 |
0.6× |
| Angio internal mammary (75756) |
$3,903 |
$5,204 |
1.3× |
| Angio pulmonary bilat (75743) |
$5,315.25 |
$7,087 |
1.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,400.75 |
$7,201 |
1.8× |
| Angiography extremity bilateral rs&i (75716) |
$4,638 |
$6,184 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$4,126.50 |
$5,502 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,963 |
$5,284 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,405 |
$4,540 |
1.1× |
| Ankle 2 views (73600) |
$353.25 |
$471 |
4.3× |
| Aortography thoracic serialography rs&i (75605) |
$4,294.50 |
$5,726 |
0.8× |
| Artery X-Rays Abdomen (75726) |
$4,294.50 |
$5,726 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$5,144.25 |
$6,859 |
1.7× |
| Artery X-Rays Pelvis (75736) |
$4,294.50 |
$5,726 |
0.8× |
| Artery X-Rays Spine (75705) |
$4,294.50 |
$5,726 |
0.8× |
| Arthrogram hip (73525) |
$1,150.50 |
$1,534 |
3.5× |
| Arthrogram Wrist (73115) |
$417.75 |
$557 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$949.50 |
$1,266 |
7.5× |
| Bone age studies (77072) |
$442.50 |
$590 |
4.5× |
| Bone Imaging 3 Phase (78315) |
$2,005.50 |
$2,674 |
5.3× |
| Bone Imaging Whole Body (78306) |
$1,896.75 |
$2,529 |
5.0× |
| Bone survey infant (77076) |
$403.50 |
$538 |
4.1× |
| Brachytx isodose complex (77318) |
$1,764 |
$2,352 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,323.75 |
$1,765 |
3.7× |
| Brachytx Isodose Plan Simple (77316) |
$719.25 |
$959 |
2.0× |
| Brain Flow Imaging Only (78610) |
$453.75 |
$605 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,834.50 |
$6,446 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,282.75 |
$4,377 |
9.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$3,313.50 |
$4,418 |
4.5× |
| Cat Scan Follow-Up Study (76380) |
$630.75 |
$841 |
7.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,215.75 |
$1,621 |
2.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,861.50 |
$2,482 |
3.6× |
| Chest 1 view (71045) |
$251.25 |
$335 |
3.1× |
| Chest 2 views (71046) |
$293.25 |
$391 |
3.6× |
| Chest 3 views (71047) |
$394.50 |
$526 |
4.8× |
| Chest 4 or more views (71048) |
$401.25 |
$535 |
4.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$132.75 |
$177 |
1.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$478.50 |
$638 |
4.8× |
| Clavicle complete (73000) |
$357.75 |
$477 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$148.50 |
$198 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$853.50 |
$1,138 |
6.7× |
| Contrast Exam Abdominl Aorta (75625) |
$3,521.25 |
$4,695 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$726 |
$968 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$994.50 |
$1,326 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,555.25 |
$3,407 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,412.75 |
$3,217 |
10.7× |
| CT abdomen w contrast (74160) |
$1,925.25 |
$2,567 |
11.6× |
| CT abdomen w wo contrast (74170) |
$2,010 |
$2,680 |
12.1× |
| CT abdomen w/o contrast (74150) |
$1,689.75 |
$2,253 |
17.1× |
| CT Angio Abdomen and Pelvis (74174) |
$2,904 |
$3,872 |
8.8× |
| CT Angio Chest (71275) |
$2,397.75 |
$3,197 |
14.4× |
| CT Angio Head (70496) |
$2,493.75 |
$3,325 |
15.0× |
| CT angio hrt w/3d image (75574) |
$2,499.75 |
$3,333 |
7.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,772.25 |
$2,363 |
10.7× |
| CT Angio Neck (70498) |
$2,215.50 |
$2,954 |
13.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,621.50 |
$2,162 |
9.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$725.25 |
$967 |
4.4× |
| CT cervical spine w/ contrast (72126) |
$1,701 |
$2,268 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,539.75 |
$2,053 |
15.6× |
| CT chest w contrast (71260) |
$1,714.50 |
$2,286 |
10.3× |
| CT chest w/wo contrast (71270) |
$1,794 |
$2,392 |
10.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,139 |
$2,852 |
21.6× |
| CT head/brain with contrast (70460) |
$1,467.75 |
$1,957 |
8.8× |
| CT head/brain without and with contrast (70470) |
$1,599 |
$2,132 |
9.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,827.50 |
$3,770 |
8.6× |
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines |
$97.50–$3,018 |
$130–$4,024 |
varies |
| CT hrt w/3d image congen (75573) |
$2,646 |
$3,528 |
8.0× |
| CT iac w contrast (70481) |
$1,458.75 |
$1,945 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$2,005.50 |
$2,674 |
12.1× |
| CT lower ext w/o (73700) |
$1,346.25 |
$1,795 |
13.6× |
| CT lower extremity w/contrast material (73701) |
$1,522.50 |
$2,030 |
9.2× |
| CT lumbar spine w contrast (72132) |
$1,794 |
$2,392 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$1,701.75 |
$2,269 |
17.2× |
| CT maxillofacial w contrast (70487) |
$1,491 |
$1,988 |
9.0× |
| CT maxillofacial wo contrast (70486) |
$1,279.50 |
$1,706 |
12.9× |
| CT neck tissue combo (70492) |
$1,720.50 |
$2,294 |
10.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,629.75 |
$2,173 |
9.8× |
| CT orbits w/o contrast (70480) |
$1,373.25 |
$1,831 |
13.9× |
| CT pelvis w&w/o contrast (72194) |
$1,846.50 |
$2,462 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,366.50 |
$1,822 |
13.8× |
| CT scan of leg combo (73702) |
$1,587 |
$2,116 |
9.6× |
| CT scans face/jaw combo (70488) |
$1,545 |
$2,060 |
9.3× |
| CT soft tissue neck w contrast (70491) |
$1,697.25 |
$2,263 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,363.50 |
$1,818 |
13.8× |
| CT thoracic spine w contrast (72129) |
$1,701 |
$2,268 |
10.3× |
| CT thoracic spine w/o contrast (72128) |
$1,437.75 |
$1,917 |
14.5× |
| CT thoracic spine w/wo cont (72130) |
$2,005.50 |
$2,674 |
12.1× |
| CT thorax w/o contrast (71250) |
$1,692.75 |
$2,257 |
17.1× |
| CT unlisted procedure (76497) |
$1,578.75 |
$2,105 |
19.2× |
| CT upper ext wo (73200) |
$1,445.25 |
$1,927 |
14.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,182.50 |
$2,910 |
13.2× |
| CT upper extremity with contrast (73201) |
$1,583.25 |
$2,111 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,667.75 |
$3,557 |
16.1× |
| Cta Abdomen (74175) |
$2,401.50 |
$3,202 |
14.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,493.75 |
$3,325 |
7.6× |
| CTA pelvis (72191) |
$2,373.75 |
$3,165 |
14.3× |
| Dilation ureters/urethra rs&i (74485) |
$1,712.25 |
$2,283 |
0.9× |
| Discography Cerv/Thor Spine (72285) |
$2,840.25 |
$3,787 |
1.5× |
| Diskography lumbar (72295) |
$2,909.25 |
$3,879 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$416.25 |
$555 |
4.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$651 |
$868 |
6.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$645.75 |
$861 |
6.5× |
| Dxa Bone Density Axial (77080) |
$591 |
$788 |
6.0× |
| Dxa bone density study (77085) |
$591.75 |
$789 |
6.0× |
| Echo exam of fetal heart (76825) |
$561 |
$748 |
1.1× |
| Echo exam uterus (76831) |
$788.25 |
$1,051 |
3.5× |
| Echo Guide For Artery Repair (76936) |
$2,065.50 |
$2,754 |
10.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$543 |
$724 |
2.4× |
| Echograp Trans R Pros Study (76873) |
$1,309.50 |
$1,746 |
13.2× |
| Esophagram (74220) |
$691.50 |
$922 |
4.2× |
| Fetal Biophys Profile W/Nst (76818) |
$1,002 |
$1,336 |
10.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$771.75 |
$1,029 |
7.8× |
| Fluoroscopy up to 1 hr (76000) |
$977.25 |
$1,303 |
4.3× |
| Follow-Up Angiography (75898) |
$2,489.25 |
$3,319 |
0.8× |
| Foot 2 views (73620) |
$353.25 |
$471 |
4.3× |
| Forearm 2 views (73090) |
$320.25 |
$427 |
3.9× |
| Gastric emptying imaging study (78264) |
$1,799.25 |
$2,399 |
4.8× |
| Gastroesophageal Reflux Exam (78262) |
$1,232.25 |
$1,643 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,923 |
$2,564 |
5.1× |
| Hand 2 views (73120) |
$322.50 |
$430 |
3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$14,353.50 |
$19,138 |
21.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$9,045 |
$12,060 |
13.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$6,353.25 |
$8,471 |
9.6× |
| Heart Image (Pet) Multiple (78492) |
$6,250.50 |
$8,334 |
4.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,020.25 |
$4,027 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,850 |
$3,800 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,885.50 |
$2,514 |
3.7× |
| Hepatobiliary System Imaging (78226) |
$1,587 |
$2,116 |
4.2× |
| Ht Musc Image Planar Mult (78454) |
$5,794.50 |
$7,726 |
4.7× |
| Ht Muscle Image Spect Sing (78451) |
$3,945.75 |
$5,261 |
3.2× |
| Hysterosalpingogram (74740) |
$940.50 |
$1,254 |
4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$440.25 |
$587 |
5.3× |
| Infant hip ultrasound, limited static exam (76886) |
$360 |
$480 |
4.4× |
| Interstitial radiation source applic complex (77778) |
$9,868.50 |
$13,158 |
15.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,053 |
$5,404 |
6.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,747.25 |
$3,663 |
5.3× |
| Intracavitary radiation source applic simple (77761) |
$1,353.75 |
$1,805 |
2.6× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$9,192 |
$12,256 |
1.3× |
| Joint Survey Single View (77077) |
$423.75 |
$565 |
4.3× |
| K Flow/Funct Image W/Drug (78708) |
$1,606.50 |
$2,142 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,565.25 |
$2,087 |
3.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,133.25 |
$1,511 |
3.0× |
| Kidney Imaging Morphol (78700) |
$1,113 |
$1,484 |
2.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,419.75 |
$1,893 |
3.8× |
| Knee 3 Views (73562) |
$332.25 |
$443 |
4.0× |
| Liver & Spleen Imaging Static Only (78215) |
$1,494.75 |
$1,993 |
4.0× |
| Liver imaging static only (78201) |
$1,241.25 |
$1,655 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,078.25 |
$2,771 |
4.0× |
| Lung perfusion differential (78597) |
$1,440 |
$1,920 |
3.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,110.50 |
$2,814 |
4.1× |
| Lung Ventilation Imaging (78579) |
$478.50 |
$638 |
1.3× |
| Lymph System Imaging (78195) |
$1,683.75 |
$2,245 |
3.3× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,379 |
$3,172 |
4.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,179.50 |
$2,906 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,489.25 |
$3,319 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$2,073 |
$2,764 |
9.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$3,105.75 |
$4,141 |
18.7× |
| Magnetic Resonance Elastography (76391) |
$284.25 |
$379 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$762 |
$1,016 |
3.4× |
| Mammary ductogram or galactogram single (77053) |
$691.50 |
$922 |
3.1× |
| Meckels Divert Exam (78290) |
$1,422.75 |
$1,897 |
3.8× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$621 |
$828 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,016 |
$2,688 |
5.7× |
| Mr safety determination physician/other qhp (76016) |
$102.75 |
$137 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$40 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$108 |
$144 |
1.2× |
| Mr safety implt pos&/immoblj (76019) |
$70.50 |
$94 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$283.50 |
$378 |
1.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,393.25 |
$3,191 |
7.3× |
| MRA head w/o contrast (70544) |
$1,984.50 |
$2,646 |
8.8× |
| MRA head with contrast (70545) |
$2,085 |
$2,780 |
6.3× |
| MRA neck w contrast (70548) |
$2,048.25 |
$2,731 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,235 |
$2,980 |
6.8× |
| MRA neck w/o contrast (70547) |
$1,918.50 |
$2,558 |
8.5× |
| MRI abdomen w contrast (74182) |
$2,739 |
$3,652 |
8.3× |
| MRI abdomen w/o contrast (74181) |
$2,548.50 |
$3,398 |
11.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,701.50 |
$3,602 |
3.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,928.75 |
$3,905 |
8.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,438.25 |
$3,251 |
3.3× |
| MRI brain functional w/o physician admnistration (70554) |
$2,503.50 |
$3,338 |
11.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$262.50 |
$350 |
1.2× |
| MRI cardiac w/o cont stress (75559) |
$4,734 |
$6,312 |
9.2× |
| MRI cardiac w/o contrast (75557) |
$2,209.50 |
$2,946 |
9.8× |
| MRI cervical spine w contrast (72142) |
$2,644.50 |
$3,526 |
8.0× |
| MRI cervical spine w/o cont (72141) |
$2,152.50 |
$2,870 |
9.5× |
| MRI chest w/o contrast (71550) |
$2,026.50 |
$2,702 |
9.0× |
| MRI chest with contrast (71551) |
$2,580 |
$3,440 |
3.5× |
| MRI chest wo w contrast (71552) |
$3,008.25 |
$4,011 |
9.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,517.75 |
$3,357 |
7.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,928.75 |
$3,905 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,370.75 |
$3,161 |
10.5× |
| MRI lumbar spine w contrast (72149) |
$2,721.75 |
$3,629 |
8.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,886.75 |
$3,849 |
8.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,100 |
$2,800 |
9.3× |
| MRI orbit face neck w contrast (70542) |
$2,043 |
$2,724 |
6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,430.75 |
$3,241 |
7.4× |
| MRI pelvis w contrast (72196) |
$2,644.50 |
$3,526 |
8.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,886.75 |
$3,849 |
8.7× |
| MRI pelvis w/o contrast (72195) |
$2,475 |
$3,300 |
11.0× |
| MRI spectroscopy (76390) |
$1,794 |
$2,392 |
21.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,265 |
$3,020 |
10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,302.50 |
$3,070 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,086.50 |
$2,782 |
9.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,928.75 |
$3,905 |
8.9× |
| MRI, abdomen, combo (74183) |
$2,929.50 |
$3,906 |
8.9× |
| MRI, dorsal spine combo (72157) |
$2,886.75 |
$3,849 |
8.7× |
| MRI, dorsal spine contrast (72147) |
$2,721.75 |
$3,629 |
8.2× |
| MRI, joint upper extrem (73221) |
$2,370.75 |
$3,161 |
10.5× |
| MRI, joint upper extrem combo (73223) |
$2,928.75 |
$3,905 |
8.9× |
| MRI, lumbar spine combo (72158) |
$2,886.75 |
$3,849 |
8.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,281.75 |
$5,709 |
3.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,952.50 |
$5,270 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,776.50 |
$7,702 |
4.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$4,738.50 |
$6,318 |
3.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,251.50 |
$3,002 |
1.6× |
| N-invas est c ffr sw aly CTA (75580) |
$2,020.50 |
$2,694 |
2.5× |
| Neck soft tissue (70360) |
$350.25 |
$467 |
4.3× |
| Nm csf leak detection (78650) |
$1,645.50 |
$2,194 |
1.3× |
| Nm myocard infarct spect (78469) |
$842.25 |
$1,123 |
1.6× |
| Nonvascular Shunt X-Ray (75809) |
$467.25 |
$623 |
4.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,010 |
$14,680 |
8.4× |
| Nuclear Rx Intra-Arterial (79445) |
$1,280.25 |
$1,707 |
5.8× |
Nuclear Rx Oral Admin (79005)
range across 2 matching MRF lines |
$288.75–$1,642.50 |
$385–$2,190 |
varies |
| Ob us nuchal meas 1 gest (76813) |
$660 |
$880 |
6.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$404.25 |
$539 |
4.1× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$127.50 |
$170 |
1.3× |
| Optic foramina (70190) |
$426.75 |
$569 |
5.2× |
| Panoramic X-ray of jaws (70355) |
$270 |
$360 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,870.50 |
$2,494 |
3.6× |
| Parathyroid Planar Imaging (78070) |
$1,436.25 |
$1,915 |
3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,792.50 |
$2,390 |
4.7× |
| Pelvis 1 or 2 views (72170) |
$288.75 |
$385 |
2.9× |
| Pet Image Skull-Thigh (78812) |
$5,066.25 |
$6,755 |
3.7× |
| Pet Image W/Ct Lmtd (78814) |
$4,332.75 |
$5,777 |
3.2× |
| PET image w/CT, full body (78816) |
$4,854.75 |
$6,473 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,854.75 |
$6,473 |
3.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,854.75 |
$6,473 |
4.0× |
| Pet Myocardial Sngl Study (78491) |
$4,204.50 |
$5,606 |
3.1× |
| PET whole body (78813) |
$5,198.25 |
$6,931 |
3.8× |
| Proton trmt simple w/comp (77522) |
$4,263.75 |
$5,685 |
3.6× |
| Proton tx delivery complex (77525) |
$7,211.25 |
$9,615 |
6.1× |
| Proton tx delivery intermediate (77523) |
$6,201 |
$8,268 |
5.2× |
| Proton tx delivery simple w/o compensation (77520) |
$3,010.50 |
$4,014 |
5.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,413.25 |
$4,551 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,440 |
$1,920 |
3.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$2,019.75 |
$2,693 |
2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$471.75 |
$629 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$746.25 |
$995 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$393 |
$524 |
4.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$345 |
$460 |
4.2× |
| Radex elbow complete minimum 3 views (73080) |
$393 |
$524 |
4.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$489.75 |
$653 |
5.0× |
| Radex fingr minimum 2 views (73140) |
$272.25 |
$363 |
3.3× |
| Radex foot complete minimum 3 views (73630) |
$452.25 |
$603 |
5.5× |
| Radex Hand Minimum 3 Views (73130) |
$333.75 |
$445 |
4.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$292.50 |
$390 |
3.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$524.25 |
$699 |
5.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$367.50 |
$490 |
4.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$384.75 |
$513 |
4.7× |
| Radex shoulder complete minimum 2 views (73030) |
$394.50 |
$526 |
4.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$387 |
$516 |
4.7× |
| Radex Spine 1 View Specify Level (72020) |
$291 |
$388 |
3.5× |
| Radex Sternum Minimum 2 Views (71120) |
$398.25 |
$531 |
4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$546 |
$728 |
6.6× |
| Radex Toe Minimum 2 Views (73660) |
$272.25 |
$363 |
3.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$345 |
$460 |
3.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$413.25 |
$551 |
5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$279.75 |
$373 |
2.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$27,275.25 |
$36,367 |
3.9× |
| Radiation treatment delivery level 1 (77402) |
$828 |
$1,104 |
8.6× |
| Radiation treatment delivery level 2 (77407) |
$953.25 |
$1,271 |
2.6× |
| Radiation treatment delivery level 3 (77412) |
$1,326.75 |
$1,769 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$421.50 |
$562 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$366.75 |
$489 |
3.7× |
| Radiologic exam colon double contrast study (74280) |
$966 |
$1,288 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$726.75 |
$969 |
4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$759 |
$1,012 |
4.6× |
| Radiologic exam knee complete 4/more views (73564) |
$414.75 |
$553 |
4.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$404.25 |
$539 |
4.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$561.75 |
$749 |
3.4× |
| Radiologic exam swallow function contrast study (74230) |
$582 |
$776 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$675.75 |
$901 |
4.1× |
| Radiologic examination femur 1 view (73551) |
$344.25 |
$459 |
4.2× |
| Radiologic examination femur minimum 2 views (73552) |
$368.25 |
$491 |
4.5× |
| Radiologic examination knee 1/2 views (73560) |
$321 |
$428 |
3.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$619.50 |
$826 |
6.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$355.50 |
$474 |
4.3× |
| Radiopharm Dacryocystography (78660) |
$914.25 |
$1,219 |
2.4× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$288.75 |
$385 |
1.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,755 |
$2,340 |
8.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$311.25 |
$415 |
0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$311.25 |
$415 |
0.9× |
| Ribs bilateral 3 views (71110) |
$552.75 |
$737 |
5.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,992.50 |
$3,990 |
5.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,286 |
$3,048 |
4.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,109 |
$2,812 |
4.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,531.25 |
$3,375 |
2.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,514.25 |
$2,019 |
6.9× |
| Salivary Gland Imaging (78230) |
$569.25 |
$759 |
1.5× |
| Scapula (73010) |
$287.25 |
$383 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$83.25 |
$111 |
3.6× |
| Shoulder 1 view (73020) |
$234.75 |
$313 |
2.9× |
| Shoulder Arthrography (73040) |
$895.50 |
$1,194 |
2.7× |
| Skull less than 4 views (70250) |
$428.25 |
$571 |
4.3× |
| Special dosimetry (77331) |
$510 |
$680 |
4.0× |
| Special Physics Consult (77370) |
$1,302 |
$1,736 |
10.2× |
| Special teletherapy port plan (77321) |
$2,196.75 |
$2,929 |
6.2× |
| Special treatment procedure (77470) |
$6,062.25 |
$8,083 |
11.6× |
| Speech evaluation, complex (70371) |
$1,068.75 |
$1,425 |
4.7× |
| Spleen Imaging (78185) |
$469.50 |
$626 |
1.2× |
| Srs Multisource (77371) |
$56,151 |
$74,868 |
8.1× |
| Stereotactic Body Radiation Delivery (77373) |
$8,423.25 |
$11,231 |
5.0× |
| Sternoclavicular joints (71130) |
$405 |
$540 |
4.9× |
| Superior sagittal sinus venogram (75870) |
$3,800.25 |
$5,067 |
1.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$3,790.50 |
$5,054 |
39.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,168 |
$4,224 |
8.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$949.50 |
$1,266 |
2.7× |
| Testicular Imaging W/Flow (78761) |
$1,132.50 |
$1,510 |
3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,862 |
$3,816 |
8.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,772 |
$3,696 |
7.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,714.50 |
$2,286 |
13.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$208.50 |
$278 |
1.3× |
| Thoracic spine 2 views (72070) |
$342.75 |
$457 |
3.5× |
| Thoracic spine 3 views (72072) |
$468 |
$624 |
4.7× |
| Thoracolumbar 2 views (72080) |
$342.75 |
$457 |
4.2× |
| Thyroid Met Imaging Body (78018) |
$2,016 |
$2,688 |
3.9× |
| Thyroid Uptake Measurement (78012) |
$738 |
$984 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,259.25 |
$1,679 |
3.3× |
| Tx Devices Design & Construction Complex (77334) |
$2,224.50 |
$2,966 |
6.3× |
| Tx devices design & construction intermediate (77333) |
$1,484.25 |
$1,979 |
11.7× |
| Tx devices design & construction simple (77332) |
$877.50 |
$1,170 |
6.9× |
| Ultrasound Breast Limited (76642) |
$540 |
$720 |
6.6× |
| Ultrasound elastography first target lesion (76982) |
$252 |
$336 |
2.5× |
| Ultrasound Elastography Parenchyma (76981) |
$262.50 |
$350 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$532.50 |
$710 |
5.4× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$303 |
$404 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$752.25 |
$1,003 |
7.6× |
| Umbilical-artery Doppler (OB) (76820) |
$561 |
$748 |
5.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$564.75 |
$753 |
6.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,616.25 |
$2,155 |
19.6× |
Unlisted us procedure (76999)
range across 2 matching MRF lines |
$460.50–$612.75 |
$614–$817 |
varies |
| Upper gi w/o kub (74240) |
$561.75 |
$749 |
3.4× |
| Ureteral Reflux Study (78740) |
$1,253.25 |
$1,671 |
3.3× |
| Urethrocystogram voiding (74455) |
$835.50 |
$1,114 |
3.7× |
| Urethrocystography retrograde (74450) |
$816 |
$1,088 |
3.6× |
| Us breast unilateral complete (76641) |
$734.25 |
$979 |
7.4× |
| Us chest (76604) |
$654.75 |
$873 |
6.6× |
| Us complete joint (76881) |
$881.25 |
$1,175 |
8.9× |
| Us exam, pelvic, limited (76857) |
$567 |
$756 |
5.7× |
| Us head (76506) |
$584.25 |
$779 |
5.9× |
| Us kidney transplant (76776) |
$804 |
$1,072 |
8.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$565.50 |
$754 |
5.7× |
| Us ob detailed single fetus (76811) |
$1,159.50 |
$1,546 |
5.1× |
| Us ob limited 1 or more fetuses (76815) |
$752.25 |
$1,003 |
7.6× |
| Us ob transvaginal (76817) |
$803.25 |
$1,071 |
8.1× |
| Us pelvic non ob complete (76856) |
$777 |
$1,036 |
7.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$840 |
$1,120 |
8.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$513.75 |
$685 |
5.2× |
| Us retroperitoneal complete (76770) |
$1,104 |
$1,472 |
11.2× |
| Us retroperitoneal limited (76775) |
$532.50 |
$710 |
5.4× |
| Us scrotum and contents (76870) |
$735.75 |
$981 |
7.4× |
| Us spinal canal and contents (76800) |
$1,079.25 |
$1,439 |
10.9× |
| Us thyroid (76536) |
$798.75 |
$1,065 |
8.1× |
| Us transrectal (76872) |
$954.75 |
$1,273 |
9.7× |
| Vascular Flow Imaging (78445) |
$845.25 |
$1,127 |
2.2× |
| Vein X-Ray Chest (75827) |
$3,366 |
$4,488 |
2.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,827.75 |
$2,437 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$1,424.25 |
$1,899 |
2.4× |
| Vein X-Ray Spleen/Liver (75810) |
$3,682.50 |
$4,910 |
1.2× |
| Venogram Sinus/Jugular (75860) |
$2,489.25 |
$3,319 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$2,489.25 |
$3,319 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,524.25 |
$4,699 |
1.2× |
| Venography extremity bilateral rs&i (75822) |
$1,962 |
$2,616 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,630.50 |
$2,174 |
1.1× |
| Venography Orbital Rs&I (75880) |
$1,475.25 |
$1,967 |
2.5× |
| Venography Renal Bilateral (75833) |
$3,402 |
$4,536 |
1.1× |
| Venography Renal Unilateral (75831) |
$2,489.25 |
$3,319 |
0.8× |
| Venous sampling by catheter (75893) |
$2,690.25 |
$3,587 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$616.50 |
$822 |
7.5× |
| Wrist 2 views (73100) |
$354 |
$472 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$394.50 |
$526 |
4.8× |
| X-ray antegrade pyelogram tube (74425) |
$1,129.50 |
$1,506 |
3.4× |
| X-Ray Aorta Leg Arteries (75630) |
$5,406 |
$7,208 |
1.8× |
| X-Ray Bend Only L-S Spine (72120) |
$414.75 |
$553 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$312 |
$416 |
3.8× |
| X-Ray Exam Breast Specimen (76098) |
$451.50 |
$602 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$291 |
$388 |
3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$291 |
$388 |
2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$291 |
$388 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$345 |
$460 |
4.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$387.75 |
$517 |
4.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$604.50 |
$806 |
6.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$535.50 |
$714 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$540.75 |
$721 |
5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$564.75 |
$753 |
5.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$666.75 |
$889 |
6.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$342.75 |
$457 |
4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$561.75 |
$749 |
5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$422.25 |
$563 |
4.3× |
| X-ray humerus (73060) |
$399 |
$532 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$252.75 |
$337 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$331.50 |
$442 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$346.50 |
$462 |
3.5× |
| X-ray nose-rectum child f.b. (76010) |
$319.50 |
$426 |
3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$597.75 |
$797 |
6.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$459.75 |
$613 |
4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231.75 |
$309 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$459.75 |
$613 |
5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$640.50 |
$854 |
6.5× |
| X-ray thoracic spine 4 vw (72074) |
$480 |
$640 |
4.9× |
| X-Ray Tmj Unilat (70328) |
$372.75 |
$497 |
4.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$850.50 |
$1,134 |
2.6× |
| X-Rays Bone Length Studies (77073) |
$374.25 |
$499 |
3.8× |
| X-Rays Bone Survey Complete (77075) |
$836.25 |
$1,115 |
8.5× |
| Xr c-spine 4 or 5 views (72050) |
$489.75 |
$653 |
5.0× |
| Xr facial bones less than 3 views (70140) |
$450 |
$600 |
5.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$374.25 |
$499 |
3.8× |
| Xr orbits complete 4 views (70200) |
$577.50 |
$770 |
5.8× |
| Xr Tomogram Single Plane (76100) |
$1,032.75 |
$1,377 |
10.4× |