| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,470.40 |
$10,784 |
4.7× |
| Abdomen 2 views (74019) |
$621 |
$1,035 |
5.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,663.80 |
$2,773 |
4.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,789.60 |
$11,316 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$5,643.60 |
$9,406 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$4,379.40 |
$7,299 |
1.4× |
| Angiography internal mammary rs&i (75756) |
$7,256.40 |
$12,094 |
2.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,319.80 |
$5,533 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,643.60 |
$9,406 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,571.40 |
$7,619 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$3,306 |
$5,510 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,319.80 |
$5,533 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,720.20 |
$2,867 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,789.60 |
$11,316 |
2.1× |
| Ankle 2 views (73600) |
$441 |
$735 |
5.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$958.20 |
$1,597 |
2.7× |
| Aortogram thoracic (75605) |
$4,461 |
$7,435 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,643.60 |
$9,406 |
1.8× |
| Aortography abdominal serialography rs&i (75625) |
$3,019.80 |
$5,033 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,261.40 |
$3,769 |
0.7× |
| Arthrogram hip (73525) |
$1,178.40 |
$1,964 |
3.4× |
| Arthrogram shoulder (73040) |
$747 |
$1,245 |
2.1× |
| Arthrography knee lt (73580) |
$997.20 |
$1,662 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$961.80 |
$1,603 |
7.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,441.80 |
$2,403 |
3.6× |
| Bone &/joint imaging whole body (78306) |
$1,872.60 |
$3,121 |
4.7× |
| Bone age studies (77072) |
$263.40 |
$439 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$2,195.40 |
$3,659 |
5.5× |
| Bone survey complete (77075) |
$2,342.40 |
$3,904 |
22.4× |
| Brachytx isodose complex (77318) |
$3,636 |
$6,060 |
9.7× |
| Brachytx isodose intermed (77317) |
$3,226.20 |
$5,377 |
8.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,449.20 |
$4,082 |
6.5× |
| Brain image w/flow 4 + views (78606) |
$1,311 |
$2,185 |
2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,373.40 |
$7,289 |
3.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$879 |
$1,465 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,470.80 |
$4,118 |
7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,002.60 |
$1,671 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$472.20 |
$787 |
5.4× |
| Chest 1 view (71045) |
$490.20 |
$817 |
5.6× |
| Chest 3 views (71047) |
$859.20 |
$1,432 |
9.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$925.80 |
$1,543 |
5.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,208.40 |
$2,014 |
1.5× |
| Clavicle complete (73000) |
$596.40 |
$994 |
6.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$144 |
$240 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,477.20 |
$2,462 |
11.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,888.60 |
$6,481 |
11.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,812.80 |
$4,688 |
11.8× |
| CT abdomen w contrast (74160) |
$1,854.60 |
$3,091 |
10.6× |
| CT abdomen w wo contrast (74170) |
$2,097 |
$3,495 |
11.9× |
| CT abdomen w/o contrast (74150) |
$1,737 |
$2,895 |
16.6× |
| CT angio hrt w/3d image (75574) |
$1,004.40 |
$1,674 |
2.9× |
| CT angiography upper extremity lt (73206) |
$2,046 |
$3,410 |
11.6× |
| CT c-spine w/o contrast (72125) |
$1,911 |
$3,185 |
18.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,046 |
$3,410 |
11.6× |
| CT cervical spine with contrast (72126) |
$1,940.40 |
$3,234 |
5.6× |
| CT chest w/wo contrast (71270) |
$2,097 |
$3,495 |
11.9× |
| CT chest with contrast (71260) |
$1,917.60 |
$3,196 |
10.9× |
| CT head/brain with contrast (70460) |
$2,134.20 |
$3,557 |
12.1× |
| CT head/brain without and with contrast (70470) |
$2,148 |
$3,580 |
12.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$965.40 |
$1,609 |
2.8× |
| CT hrt w/3d image congen (75573) |
$984.60 |
$1,641 |
2.8× |
| CT iac w contrast (70481) |
$2,134.20 |
$3,557 |
12.1× |
| CT limited/localized follow up study (76380) |
$1,394.40 |
$2,324 |
16.0× |
| CT lower ext w/o (73700) |
$2,382 |
$3,970 |
22.7× |
| CT lower extremity w wo contrast (73702) |
$2,562.60 |
$4,271 |
14.6× |
| CT lower extremity with contrast (73701) |
$2,495.40 |
$4,159 |
14.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,046 |
$3,410 |
11.6× |
| CT lumbar spine w/o contrast (72131) |
$1,911 |
$3,185 |
18.3× |
| CT lumbar spine with contrast (72132) |
$1,940.40 |
$3,234 |
5.6× |
| CT maxillofacial w contrast (70487) |
$2,134.20 |
$3,557 |
12.1× |
| CT maxillofacial w/o contrast (70486) |
$1,911 |
$3,185 |
18.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,241 |
$3,735 |
12.8× |
| CT neck soft tissue w contrast (70491) |
$1,621.20 |
$2,702 |
9.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,241 |
$3,735 |
12.8× |
| CT orbits w/o contrast (70480) |
$1,754.40 |
$2,924 |
16.8× |
| CT pelvis w & w/o contrast (72194) |
$1,860 |
$3,100 |
10.6× |
| CT pelvis w/o contrast (72192) |
$1,571.40 |
$2,619 |
15.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,962.60 |
$3,271 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,394.40 |
$2,324 |
13.3× |
| CT thoracic spine w/contrast (72129) |
$1,940.40 |
$3,234 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,911 |
$3,185 |
18.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,097 |
$3,495 |
11.9× |
| CT thorax w/o contrast (71250) |
$1,893 |
$3,155 |
18.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,723.80 |
$2,873 |
9.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,563.60 |
$2,606 |
14.9× |
| CT upper extremity with contrast (73201) |
$1,641.60 |
$2,736 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,042.40 |
$3,404 |
11.6× |
| Cta Abdomen (74175) |
$2,046 |
$3,410 |
11.6× |
| CTA abdomen pelvis (74174) |
$4,093.20 |
$6,822 |
11.7× |
| CTA chest (71275) |
$2,320.80 |
$3,868 |
13.2× |
| Cta Head (70496) |
$2,255.40 |
$3,759 |
12.8× |
| CTA lwr ext w&w/o contrast (73706) |
$2,691 |
$4,485 |
15.3× |
| Cta Neck (70498) |
$2,046 |
$3,410 |
11.6× |
| Cta Pelvis (72191) |
$2,046 |
$3,410 |
11.6× |
| Cystography minimum 3 views rs&i (74430) |
$851.40 |
$1,419 |
2.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$768.60 |
$1,281 |
7.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,198.80 |
$1,998 |
11.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$349.80 |
$583 |
3.3× |
| Echo exam of fetal heart (76825) |
$1,175.40 |
$1,959 |
2.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$882.60 |
$1,471 |
3.7× |
| Echoencephalography real time imaging (76506) |
$843.60 |
$1,406 |
8.1× |
| Esophagus (74220) |
$516.60 |
$861 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$843 |
$1,405 |
8.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$550.20 |
$917 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$748.80 |
$1,248 |
3.1× |
| Foot 2 views (73620) |
$359.40 |
$599 |
4.1× |
| Forearm 2 views (73090) |
$433.20 |
$722 |
5.0× |
| Functional MRI brain by phys/psych (70555) |
$862.80 |
$1,438 |
3.6× |
| Functional MRI brain by tech (70554) |
$2,058.60 |
$3,431 |
8.6× |
| Gated Heart Planar Single (78472) |
$1,441.20 |
$2,402 |
3.6× |
| Hand 2 views (73120) |
$332.40 |
$554 |
3.2× |
| Hand 3 views (73130) |
$482.40 |
$804 |
5.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,775 |
$4,625 |
4.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,830.80 |
$4,718 |
4.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,887.20 |
$4,812 |
4.1× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$613.20 |
$1,022 |
1.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$613.20 |
$1,022 |
1.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,348.60 |
$5,581 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,970 |
$4,950 |
5.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,677.60 |
$2,796 |
4.2× |
| Ht muscle image spect sing (78451) |
$5,877 |
$9,795 |
4.5× |
| Humerus Min 2 Views Left (73060) |
$446.40 |
$744 |
5.1× |
| Hysterosalpingogram (74740) |
$997.20 |
$1,662 |
4.2× |
| Interstitial radiation source applic complex (77778) |
$14,374.80 |
$23,958 |
20.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$20,797.80 |
$34,663 |
29.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$20,389.80 |
$33,983 |
36.8× |
| Intracavitary radiation source applic simple (77761) |
$19,990.20 |
$33,317 |
36.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$879 |
$1,465 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,641.60 |
$2,736 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,150.80 |
$1,918 |
2.1× |
| Knee 3 views (73562) |
$472.80 |
$788 |
5.4× |
| Liver & spleen imaging static only (78215) |
$1,593.60 |
$2,656 |
4.0× |
| Liver imaging static only (78201) |
$1,149.60 |
$1,916 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$1,853.40 |
$3,089 |
3.4× |
| Lung perfusion differential (78597) |
$990 |
$1,650 |
2.5× |
| Lung Ventilation Imaging (78579) |
$971.40 |
$1,619 |
2.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$7,150.20 |
$11,917 |
2.3× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$4,335 |
$7,225 |
2.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,101.40 |
$5,169 |
1.0× |
| Lymphoscintigraphy (78195) |
$1,890 |
$3,150 |
3.5× |
| Mammary ductogram or galactogram single (77053) |
$353.40 |
$589 |
1.5× |
| Meckels Diverticulum (78290) |
$1,006.80 |
$1,678 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,170.60 |
$1,951 |
3.1× |
| Mr safety determination physician/other qhp (76016) |
$193.80 |
$323 |
2.2× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$315.60 |
$526 |
5.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$64.20 |
$107 |
2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$206.40 |
$344 |
2.2× |
| MRA head w & w/o contrast (70546) |
$3,276.60 |
$5,461 |
9.4× |
| MRA head w/o contrast (70544) |
$2,606.40 |
$4,344 |
10.9× |
| MRA head with contrast (70545) |
$2,795.40 |
$4,659 |
8.0× |
| MRA neck w contrast (70548) |
$2,346.60 |
$3,911 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,460.60 |
$4,101 |
7.0× |
| MRA neck w/o contrast (70547) |
$2,132.40 |
$3,554 |
8.9× |
| MRI abdomen w contrast (74182) |
$1,753.20 |
$2,922 |
5.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,007.80 |
$5,013 |
8.6× |
| MRI abdomen w/o contrast (74181) |
$1,669.80 |
$2,783 |
7.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,580 |
$4,300 |
3.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,462 |
$5,770 |
4.4× |
| MRI c-spine with contrast (72142) |
$2,091 |
$3,485 |
6.0× |
| MRI cardiac w/o cont stress (75559) |
$2,030.40 |
$3,384 |
3.7× |
| MRI cardiac w/o contrast (75557) |
$1,933.80 |
$3,223 |
8.1× |
| MRI cervical spine w/o contrast (72141) |
$1,943.40 |
$3,239 |
8.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,007.80 |
$5,013 |
8.6× |
| MRI chest w/o contrast (71550) |
$1,669.80 |
$2,783 |
7.0× |
| MRI fetal sngl/1st gestation (74712) |
$903 |
$1,505 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,816.80 |
$3,028 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,391.40 |
$2,319 |
5.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,460.60 |
$4,101 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,461 |
$2,435 |
4.2× |
| MRI pelvis w contrast (72196) |
$1,852.80 |
$3,088 |
5.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,007.80 |
$5,013 |
8.6× |
| MRI pelvis w/o contrast (72195) |
$2,040.60 |
$3,401 |
8.5× |
| MRI scan of arm joint before and after contrast (73223) |
$4,184.40 |
$6,974 |
12.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,553.60 |
$4,256 |
3.3× |
| MRI scan of leg joint before and after contrast (73723) |
$2,781.60 |
$4,636 |
8.0× |
| MRI spectroscopy (76390) |
$158.40 |
$264 |
1.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,605.20 |
$4,342 |
7.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,264.40 |
$3,774 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,007.80 |
$5,013 |
8.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,264.40 |
$3,774 |
6.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,007.80 |
$5,013 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,040.60 |
$3,401 |
8.5× |
| MRI tmj (70336) |
$1,852.80 |
$3,088 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,040.60 |
$3,401 |
8.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,007.80 |
$5,013 |
8.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,734 |
$2,890 |
7.3× |
| Myocardial Spect Multiple Studies (78452) |
$7,548 |
$12,580 |
5.8× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,451.20 |
$5,752 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,218 |
$7,030 |
2.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,943.60 |
$9,906 |
2.7× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$6,922.80 |
$11,538 |
3.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,585.60 |
$5,976 |
4.2× |
| Neck soft tissue (70360) |
$370.20 |
$617 |
4.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$918.60 |
$1,531 |
2.3× |
| Nm cisternogram (78630) |
$1,946.40 |
$3,244 |
3.6× |
| Nm gastric emptying study (78264) |
$1,934.40 |
$3,224 |
4.8× |
| Nm peritoneal-venous shunt patency (78291) |
$850.80 |
$1,418 |
2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$14,391.60 |
$23,986 |
10.4× |
| Nuclear Rx Oral Admin (79005) |
$1,637.40 |
$2,729 |
7.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$749.40 |
$1,249 |
7.2× |
| Orthopantogram (70355) |
$558 |
$930 |
6.4× |
| Osseous survey infant (77076) |
$377.40 |
$629 |
3.6× |
| Osseous survey limited (77074) |
$536.40 |
$894 |
5.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,611 |
$2,685 |
3.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,450.20 |
$2,417 |
3.6× |
| Parathyroid imaging (78070) |
$1,261.20 |
$2,102 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$472.80 |
$788 |
4.5× |
| Peritoneogram rs&i (74190) |
$751.80 |
$1,253 |
1.4× |
| PET image w/CT, skull-thigh (78815) |
$5,271 |
$8,785 |
3.7× |
| PET imaging CT for attenuation limited area (78814) |
$3,791.40 |
$6,319 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$5,522.40 |
$9,204 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,460.60 |
$4,101 |
7.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,452 |
$7,420 |
1.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,838.80 |
$6,398 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,195.80 |
$1,993 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,089.20 |
$3,482 |
3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$910.20 |
$1,517 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$193.80 |
$323 |
2.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$285.60 |
$476 |
2.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$250.80 |
$418 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$700.20 |
$1,167 |
6.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,138 |
$30,230 |
2.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,270.80 |
$2,118 |
2.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$487.20 |
$812 |
4.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$792.60 |
$1,321 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$418.80 |
$698 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$539.40 |
$899 |
6.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$652.20 |
$1,087 |
6.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$818.40 |
$1,364 |
9.4× |
| Radiologic exam colon single contrast study (74270) |
$1,219.20 |
$2,032 |
6.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$573.60 |
$956 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$808.80 |
$1,348 |
4.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$533.40 |
$889 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$222.60 |
$371 |
2.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,433.80 |
$5,723 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,173.60 |
$6,956 |
1.3× |
| Ribs bilateral 3 views (71110) |
$880.80 |
$1,468 |
8.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,700.60 |
$4,501 |
5.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,000.60 |
$5,001 |
5.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,723.60 |
$6,206 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,834.60 |
$6,391 |
2.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,650.40 |
$6,084 |
2.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,344.60 |
$2,241 |
5.8× |
| Rp Therapy Intravenous Administration (79101) |
$663.60 |
$1,106 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$357 |
$595 |
3.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$666.60 |
$1,111 |
2.8× |
| Scanogram (77073) |
$327.60 |
$546 |
3.1× |
| Scapula complete (73010) |
$435.60 |
$726 |
4.2× |
| Screening digital breast tomosynthesis (77063) |
$18 |
$30 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,597.20 |
$2,662 |
15.3× |
| Sialogram (70390) |
$1,383.60 |
$2,306 |
5.8× |
| Simulation intermediate (77285) |
$1,263 |
$2,105 |
3.4× |
| Small bowel series (74250) |
$946.80 |
$1,578 |
5.4× |
| Spec medical radj physics consltj (77370) |
$1,634.40 |
$2,724 |
12.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$3,412.80 |
$5,688 |
9.1× |
| Special treatment procedure (77470) |
$2,611.20 |
$4,352 |
4.7× |
| Spine thoracic 3 views (72072) |
$664.20 |
$1,107 |
6.3× |
| Splenoportograpy rs&i (75810) |
$3,139.20 |
$5,232 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$10,692.60 |
$17,821 |
6.0× |
| Superior sagittal sinus venogram (75870) |
$3,460.80 |
$5,768 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,847 |
$4,745 |
7.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,467.60 |
$2,446 |
3.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,188.80 |
$3,648 |
5.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$789 |
$1,315 |
5.9× |
| Thoracolumbar 2 views (72080) |
$614.40 |
$1,024 |
7.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,630.40 |
$4,384 |
4.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$893.40 |
$1,489 |
2.2× |
| Thyroid uptake measurement (78012) |
$768 |
$1,280 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,407 |
$2,345 |
3.5× |
| Tmj unilateral (70328) |
$199.80 |
$333 |
2.3× |
| Tomogram (76100) |
$1,223.40 |
$2,039 |
11.7× |
| Treatment devices simple (77332) |
$673.80 |
$1,123 |
5.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,024 |
$5,040 |
5.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$784.80 |
$1,308 |
2.0× |
| Tx devices design & construction complex (77334) |
$1,776.60 |
$2,961 |
4.7× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$473.40 |
$789 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$660.60 |
$1,101 |
6.3× |
| Umbilical-artery Doppler (OB) (76820) |
$376.80 |
$628 |
3.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$214.20 |
$357 |
2.5× |
| Unlisted fluoroscopic procedure (76496) |
$339.60 |
$566 |
3.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,115.10 |
$1,858.50 |
12.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$322.20 |
$537 |
3.2× |
| Unlisted Ultrasound Procedure (76999) |
$202.20 |
$337 |
2.3× |
| Upper Extremity Infant (73092) |
$234.60 |
$391 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,068.60 |
$1,781 |
4.5× |
| Urethrocystography voiding (74455) |
$1,167.60 |
$1,946 |
4.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,366.80 |
$2,278 |
7.8× |
| Us abdl aorta screen aaa (76706) |
$319.80 |
$533 |
3.1× |
| Us breast unilateral complete (76641) |
$329.40 |
$549 |
3.1× |
| Us breast unilateral limited (76642) |
$255.60 |
$426 |
2.9× |
| Us chest (76604) |
$724.80 |
$1,208 |
6.9× |
| Us compl joint r-t w/image documentation (76881) |
$1,070.40 |
$1,784 |
10.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$487.80 |
$813 |
4.7× |
| Us guided compression repair (76936) |
$936 |
$1,560 |
4.3× |
| Us infant hips dynamic (76885) |
$190.20 |
$317 |
2.2× |
| Us kidney transplant (76776) |
$1,050 |
$1,750 |
10.0× |
| Us ob detailed single fetus (76811) |
$885 |
$1,475 |
3.7× |
| Us ob transvaginal (76817) |
$972 |
$1,620 |
9.3× |
| Us pelvic non ob complete (76856) |
$1,075.20 |
$1,792 |
10.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$615 |
$1,025 |
5.9× |
| Us pregnancy ltd (76815) |
$378.60 |
$631 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$942 |
$1,570 |
9.0× |
| Us retroperitoneal complete (76770) |
$1,041 |
$1,735 |
9.9× |
| Us retroperitoneal limited (76775) |
$643.80 |
$1,073 |
6.1× |
| Us scrotum and contents (76870) |
$1,051.20 |
$1,752 |
10.0× |
| Us soft tissue head/neck (76536) |
$1,029 |
$1,715 |
9.8× |
| Us spinal canal and contents (76800) |
$433.80 |
$723 |
4.1× |
| Us transrectal (76872) |
$357 |
$595 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$1,035.60 |
$1,726 |
9.9× |
| Us, eye b-scan (76512) |
$295.20 |
$492 |
2.8× |
| Venogram extremity bilateral (75822) |
$1,445.40 |
$2,409 |
0.9× |
| Venogram orbital (75880) |
$1,854.60 |
$3,091 |
3.0× |
| Venography caval inferior serialography rs&i (75825) |
$5,123.40 |
$8,539 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$5,226 |
$8,710 |
3.3× |
| Venography extremity unilateral rs&i (75820) |
$1,398 |
$2,330 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,838.80 |
$6,398 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,275.40 |
$5,459 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,645 |
$6,075 |
1.2× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,306 |
$5,510 |
0.6× |
| Wrist 2 views (73100) |
$319.80 |
$533 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$757.20 |
$1,262 |
7.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$446.40 |
$744 |
5.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$635.40 |
$1,059 |
7.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,280.40 |
$2,134 |
7.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$348.60 |
$581 |
4.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$498.60 |
$831 |
5.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$666.60 |
$1,111 |
6.4× |
| X-ray exam hip uni 1 view (73501) |
$193.80 |
$323 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$211.80 |
$353 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$349.20 |
$582 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$349.20 |
$582 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$666.60 |
$1,111 |
6.4× |
| X-ray exam of femur 1 (73551) |
$211.80 |
$353 |
2.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$994.20 |
$1,657 |
5.7× |
| X-ray eye for foreign body (70030) |
$466.80 |
$778 |
5.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$625.80 |
$1,043 |
6.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$474.60 |
$791 |
5.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$466.80 |
$778 |
5.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,284.40 |
$5,474 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$396.60 |
$661 |
4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$397.20 |
$662 |
4.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$774.60 |
$1,291 |
7.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$495 |
$825 |
5.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$223.80 |
$373 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$502.80 |
$838 |
4.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$830.40 |
$1,384 |
7.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$211.80 |
$353 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$539.40 |
$899 |
6.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$195.60 |
$326 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$520.20 |
$867 |
5.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$612.60 |
$1,021 |
5.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$747 |
$1,245 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,302.60 |
$2,171 |
3.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$492 |
$820 |
5.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$861.60 |
$1,436 |
8.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$924.60 |
$1,541 |
8.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$429.60 |
$716 |
4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$435.60 |
$726 |
5.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$687.60 |
$1,146 |
7.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$515.40 |
$859 |
5.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$469.20 |
$782 |
5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$573.60 |
$956 |
5.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$414.60 |
$691 |
4.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$399 |
$665 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$483.60 |
$806 |
5.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$460.80 |
$768 |
5.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$442.80 |
$738 |
4.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$847.20 |
$1,412 |
8.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$366.60 |
$611 |
4.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$490.20 |
$817 |
5.6× |
| Xr c-spine 6 or more views (72052) |
$1,077 |
$1,795 |
10.3× |
| Xr chest 4+ views (71048) |
$902.40 |
$1,504 |
8.6× |
| Xr finger(s) 2+ views (73140) |
$375.60 |
$626 |
4.3× |
| Xr shoulder 1 view (73020) |
$418.80 |
$698 |
4.8× |
| Xr spine cervical 4 or 5 views (72050) |
$745.20 |
$1,242 |
7.1× |
| Xr tibia/fibula 2 views (73590) |
$439.20 |
$732 |
5.0× |
| Xr tmj bilateral (70330) |
$228 |
$380 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$407.40 |
$679 |
4.7× |