| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,427.20 |
$9,284 |
5.3× |
| Abdomen 1 View (74018) |
$395.20 |
$494 |
4.4× |
| Abdomen 2 views (74019) |
$400.80 |
$501 |
3.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,622.40 |
$2,028 |
4.0× |
| Angio internal mammary (75756) |
$4,090.40 |
$5,113 |
1.3× |
| Angio pulmonary bilat (75743) |
$5,523.20 |
$6,904 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$6,377.60 |
$7,972 |
2.0× |
| Angiography extremity unilateral rs&i (75710) |
$5,683.20 |
$7,104 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,423.20 |
$6,779 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,603.20 |
$4,504 |
1.1× |
| Ankle 2 views (73600) |
$297.60 |
$372 |
3.3× |
| Aortography thoracic serialography rs&i (75605) |
$5,828 |
$7,285 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,993.60 |
$6,242 |
1.5× |
| Artery X-Rays Abdomen (75726) |
$7,335.20 |
$9,169 |
1.3× |
| Artery X-Rays Pelvis (75736) |
$6,247.20 |
$7,809 |
1.1× |
| Artery X-Rays Spine (75705) |
$6,616 |
$8,270 |
1.2× |
| Arthrogram hip (73525) |
$1,340.80 |
$1,676 |
3.8× |
| Arthrogram Wrist (73115) |
$1,036 |
$1,295 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$778.40 |
$973 |
5.7× |
| Bone age studies (77072) |
$386.40 |
$483 |
3.6× |
| Bone Imaging 3 Phase (78315) |
$2,588.80 |
$3,236 |
6.3× |
| Bone Imaging Limited Area (78300) |
$794.40 |
$993 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$1,321.60 |
$1,652 |
3.2× |
| Bone Imaging Whole Body (78306) |
$2,167.20 |
$2,709 |
5.3× |
| Bone marrow imaging; whole body (78104) |
$1,644 |
$2,055 |
4.0× |
| Bone survey infant (77076) |
$1,063.20 |
$1,329 |
10.0× |
| Brachytx isodose complex (77318) |
$2,344.80 |
$2,931 |
6.1× |
| Brachytx isodose intermed (77317) |
$2,007.20 |
$2,509 |
5.2× |
| Brachytx Isodose Plan Simple (77316) |
$1,802.40 |
$2,253 |
4.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,508.80 |
$1,886 |
2.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$952.80 |
$1,191 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,936.80 |
$8,671 |
4.7× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$1,846.40 |
$2,308 |
3.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,493.60 |
$5,617 |
12.6× |
| Cat Scan Follow-Up Study (76380) |
$1,300 |
$1,625 |
14.6× |
| Cerebrospinal Fluid Scan (78630) |
$1,567.20 |
$1,959 |
2.8× |
| Chest 1 view (71045) |
$307.20 |
$384 |
3.5× |
| Chest 2 views (71046) |
$380.80 |
$476 |
4.3× |
| Chest 3 views (71047) |
$392 |
$490 |
4.4× |
| Chest 4 or more views (71048) |
$496.80 |
$621 |
4.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,654.40 |
$2,068 |
2.1× |
| Clavicle complete (73000) |
$418.40 |
$523 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$3,050.40 |
$3,813 |
28.6× |
| Continuing medical physics consltj pr wk (77336) |
$987.20 |
$1,234 |
7.2× |
| Contrast Exam Abdominl Aorta (75625) |
$6,025.60 |
$7,532 |
1.9× |
| Contrast X-Ray Bladder (74430) |
$896 |
$1,120 |
2.5× |
| Contrast X-Ray Of Elbow (73085) |
$996 |
$1,245 |
2.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,295.20 |
$1,619 |
3.6× |
| Corpora cavernosography (74445) |
$3,080 |
$3,850 |
28.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,212.80 |
$6,516 |
14.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,235.20 |
$5,294 |
17.4× |
| CT abdomen w contrast (74160) |
$3,044 |
$3,805 |
17.0× |
| CT abdomen w wo contrast (74170) |
$2,667.20 |
$3,334 |
14.9× |
| CT abdomen w/o contrast (74150) |
$2,257.60 |
$2,822 |
21.1× |
| CT Angio Abdomen and Pelvis (74174) |
$4,633.60 |
$5,792 |
13.0× |
| CT Angio Chest (71275) |
$3,498.40 |
$4,373 |
19.5× |
| CT Angio Head (70496) |
$3,371.20 |
$4,214 |
18.8× |
| CT angio hrt w/3d image (75574) |
$4,335.20 |
$5,419 |
12.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,888 |
$3,610 |
16.1× |
| CT Angio Neck (70498) |
$3,371.20 |
$4,214 |
18.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,649.60 |
$3,312 |
14.8× |
| CT bone density (77078) |
$860.80 |
$1,076 |
9.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$800 |
$1,000 |
4.5× |
| CT cervical spine w/ contrast (72126) |
$2,797.60 |
$3,497 |
7.8× |
| CT cervical spine w/o contrast (72125) |
$2,715.20 |
$3,394 |
25.4× |
| CT cervical spine w/wo cont (72127) |
$3,256 |
$4,070 |
18.2× |
| CT chest w contrast (71260) |
$2,969.60 |
$3,712 |
16.6× |
| CT chest w/wo contrast (71270) |
$3,485.60 |
$4,357 |
19.5× |
| CT head/brain with contrast (70460) |
$2,648.80 |
$3,311 |
14.8× |
| CT head/brain without and with contrast (70470) |
$2,932.80 |
$3,666 |
16.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$4,017.60 |
$5,022 |
11.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$964 |
$1,205 |
10.8× |
| CT hrt w/3d image congen (75573) |
$3,997.60 |
$4,997 |
11.2× |
| CT iac w contrast (70481) |
$2,951.20 |
$3,689 |
16.5× |
| CT l-spine w&w/o contrast (72133) |
$3,156 |
$3,945 |
17.6× |
| CT lower ext w/o (73700) |
$2,452 |
$3,065 |
23.0× |
| CT lower extremity w/contrast material (73701) |
$2,743.20 |
$3,429 |
15.3× |
| CT lumbar spine w contrast (72132) |
$2,603.20 |
$3,254 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$2,652 |
$3,315 |
24.8× |
| CT maxillofacial w contrast (70487) |
$2,778.40 |
$3,473 |
15.5× |
| CT maxillofacial wo contrast (70486) |
$2,199.20 |
$2,749 |
20.6× |
| CT neck tissue combo (70492) |
$3,290.40 |
$4,113 |
18.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,222.40 |
$4,028 |
18.0× |
| CT orbits w/o contrast (70480) |
$2,098.40 |
$2,623 |
19.6× |
| CT pelvis w&w/o contrast (72194) |
$2,727.20 |
$3,409 |
15.2× |
| CT pelvis w/o contrast (72192) |
$2,350.40 |
$2,938 |
22.0× |
| CT scan of leg combo (73702) |
$2,996 |
$3,745 |
16.7× |
| CT scans face/jaw combo (70488) |
$2,981.60 |
$3,727 |
16.6× |
| CT soft tissue neck w contrast (70491) |
$2,808 |
$3,510 |
15.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,528 |
$3,160 |
23.7× |
| CT thoracic spine w contrast (72129) |
$2,824.80 |
$3,531 |
15.8× |
| CT thoracic spine w/o contrast (72128) |
$2,585.60 |
$3,232 |
24.2× |
| CT thoracic spine w/wo cont (72130) |
$3,156 |
$3,945 |
17.6× |
| CT thorax w/o contrast (71250) |
$2,569.60 |
$3,212 |
24.1× |
| CT unlisted procedure (76497) |
$150.40 |
$188 |
1.7× |
| CT upper ext wo (73200) |
$2,455.20 |
$3,069 |
23.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,085.60 |
$3,857 |
17.2× |
| CT upper extremity with contrast (73201) |
$3,130.40 |
$3,913 |
8.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,636.80 |
$4,546 |
20.3× |
| Cta Abdomen (74175) |
$3,483.20 |
$4,354 |
19.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,371.20 |
$4,214 |
9.5× |
| CTA pelvis (72191) |
$2,620.80 |
$3,276 |
14.6× |
| Dilation ureters/urethra rs&i (74485) |
$2,608 |
$3,260 |
1.2× |
| Discography Cerv/Thor Spine (72285) |
$3,407.20 |
$4,259 |
1.7× |
| Diskography lumbar (72295) |
$4,131.20 |
$5,164 |
2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$444 |
$555 |
4.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$745.60 |
$932 |
7.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$540 |
$675 |
5.1× |
| Dxa Bone Density Axial (77080) |
$477.60 |
$597 |
4.5× |
| Echo exam of fetal heart (76825) |
$1,863.20 |
$2,329 |
3.3× |
| Echo Guide For Artery Repair (76936) |
$1,760 |
$2,200 |
8.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,388.80 |
$1,736 |
5.7× |
| Echograp Trans R Pros Study (76873) |
$1,686.40 |
$2,108 |
15.8× |
| Esophagram (74220) |
$841.60 |
$1,052 |
4.7× |
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines |
$687.20–$1,010.40 |
$859–$1,263 |
varies |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines |
$427.20–$768 |
$534–$960 |
varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,491.20 |
$3,114 |
10.2× |
| Fluoroscopy up to 1 hr (76000) |
$811.20 |
$1,014 |
3.3× |
| Follow-Up Angiography (75898) |
$1,855.20 |
$2,319 |
0.6× |
| Foot 2 views (73620) |
$294.40 |
$368 |
3.3× |
| Forearm 2 views (73090) |
$407.20 |
$509 |
4.6× |
| Gastric emptying imaging study (78264) |
$2,326.40 |
$2,908 |
5.7× |
| Gastroesophageal Reflux Exam (78262) |
$1,687.20 |
$2,109 |
4.1× |
| Gated Heart Planar Single (78472) |
$2,220 |
$2,775 |
5.4× |
| Hand 2 views (73120) |
$345.60 |
$432 |
3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$7,611.20 |
$9,514 |
10.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,660 |
$8,325 |
9.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,896.80 |
$6,121 |
6.9× |
| Heart Image (Pet) Multiple (78492) |
$6,462.40 |
$8,078 |
4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,239.20 |
$6,549 |
1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,417.60 |
$5,522 |
1.4× |
| Hepatobil Syst Image W/Drug (78227) |
$2,271.20 |
$2,839 |
4.1× |
| Hepatobiliary System Imaging (78226) |
$2,272 |
$2,840 |
5.6× |
| Ht Muscle Image Spect Sing (78451) |
$3,479.20 |
$4,349 |
2.6× |
| Hysterosalpingogram (74740) |
$1,132.80 |
$1,416 |
4.6× |
| Image fusion (77399) |
$640.80 |
$801 |
4.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$785.60 |
$982 |
8.8× |
| Infant hip ultrasound, limited static exam (76886) |
$752 |
$940 |
8.5× |
| Interstitial radiation source applic complex (77778) |
$5,296.80 |
$6,621 |
7.4× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$16,071.20 |
$20,089 |
2.1× |
| Joint Survey Single View (77077) |
$337.60 |
$422 |
3.2× |
| K Flow/Funct Image W/Drug (78708) |
$2,408.80 |
$3,011 |
4.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,810.40 |
$2,263 |
3.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,772.80 |
$2,216 |
4.3× |
| Knee 3 Views (73562) |
$406.40 |
$508 |
4.6× |
| Leveen/Shunt Patency Exam (78291) |
$1,248.80 |
$1,561 |
3.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,614.40 |
$2,018 |
4.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$767.20 |
$959 |
1.9× |
| Liver imaging static only (78201) |
$1,817.60 |
$2,272 |
3.3× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,003.20 |
$2,504 |
3.6× |
| Lung perfusion differential (78597) |
$1,495.20 |
$1,869 |
3.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,969.60 |
$2,462 |
3.6× |
| Lung Ventilation Imaging (78579) |
$1,262.40 |
$1,578 |
3.1× |
| Lymph System Imaging (78195) |
$2,459.20 |
$3,074 |
4.4× |
| Magnetic Image Jaw Joint (70336) |
$3,248.80 |
$4,061 |
13.3× |
| Magnetic Resonance Elastography (76391) |
$1,059.20 |
$1,324 |
4.3× |
| Meckels Divert Exam (78290) |
$1,892 |
$2,365 |
4.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,862.40 |
$4,828 |
10.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,717.60 |
$4,647 |
10.4× |
| MRA head w/o contrast (70544) |
$2,653.60 |
$3,317 |
10.9× |
| MRA head with contrast (70545) |
$3,000 |
$3,750 |
8.4× |
| MRA neck w contrast (70548) |
$3,000.80 |
$3,751 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,557.60 |
$4,447 |
10.0× |
| MRA neck w/o contrast (70547) |
$2,566.40 |
$3,208 |
10.5× |
| MRI abdomen w contrast (74182) |
$3,056.80 |
$3,821 |
8.6× |
| MRI abdomen w/o contrast (74181) |
$3,511.20 |
$4,389 |
14.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,850.40 |
$4,813 |
4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,594.40 |
$5,743 |
12.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,850.40 |
$4,813 |
4.8× |
| MRI bone marrow blood supply (77084) |
$2,945.60 |
$3,682 |
12.1× |
| MRI brain functional w/o physician admnistration (70554) |
$2,805.60 |
$3,507 |
11.5× |
| MRI brain functional w/physician admnistration (70555) |
$2,097.60 |
$2,622 |
8.6× |
| MRI cardiac w/o contrast (75557) |
$3,496.80 |
$4,371 |
14.3× |
| MRI cervical spine w contrast (72142) |
$3,257.60 |
$4,072 |
9.1× |
| MRI cervical spine w/o cont (72141) |
$3,659.20 |
$4,574 |
15.0× |
| MRI chest w/o contrast (71550) |
$3,689.60 |
$4,612 |
15.1× |
| MRI chest wo w contrast (71552) |
$4,724 |
$5,905 |
13.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,531.20 |
$4,414 |
9.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,484.80 |
$5,606 |
12.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,271.20 |
$4,089 |
13.4× |
| MRI lumbar spine w contrast (72149) |
$3,289.60 |
$4,112 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$5,033.60 |
$6,292 |
14.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,367.20 |
$4,209 |
13.8× |
| MRI orbit face neck w contrast (70542) |
$3,851.20 |
$4,814 |
10.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,780 |
$5,975 |
13.4× |
| MRI pelvis w/o & w contrast (72197) |
$4,811.20 |
$6,014 |
13.5× |
| MRI pelvis w/o contrast (72195) |
$3,602.40 |
$4,503 |
14.8× |
| MRI spectroscopy (76390) |
$1,780.80 |
$2,226 |
20.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,687.20 |
$4,609 |
15.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,152 |
$3,940 |
8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,146.40 |
$3,933 |
12.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,528.80 |
$5,661 |
12.7× |
| MRI, abdomen, combo (74183) |
$4,865.60 |
$6,082 |
13.7× |
| MRI, dorsal spine combo (72157) |
$5,039.20 |
$6,299 |
14.1× |
| MRI, dorsal spine contrast (72147) |
$3,152.80 |
$3,941 |
8.8× |
| MRI, joint upper extrem (73221) |
$3,271.20 |
$4,089 |
13.4× |
| MRI, joint upper extrem combo (73223) |
$4,187.20 |
$5,234 |
11.7× |
| MRI, lumbar spine combo (72158) |
$4,865.60 |
$6,082 |
13.7× |
| Myelogram Lumbar (72265) |
$1,900.80 |
$2,376 |
2.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$1,022.40 |
$1,278 |
2.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,274.40 |
$7,843 |
4.7× |
| Myocardial Spect Multiple Studies (78452) |
$5,011.20 |
$6,264 |
3.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$4,938.40 |
$6,173 |
3.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$5,207.20 |
$6,509 |
3.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$7,006.40 |
$8,758 |
3.1× |
| Neck soft tissue (70360) |
$388 |
$485 |
4.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$792.80 |
$991 |
1.9× |
| Nm csf leak detection (78650) |
$1,864 |
$2,330 |
1.4× |
| Nonvascular Shunt X-Ray (75809) |
$799.20 |
$999 |
7.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,828.80 |
$11,036 |
6.2× |
| Nuclear Rx Intra-Arterial (79445) |
$1,530.40 |
$1,913 |
6.4× |
| Nuclear Rx Oral Admin (79005) |
$1,682.40 |
$2,103 |
7.1× |
| Ob us nuchal meas 1 gest (76813) |
$512 |
$640 |
4.8× |
| Panoramic X-ray of jaws (70355) |
$432.80 |
$541 |
4.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,536 |
$3,170 |
4.6× |
| Parathyroid Planar Imaging (78070) |
$2,087.20 |
$2,609 |
5.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,280.80 |
$2,851 |
5.6× |
| Pelvis 1 or 2 views (72170) |
$392 |
$490 |
3.7× |
| Perineogram (74775) |
$875.20 |
$1,094 |
3.6× |
| Peritoneogram Rs&I (74190) |
$1,080 |
$1,350 |
1.9× |
| Pet Image Skull-Thigh (78812) |
$6,027.20 |
$7,534 |
4.1× |
| Pet Image W/Ct Lmtd (78814) |
$6,559.20 |
$8,199 |
4.5× |
| PET image w/CT, full body (78816) |
$7,892 |
$9,865 |
5.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,500 |
$9,375 |
5.1× |
| Pet Myocardial Sngl Study (78491) |
$5,818.40 |
$7,273 |
4.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,051.20 |
$5,064 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$808 |
$1,010 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$977.60 |
$1,222 |
1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$467.20 |
$584 |
5.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$403.20 |
$504 |
4.5× |
| Radex elbow complete minimum 3 views (73080) |
$456 |
$570 |
5.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$621.60 |
$777 |
5.8× |
| Radex fingr minimum 2 views (73140) |
$341.60 |
$427 |
3.8× |
| Radex foot complete minimum 3 views (73630) |
$488 |
$610 |
5.5× |
| Radex Hand Minimum 3 Views (73130) |
$432.80 |
$541 |
4.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$327.20 |
$409 |
3.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$538.40 |
$673 |
5.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$435.20 |
$544 |
4.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$520.80 |
$651 |
5.9× |
| Radex shoulder complete minimum 2 views (73030) |
$461.60 |
$577 |
5.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$323.20 |
$404 |
3.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,486.40 |
$1,858 |
8.3× |
| Radex Spine 1 View Specify Level (72020) |
$388.80 |
$486 |
4.4× |
| Radex Sternum Minimum 2 Views (71120) |
$475.20 |
$594 |
5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$432 |
$540 |
4.9× |
| Radex Toe Minimum 2 Views (73660) |
$344 |
$430 |
3.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$404.80 |
$506 |
3.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$440.80 |
$551 |
5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$747.20 |
$934 |
7.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$26,032 |
$32,540 |
3.5× |
| Radiation treatment delivery level 1 (77402) |
$752.80 |
$941 |
7.2× |
| Radiation treatment delivery level 2 (77407) |
$2,852.80 |
$3,566 |
7.2× |
| Radiation treatment delivery level 3 (77412) |
$4,083.20 |
$5,104 |
7.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$607.20 |
$759 |
5.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$442.40 |
$553 |
4.1× |
| Radiologic exam colon double contrast study (74280) |
$1,545.60 |
$1,932 |
8.6× |
| Radiologic exam colon single contrast study (74270) |
$1,047.20 |
$1,309 |
5.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$608.80 |
$761 |
3.4× |
| Radiologic exam knee complete 4/more views (73564) |
$604 |
$755 |
5.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$562.40 |
$703 |
5.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$958.40 |
$1,198 |
5.3× |
| Radiologic exam swallow function contrast study (74230) |
$757.60 |
$947 |
4.2× |
| Radiologic exam teeth complete full mouth (70320) |
$353.60 |
$442 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,072.80 |
$1,341 |
6.0× |
| Radiologic examination femur 1 view (73551) |
$358.40 |
$448 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$455.20 |
$569 |
5.1× |
| Radiologic examination knee 1/2 views (73560) |
$397.60 |
$497 |
4.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$567.20 |
$709 |
5.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$445.60 |
$557 |
5.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$159.20 |
$199 |
1.8× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) |
$896 |
$1,120 |
3.8× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$1,360 |
$1,700 |
2.5× |
| Renal Cyst Study (74470) |
$1,099.20 |
$1,374 |
2.0× |
| Ribs bilateral 3 views (71110) |
$736.80 |
$921 |
6.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,027.20 |
$1,284 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,116.80 |
$2,646 |
5.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,308.80 |
$5,386 |
7.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$3,667.20 |
$4,584 |
6.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,318.40 |
$4,148 |
6.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,880.80 |
$4,851 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,759.20 |
$5,949 |
3.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,880.80 |
$4,851 |
2.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,126.40 |
$1,408 |
4.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,462.40 |
$1,828 |
6.1× |
| Scapula (73010) |
$395.20 |
$494 |
3.7× |
| Shoulder 1 view (73020) |
$386.40 |
$483 |
4.3× |
| Shoulder Arthrography (73040) |
$1,088.80 |
$1,361 |
3.1× |
| Sialogram (70390) |
$636.80 |
$796 |
2.6× |
| Skull less than 4 views (70250) |
$434.40 |
$543 |
4.1× |
| Special dosimetry (77331) |
$985.60 |
$1,232 |
7.2× |
| Special Physics Consult (77370) |
$1,398.40 |
$1,748 |
10.2× |
| Special teletherapy port plan (77321) |
$2,856 |
$3,570 |
7.5× |
| Special treatment procedure (77470) |
$3,699.20 |
$4,624 |
6.6× |
| Spleen Imaging (78185) |
$2,154.40 |
$2,693 |
5.3× |
| Stereotactic Body Radiation Delivery (77373) |
$11,344.80 |
$14,181 |
6.2× |
| Sternoclavicular joints (71130) |
$434.40 |
$543 |
4.9× |
| Superior sagittal sinus venogram (75870) |
$2,976 |
$3,720 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$6,175.20 |
$7,719 |
16.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,511.20 |
$4,389 |
9.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,287.20 |
$1,609 |
5.3× |
| Testicular Imaging W/Flow (78761) |
$1,188.80 |
$1,486 |
2.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,647.20 |
$3,309 |
6.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,047.20 |
$2,559 |
5.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,281.60 |
$1,602 |
9.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$935.20 |
$1,169 |
5.2× |
| Thoracic spine 2 views (72070) |
$502.40 |
$628 |
4.7× |
| Thoracic spine 3 views (72072) |
$613.60 |
$767 |
5.7× |
| Thoracolumbar 2 views (72080) |
$561.60 |
$702 |
6.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,268 |
$1,585 |
3.1× |
| Thyroid Met Imaging Body (78018) |
$2,408 |
$3,010 |
4.3× |
| Thyroid Uptake Measurement (78012) |
$896 |
$1,120 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,609.60 |
$2,012 |
3.9× |
| Tx Devices Design & Construction Complex (77334) |
$1,766.40 |
$2,208 |
4.6× |
| Tx devices design & construction intermediate (77333) |
$953.60 |
$1,192 |
6.9× |
| Tx devices design & construction simple (77332) |
$768 |
$960 |
5.6× |
| Ultrasound Breast Limited (76642) |
$455.20 |
$569 |
5.1× |
| Ultrasound Exam Aaa Screen (76706) |
$623.20 |
$779 |
5.8× |
| Ultrasound, abdomen limited (76705) |
$824.80 |
$1,031 |
7.7× |
| Umbilical-artery Doppler (OB) (76820) |
$511.20 |
$639 |
4.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$951.20 |
$1,189 |
10.7× |
| Unlisted fluoroscopic procedure (76496) |
$277.60 |
$347 |
3.1× |
Unlisted magnetic resonance procedure (76498)
range across 3 matching MRF lines |
$207.20–$2,541.60 |
$259–$3,177 |
varies |
| Unlisted us procedure (76999) |
$619.20 |
$774 |
7.0× |
| Upper gi w/o kub (74240) |
$1,040 |
$1,300 |
5.8× |
| Ureteral Reflux Study (78740) |
$1,284 |
$1,605 |
3.1× |
| Urethrocystogram voiding (74455) |
$1,463.20 |
$1,829 |
6.0× |
| Urethrocystography retrograde (74450) |
$846.40 |
$1,058 |
3.5× |
| Us breast unilateral complete (76641) |
$522.40 |
$653 |
4.9× |
| Us chest (76604) |
$727.20 |
$909 |
6.8× |
| Us complete joint (76881) |
$648 |
$810 |
6.1× |
| Us exam, pelvic, limited (76857) |
$508.80 |
$636 |
4.8× |
| Us head (76506) |
$756 |
$945 |
7.1× |
| Us kidney transplant (76776) |
$910.40 |
$1,138 |
8.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$471.20 |
$589 |
4.4× |
| Us ob detailed single fetus (76811) |
$973.60 |
$1,217 |
4.0× |
| Us ob limited 1 or more fetuses (76815) |
$548 |
$685 |
5.1× |
| Us ob transvaginal (76817) |
$913.60 |
$1,142 |
8.6× |
| Us pelvic non ob complete (76856) |
$996 |
$1,245 |
9.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$984.80 |
$1,231 |
9.2× |
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines |
$310.40–$503.20 |
$388–$629 |
varies |
| Us retroperitoneal complete (76770) |
$1,036 |
$1,295 |
9.7× |
| Us retroperitoneal limited (76775) |
$712.80 |
$891 |
6.7× |
| Us scrotum and contents (76870) |
$923.20 |
$1,154 |
8.6× |
| Us spinal canal and contents (76800) |
$672 |
$840 |
6.3× |
| Us thyroid (76536) |
$892 |
$1,115 |
8.4× |
| Us transrectal (76872) |
$785.60 |
$982 |
7.4× |
| Vein X-Ray Chest (75827) |
$2,807.20 |
$3,509 |
1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,250.40 |
$4,063 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$4,001.60 |
$5,002 |
1.2× |
| Venography Adrenal Unilateral (75840) |
$4,469.60 |
$5,587 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$5,555.20 |
$6,944 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$2,691.20 |
$3,364 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$2,198.40 |
$2,748 |
1.4× |
| Venography Renal Bilateral (75833) |
$5,108.80 |
$6,386 |
1.6× |
| Venography Renal Unilateral (75831) |
$5,091.20 |
$6,364 |
1.6× |
| Venous sampling by catheter (75893) |
$5,493.60 |
$6,867 |
1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$2,106.40 |
$2,633 |
5.2× |
| Wrist 2 views (73100) |
$299.20 |
$374 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$461.60 |
$577 |
5.2× |
| X-ray antegrade pyelogram tube (74425) |
$939.20 |
$1,174 |
2.6× |
| X-Ray Aorta Leg Arteries (75630) |
$4,628 |
$5,785 |
1.4× |
| X-Ray Bend Only L-S Spine (72120) |
$575.20 |
$719 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$347.20 |
$434 |
3.9× |
| X-Ray Exam Breast Specimen (76098) |
$723.20 |
$904 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$557.60 |
$697 |
6.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$634.40 |
$793 |
5.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$680.80 |
$851 |
6.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$293.60 |
$367 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$358.40 |
$448 |
4.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$463.20 |
$579 |
4.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$527.20 |
$659 |
4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$592.80 |
$741 |
5.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$632 |
$790 |
5.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$738.40 |
$923 |
6.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$505.60 |
$632 |
5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,072 |
$1,340 |
10.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$616 |
$770 |
5.8× |
| X-ray eye for foreign body (70030) |
$273.60 |
$342 |
3.1× |
| X-ray humerus (73060) |
$404 |
$505 |
4.5× |
| X-ray IV pyelogram (ivp) (74400) |
$1,124.80 |
$1,406 |
6.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$315.20 |
$394 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$403.20 |
$504 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$585.60 |
$732 |
5.5× |
| X-ray nose-rectum child f.b. (76010) |
$372.80 |
$466 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$828.80 |
$1,036 |
7.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$454.40 |
$568 |
4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$317.60 |
$397 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$440.80 |
$551 |
5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$936 |
$1,170 |
10.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$780 |
$975 |
7.3× |
| X-ray thoracic spine 4 vw (72074) |
$649.60 |
$812 |
6.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,090.40 |
$1,363 |
3.1× |
| X-Rays Bone Length Studies (77073) |
$749.60 |
$937 |
7.0× |
| X-Rays Bone Survey Complete (77075) |
$1,091.20 |
$1,364 |
10.2× |
| Xr c-spine 4 or 5 views (72050) |
$736 |
$920 |
6.9× |
| Xr facial bones less than 3 views (70140) |
$313.60 |
$392 |
3.5× |
| Xr orbits complete 4 views (70200) |
$477.60 |
$597 |
4.5× |
| Xr Tomogram Single Plane (76100) |
$773.60 |
$967 |
7.2× |