| 3-D radiotherapy plan dose-volume histograms (77295) |
$12,505.50 |
$16,674 |
7.0× |
| Abdomen 1 View (74018) |
$345.75 |
$461 |
3.1× |
| Abdomen 2 views (74019) |
$431.25 |
$575 |
3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,643.25 |
$2,191 |
3.2× |
| Angio internal mammary (75756) |
$4,242.75 |
$5,657 |
1.0× |
| Angio pulmonary bilat (75743) |
$4,469.25 |
$5,959 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$5,166 |
$6,888 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$4,481.25 |
$5,975 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,242.75 |
$5,657 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,087 |
$4,116 |
0.8× |
| Ankle 2 views (73600) |
$392.25 |
$523 |
3.5× |
| Aortography thoracic serialography rs&i (75605) |
$7,406.25 |
$9,875 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$8,218.50 |
$10,958 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$4,242.75 |
$5,657 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$7,720.50 |
$10,294 |
1.1× |
| Artery X-Rays Spine (75705) |
$7,017.75 |
$9,357 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$1,228.50 |
$1,638 |
7.1× |
| Bone age studies (77072) |
$356.25 |
$475 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$3,309 |
$4,412 |
6.4× |
| Bone Imaging Limited Area (78300) |
$1,508.25 |
$2,011 |
2.9× |
| Bone Imaging Whole Body (78306) |
$3,008.25 |
$4,011 |
5.9× |
| Bone marrow imaging limited area (78102) |
$1,381.50 |
$1,842 |
2.7× |
| Bone survey infant (77076) |
$756 |
$1,008 |
5.6× |
| Brachytx isodose complex (77318) |
$8,591.25 |
$11,455 |
17.8× |
| Brachytx isodose intermed (77317) |
$6,355.50 |
$8,474 |
13.2× |
| Brachytx Isodose Plan Simple (77316) |
$5,700.75 |
$7,601 |
11.8× |
| Brain Image W/Flow < 4 Views (78601) |
$700.50 |
$934 |
1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,340 |
$3,120 |
3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,661 |
$7,548 |
3.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,821.25 |
$5,095 |
8.5× |
| Cat Scan Follow-Up Study (76380) |
$722.25 |
$963 |
6.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,889.25 |
$2,519 |
2.7× |
| Cerebrospinal Fluid Scan (78630) |
$2,406.75 |
$3,209 |
3.4× |
| Chest 1 view (71045) |
$456.75 |
$609 |
4.1× |
| Chest 2 views (71046) |
$532.50 |
$710 |
4.8× |
| Chest 3 views (71047) |
$566.25 |
$755 |
5.1× |
| Chest 4 or more views (71048) |
$642 |
$856 |
4.8× |
| Clavicle complete (73000) |
$499.50 |
$666 |
4.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,571.25 |
$2,095 |
11.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,409.25 |
$1,879 |
8.2× |
| Contrast Exam Abdominl Aorta (75625) |
$5,917.50 |
$7,890 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$967.50 |
$1,290 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,337 |
$7,116 |
11.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,480 |
$4,640 |
11.3× |
| CT abdomen w contrast (74160) |
$2,802 |
$3,736 |
12.4× |
| CT abdomen w wo contrast (74170) |
$3,119.25 |
$4,159 |
13.8× |
| CT abdomen w/o contrast (74150) |
$1,908.75 |
$2,545 |
14.2× |
| CT Angio Abdomen and Pelvis (74174) |
$5,618.25 |
$7,491 |
12.5× |
| CT Angio Chest (71275) |
$3,747.75 |
$4,997 |
16.6× |
| CT Angio Head (70496) |
$3,613.50 |
$4,818 |
16.0× |
| CT angio hrt w/3d image (75574) |
$3,135.75 |
$4,181 |
7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,195.75 |
$4,261 |
14.2× |
| CT Angio Neck (70498) |
$3,582.75 |
$4,777 |
15.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,261.75 |
$4,349 |
14.5× |
| CT cervical spine w/ contrast (72126) |
$3,268.50 |
$4,358 |
7.3× |
| CT cervical spine w/o contrast (72125) |
$3,171 |
$4,228 |
23.6× |
| CT cervical spine w/wo cont (72127) |
$3,318 |
$4,424 |
14.7× |
| CT chest w contrast (71260) |
$3,081 |
$4,108 |
13.7× |
| CT chest w/wo contrast (71270) |
$3,569.25 |
$4,759 |
15.8× |
| CT colonography screening (74263) |
$1,156.50 |
$1,542 |
3.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,062 |
$1,416 |
7.9× |
| CT head/brain with contrast (70460) |
$2,870.25 |
$3,827 |
12.7× |
| CT head/brain without and with contrast (70470) |
$3,090.75 |
$4,121 |
13.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,193 |
$2,924 |
4.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$822 |
$1,096 |
7.3× |
| CT iac w contrast (70481) |
$3,366 |
$4,488 |
14.9× |
| CT l-spine w&w/o contrast (72133) |
$2,856 |
$3,808 |
12.7× |
| CT lower ext w/o (73700) |
$2,133.75 |
$2,845 |
15.9× |
| CT lower extremity w/contrast material (73701) |
$2,829 |
$3,772 |
12.5× |
| CT lumbar spine w contrast (72132) |
$2,834.25 |
$3,779 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$2,412 |
$3,216 |
17.9× |
| CT maxillofacial w contrast (70487) |
$2,979 |
$3,972 |
13.2× |
| CT maxillofacial wo contrast (70486) |
$2,850 |
$3,800 |
21.2× |
| CT neck tissue combo (70492) |
$3,129 |
$4,172 |
13.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,828 |
$5,104 |
17.0× |
| CT orbits w/o contrast (70480) |
$2,843.25 |
$3,791 |
21.1× |
| CT pelvis w&w/o contrast (72194) |
$2,955 |
$3,940 |
13.1× |
| CT pelvis w/o contrast (72192) |
$1,961.25 |
$2,615 |
14.6× |
| CT scans face/jaw combo (70488) |
$3,303 |
$4,404 |
14.6× |
| CT soft tissue neck w contrast (70491) |
$2,734.50 |
$3,646 |
12.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,043.75 |
$2,725 |
15.2× |
| CT thoracic spine w contrast (72129) |
$2,657.25 |
$3,543 |
11.8× |
| CT thoracic spine w/o contrast (72128) |
$2,110.50 |
$2,814 |
15.7× |
| CT thoracic spine w/wo cont (72130) |
$2,870.25 |
$3,827 |
12.7× |
| CT thorax w/o contrast (71250) |
$2,138.25 |
$2,851 |
15.9× |
| CT upper ext wo (73200) |
$2,783.25 |
$3,711 |
20.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,067.50 |
$4,090 |
13.6× |
| CT upper extremity with contrast (73201) |
$2,925.75 |
$3,901 |
6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,349 |
$3,132 |
10.4× |
| Cta Abdomen (74175) |
$3,350.25 |
$4,467 |
14.9× |
| CTA pelvis (72191) |
$3,105 |
$4,140 |
13.8× |
| Dilation ureters/urethra rs&i (74485) |
$3,061.50 |
$4,082 |
1.1× |
| Diskography lumbar (72295) |
$4,194 |
$5,592 |
1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$425.25 |
$567 |
3.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$865.50 |
$1,154 |
6.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$635.25 |
$847 |
4.7× |
| Dxa Bone Density Axial (77080) |
$646.50 |
$862 |
4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$307.50 |
$410 |
2.7× |
| Echo exam of fetal heart (76825) |
$1,827 |
$2,436 |
2.6× |
| Echo exam uterus (76831) |
$924.75 |
$1,233 |
3.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$677.25 |
$903 |
2.2× |
| Echograp Trans R Pros Study (76873) |
$496.50 |
$662 |
3.7× |
| Esophagram (74220) |
$850.50 |
$1,134 |
3.8× |
| Fetal Biophys Profile W/Nst (76818) |
$1,013.25 |
$1,351 |
7.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$902.25 |
$1,203 |
6.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,848 |
$2,464 |
6.0× |
| Fluoroscopy up to 1 hr (76000) |
$840.75 |
$1,121 |
2.7× |
| Follow-Up Angiography (75898) |
$2,595 |
$3,460 |
0.6× |
| Foot 2 views (73620) |
$422.25 |
$563 |
3.8× |
| Forearm 2 views (73090) |
$458.25 |
$611 |
4.1× |
| Gastric emptying imaging study (78264) |
$3,845.25 |
$5,127 |
7.5× |
| Gated Heart Planar Single (78472) |
$1,509 |
$2,012 |
2.9× |
| Hand 2 views (73120) |
$422.25 |
$563 |
3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$12,091.50 |
$16,122 |
13.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$8,811.75 |
$11,749 |
9.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,215.50 |
$6,954 |
5.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,382 |
$7,176 |
1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,469.25 |
$5,959 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$3,897.75 |
$5,197 |
5.6× |
| Hepatobiliary System Imaging (78226) |
$2,061.75 |
$2,749 |
4.0× |
| Ht Muscle Image Spect Sing (78451) |
$3,699 |
$4,932 |
2.2× |
| Hysterosalpingogram (74740) |
$1,095.75 |
$1,461 |
3.6× |
| Interstitial radiation source applic complex (77778) |
$4,688.25 |
$6,251 |
5.2× |
| K Flow/Funct Image W/Drug (78708) |
$3,513 |
$4,684 |
5.0× |
| K Flow/Funct Image W/O Drug (78707) |
$2,987.25 |
$3,983 |
4.3× |
| Knee 3 Views (73562) |
$513 |
$684 |
4.6× |
| Liver & Spleen Imaging Static Only (78215) |
$1,396.50 |
$1,862 |
2.7× |
| Liver imaging static only (78201) |
$1,868.25 |
$2,491 |
2.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,941.50 |
$3,922 |
4.2× |
| Lung perfusion differential (78597) |
$1,836.75 |
$2,449 |
3.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,790 |
$3,720 |
4.0× |
| Lymph System Imaging (78195) |
$3,412.50 |
$4,550 |
4.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,056.75 |
$5,409 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$2,406 |
$3,208 |
7.8× |
| Magnetic Resonance Elastography (76391) |
$4,080 |
$5,440 |
13.3× |
| Meckels Divert Exam (78290) |
$2,287.50 |
$3,050 |
4.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,201.50 |
$5,602 |
8.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,250.25 |
$5,667 |
9.5× |
| MRA head w/o contrast (70544) |
$2,895 |
$3,860 |
9.4× |
| MRA head with contrast (70545) |
$3,003 |
$4,004 |
6.7× |
| MRA neck w contrast (70548) |
$2,376 |
$3,168 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,946.50 |
$5,262 |
8.8× |
| MRA neck w/o contrast (70547) |
$1,993.50 |
$2,658 |
6.5× |
| MRI abdomen w contrast (74182) |
$3,610.50 |
$4,814 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$3,167.25 |
$4,223 |
10.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,846 |
$5,128 |
3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,620.75 |
$6,161 |
10.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,042.50 |
$5,390 |
4.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,934.75 |
$3,913 |
9.6× |
| MRI cardiac w/o contrast (75557) |
$2,190.75 |
$2,921 |
7.1× |
| MRI cervical spine w contrast (72142) |
$4,356.75 |
$5,809 |
9.7× |
| MRI cervical spine w/o cont (72141) |
$4,149.75 |
$5,533 |
13.5× |
| MRI chest w/o contrast (71550) |
$2,969.25 |
$3,959 |
9.7× |
| MRI chest wo w contrast (71552) |
$4,592.25 |
$6,123 |
10.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,796 |
$3,728 |
6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,152.75 |
$5,537 |
9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,465.25 |
$3,287 |
8.0× |
| MRI lumbar spine w contrast (72149) |
$4,137.75 |
$5,517 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$5,874 |
$7,832 |
13.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,828.25 |
$3,771 |
9.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,503.75 |
$6,005 |
10.0× |
| MRI pelvis w contrast (72196) |
$3,657 |
$4,876 |
8.2× |
| MRI pelvis w/o & w contrast (72197) |
$4,268.25 |
$5,691 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,347.50 |
$3,130 |
7.6× |
| MRI spectroscopy (76390) |
$2,009.25 |
$2,679 |
18.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,201.75 |
$4,269 |
10.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,953.25 |
$5,271 |
8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,275.25 |
$4,367 |
10.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,824 |
$6,432 |
10.8× |
| MRI, abdomen, combo (74183) |
$4,268.25 |
$5,691 |
9.5× |
| MRI, dorsal spine combo (72157) |
$4,499.25 |
$5,999 |
10.0× |
| MRI, dorsal spine contrast (72147) |
$4,013.25 |
$5,351 |
8.9× |
| MRI, joint upper extrem (73221) |
$2,465.25 |
$3,287 |
8.0× |
| MRI, joint upper extrem combo (73223) |
$4,300.50 |
$5,734 |
9.6× |
| MRI, lumbar spine combo (72158) |
$4,612.50 |
$6,150 |
10.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,029 |
$5,372 |
2.4× |
| N-invas est c ffr sw aly CTA (75580) |
$5,399.25 |
$7,199 |
4.9× |
| Neck soft tissue (70360) |
$378.75 |
$505 |
3.4× |
| Nonvascular Shunt X-Ray (75809) |
$684.75 |
$913 |
5.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,947.50 |
$15,930 |
6.7× |
| Nuclear Rx Oral Admin (79005) |
$3,177.75 |
$4,237 |
10.6× |
| Ob us nuchal meas 1 gest (76813) |
$660.75 |
$881 |
4.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,263.25 |
$4,351 |
4.7× |
| Parathyroid Planar Imaging (78070) |
$1,518.75 |
$2,025 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$453.75 |
$605 |
3.4× |
| Peritoneogram Rs&I (74190) |
$1,133.25 |
$1,511 |
1.6× |
| Pet Image W/Ct Lmtd (78814) |
$5,261.25 |
$7,015 |
2.9× |
| PET image w/CT, full body (78816) |
$8,457.75 |
$11,277 |
4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,382.75 |
$11,177 |
4.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,985.25 |
$6,647 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,864.50 |
$2,486 |
3.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$569.25 |
$759 |
4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,079.25 |
$1,439 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$539.25 |
$719 |
4.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$354 |
$472 |
3.2× |
| Radex elbow complete minimum 3 views (73080) |
$551.25 |
$735 |
4.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$685.50 |
$914 |
5.1× |
| Radex fingr minimum 2 views (73140) |
$418.50 |
$558 |
3.7× |
| Radex foot complete minimum 3 views (73630) |
$529.50 |
$706 |
4.7× |
| Radex Hand Minimum 3 Views (73130) |
$508.50 |
$678 |
4.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$441.75 |
$589 |
3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$597 |
$796 |
5.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$477.75 |
$637 |
4.3× |
| Radex shoulder complete minimum 2 views (73030) |
$564.75 |
$753 |
5.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$317.25 |
$423 |
2.8× |
| Radex Spine 1 View Specify Level (72020) |
$287.25 |
$383 |
2.6× |
| Radex Sternum Minimum 2 Views (71120) |
$455.25 |
$607 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$504 |
$672 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$387.75 |
$517 |
3.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$463.50 |
$618 |
3.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$575.25 |
$767 |
5.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$33,723 |
$44,964 |
3.6× |
| Radiation treatment delivery level 1 (77402) |
$663.75 |
$885 |
5.1× |
| Radiation treatment delivery level 2 (77407) |
$783 |
$1,044 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$2,044.50 |
$2,726 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$560.25 |
$747 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$445.50 |
$594 |
3.3× |
| Radiologic exam colon double contrast study (74280) |
$1,132.50 |
$1,510 |
5.0× |
| Radiologic exam colon single contrast study (74270) |
$999.75 |
$1,333 |
4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$946.50 |
$1,262 |
4.2× |
| Radiologic exam knee complete 4/more views (73564) |
$585.75 |
$781 |
4.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$801.75 |
$1,069 |
6.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$713.25 |
$951 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$661.50 |
$882 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$993.75 |
$1,325 |
4.4× |
| Radiologic examination femur 1 view (73551) |
$286.50 |
$382 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$360 |
$480 |
3.2× |
| Radiologic examination knee 1/2 views (73560) |
$378.75 |
$505 |
3.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$461.25 |
$615 |
4.1× |
| Ribs bilateral 3 views (71110) |
$675.75 |
$901 |
5.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,660.50 |
$2,214 |
3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,270.50 |
$5,694 |
6.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$3,619.50 |
$4,826 |
5.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$4,448.25 |
$5,931 |
6.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,922.50 |
$5,230 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,920.75 |
$10,561 |
4.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,790.50 |
$5,054 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,995.75 |
$2,661 |
6.7× |
| Scapula (73010) |
$522.75 |
$697 |
3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$216.75 |
$289 |
9.3× |
| Shoulder 1 view (73020) |
$408.75 |
$545 |
3.7× |
| Shoulder Arthrography (73040) |
$1,031.25 |
$1,375 |
2.3× |
| Sialogram (70390) |
$612.75 |
$817 |
2.0× |
| Skull less than 4 views (70250) |
$527.25 |
$703 |
3.9× |
| Special dosimetry (77331) |
$991.50 |
$1,322 |
5.7× |
| Special Physics Consult (77370) |
$1,871.25 |
$2,495 |
10.8× |
| Special teletherapy port plan (77321) |
$3,555 |
$4,740 |
7.4× |
| Special treatment procedure (77470) |
$4,537.50 |
$6,050 |
6.4× |
| Stereotactic Body Radiation Delivery (77373) |
$11,319.75 |
$15,093 |
4.9× |
| Sternoclavicular joints (71130) |
$492.75 |
$657 |
4.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$7,378.50 |
$9,838 |
15.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,131 |
$1,508 |
2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$3,830.25 |
$5,107 |
8.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,925.75 |
$3,901 |
6.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,046.75 |
$2,729 |
11.8× |
| Thoracic spine 2 views (72070) |
$467.25 |
$623 |
3.5× |
| Thoracic spine 3 views (72072) |
$621 |
$828 |
4.6× |
| Thoracolumbar 2 views (72080) |
$519.75 |
$693 |
4.6× |
| Thyroid Met Imaging Body (78018) |
$4,301.25 |
$5,735 |
6.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,195.75 |
$4,261 |
6.2× |
| Tx Devices Design & Construction Complex (77334) |
$3,167.25 |
$4,223 |
6.6× |
| Tx devices design & construction intermediate (77333) |
$1,601.25 |
$2,135 |
9.3× |
| Tx devices design & construction simple (77332) |
$1,007.25 |
$1,343 |
5.8× |
| Ultrasound Breast Limited (76642) |
$528.75 |
$705 |
4.7× |
| Ultrasound Exam Aaa Screen (76706) |
$465 |
$620 |
3.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$643.50 |
$858 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$879 |
$1,172 |
6.5× |
| Umbilical-artery Doppler (OB) (76820) |
$445.50 |
$594 |
3.3× |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$136.50–$1,935.75 |
$182–$2,581 |
varies |
| Unlisted fluoroscopic procedure (76496) |
$929.25 |
$1,239 |
8.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$283.50 |
$378 |
0.6× |
| Unlisted us procedure (76999) |
$683.25 |
$911 |
6.1× |
| Upper gi w/o kub (74240) |
$831 |
$1,108 |
3.7× |
| Urethrocystogram voiding (74455) |
$868.50 |
$1,158 |
2.8× |
| Urethrocystography retrograde (74450) |
$778.50 |
$1,038 |
2.5× |
| Us breast unilateral complete (76641) |
$747.75 |
$997 |
5.6× |
| Us chest (76604) |
$701.25 |
$935 |
5.2× |
| Us complete joint (76881) |
$682.50 |
$910 |
5.1× |
| Us exam, pelvic, limited (76857) |
$784.50 |
$1,046 |
5.8× |
| Us head (76506) |
$616.50 |
$822 |
4.6× |
| Us kidney transplant (76776) |
$694.50 |
$926 |
5.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$395.25 |
$527 |
2.9× |
| Us ob detailed single fetus (76811) |
$1,161.75 |
$1,549 |
3.8× |
| Us ob limited 1 or more fetuses (76815) |
$927 |
$1,236 |
6.9× |
| Us ob transvaginal (76817) |
$841.50 |
$1,122 |
6.3× |
| Us pelvic non ob complete (76856) |
$1,311.75 |
$1,749 |
9.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,194 |
$1,592 |
8.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$807.75 |
$1,077 |
6.0× |
| Us retroperitoneal complete (76770) |
$821.25 |
$1,095 |
6.1× |
| Us retroperitoneal limited (76775) |
$606.75 |
$809 |
4.5× |
| Us scrotum and contents (76870) |
$1,255.50 |
$1,674 |
9.3× |
| Us spinal canal and contents (76800) |
$465 |
$620 |
3.5× |
| Us thyroid (76536) |
$1,015.50 |
$1,354 |
7.6× |
| Us transrectal (76872) |
$1,059 |
$1,412 |
7.9× |
| Vein X-Ray Chest (75827) |
$3,219.75 |
$4,293 |
1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,578.25 |
$4,771 |
0.9× |
| Venogram Sinus/Jugular (75860) |
$4,469.25 |
$5,959 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,329 |
$5,772 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,766.75 |
$3,689 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$2,144.25 |
$2,859 |
1.1× |
| Venography Renal Bilateral (75833) |
$4,548.75 |
$6,065 |
1.1× |
| Venography Renal Unilateral (75831) |
$4,469.25 |
$5,959 |
1.1× |
| Venous sampling by catheter (75893) |
$7,406.25 |
$9,875 |
1.0× |
| Wrist 2 views (73100) |
$388.50 |
$518 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$525.75 |
$701 |
4.7× |
| X-ray antegrade pyelogram tube (74425) |
$1,047 |
$1,396 |
2.3× |
| X-Ray Aorta Leg Arteries (75630) |
$6,672.75 |
$8,897 |
1.6× |
| X-Ray Bend Only L-S Spine (72120) |
$635.25 |
$847 |
4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$459.75 |
$613 |
4.1× |
| X-Ray Exam Breast Specimen (76098) |
$1,008 |
$1,344 |
1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$496.50 |
$662 |
4.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$663 |
$884 |
4.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$351.75 |
$469 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$399 |
$532 |
3.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$591 |
$788 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$671.25 |
$895 |
5.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$957.75 |
$1,277 |
7.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,115.25 |
$1,487 |
8.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$576 |
$768 |
5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,056 |
$1,408 |
7.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$660.75 |
$881 |
4.9× |
| X-ray eye for foreign body (70030) |
$264 |
$352 |
2.4× |
| X-ray humerus (73060) |
$402 |
$536 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$453 |
$604 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$453 |
$604 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$576.75 |
$769 |
4.3× |
| X-ray nose-rectum child f.b. (76010) |
$360.75 |
$481 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$794.25 |
$1,059 |
5.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$696.75 |
$929 |
5.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$410.25 |
$547 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$571.50 |
$762 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$525 |
$700 |
4.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$693.75 |
$925 |
5.2× |
| X-ray thoracic spine 4 vw (72074) |
$691.50 |
$922 |
5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,008.75 |
$1,345 |
2.2× |
| X-Rays Bone Length Studies (77073) |
$450.75 |
$601 |
3.4× |
| X-Rays Bone Survey Complete (77075) |
$949.50 |
$1,266 |
7.1× |
| Xr c-spine 4 or 5 views (72050) |
$838.50 |
$1,118 |
6.2× |
| Xr facial bones less than 3 views (70140) |
$492.75 |
$657 |
4.4× |
| Xr orbits complete 4 views (70200) |
$667.50 |
$890 |
5.0× |