| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$6,897 |
$6,897 |
4.7× |
| Acute gi blood loss imaging (78278) |
$1,725 |
$1,725 |
4.1× |
| Angio adrenal bilat select (75733) |
$3,792 |
$3,792 |
1.1× |
| Angio adrenal unilat select (75731) |
$2,471 |
$2,471 |
0.7× |
| Angio extremity unilateral (75710) |
$2,814 |
$2,814 |
0.8× |
| Angio pulmonary unilateral (75741) |
$2,729 |
$2,729 |
0.8× |
| Angiogram extremity bilateral (75716) |
$3,055 |
$3,055 |
0.9× |
| Angiogram pelvic (75736) |
$4,925 |
$4,925 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$3,194 |
$3,194 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,368 |
$3,368 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,027 |
$5,027 |
0.8× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,614 |
$1,614 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,869 |
$2,869 |
0.9× |
| Ankle 2 views (73600) |
$566.50 |
$566.50 |
6.1× |
| Arthrography knee lt (73580) |
$2,684 |
$2,684 |
7.2× |
| Arthrography wrist lt (73115) |
$1,923.50 |
$1,923.50 |
5.2× |
| Barium enema (74270) |
$1,499 |
$1,499 |
8.0× |
| Basic dosimetry (77300) |
$1,201 |
$1,201 |
8.4× |
| Bilat selctv renal venogram (75833) |
$2,839 |
$2,839 |
0.8× |
| Bone age studies (77072) |
$576 |
$576 |
5.2× |
| Bone imaging limited area (78300) |
$3,213 |
$3,213 |
7.5× |
| Bone marrow imaging whole body (78104) |
$5,330 |
$5,330 |
12.5× |
| Bone survey complete (77075) |
$1,701 |
$1,701 |
15.3× |
| Bowel imaging (78290) |
$1,889 |
$1,889 |
4.4× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$3,361 |
$3,361 |
8.4× |
| Brain image w/flow 4 + views (78606) |
$2,251 |
$2,251 |
3.9× |
| Cerebrospinal fluid leakage (78650) |
$2,841 |
$2,841 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,068 |
$1,068 |
5.7× |
| Cisternogram (78630) |
$2,579 |
$2,579 |
4.5× |
| Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) |
$857 |
$857 |
1.0× |
| Clavicle complete (73000) |
$589 |
$589 |
6.4× |
| Computed tomographic (CT) colonography, screening, including image postprocessing UNSCHEDULED (74263) |
$761 |
$761 |
3.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,696 |
$2,696 |
14.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,840 |
$1,840 |
12.9× |
| Contrast exam abdominl aorta (75625) |
$3,116 |
$3,116 |
0.9× |
| Contrast exam thoracic aorta (75605) |
$5,493 |
$5,493 |
0.9× |
| Corpora cavernosography (74445) |
$1,539 |
$1,539 |
13.8× |
| Csf shunt evaluation (78645) |
$2,018 |
$2,018 |
3.5× |
| CT - st neck w&wo contr (70492) |
$3,340 |
$3,340 |
17.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$8,244 |
$8,244 |
22.2× |
| CT abdomen and pelvis without contrast (74176) |
$4,523 |
$4,523 |
17.8× |
| CT abdomen w wo contrast (74170) |
$4,036 |
$4,036 |
21.6× |
| CT abdomen w/contrast (74160) |
$3,256 |
$3,256 |
17.4× |
| CT abdomen w/o contrast (74150) |
$1,727 |
$1,727 |
15.5× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$8,244 |
$8,244 |
22.2× |
| CT angio abdom w/o & w/dye (74175) |
$5,012 |
$5,012 |
26.8× |
| CT angio abdominal arteries (75635) |
$3,557 |
$3,557 |
19.0× |
| CT angio hrt w/3d image (75574) |
$1,534 |
$1,534 |
4.1× |
| CT angiograph pelv w/o&w/dye (72191) |
$4,210 |
$4,210 |
22.5× |
| CT cervical spine w/contrast (72126) |
$2,488 |
$2,488 |
6.7× |
| CT cervical spine w/o contrast (72125) |
$2,564 |
$2,564 |
23.0× |
| CT chest w/contrast (71260) |
$3,359 |
$3,359 |
18.0× |
| CT colonography diag w cont (74262) |
$2,798 |
$2,798 |
15.0× |
| CT colonography w/o cntrst (74261) |
$2,798 |
$2,798 |
25.1× |
| CT extremity upper w & w/o contrast (73202) |
$5,594.50 |
$5,594.50 |
30.0× |
| CT head/brain with contrast (70460) |
$2,480 |
$2,480 |
13.3× |
| CT head/brain without and with contrast (70470) |
$3,357 |
$3,357 |
18.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,534 |
$1,534 |
4.1× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$688 |
$688 |
7.4× |
| CT limited/localized follow up study (76380) |
$1,128 |
$1,128 |
12.2× |
| CT lower ext w/wo contrast (73702) |
$5,594.50 |
$5,594.50 |
30.0× |
| CT lower extremity w contrast (73701) |
$4,459.50 |
$4,459.50 |
23.9× |
| CT lower extremity w/o contrast unilateral (73700) |
$3,730 |
$3,730 |
33.5× |
| CT lumbar spine w/contrast (72132) |
$3,357 |
$3,357 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$2,891 |
$2,891 |
26.0× |
| CT lumbar spine w/o then w/ con (72133) |
$4,686 |
$4,686 |
25.1× |
| CT maxillofacial area w/o contrast (70486) |
$1,520.50 |
$1,520.50 |
13.7× |
| CT maxillofacial w/contrast (70487) |
$2,696 |
$2,696 |
14.4× |
| CT maxillofacial w/o then w/ con (70488) |
$3,357 |
$3,357 |
18.0× |
| CT orbit sella ear w/o con (70480) |
$2,541 |
$2,541 |
22.8× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$3,357 |
$3,357 |
18.0× |
| CT pelvis w & w/o contrast (72194) |
$4,210 |
$4,210 |
22.5× |
| CT pelvis w/o contrast (72192) |
$2,798 |
$2,798 |
25.1× |
| CT soft tissue neck w/contrast (70491) |
$2,776 |
$2,776 |
14.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,324 |
$2,324 |
20.9× |
| CT spine cervical w/wo contrast (72127) |
$4,210 |
$4,210 |
22.5× |
| CT thoracic spine w/contrast (72129) |
$3,357 |
$3,357 |
18.0× |
| CT thoracic spine w/o contrast (72128) |
$2,798 |
$2,798 |
25.1× |
| CT thoracic spine w/o then w/ con (72130) |
$4,210 |
$4,210 |
22.5× |
| CT thorax lung cancer scr c- (71271) |
$1,128 |
$1,128 |
10.1× |
| CT thorax w/o contrast (71250) |
$2,100 |
$2,100 |
18.9× |
| CT thorax w/o then w/ contrast (71270) |
$4,210 |
$4,210 |
22.5× |
| CT upper extremity w/dye (73201) |
$4,459.50 |
$4,459.50 |
12.0× |
| CT upper extremity w/o contrast rt (73200) |
$3,577.50 |
$3,577.50 |
32.1× |
| CTA chest w/wo contrast (71275) |
$2,798 |
$2,798 |
15.0× |
| CTA head w contrast (70496) |
$3,357 |
$3,357 |
18.0× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$5,594.50 |
$5,594.50 |
30.0× |
| Cta Neck (70498) |
$3,340 |
$3,340 |
17.9× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$5,594.50 |
$5,594.50 |
30.0× |
| Dilation ureters/urethra rs&i (74485) |
$1,871 |
$1,871 |
0.8× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$2,284 |
$2,284 |
1.1× |
| Diskography lumbar (72295) |
$3,828 |
$3,828 |
1.8× |
| Doppler echo fetal spectral display complete (76827) |
$684 |
$684 |
6.1× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$684 |
$684 |
6.1× |
| Doppler fetal mid cerebral artery (76821) |
$661 |
$661 |
5.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,253 |
$2,253 |
8.9× |
| Esophageal motility (78258) |
$1,268 |
$1,268 |
3.0× |
| Esophogram (74220) |
$1,040 |
$1,040 |
5.6× |
| Fetal biophysical profile non-stress testing (76818) |
$1,823 |
$1,823 |
16.4× |
| Fetal biophysical profile w/o nst (76819) |
$1,823 |
$1,823 |
16.4× |
| Fetal echo complete (76825) |
$2,253 |
$2,253 |
3.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$1,421.50 |
$1,421.50 |
5.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,562 |
$2,562 |
4.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$1,709 |
$1,709 |
4.0× |
| Gastric emptying study (78264) |
$1,491.50 |
$1,491.50 |
3.5× |
| Gastroesophageal reflux study (78262) |
$1,191 |
$1,191 |
2.8× |
| Gated heart planar single (78472) |
$1,831 |
$1,831 |
4.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$7,155 |
$7,155 |
9.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$7,155 |
$7,155 |
9.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$7,902 |
$7,902 |
10.7× |
| Heart infarct image (78466) |
$1,938 |
$1,938 |
4.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,073 |
$3,073 |
0.9× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$3,053 |
$3,053 |
0.9× |
| Hepatobil syst image w/drug (78227) |
$2,250 |
$2,250 |
3.9× |
| Hepatobiliary system imaging (78226) |
$1,896 |
$1,896 |
4.5× |
| Humerus min 2 views (73060) |
$661.50 |
$661.50 |
7.1× |
| Hysterosalpingography (74740) |
$1,363 |
$1,363 |
5.4× |
| Imrt planning (77301) |
$13,830 |
$13,830 |
9.4× |
| Infusion of radioelement (77750) |
$1,726 |
$1,726 |
4.2× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$6,829 |
$6,829 |
9.2× |
| Intracavitary radiation source applic complex (77763) |
$7,228 |
$7,228 |
9.7× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$2,837 |
$2,837 |
7.1× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$2,387 |
$2,387 |
6.0× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$3,865 |
$3,865 |
9.7× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$2,767 |
$2,767 |
6.9× |
| Ivp (74400) |
$1,616 |
$1,616 |
8.7× |
| Ivp w tomography (74415) |
$1,767 |
$1,767 |
9.5× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$2,636 |
$2,636 |
4.6× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,710 |
$1,710 |
3.0× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$2,636 |
$2,636 |
4.6× |
| Liver & spleen; static only (78215) |
$1,652 |
$1,652 |
3.9× |
| Liver & spleen; w vasc flow (78216) |
$2,567 |
$2,567 |
6.0× |
| Liver imaging w/vascular flow (78202) |
$2,567 |
$2,567 |
4.4× |
| Lung perf&ventilat diferentl (78598) |
$2,829 |
$2,829 |
4.9× |
| Lung perfusion differential (78597) |
$2,168 |
$2,168 |
5.1× |
| Lung ventilat&perfus imaging (78582) |
$2,251 |
$2,251 |
3.9× |
| Lung ventilation imaging (78579) |
$1,911 |
$1,911 |
4.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,679 |
$2,679 |
0.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$5,443 |
$5,443 |
14.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$5,443 |
$5,443 |
14.7× |
| Mammary ductogram multiple ducts (77054) |
$1,697 |
$1,697 |
6.7× |
| Mammary ductogram single (77053) |
$1,366 |
$1,366 |
5.4× |
| Mlc device(s) for imrt (77338) |
$2,570 |
$2,570 |
6.4× |
| MRA head w & w/o contrast (70546) |
$4,946 |
$4,946 |
13.3× |
| MRA head w/contrast (70545) |
$4,328 |
$4,328 |
11.7× |
| MRA head w/o contrast (70544) |
$4,328 |
$4,328 |
17.0× |
| MRA neck w/contrast (70548) |
$4,328 |
$4,328 |
11.7× |
| MRA neck w/o contrast (70547) |
$4,328 |
$4,328 |
17.0× |
| MRA neck w/wo contrast (70549) |
$4,946 |
$4,946 |
13.3× |
| MRI abdomen w/contrast (74182) |
$3,969.50 |
$3,969.50 |
10.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,739 |
$5,739 |
15.4× |
| MRI abdomen w/o contrast (74181) |
$3,969.50 |
$3,969.50 |
15.6× |
| MRI any jnt lwr ext with con lt (73722) |
$3,702 |
$3,702 |
4.4× |
| MRI bone marrow (77084) |
$1,682 |
$1,682 |
6.6× |
| MRI breast without contrast bilateral (77047) |
$5,317 |
$5,317 |
20.9× |
| MRI breast without contrast material unilateral (77046) |
$3,054 |
$3,054 |
12.0× |
| MRI cardiac w/o contrast (75557) |
$3,969.50 |
$3,969.50 |
15.6× |
| MRI cervical spine w/o contrast (72141) |
$3,607 |
$3,607 |
14.2× |
| MRI cervical spine with contrast (72142) |
$4,616 |
$4,616 |
12.4× |
| MRI chest w & w/o contrast (71552) |
$4,604 |
$4,604 |
12.4× |
| MRI chest w/contrast (71551) |
$4,604 |
$4,604 |
5.5× |
| MRI chest w/o contrast (71550) |
$4,528.50 |
$4,528.50 |
17.8× |
| MRI joint upper ext w/contrast (73222) |
$4,237 |
$4,237 |
5.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$6,140 |
$6,140 |
16.5× |
| MRI joint upr extrem w/o dye (73221) |
$4,237 |
$4,237 |
16.7× |
| Mri Lower Extremity W/O Dye (73718) |
$3,702 |
$3,702 |
14.6× |
| MRI lumbar spine with contrast (72149) |
$5,080 |
$5,080 |
13.7× |
| MRI lumbar w/wo contrast (72158) |
$6,398 |
$6,398 |
17.2× |
| MRI lwr ext w/o jnts with con rt (73719) |
$3,702 |
$3,702 |
10.0× |
| MRI orbit/face/neck w/contrast (70542) |
$3,850 |
$3,850 |
10.4× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$4,946 |
$4,946 |
13.3× |
| MRI orbit/face/neck w/o contrast (70540) |
$3,241.50 |
$3,241.50 |
12.8× |
| MRI pelvis w/ contrast (72196) |
$3,969.50 |
$3,969.50 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$4,462 |
$4,462 |
17.6× |
| MRI pelvis w/wo contrast (72197) |
$4,763 |
$4,763 |
12.8× |
| MRI spine cervical wo/w contrast (72156) |
$5,814 |
$5,814 |
15.7× |
| MRI spine thoracic w/contrast (72147) |
$5,080 |
$5,080 |
13.7× |
| MRI thoracic spine w wo contrast (72157) |
$6,398 |
$6,398 |
17.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,969.50 |
$3,969.50 |
15.6× |
| MRI tmj (70336) |
$3,969.50 |
$3,969.50 |
15.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,626.50 |
$5,626.50 |
22.1× |
| Mri Upper Extremity W/Dye (73219) |
$5,626.50 |
$5,626.50 |
15.1× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$5,443 |
$5,443 |
14.7× |
| Myelogram thoracic (72255) |
$2,890 |
$2,890 |
3.5× |
| Myelography 2 or more regions (72270) |
$2,670 |
$2,670 |
3.2× |
| Myelography lumbosacral (72265) |
$1,829 |
$1,829 |
2.2× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$1,394 |
$1,394 |
1.0× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$6,715 |
$6,715 |
4.4× |
| Nm adrenal imaging (78075) |
$5,330 |
$5,330 |
3.9× |
| Nm bone 3 phase (78315) |
$1,737 |
$1,737 |
4.1× |
| Nm bone imaging whole body (78306) |
$2,949 |
$2,949 |
6.9× |
| Nm bone marrow scan multiple (78103) |
$5,330 |
$5,330 |
12.5× |
| Nm bone multi (78305) |
$3,213 |
$3,213 |
7.5× |
| Nm heart perfusion spect stress rest (78452) |
$5,860 |
$5,860 |
4.3× |
| Nm kidney imaging morphology (78700) |
$1,477 |
$1,477 |
3.5× |
| Nm liver image static only (78201) |
$2,567 |
$2,567 |
4.4× |
| Nm lymph system (78195) |
$1,954 |
$1,954 |
3.4× |
| Nm thyroid imaging only (78013) |
$970 |
$970 |
2.3× |
| Nose to rectum for fb child (76010) |
$1,308 |
$1,308 |
14.1× |
| Nuclear medicine study of salivary gland with serial images (78231) |
$1,725 |
$1,725 |
4.1× |
| Nuclear rx IV admin (79101) |
$2,870 |
$2,870 |
11.6× |
| Ob us < 14 wks single fetus (76801) |
$1,524 |
$1,524 |
13.7× |
| Ob us nuchal meas 1 gest (76813) |
$684 |
$684 |
6.1× |
| Oral radiopharm rx (79005) |
$2,244 |
$2,244 |
9.0× |
| Parathyroid imaging (78070) |
$800 |
$800 |
1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,066 |
$2,066 |
4.9× |
| Peritoneal-venous shunt patency test (78291) |
$1,409 |
$1,409 |
3.3× |
| PET brain metabolic eval (78608) |
$8,878 |
$8,878 |
5.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,878 |
$8,878 |
5.8× |
| PET imaging CT for attenuation limited area (78814) |
$8,878 |
$8,878 |
5.8× |
| PET imaging for CT attenuation whole body (78816) |
$8,878 |
$8,878 |
5.8× |
| Proton treatment complex (77525) |
$7,555 |
$7,555 |
5.7× |
| Proton trmt intermediate (77523) |
$7,548 |
$7,548 |
5.7× |
| Proton trmt simple w/comp (77522) |
$7,423 |
$7,423 |
5.6× |
| Proton trmt simple w/o comp (77520) |
$4,472 |
$4,472 |
7.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,004 |
$3,004 |
0.9× |
| Pulmonary perfusion imaging particulate (78580) |
$1,971 |
$1,971 |
4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,094 |
$1,094 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$705 |
$705 |
7.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,204 |
$1,204 |
10.8× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$2,289 |
$2,289 |
20.6× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$2,289 |
$2,289 |
20.6× |
| Radex hip unilateral with pelvis 1 view (73501) |
$571 |
$571 |
6.2× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$704 |
$704 |
7.6× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$1,788 |
$1,788 |
16.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$853 |
$853 |
7.7× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$2,679 |
$2,679 |
24.1× |
| Radex spine cervical 2 or 3 views (72040) |
$730 |
$730 |
7.9× |
| Radex spine cervical 4 or 5 views (72050) |
$904 |
$904 |
8.1× |
| Radex spine cervical 6 or more views (72052) |
$1,084 |
$1,084 |
9.7× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$705 |
$705 |
7.6× |
| Radiation delivery stereotactic cranial linear (77372) |
$46,308 |
$46,308 |
5.9× |
| Radiation tx delivery lvl 1 (77402) |
$957.50 |
$957.50 |
8.8× |
| Radiation tx delivery lvl 2 (77407) |
$1,293 |
$1,293 |
3.1× |
| Radiation tx delivery lvl 3 (77412) |
$1,198.50 |
$1,198.50 |
2.0× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$827 |
$827 |
7.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$838 |
$838 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,404 |
$1,404 |
7.5× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$544 |
$544 |
5.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$673 |
$673 |
7.3× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$1,198 |
$1,198 |
10.8× |
| Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) |
$571 |
$571 |
5.1× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$705 |
$705 |
6.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$657 |
$657 |
1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$983 |
$983 |
2.4× |
| Renal cyst study (74470) |
$1,069 |
$1,069 |
1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,645 |
$1,645 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,337 |
$2,337 |
5.5× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$4,995 |
$4,995 |
8.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,857 |
$2,857 |
4.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,857 |
$2,857 |
4.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,918 |
$5,918 |
4.3× |
| Rp loclzj tum spect CT 2area/sep acquisj img (78832) |
$6,715 |
$6,715 |
4.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$5,918 |
$5,918 |
4.3× |
| Saline infused sonohysterogram (76831) |
$518 |
$518 |
2.0× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$172 |
$172 |
7.4× |
| Selective spinal angiogram (75705) |
$6,241 |
$6,241 |
1.1× |
| Shoulder arthrogram (73040) |
$2,037.50 |
$2,037.50 |
5.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,358 |
$1,358 |
12.2× |
| Simulation complex (77290) |
$5,086 |
$5,086 |
12.8× |
| Simulation intermediate (77285) |
$4,353 |
$4,353 |
10.9× |
| Simulation simple (77280) |
$2,823 |
$2,823 |
19.7× |
| Small bowel series (74250) |
$1,097 |
$1,097 |
5.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,512 |
$2,512 |
6.3× |
| Special dosimetry (77331) |
$999 |
$999 |
7.0× |
| Special physics consult (77370) |
$2,238 |
$2,238 |
15.6× |
| Special treatment procedure (77470) |
$3,058 |
$3,058 |
5.2× |
| Speech evaluation complex (70371) |
$1,035 |
$1,035 |
4.1× |
| Stereotactic body radiation delivery (77373) |
$18,656 |
$18,656 |
9.8× |
| Surface application of low dose rate radionuclide source 2nd-5th Sessions (77789) |
$1,076 |
$1,076 |
9.9× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) |
$2,321.50 |
$2,321.50 |
9.1× |
| Testicular imaging w/flow (78761) |
$1,407 |
$1,407 |
3.3× |
| Thyroid met imaging body (78018) |
$2,940 |
$2,940 |
5.1× |
| Thyroid uptake single/multiple quant measurement (78012) |
$759 |
$759 |
1.8× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,704 |
$1,704 |
4.0× |
| Treatment device intermediate (77333) |
$2,313 |
$2,313 |
16.2× |
| Treatment devices complex (77334) |
$2,682 |
$2,682 |
6.7× |
| Treatment devices simple (77332) |
$1,190 |
$1,190 |
8.3× |
| Ultrasound breast limited (76642) |
$1,187 |
$1,187 |
12.8× |
| Ultrasound, abdomen limited (76705) |
$1,221 |
$1,221 |
11.0× |
| Ultrasound, elastography; first target lesion (76982) |
$655 |
$655 |
5.9× |
| Umbilical-artery Doppler (OB) (76820) |
$1,472 |
$1,472 |
13.2× |
| Unlisted diagnostic radiographic procedure (76499) |
$111 |
$111 |
1.2× |
| Unlisted gastrointestinal procedure, diagnostic nuclear medicine UNSCHEDULED (78299) |
$1,673 |
$1,673 |
3.9× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$2,636 |
$2,636 |
6.2× |
| Unlisted magnetic resonance procedure (76498) |
$2,792 |
$2,792 |
30.1× |
| Urea breath test, C-14 (isotopic); acquisition for analysis Other Outpatient (78267) |
$106 |
$106 |
9.6× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$467 |
$467 |
4.9× |
| Urethrocystography retrograde rs&i (74450) |
$1,230 |
$1,230 |
4.8× |
| Urethrocystography voiding (74455) |
$2,366 |
$2,366 |
9.3× |
| Urography antegrade (74425) |
$984 |
$984 |
2.6× |
| Urography retrograde w/wo kub (74420) |
$1,285 |
$1,285 |
3.5× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) |
$1,616 |
$1,616 |
8.7× |
| Us abdominal aorta real time screen study aaa (76706) |
$692 |
$692 |
6.2× |
| Us breast uni real time with image complete (76641) |
$1,187 |
$1,187 |
10.7× |
| Us chest (76604) |
$1,215 |
$1,215 |
10.9× |
| Us compl joint r-t w/image documentation (76881) |
$1,659 |
$1,659 |
14.9× |
| Us elastography parenchyma (76981) |
$1,265 |
$1,265 |
11.4× |
| Us encephalogram (76506) |
$1,288 |
$1,288 |
11.6× |
| Us guided compression repair (76936) |
$1,507 |
$1,507 |
6.6× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$1,139 |
$1,139 |
12.3× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$1,021 |
$1,021 |
11.0× |
| Us kidney transplanted (76776) |
$1,288 |
$1,288 |
11.6× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$1,254 |
$1,254 |
11.3× |
| Us ob detailed single fetus (76811) |
$1,654 |
$1,654 |
6.5× |
| Us ob followup per fetus (76816) |
$970 |
$970 |
8.7× |
| Us ob limited 1 or more fetuses (76815) |
$1,276 |
$1,276 |
11.5× |
| Us obstetric transvaginal (76817) |
$970 |
$970 |
8.7× |
| Us pelvic limited or f/u non-ob (76857) |
$1,218 |
$1,218 |
10.9× |
| Us pelvis complete (76856) |
$1,420 |
$1,420 |
12.8× |
| Us retroperitoneal complete (76770) |
$1,712 |
$1,712 |
15.4× |
| Us retroperitoneal limited (76775) |
$1,288 |
$1,288 |
11.6× |
| Us scrotum (76870) |
$1,094 |
$1,094 |
9.8× |
| Us soft tissue head/neck (76536) |
$1,250 |
$1,250 |
11.2× |
| Us spinal canal (76800) |
$1,524 |
$1,524 |
13.7× |
| Us transrectal (76872) |
$1,606 |
$1,606 |
14.4× |
| Us transrectal prostate volume (76873) |
$1,719 |
$1,719 |
15.4× |
| Us unlstd proc (76999) |
$586 |
$586 |
6.3× |
| Vascular flow imaging (78445) |
$1,159 |
$1,159 |
2.7× |
| Vasography, vesiculography, or epididymography, radiological supervision and interpretation Other Diagnostic Radiology… (74440) |
$966 |
$966 |
3.8× |
| Vein X-ray liver w/hemodynam (75885) |
$3,026 |
$3,026 |
0.9× |
| Venogram extremity bilateral (75822) |
$1,772 |
$1,772 |
1.1× |
| Venogram ivc w serialography (75825) |
$2,824 |
$2,824 |
0.8× |
| Venogram svc w serialography (75827) |
$1,771 |
$1,771 |
1.1× |
| Venography adrenal unilateral selective rs&i (75840) |
$3,792 |
$3,792 |
1.1× |
| Venography ext unilateral (75820) |
$1,629 |
$1,629 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,631 |
$2,631 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,220 |
$3,220 |
1.0× |
| Venous sampling by catheter (75893) |
$5,509 |
$5,509 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$706 |
$706 |
7.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$708.50 |
$708.50 |
7.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$884.50 |
$884.50 |
9.5× |
| X-ray aorta leg arteries (75630) |
$4,790 |
$4,790 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,032 |
$2,032 |
10.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$853 |
$853 |
9.2× |
| X-ray exam hips bi 3-4 views (73522) |
$1,054 |
$1,054 |
9.5× |
| X-ray exam of finger(s) (73140) |
$276.50 |
$276.50 |
3.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$947 |
$947 |
5.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$676 |
$676 |
7.3× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$908 |
$908 |
9.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,178.50 |
$1,178.50 |
12.7× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$566.50 |
$566.50 |
5.1× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$647 |
$647 |
7.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$558.50 |
$558.50 |
6.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$467 |
$467 |
5.0× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$630.50 |
$630.50 |
6.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$630.50 |
$630.50 |
5.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$473 |
$473 |
5.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$904 |
$904 |
8.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,231 |
$1,231 |
11.1× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$814 |
$814 |
7.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$584 |
$584 |
6.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$889 |
$889 |
8.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$609 |
$609 |
5.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$521 |
$521 |
4.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$834 |
$834 |
9.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$752 |
$752 |
8.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$906 |
$906 |
9.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$945 |
$945 |
8.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$961 |
$961 |
8.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$846 |
$846 |
9.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$412 |
$412 |
4.4× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$557 |
$557 |
6.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$897 |
$897 |
9.7× |
| Xr abdomen 1 view (74018) |
$531 |
$531 |
5.7× |
| Xr abdomen 2 views (74019) |
$807 |
$807 |
7.2× |
| Xr abdomen 3 views (74021) |
$1,198 |
$1,198 |
10.8× |
| Xr arthrogram ankle (73615) |
$2,321.50 |
$2,321.50 |
6.2× |
| Xr arthrogram elbow (73085) |
$2,277 |
$2,277 |
6.1× |
| Xr arthrogram hip (73525) |
$2,037.50 |
$2,037.50 |
5.5× |
| Xr bone density appendicular (77081) |
$808 |
$808 |
8.7× |
| Xr bone density axial (77080) |
$808 |
$808 |
7.3× |
| Xr bone length study (77073) |
$834 |
$834 |
7.5× |
| Xr bone survey infant (77076) |
$806 |
$806 |
7.2× |
| Xr bone survey limited (77074) |
$1,442 |
$1,442 |
13.0× |
| Xr chest 1 view (71045) |
$661 |
$661 |
7.1× |
| Xr chest 2 views (71046) |
$698 |
$698 |
7.5× |
| Xr chest 3 views (71047) |
$773 |
$773 |
8.3× |
| Xr cystogram 3+ views (74430) |
$902 |
$902 |
2.4× |
| Xr eye foreign body (70030) |
$1 |
$1 |
0.0× |
| Xr facial bones 3 views (70150) |
$726 |
$726 |
6.5× |
| Xr lower extremity 2 views infant (73592) |
$520.50 |
$520.50 |
5.6× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$850 |
$850 |
7.6× |
| Xr mandible 4 views (70110) |
$634 |
$634 |
5.7× |
| Xr myelogram c-spine (72240) |
$1,989 |
$1,989 |
2.4× |
| Xr nasal bones (70160) |
$500 |
$500 |
5.4× |
| Xr pelvis 3 views (72190) |
$705 |
$705 |
6.3× |
| Xr sella turcica (70240) |
$467 |
$467 |
5.0× |
| Xr sialogram (70390) |
$1,230 |
$1,230 |
4.8× |
| Xr spine 1 view (72020) |
$376 |
$376 |
4.1× |
| Xr sternum 2 views (71120) |
$571 |
$571 |
6.2× |
| Xr surgical specimen (76098) |
$555 |
$555 |
1.0× |
| Xr upper extremity 2 views infant (73092) |
$1,058.50 |
$1,058.50 |
9.5× |
| Xray elbow 2 views (73070) |
$704.50 |
$704.50 |
7.6× |
| Xray forearm 2 views (73090) |
$607 |
$607 |
6.6× |
| Xray knee 1 or 2 views rt (73560) |
$601.50 |
$601.50 |
6.5× |
| Xray neck soft tissue (70360) |
$399 |
$399 |
4.3× |
| Xray orbits complete min 4 views (70200) |
$806 |
$806 |
7.2× |
| Xray pelvis 1 or 2 views (72170) |
$539 |
$539 |
4.8× |
| Xray ribs bilateral 3 views (71110) |
$748 |
$748 |
6.7× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$700 |
$700 |
6.3× |
| Xray scapula complete (73010) |
$500 |
$500 |
4.5× |
| Xray shoulder 1 view (73020) |
$687 |
$687 |
7.4× |
| Xray sinuses paranasal <3 views (70210) |
$609 |
$609 |
6.6× |
| Xray spine thoracic 2 views (72070) |
$630 |
$630 |
5.7× |
| Xray spine thoracic 3 views (72072) |
$705 |
$705 |
6.3× |
| Xray tibia-fibula 2 views bil (73590) |
$601.50 |
$601.50 |
6.5× |
| Xray tmj open - closed unilat (70328) |
$609 |
$609 |
6.6× |
| Xray tmj's bilateral open-clsc (70330) |
$701 |
$701 |
7.6× |