| 3-D radiotherapy plan dose-volume histograms (77295) |
$965.80 |
$4,829 |
0.8× |
| Abdomen 2 views (74019) |
$381.20 |
$1,906 |
4.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$843.80 |
$4,219 |
2.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,501.60 |
$7,508 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,065.60 |
$5,328 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,321.40 |
$6,607 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$890 |
$4,450 |
0.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$1,501.60 |
$7,508 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$766.60 |
$3,833 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$761.60 |
$3,808 |
0.3× |
| Angiography Spinal Selective Rs&I (75705) |
$890 |
$4,450 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$875.80 |
$4,379 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$742.80 |
$3,714 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$945.40 |
$4,727 |
0.3× |
| Ankle 2 views (73600) |
$223.60 |
$1,118 |
2.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$227.80 |
$1,139 |
0.7× |
| Aortogram thoracic (75605) |
$1,852.60 |
$9,263 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,924.40 |
$9,622 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,458.20 |
$7,291 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,501.60 |
$7,508 |
0.5× |
| Arthrogram elbow (73085) |
$728.80 |
$3,644 |
2.4× |
| Arthrogram hip (73525) |
$670.80 |
$3,354 |
2.2× |
| Arthrogram shoulder (73040) |
$670.80 |
$3,354 |
2.2× |
| Arthrogram wrist (73115) |
$670.80 |
$3,354 |
2.2× |
| Arthrography knee lt (73580) |
$670.80 |
$3,354 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$249.60 |
$1,248 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$983.40 |
$4,917 |
2.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$437.60 |
$2,188 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$2,112 |
$10,560 |
6.0× |
| Bone age studies (77072) |
$231 |
$1,155 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$2,110 |
$10,550 |
6.0× |
| Bone Marrow Imaging Limited Area (78102) |
$217.60 |
$1,088 |
0.6× |
| Bone survey complete (77075) |
$557.60 |
$2,788 |
6.1× |
| Brachytx isodose complex (77318) |
$625.40 |
$3,127 |
1.9× |
| Brachytx isodose intermed (77317) |
$451.80 |
$2,259 |
1.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$287.20 |
$1,436 |
0.9× |
| Brain image w/flow 4 + views (78606) |
$1,574.60 |
$7,873 |
3.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,278.40 |
$6,392 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$306.80 |
$1,534 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$280 |
$1,400 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$302.20 |
$1,511 |
4.0× |
| Chest 1 view (71045) |
$168.80 |
$844 |
2.2× |
| Chest 3 views (71047) |
$333.40 |
$1,667 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$240.20 |
$1,201 |
1.6× |
| Cineradiography/videoradiography (76120) |
$39.40 |
$197 |
0.4× |
| Clavicle complete (73000) |
$223.60 |
$1,118 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$62.50 |
$312.50 |
0.7× |
| Continuing medical physics consltj pr wk (77336) |
$339.60 |
$1,698 |
2.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$114 |
$570 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,862.80 |
$19,314 |
12.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,852.40 |
$14,262 |
13.7× |
| CT abdomen w contrast (74160) |
$1,820.40 |
$9,102 |
11.9× |
| CT abdomen w wo contrast (74170) |
$2,443 |
$12,215 |
15.9× |
| CT abdomen w/o contrast (74150) |
$1,586.20 |
$7,931 |
17.3× |
| CT angio hrt w/3d image (75574) |
$1,338.80 |
$6,694 |
4.4× |
| CT angiography upper extremity lt (73206) |
$929.60 |
$4,648 |
6.1× |
| CT c-spine w/o contrast (72125) |
$2,020.40 |
$10,102 |
22.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$94.40 |
$472 |
0.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,428.40 |
$12,142 |
15.8× |
| CT cervical spine with contrast (72126) |
$2,241.40 |
$11,207 |
7.3× |
| CT chest w/wo contrast (71270) |
$1,920.60 |
$9,603 |
12.5× |
| CT chest with contrast (71260) |
$1,846.20 |
$9,231 |
12.0× |
| CT head/brain with contrast (70460) |
$2,144.80 |
$10,724 |
14.0× |
| CT head/brain without and with contrast (70470) |
$1,952.20 |
$9,761 |
12.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$100 |
$500 |
0.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$16.50 |
$82.50 |
0.2× |
| CT hrt w/3d image congen (75573) |
$116.80 |
$584 |
0.4× |
| CT iac w contrast (70481) |
$1,514.60 |
$7,573 |
9.9× |
| CT limited/localized follow up study (76380) |
$467 |
$2,335 |
6.1× |
| CT lower ext w/o (73700) |
$746.80 |
$3,734 |
8.2× |
| CT lower extremity w wo contrast (73702) |
$1,443.20 |
$7,216 |
9.4× |
| CT lower extremity with contrast (73701) |
$1,358.40 |
$6,792 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,961.80 |
$9,809 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$993.80 |
$4,969 |
10.9× |
| CT lumbar spine with contrast (72132) |
$1,885.40 |
$9,427 |
6.2× |
| CT maxillofacial w contrast (70487) |
$1,196 |
$5,980 |
7.8× |
| CT maxillofacial w/o contrast (70486) |
$543.80 |
$2,719 |
5.9× |
| CT maxillofacial w/wo contrast (70488) |
$624.80 |
$3,124 |
4.1× |
| CT neck soft tissue w contrast (70491) |
$1,659.40 |
$8,297 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,659.40 |
$8,297 |
10.8× |
| CT orbits w/o contrast (70480) |
$1,474.60 |
$7,373 |
16.1× |
| CT pelvis w & w/o contrast (72194) |
$2,352.40 |
$11,762 |
15.3× |
| CT pelvis w/o contrast (72192) |
$1,607.60 |
$8,038 |
17.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$957.60 |
$4,788 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$2,026.40 |
$10,132 |
22.2× |
| CT thoracic spine w/contrast (72129) |
$2,490.40 |
$12,452 |
16.2× |
| CT thoracic spine w/o contrast (72128) |
$1,043.90 |
$5,219.50 |
11.4× |
| CT thoracic spine w/wo contrast (72130) |
$732.80 |
$3,664 |
4.8× |
| CT thorax w/o contrast (71250) |
$1,767.60 |
$8,838 |
19.3× |
| CT unlisted procedure (76497) |
$130.50 |
$652.50 |
1.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$738.80 |
$3,694 |
4.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,273.60 |
$6,368 |
13.9× |
| CT upper extremity with contrast (73201) |
$1,358.40 |
$6,792 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,143 |
$15,715 |
20.5× |
| Cta Abdomen (74175) |
$1,221.40 |
$6,107 |
8.0× |
| CTA abdomen pelvis (74174) |
$2,192.40 |
$10,962 |
7.2× |
| CTA chest (71275) |
$962 |
$4,810 |
6.3× |
| Cta Head (70496) |
$962 |
$4,810 |
6.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$187.60 |
$938 |
0.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,165.60 |
$5,828 |
7.6× |
| Cta Neck (70498) |
$1,258.20 |
$6,291 |
8.2× |
| Cta Pelvis (72191) |
$1,032.80 |
$5,164 |
6.7× |
| Cystography minimum 3 views rs&i (74430) |
$458.60 |
$2,293 |
1.5× |
| Diskogram cervical (72285) |
$2,396 |
$11,980 |
1.4× |
| Diskography lumbar (72295) |
$2,396 |
$11,980 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$104 |
$520 |
1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$159 |
$795 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$224.40 |
$1,122 |
2.5× |
| Echoencephalography real time imaging (76506) |
$673.60 |
$3,368 |
7.4× |
| Esophagus (74220) |
$564 |
$2,820 |
3.7× |
| Fetal biophysical profile non-stress testing (76818) |
$1,121 |
$5,605 |
12.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$817.40 |
$4,087 |
8.9× |
| Fluoroscopy up to 1 hr (76000) |
$147.40 |
$737 |
0.7× |
| Foot 2 views (73620) |
$223.60 |
$1,118 |
2.9× |
| Forearm 2 views (73090) |
$279.60 |
$1,398 |
3.7× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$351.60 |
$1,758 |
0.7× |
| Gastrointestinal Protein Loss (78282) |
$198.20 |
$991 |
0.6× |
| Gated Heart Planar Single (78472) |
$1,229.40 |
$6,147 |
3.5× |
| Hand 2 views (73120) |
$223.60 |
$1,118 |
2.4× |
| Hand 3 views (73130) |
$279.60 |
$1,398 |
3.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$507 |
$2,535 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$507 |
$2,535 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$507 |
$2,535 |
0.8× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$199.40 |
$997 |
0.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$138.80 |
$694 |
0.4× |
| Heart Infarct Image (78466) |
$1,547.60 |
$7,738 |
4.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$890 |
$4,450 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,268.60 |
$6,343 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$332.60 |
$1,663 |
1.0× |
| Ht muscle image spect sing (78451) |
$779.80 |
$3,899 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$279.60 |
$1,398 |
3.7× |
| Hysterosalpingogram (74740) |
$334.80 |
$1,674 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$1,723 |
$8,615 |
2.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,704.80 |
$8,524 |
2.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,396.60 |
$6,983 |
2.9× |
| Intracavitary radiation source applic simple (77761) |
$618.80 |
$3,094 |
1.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$412.80 |
$2,064 |
4.5× |
| Kidney funcj study non-img radioisotopic study (78725) |
$174.80 |
$874 |
0.5× |
| Kidney imaging morphology (78700) |
$1,076.20 |
$5,381 |
3.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$510.60 |
$2,553 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$394.20 |
$1,971 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,551 |
$7,755 |
3.3× |
| Knee 3 views (73562) |
$279.60 |
$1,398 |
3.7× |
| Liver & spleen imaging static only (78215) |
$534 |
$2,670 |
1.5× |
| Liver imaging w/vascular flow (78202) |
$436.20 |
$2,181 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$245.80 |
$1,229 |
0.5× |
| Lung perfusion differential (78597) |
$157 |
$785 |
0.4× |
| Lung Ventilation Imaging (78579) |
$183.40 |
$917 |
0.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,376.40 |
$6,882 |
0.5× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$651.40 |
$3,257 |
0.2× |
| Lymphoscintigraphy (78195) |
$404.20 |
$2,021 |
0.9× |
| Mammary ductogram or galactogram multiple (77054) |
$132 |
$660 |
0.6× |
| Mammary ductogram or galactogram single (77053) |
$94.40 |
$472 |
0.5× |
| Meckels Diverticulum (78290) |
$534 |
$2,670 |
1.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$78.60 |
$393 |
0.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,495.80 |
$12,479 |
7.6× |
| Mr safety determination physician/other qhp (76016) |
$47.80 |
$239 |
0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$13.40 |
$67 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$50 |
$250 |
0.6× |
| MRA head w & w/o contrast (70546) |
$1,045.20 |
$5,226 |
3.4× |
| MRA head w/o contrast (70544) |
$1,476 |
$7,380 |
7.1× |
| MRA head with contrast (70545) |
$1,041 |
$5,205 |
3.4× |
| MRA neck w contrast (70548) |
$1,886.60 |
$9,433 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,695 |
$8,475 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,476 |
$7,380 |
7.1× |
| MRI abdomen w contrast (74182) |
$1,067.40 |
$5,337 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,536.20 |
$12,681 |
8.3× |
| MRI abdomen w/o contrast (74181) |
$1,823.20 |
$9,116 |
8.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,715.80 |
$8,579 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,742 |
$8,710 |
2.5× |
| MRI bone marrow blood supply (77084) |
$723.80 |
$3,619 |
3.5× |
| MRI breast w/o contrast bilateral (77047) |
$575.20 |
$2,876 |
2.8× |
| MRI breast w/o contrast unilat (77046) |
$502.40 |
$2,512 |
2.4× |
| MRI c-spine with contrast (72142) |
$2,179.60 |
$10,898 |
7.1× |
| MRI cervical spine w/o contrast (72141) |
$2,001.40 |
$10,007 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,014.60 |
$5,073 |
3.3× |
| MRI chest w/o contrast (71550) |
$1,233.20 |
$6,166 |
5.9× |
| MRI chest with contrast (71551) |
$861.60 |
$4,308 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,067.40 |
$5,337 |
3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,067.40 |
$5,337 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,655.80 |
$8,279 |
7.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,090.20 |
$10,451 |
10.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,141.60 |
$10,708 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,107.20 |
$10,536 |
6.9× |
| MRI pelvis w contrast (72196) |
$701.40 |
$3,507 |
2.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,742 |
$8,710 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,398.60 |
$6,993 |
6.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,827.60 |
$9,138 |
6.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,827.60 |
$9,138 |
6.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,916.60 |
$14,583 |
9.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,398.40 |
$11,992 |
7.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,913 |
$14,565 |
9.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,138.40 |
$10,692 |
7.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,913 |
$14,565 |
9.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,126.20 |
$5,631 |
5.4× |
| MRI tmj (70336) |
$723.80 |
$3,619 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,655.80 |
$8,279 |
7.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,827.60 |
$9,138 |
6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,655.80 |
$8,279 |
7.9× |
| Myelogram Lumbar (72265) |
$1,792.60 |
$8,963 |
2.6× |
| Myelography 2 or more regions (72270) |
$429.60 |
$2,148 |
0.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,457.40 |
$7,287 |
1.3× |
| Myocardial infarct spect (78469) |
$463.20 |
$2,316 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,615.60 |
$13,078 |
2.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$553.20 |
$2,766 |
0.7× |
| Neck soft tissue (70360) |
$251 |
$1,255 |
3.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$414.80 |
$2,074 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$199.60 |
$998 |
0.6× |
| Nm adrenal scan (78075) |
$495.80 |
$2,479 |
0.4× |
| Nm bone marrow wb (78104) |
$223 |
$1,115 |
0.6× |
| Nm cisternogram (78630) |
$842 |
$4,210 |
1.8× |
| Nm csf leak detection (78650) |
$377.60 |
$1,888 |
0.3× |
| Nm gastric emptying study (78264) |
$1,118.20 |
$5,591 |
3.2× |
| Nm gastroesophageal reflux study (78262) |
$507.20 |
$2,536 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$301.40 |
$1,507 |
0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,625.60 |
$8,128 |
1.3× |
| Nuclear medicine study of endocrine organs (78099) |
$236.20 |
$1,181 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$325.80 |
$1,629 |
0.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$265 |
$1,325 |
0.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$483.60 |
$2,418 |
1.4× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$320.80 |
$1,604 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$1,425 |
$7,125 |
7.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$688.60 |
$3,443 |
7.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$127.60 |
$638 |
1.4× |
| Orthopantogram (70355) |
$80 |
$400 |
1.1× |
| Osseous survey infant (77076) |
$84.20 |
$421 |
0.9× |
| Osseous survey limited (77074) |
$93.40 |
$467 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$226.20 |
$1,131 |
0.6× |
| Parathyroid imaging (78070) |
$542.20 |
$2,711 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$323.80 |
$1,619 |
3.5× |
| Peritoneogram rs&i (74190) |
$153.80 |
$769 |
0.3× |
| PET image w/CT, skull-thigh (78815) |
$1,278.40 |
$6,392 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$4,242 |
$21,210 |
3.4× |
| PET imaging for CT attenuation whole body (78816) |
$1,278.40 |
$6,392 |
1.0× |
| Pr csf ventriculography (78635) |
$207.40 |
$1,037 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,827.60 |
$9,138 |
6.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$730.80 |
$3,654 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$335.80 |
$1,679 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$715.40 |
$3,577 |
1.5× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$500.40 |
$2,502 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$222.40 |
$1,112 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$217 |
$1,085 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$315.80 |
$1,579 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$80.20 |
$401 |
0.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$112.80 |
$564 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$153 |
$765 |
1.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$5,067.40 |
$25,337 |
0.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$281.80 |
$1,409 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$146 |
$730 |
1.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$146 |
$730 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$311.20 |
$1,556 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$280.40 |
$1,402 |
3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$457.20 |
$2,286 |
5.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$302.20 |
$1,511 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$624.40 |
$3,122 |
4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$116.20 |
$581 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$640 |
$3,200 |
4.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$636.80 |
$3,184 |
4.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$223.60 |
$1,118 |
2.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$79.40 |
$397 |
1.0× |
| Radiological examination surgical specimen (76098) |
$235 |
$1,175 |
0.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,248.20 |
$6,241 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,651.80 |
$8,259 |
0.6× |
| Ribs bilateral 3 views (71110) |
$155 |
$775 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,190.40 |
$10,952 |
6.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,551 |
$7,755 |
3.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,712.60 |
$18,563 |
7.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$518 |
$2,590 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$141.80 |
$709 |
0.7× |
| Rp Therapy Intravenous Administration (79101) |
$119.20 |
$596 |
0.6× |
| Sacroiliac Joints < 3 Views (72200) |
$95.60 |
$478 |
1.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$122.20 |
$611 |
0.6× |
| Salivary gland imaging (78230) |
$194.20 |
$971 |
0.6× |
| Scanogram (77073) |
$372.40 |
$1,862 |
4.1× |
| Scapula complete (73010) |
$279.60 |
$1,398 |
3.1× |
| Screening digital breast tomosynthesis (77063) |
$25.80 |
$129 |
1.1× |
| Sella turcica (70240) |
$40.20 |
$201 |
0.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$475.40 |
$2,377 |
5.2× |
| Sialogram (70390) |
$122.20 |
$611 |
0.6× |
| Simulation intermediate (77285) |
$458 |
$2,290 |
1.4× |
| Small bowel series (74250) |
$497.40 |
$2,487 |
3.2× |
| Spec medical radj physics consltj (77370) |
$309.60 |
$1,548 |
2.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$527.20 |
$2,636 |
1.6× |
| Special dosimetry (77331) |
$335.20 |
$1,676 |
2.9× |
| Special treatment procedure (77470) |
$844.40 |
$4,222 |
1.7× |
| Spine thoracic 3 views (72072) |
$437.80 |
$2,189 |
4.8× |
| Stereotactic body radiation delivery (77373) |
$1,122.20 |
$5,611 |
0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$74.80 |
$374 |
0.8× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$64 |
$320 |
0.7× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$55 |
$275 |
0.6× |
| Tbs Technical Calculation Only (77091) |
$53.80 |
$269 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$626 |
$3,130 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$279.20 |
$1,396 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$314.40 |
$1,572 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$708.20 |
$3,541 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$382 |
$1,910 |
3.2× |
| Therapeutic Enema (74283) |
$368 |
$1,840 |
2.4× |
| Thoracolumbar 2 views (72080) |
$183.60 |
$918 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,315.60 |
$11,578 |
4.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$363.80 |
$1,819 |
1.0× |
| Thyroid uptake measurement (78012) |
$439.60 |
$2,198 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$673.60 |
$3,368 |
1.9× |
| Tomogram (76100) |
$133.20 |
$666 |
1.5× |
| Treatment device intermediate (77333) |
$311.60 |
$1,558 |
2.6× |
| Treatment devices simple (77332) |
$241.60 |
$1,208 |
2.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,173.20 |
$20,866 |
8.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$666.80 |
$3,334 |
1.9× |
| Tx devices design & construction complex (77334) |
$541.60 |
$2,708 |
1.7× |
| Ultrasound elastography first target lesion (76982) |
$68.60 |
$343 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$874 |
$4,370 |
9.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$39.40 |
$197 |
0.5× |
| Unlisted fluoroscopic procedure (76496) |
$89 |
$445 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$360.80 |
$1,804 |
4.7× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$218.40 |
$1,092 |
0.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$91.20 |
$456 |
1.0× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$255 |
$1,275 |
0.7× |
| Unlisted Ultrasound Procedure (76999) |
$524.20 |
$2,621 |
6.9× |
| Upper Extremity Infant (73092) |
$223.60 |
$1,118 |
2.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$208.80 |
$1,044 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$588.80 |
$2,944 |
2.8× |
| Urethrocystography voiding (74455) |
$629 |
$3,145 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$774.80 |
$3,874 |
5.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$384.80 |
$1,924 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$177.40 |
$887 |
1.9× |
| Us breast unilateral complete (76641) |
$250 |
$1,250 |
2.7× |
| Us breast unilateral limited (76642) |
$364.40 |
$1,822 |
4.8× |
| Us chest (76604) |
$667.20 |
$3,336 |
7.3× |
| Us compl joint r-t w/image documentation (76881) |
$1,109.40 |
$5,547 |
12.1× |
| Us elastography parenchyma (76981) |
$96.40 |
$482 |
1.1× |
| Us guided compression repair (76936) |
$704 |
$3,520 |
3.7× |
| Us infant hips limited static (76886) |
$135 |
$675 |
1.8× |
| Us kidney transplant (76776) |
$231 |
$1,155 |
2.5× |
| Us ob transvaginal (76817) |
$524.20 |
$2,621 |
5.7× |
| Us pelvic non ob complete (76856) |
$916 |
$4,580 |
10.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$471.60 |
$2,358 |
5.2× |
| Us pregnancy ltd (76815) |
$135 |
$675 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$836.60 |
$4,183 |
9.1× |
| Us retroperitoneal complete (76770) |
$902.40 |
$4,512 |
9.9× |
| Us retroperitoneal limited (76775) |
$239.80 |
$1,199 |
2.6× |
| Us scrotum and contents (76870) |
$810.20 |
$4,051 |
8.9× |
| Us soft tissue head/neck (76536) |
$673.60 |
$3,368 |
7.4× |
| Us spinal canal and contents (76800) |
$379 |
$1,895 |
4.1× |
| Us transrectal (76872) |
$427.80 |
$2,139 |
4.7× |
| Us transrectal prostate volume (76873) |
$73.80 |
$369 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$616.20 |
$3,081 |
6.7× |
| Us, eye b-scan (76512) |
$64.60 |
$323 |
0.7× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$146.20 |
$731 |
0.4× |
| Vascular flow imaging (78445) |
$183.60 |
$918 |
0.5× |
| Venogram extremity bilateral (75822) |
$336 |
$1,680 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$567 |
$2,835 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$1,501.60 |
$7,508 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$245.80 |
$1,229 |
0.2× |
| Venography Renal Bilateral (75833) |
$890 |
$4,450 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$813.80 |
$4,069 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$504.80 |
$2,524 |
0.2× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$859.20 |
$4,296 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$69.20 |
$346 |
0.9× |
| Wrist 2 views (73100) |
$279.60 |
$1,398 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$464.80 |
$2,324 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$296 |
$1,480 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$251.40 |
$1,257 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$835 |
$4,175 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$279.60 |
$1,398 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$335.20 |
$1,676 |
4.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$153 |
$765 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$48.20 |
$241 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$335.20 |
$1,676 |
4.4× |
| X-ray exam hip uni 4/> views (73503) |
$80.20 |
$401 |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$80.20 |
$401 |
0.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$542.20 |
$2,711 |
5.9× |
| X-ray exam of femur 1 (73551) |
$194.80 |
$974 |
2.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$186.40 |
$932 |
1.2× |
| X-ray eye for foreign body (70030) |
$294.60 |
$1,473 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$373.40 |
$1,867 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$118.80 |
$594 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$279.60 |
$1,398 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$215.80 |
$1,079 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$229.20 |
$1,146 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$57.40 |
$287 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$364.40 |
$1,822 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86.60 |
$433 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$179 |
$895 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$263.50 |
$1,317.50 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$527 |
$2,635 |
5.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$163 |
$815 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$230.80 |
$1,154 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$75 |
$375 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$370.40 |
$1,852 |
4.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$75 |
$375 |
0.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$86 |
$430 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$739 |
$3,695 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$114.40 |
$572 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$558.80 |
$2,794 |
6.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$480.40 |
$2,402 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$162.80 |
$814 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$342.60 |
$1,713 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$335.20 |
$1,676 |
4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$457.20 |
$2,286 |
6.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$168.40 |
$842 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$441.40 |
$2,207 |
4.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$309.80 |
$1,549 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$249.60 |
$1,248 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$94.60 |
$473 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$300.60 |
$1,503 |
3.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$403 |
$2,015 |
4.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$251 |
$1,255 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$335.20 |
$1,676 |
4.4× |
| Xr arthrogram ankle (73615) |
$143.20 |
$716 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$449.20 |
$2,246 |
4.9× |
| Xr chest 4+ views (71048) |
$364 |
$1,820 |
4.0× |
| Xr Cholecystography Oral Contrast (74290) |
$88.60 |
$443 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$263.20 |
$1,316 |
3.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$61.20 |
$306 |
0.7× |
| Xr shoulder 1 view (73020) |
$279.60 |
$1,398 |
3.7× |
| Xr spine cervical 4 or 5 views (72050) |
$433.80 |
$2,169 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$251.40 |
$1,257 |
3.3× |
| Xr tmj bilateral (70330) |
$97.40 |
$487 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$223.60 |
$1,118 |
2.9× |