| 3-D radiotherapy plan dose-volume histograms (77295) |
$476.77 |
$2,979.80 |
0.4× |
| Abdomen 2 views (74019) |
$58.72 |
$367 |
0.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$275.68 |
$1,723 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,280 |
$8,000 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,041.44 |
$6,509 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$566.56 |
$3,541 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,056.48 |
$6,603 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,056.80 |
$6,605 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$921.60 |
$5,760 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$682.72 |
$4,267 |
0.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$164.16 |
$1,026 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$374.72 |
$2,342 |
0.1× |
| Ankle 2 views (73600) |
$71.04 |
$444 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$108 |
$675 |
0.3× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$956.32 |
$5,977 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$576 |
$3,600 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$1,041.44 |
$6,509 |
0.4× |
| Arthrogram elbow (73085) |
$94.08 |
$588 |
0.3× |
| Arthrogram hip (73525) |
$112.64 |
$704 |
0.4× |
| Arthrogram shoulder (73040) |
$102.88 |
$643 |
0.3× |
| Arthrogram wrist (73115) |
$94.08 |
$588 |
0.3× |
| Arthrography knee lt (73580) |
$141.12 |
$882 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$49.47 |
$309.22 |
0.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$251.04 |
$1,569 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$342.56 |
$2,141 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$301.28 |
$1,883 |
0.8× |
| Bone age studies (77072) |
$35.68 |
$223 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$304 |
$1,900 |
0.8× |
| Bone Marrow Imaging Limited Area (78102) |
$141.28 |
$883 |
0.4× |
| Bone survey complete (77075) |
$144 |
$900 |
1.5× |
| Brachytx isodose complex (77318) |
$128.73 |
$804.55 |
0.4× |
| Brachytx isodose intermed (77317) |
$128.73 |
$804.55 |
0.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$128.73 |
$804.55 |
0.4× |
| Brain image w/flow 4 + views (78606) |
$166.88 |
$1,043 |
0.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$550.24 |
$3,439 |
0.4× |
| Brain Imaging Vascular Flow Only (78610) |
$179.04 |
$1,119 |
0.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$172.96 |
$1,081 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$61.12 |
$382 |
0.8× |
| Chest 1 view (71045) |
$47.36 |
$296 |
0.6× |
| Chest 3 views (71047) |
$67.68 |
$423 |
0.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$95.36 |
$596 |
0.6× |
| Cineradiography/videoradiography (76120) |
$45.28 |
$283 |
0.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$288 |
$1,800 |
0.4× |
| Clavicle complete (73000) |
$58.40 |
$365 |
0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$32.48 |
$203 |
0.3× |
| Continuing medical physics consltj pr wk (77336) |
$49.51 |
$309.43 |
0.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$72.16 |
$451 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$773.28 |
$4,833 |
2.4× |
| CT abdomen and pelvis without contrast (74176) |
$615.04 |
$3,844 |
2.8× |
| CT abdomen w contrast (74160) |
$355.04 |
$2,219 |
2.2× |
| CT abdomen w wo contrast (74170) |
$425.28 |
$2,658 |
2.7× |
| CT abdomen w/o contrast (74150) |
$306.08 |
$1,913 |
3.2× |
| CT angio hrt w/3d image (75574) |
$218.24 |
$1,364 |
0.7× |
| CT angiography upper extremity lt (73206) |
$396.80 |
$2,480 |
2.5× |
| CT c-spine w/o contrast (72125) |
$314.40 |
$1,965 |
3.3× |
| CT cervical spine w&w/o contrast (72127) |
$367.68 |
$2,298 |
2.3× |
| CT cervical spine with contrast (72126) |
$362.08 |
$2,263 |
1.1× |
| CT chest w/wo contrast (71270) |
$440.96 |
$2,756 |
2.8× |
| CT chest with contrast (71260) |
$360.96 |
$2,256 |
2.3× |
| CT head/brain with contrast (70460) |
$352.32 |
$2,202 |
2.2× |
| CT head/brain without and with contrast (70470) |
$395.68 |
$2,473 |
2.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$60 |
$375 |
0.8× |
| CT hrt w/3d image congen (75573) |
$115.84 |
$724 |
0.4× |
| CT iac w contrast (70481) |
$310.40 |
$1,940 |
1.9× |
| CT lower ext w/o (73700) |
$254.56 |
$1,591 |
2.7× |
| CT lower extremity w wo contrast (73702) |
$315.04 |
$1,969 |
2.0× |
| CT lower extremity with contrast (73701) |
$288.96 |
$1,806 |
1.8× |
| CT lumbar spine w & w/o contrast (72133) |
$367.68 |
$2,298 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$315.20 |
$1,970 |
3.3× |
| CT lumbar spine with contrast (72132) |
$362.08 |
$2,263 |
1.1× |
| CT maxillofacial w contrast (70487) |
$310.40 |
$1,940 |
1.9× |
| CT maxillofacial w/o contrast (70486) |
$268.16 |
$1,676 |
2.8× |
| CT maxillofacial w/wo contrast (70488) |
$402.56 |
$2,516 |
2.5× |
| CT neck soft tissue w contrast (70491) |
$320.80 |
$2,005 |
2.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$402.56 |
$2,516 |
2.5× |
| CT orbits w/o contrast (70480) |
$274.88 |
$1,718 |
2.9× |
| CT pelvis w & w/o contrast (72194) |
$413.60 |
$2,585 |
2.6× |
| CT pelvis w/o contrast (72192) |
$308.80 |
$1,930 |
3.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$361.12 |
$2,257 |
2.3× |
| CT soft tissue neck w/o contrast (70490) |
$274.88 |
$1,718 |
2.9× |
| CT thoracic spine w/contrast (72129) |
$362.08 |
$2,263 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$315.20 |
$1,970 |
3.3× |
| CT thoracic spine w/wo contrast (72130) |
$367.68 |
$2,298 |
2.3× |
| CT thorax w/o contrast (71250) |
$317.60 |
$1,985 |
3.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$315.04 |
$1,969 |
2.0× |
| CT upper extremity w/o contrast rt (73200) |
$254.56 |
$1,591 |
2.7× |
| CT upper extremity with contrast (73201) |
$288.96 |
$1,806 |
0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$587.52 |
$3,672 |
3.7× |
| Cta Abdomen (74175) |
$476.16 |
$2,976 |
3.0× |
| CTA abdomen pelvis (74174) |
$702.88 |
$4,393 |
2.2× |
| CTA chest (71275) |
$476.16 |
$2,976 |
3.0× |
| Cta Head (70496) |
$476.16 |
$2,976 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$396.80 |
$2,480 |
2.5× |
| Cta Neck (70498) |
$453.76 |
$2,836 |
2.8× |
| Cta Pelvis (72191) |
$396.80 |
$2,480 |
2.5× |
| Cystography minimum 3 views rs&i (74430) |
$58.88 |
$368 |
0.2× |
| Diskography lumbar (72295) |
$323.84 |
$2,024 |
0.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$45.28 |
$283 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$76.80 |
$480 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$30.56 |
$191 |
0.4× |
| Dxa bone density study axial skeleton (77085) |
$44.96 |
$281 |
0.5× |
| Echoencephalography real time imaging (76506) |
$113.92 |
$712 |
1.2× |
| Esophagus (74220) |
$69.60 |
$435 |
0.4× |
| Fetal biophysical profile non-stress testing (76818) |
$45.28 |
$283 |
0.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$97.60 |
$610 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$57.28 |
$358 |
0.3× |
| Foot 2 views (73620) |
$71.04 |
$444 |
0.9× |
| Forearm 2 views (73090) |
$71.04 |
$444 |
0.9× |
| Gated Heart Planar Single (78472) |
$284 |
$1,775 |
0.8× |
| Hand 2 views (73120) |
$71.04 |
$444 |
0.7× |
| Hand 3 views (73130) |
$94.72 |
$592 |
1.2× |
| Heart Infarct Image (78466) |
$185.60 |
$1,160 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$336 |
$2,100 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$285.28 |
$1,783 |
0.8× |
| Ht muscle image spect sing (78451) |
$506.40 |
$3,165 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$58.32 |
$364.50 |
0.7× |
| Hysterosalpingogram (74740) |
$88.16 |
$551 |
0.4× |
| Image fusion (77399) |
$49.51 |
$309.43 |
0.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$67.20 |
$420 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$282.72 |
$1,767 |
0.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$314.72 |
$1,967 |
0.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$423.36 |
$2,646 |
0.9× |
| Knee 3 views (73562) |
$94.72 |
$592 |
1.2× |
| Liver & spleen imaging static only (78215) |
$182.72 |
$1,142 |
0.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$228.64 |
$1,429 |
0.6× |
| Lung perfusion differential (78597) |
$196.48 |
$1,228 |
0.5× |
| Lung Ventilation Imaging (78579) |
$196.48 |
$1,228 |
0.5× |
| Lymphoscintigraphy (78195) |
$225.76 |
$1,411 |
0.5× |
| Meckels Diverticulum (78290) |
$221.76 |
$1,386 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$128.73 |
$804.55 |
0.4× |
| MRA head w & w/o contrast (70546) |
$845.44 |
$5,284 |
2.7× |
| MRA head w/o contrast (70544) |
$488.64 |
$3,054 |
2.3× |
| MRA head with contrast (70545) |
$552.80 |
$3,455 |
1.7× |
| MRA neck w contrast (70548) |
$552.80 |
$3,455 |
1.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$845.44 |
$5,284 |
2.7× |
| MRA neck w/o contrast (70547) |
$488.64 |
$3,054 |
2.3× |
| MRI abdomen w contrast (74182) |
$463.20 |
$2,895 |
1.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$907.04 |
$5,669 |
2.9× |
| MRI abdomen w/o contrast (74181) |
$458.56 |
$2,866 |
2.1× |
| MRI any jnt lwr ext with con lt (73722) |
$694.80 |
$4,342.50 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$463.20 |
$2,895 |
0.7× |
| MRI breast w/o contrast bilateral (77047) |
$668.64 |
$4,179 |
3.1× |
| MRI breast w/o contrast unilat (77046) |
$334.24 |
$2,089 |
1.5× |
| MRI c-spine with contrast (72142) |
$524.64 |
$3,279 |
1.7× |
| MRI cervical spine w/o contrast (72141) |
$477.28 |
$2,983 |
2.2× |
| MRI chest w/o & w/contrast material (71552) |
$907.04 |
$5,669 |
2.9× |
| MRI chest w/o contrast (71550) |
$458.56 |
$2,866 |
2.1× |
| MRI chest with contrast (71551) |
$463.20 |
$2,895 |
0.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$463.20 |
$2,895 |
1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$463.20 |
$2,895 |
1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$680.40 |
$4,252.50 |
3.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$399.36 |
$2,496 |
1.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$907.04 |
$5,669 |
2.9× |
| MRI orbit/face/neck w/contrast (70542) |
$463.20 |
$2,895 |
1.5× |
| MRI pelvis w contrast (72196) |
$463.20 |
$2,895 |
1.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$786.24 |
$4,914 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$415.04 |
$2,594 |
1.9× |
| MRI scan of arm joint before and after contrast (73223) |
$907.04 |
$5,669 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$907.04 |
$5,669 |
2.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$907.04 |
$5,669 |
2.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$524.64 |
$3,279 |
1.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$907.04 |
$5,669 |
2.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$524.64 |
$3,279 |
1.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$907.04 |
$5,669 |
2.9× |
| MRI thoracic spine w/o contrast (72146) |
$477.28 |
$2,983 |
2.2× |
| MRI tmj (70336) |
$799.04 |
$4,994 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$680.40 |
$4,252.50 |
3.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$907.04 |
$5,669 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$453.60 |
$2,835 |
2.1× |
| Myocardial infarct spect (78469) |
$273.28 |
$1,708 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$686.56 |
$4,291 |
0.6× |
| Neck soft tissue (70360) |
$32.32 |
$202 |
0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$161.92 |
$1,012 |
0.4× |
| Nm cisternogram (78630) |
$211.84 |
$1,324 |
0.4× |
| Nm csf leak detection (78650) |
$273.28 |
$1,708 |
0.2× |
| Nm gastric emptying study (78264) |
$278.24 |
$1,739 |
0.8× |
| Nm gastroesophageal reflux study (78262) |
$252.64 |
$1,579 |
0.7× |
| Nm peritoneal-venous shunt patency (78291) |
$174.24 |
$1,089 |
0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$476.77 |
$2,979.80 |
0.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$203.68 |
$1,273 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$87.04 |
$544 |
0.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$74.72 |
$467 |
0.8× |
| Osseous survey infant (77076) |
$67.20 |
$420 |
0.7× |
| Osseous survey limited (77074) |
$67.20 |
$420 |
0.7× |
| Parathyrd planar w/wo subtrj (78071) |
$290.08 |
$1,813 |
0.8× |
| Parathyroid imaging (78070) |
$233.92 |
$1,462 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$35.84 |
$224 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$736.80 |
$4,605 |
0.6× |
| PET imaging for CT attenuation whole body (78816) |
$766.24 |
$4,789 |
0.6× |
| PET whole body (78813) |
$736.80 |
$4,605 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$831.52 |
$5,197 |
2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$244.80 |
$1,530 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$307.52 |
$1,922 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$136.64 |
$854 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$24.80 |
$155 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$45.28 |
$283 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$47.36 |
$296 |
0.5× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,057.70 |
$19,110.60 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$89.78 |
$561.15 |
0.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$46.80 |
$292.48 |
0.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$89.78 |
$561.15 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$54.24 |
$339 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$44.96 |
$281 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$80.32 |
$502 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$58.72 |
$367 |
0.7× |
| Radiologic exam colon single contrast study (74270) |
$98.88 |
$618 |
0.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$72.96 |
$456 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$91.68 |
$573 |
0.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$80.64 |
$504 |
0.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$58.32 |
$364.50 |
0.7× |
| Radiological examination surgical specimen (76098) |
$108 |
$675 |
0.2× |
| Ribs bilateral 3 views (71110) |
$80.32 |
$502 |
0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$236.64 |
$1,479 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$236.64 |
$1,479 |
0.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$238.24 |
$1,489 |
0.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$508.80 |
$3,180 |
0.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$577.28 |
$3,608 |
0.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$508.80 |
$3,180 |
0.4× |
| Rp Therapy Intravenous Administration (79101) |
$221.44 |
$1,384 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$47.36 |
$296 |
0.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$161.76 |
$1,011 |
0.7× |
| Scanogram (77073) |
$40.64 |
$254 |
0.4× |
| Scapula complete (73010) |
$47.36 |
$296 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$40 |
$250 |
1.7× |
| Sella turcica (70240) |
$39.20 |
$245 |
0.5× |
| Sialogram (70390) |
$66.24 |
$414 |
0.3× |
| Simulation intermediate (77285) |
$128.73 |
$804.55 |
0.4× |
| Small bowel series (74250) |
$74.72 |
$467 |
0.5× |
| Spec medical radj physics consltj (77370) |
$49.51 |
$309.43 |
0.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$128.73 |
$804.55 |
0.4× |
| Special dosimetry (77331) |
$49.51 |
$309.43 |
0.4× |
| Special treatment procedure (77470) |
$207.94 |
$1,299.63 |
0.4× |
| Spine thoracic 3 views (72072) |
$72.64 |
$454 |
0.8× |
| Stereotactic body radiation delivery (77373) |
$676.23 |
$4,226.43 |
0.4× |
| Tbs Technical Calculation Only (77091) |
$29.60 |
$185 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$128.73 |
$804.55 |
0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$128.73 |
$804.55 |
0.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$128.73 |
$804.55 |
0.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$49.51 |
$309.43 |
0.4× |
| Thoracolumbar 2 views (72080) |
$56 |
$350 |
0.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$288.64 |
$1,804 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$230.24 |
$1,439 |
0.6× |
| Thyroid uptake measurement (78012) |
$178.24 |
$1,114 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$276.48 |
$1,728 |
0.8× |
| Tmj unilateral (70328) |
$24.80 |
$155 |
0.3× |
| Treatment device intermediate (77333) |
$49.51 |
$309.43 |
0.4× |
| Treatment devices simple (77332) |
$49.51 |
$309.43 |
0.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$507.20 |
$3,170 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$178.24 |
$1,114 |
0.5× |
| Tx devices design & construction complex (77334) |
$128.73 |
$804.55 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$84.48 |
$528 |
0.9× |
| Umbilical-artery Doppler (OB) (76820) |
$56.48 |
$353 |
0.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$24.80 |
$155 |
0.3× |
| Unlisted Ultrasound Procedure (76999) |
$83.36 |
$521 |
1.1× |
| Upper Extremity Infant (73092) |
$48.96 |
$306 |
0.5× |
| Urethrocystography retrograde rs&i (74450) |
$57.92 |
$362 |
0.3× |
| Urethrocystography voiding (74455) |
$73.12 |
$457 |
0.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$156 |
$975 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$70.08 |
$438 |
0.7× |
| Us breast unilateral complete (76641) |
$174.24 |
$1,089 |
1.8× |
| Us breast unilateral limited (76642) |
$103.92 |
$649.50 |
1.3× |
| Us chest (76604) |
$102.08 |
$638 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$84.48 |
$528 |
0.9× |
| Us guided compression repair (76936) |
$162.56 |
$1,016 |
0.8× |
| Us infant hips dynamic (76885) |
$82.56 |
$516 |
1.0× |
| Us infant hips limited static (76886) |
$24.80 |
$155 |
0.3× |
| Us kidney transplant (76776) |
$122.56 |
$766 |
1.3× |
| Us ob detailed single fetus (76811) |
$220 |
$1,375 |
1.0× |
| Us ob transvaginal (76817) |
$91.68 |
$573 |
1.0× |
| Us pelvic non ob complete (76856) |
$117.92 |
$737 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$75.04 |
$469 |
0.8× |
| Us pregnancy ltd (76815) |
$89.76 |
$561 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$169.92 |
$1,062 |
1.8× |
| Us retroperitoneal complete (76770) |
$135.68 |
$848 |
1.4× |
| Us retroperitoneal limited (76775) |
$108.80 |
$680 |
1.1× |
| Us scrotum and contents (76870) |
$89.60 |
$560 |
0.9× |
| Us soft tissue head/neck (76536) |
$83.36 |
$521 |
0.9× |
| Us spinal canal and contents (76800) |
$70.40 |
$440 |
0.7× |
| Us transrectal (76872) |
$139.52 |
$872 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$70.24 |
$439 |
0.7× |
| Venogram extremity bilateral (75822) |
$369.12 |
$2,307 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$517.76 |
$3,236 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$358.40 |
$2,240 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$369.12 |
$2,307 |
0.3× |
| Venography Renal Bilateral (75833) |
$524.48 |
$3,278 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$1,310.88 |
$8,193 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,056.64 |
$6,604 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,750.40 |
$10,940 |
0.3× |
| Wrist 2 views (73100) |
$71.04 |
$444 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$80.32 |
$502 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$36.32 |
$227 |
0.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$71.04 |
$444 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$125.28 |
$783 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$50.88 |
$318 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$71.04 |
$444 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$45.28 |
$283 |
0.5× |
| X-ray exam hip uni 1 view (73501) |
$33.92 |
$212 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$47.36 |
$296 |
0.6× |
| X-ray exam hip uni 4/> views (73503) |
$47.36 |
$296 |
0.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$47.36 |
$296 |
0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$94.72 |
$592 |
1.0× |
| X-ray exam of femur 1 (73551) |
$47.36 |
$296 |
0.6× |
| X-ray eye for foreign body (70030) |
$26.88 |
$168 |
0.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$47.36 |
$296 |
0.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$32.16 |
$201 |
0.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$71.04 |
$444 |
0.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$394.72 |
$2,467 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$71.04 |
$444 |
0.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$156 |
$975 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$54.24 |
$339 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$88.32 |
$552 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$32.64 |
$204 |
0.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$42.48 |
$265.50 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$72.64 |
$454 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$79.04 |
$494 |
0.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$72.64 |
$454 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$54.24 |
$339 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$29.44 |
$184 |
0.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$54.24 |
$339 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$42.40 |
$265 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$224.48 |
$1,403 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$58.72 |
$367 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$80.32 |
$502 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$102.08 |
$638 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$72.64 |
$454 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$51.52 |
$322 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$55.92 |
$349.50 |
0.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$54.24 |
$339 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$39.20 |
$245 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$54.24 |
$339 |
0.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$39.20 |
$245 |
0.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$44.96 |
$281 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$35.84 |
$224 |
0.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$40.32 |
$252 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$56 |
$350 |
0.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$61.12 |
$382 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$45.36 |
$283.50 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$71.04 |
$444 |
0.9× |
| Xr arthrogram ankle (73615) |
$94.08 |
$588 |
0.3× |
| Xr c-spine 6 or more views (72052) |
$141.60 |
$885 |
1.5× |
| Xr chest 4+ views (71048) |
$99.04 |
$619 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$45.36 |
$283.50 |
0.6× |
| Xr shoulder 1 view (73020) |
$48.96 |
$306 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$101.28 |
$633 |
1.1× |
| Xr tibia/fibula 2 views (73590) |
$71.04 |
$444 |
0.9× |
| Xr tmj bilateral (70330) |
$40.32 |
$252 |
0.5× |
| Xray knee 1 or 2 views rt (73560) |
$54.32 |
$339.50 |
0.7× |