| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,807.45 |
$10,559 |
4.4× |
| Abdomen 1 View (74018) |
$321.75 |
$585 |
3.8× |
| Abdomen 2 views (74019) |
$521.95 |
$949 |
5.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$915.20 |
$1,664 |
2.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,651.10 |
$3,002 |
1.3× |
| Adrenal Cortex & Medulla Img (78075) |
$1,000.45 |
$1,819 |
0.8× |
| Angio internal mammary (75756) |
$3,032.70 |
$5,514 |
1.0× |
| Angio pulmonary bilat (75743) |
$5,644.10 |
$10,262 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$4,637.05 |
$8,431 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$2,319.35 |
$4,217 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,822.05 |
$5,131 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,872.65 |
$5,223 |
0.9× |
| Ankle 2 views (73600) |
$269.50 |
$490 |
3.2× |
| Aortography thoracic serialography rs&i (75605) |
$3,032.70 |
$5,514 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$3,818.65 |
$6,943 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,751.65 |
$5,003 |
0.9× |
| Artery X-Rays Pelvis (75736) |
$3,032.70 |
$5,514 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,818.65 |
$6,943 |
0.7× |
| Arthrogram ankle (73615) |
$403.70 |
$734 |
1.2× |
| Arthrogram hip (73525) |
$567.60 |
$1,032 |
1.7× |
| Arthrogram Wrist (73115) |
$453.20 |
$824 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$741.95 |
$1,349 |
5.7× |
| Bone age studies (77072) |
$218.90 |
$398 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,565.30 |
$2,846 |
4.1× |
| Bone Imaging Limited Area (78300) |
$713.90 |
$1,298 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$820.60 |
$1,492 |
2.1× |
| Bone Imaging Whole Body (78306) |
$1,419 |
$2,580 |
3.7× |
| Bone marrow imaging; multiple areas (78103) |
$639.10 |
$1,162 |
1.7× |
| Bone marrow imaging; whole body (78104) |
$798.60 |
$1,452 |
2.1× |
| Bone survey infant (77076) |
$308 |
$560 |
3.1× |
| Brachytx isodose complex (77318) |
$2,039.95 |
$3,709 |
5.7× |
| Brachytx isodose intermed (77317) |
$887.70 |
$1,614 |
2.5× |
| Brachytx Isodose Plan Simple (77316) |
$755.70 |
$1,374 |
2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$743.05 |
$1,351 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,559.05 |
$6,471 |
2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,036.65 |
$3,703 |
6.1× |
| Cat Scan Follow-Up Study (76380) |
$1,661.55 |
$3,021 |
19.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$621.50 |
$1,130 |
1.2× |
| Cerebrospinal Fluid Scan (78630) |
$1,663.20 |
$3,024 |
3.2× |
| Chest 1 view (71045) |
$332.75 |
$605 |
4.0× |
| Chest 2 views (71046) |
$355.85 |
$647 |
4.3× |
| Chest 3 views (71047) |
$406.45 |
$739 |
4.9× |
| Chest 4 or more views (71048) |
$497.75 |
$905 |
5.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$453.75 |
$825 |
4.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$894.85 |
$1,627 |
1.2× |
| Clavicle complete (73000) |
$310.75 |
$565 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$710.60 |
$1,292 |
7.1× |
| Continuing medical physics consltj pr wk (77336) |
$1,029.05 |
$1,871 |
8.0× |
| Contrast Exam Abdominl Aorta (75625) |
$2,815.45 |
$5,119 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$997.15 |
$1,813 |
3.0× |
| Contrast X-Ray Of Elbow (73085) |
$458.15 |
$833 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$495 |
$900 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,380.20 |
$7,964 |
13.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,063.50 |
$5,570 |
13.3× |
| CT abdomen w contrast (74160) |
$2,915.55 |
$5,301 |
17.3× |
| CT abdomen w wo contrast (74170) |
$3,826.35 |
$6,957 |
22.7× |
| CT abdomen w/o contrast (74150) |
$2,410.10 |
$4,382 |
24.0× |
| CT Angio Abdomen and Pelvis (74174) |
$5,313 |
$9,660 |
15.8× |
| CT Angio Chest (71275) |
$3,674.55 |
$6,681 |
21.8× |
| CT Angio Head (70496) |
$3,020.60 |
$5,492 |
17.9× |
| CT angio hrt w/3d image (75574) |
$3,061.85 |
$5,567 |
9.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,737.35 |
$4,977 |
16.2× |
| CT Angio Neck (70498) |
$2,268.20 |
$4,124 |
13.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,737.35 |
$4,977 |
16.2× |
| CT bone density (77078) |
$662.20 |
$1,204 |
7.9× |
| CT cervical spine w/ contrast (72126) |
$2,989.80 |
$5,436 |
8.9× |
| CT cervical spine w/o contrast (72125) |
$2,727.45 |
$4,959 |
27.1× |
| CT cervical spine w/wo cont (72127) |
$3,549.15 |
$6,453 |
21.0× |
| CT chest w contrast (71260) |
$3,095.95 |
$5,629 |
18.4× |
| CT chest w/wo contrast (71270) |
$4,126.65 |
$7,503 |
24.5× |
| CT head/brain with contrast (70460) |
$2,138.95 |
$3,889 |
12.7× |
| CT head/brain without and with contrast (70470) |
$2,446.40 |
$4,448 |
14.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,895.85 |
$3,447 |
5.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$48.40 |
$88 |
0.6× |
| CT iac w contrast (70481) |
$2,244.55 |
$4,081 |
13.3× |
| CT l-spine w&w/o contrast (72133) |
$3,597 |
$6,540 |
21.3× |
| CT lower ext w/o (73700) |
$2,669.70 |
$4,854 |
26.6× |
| CT lower extremity w/contrast material (73701) |
$2,686.20 |
$4,884 |
15.9× |
| CT lumbar spine w contrast (72132) |
$2,910.60 |
$5,292 |
8.7× |
| CT lumbar spine w/o contrast (72131) |
$2,710.40 |
$4,928 |
27.0× |
| CT maxillofacial w contrast (70487) |
$2,263.80 |
$4,116 |
13.4× |
| CT maxillofacial wo contrast (70486) |
$2,123 |
$3,860 |
21.1× |
| CT neck tissue combo (70492) |
$3,060.75 |
$5,565 |
18.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,413.40 |
$4,388 |
14.3× |
| CT orbits w/o contrast (70480) |
$1,966.25 |
$3,575 |
19.6× |
| CT pelvis w&w/o contrast (72194) |
$3,613.50 |
$6,570 |
21.4× |
| CT pelvis w/o contrast (72192) |
$2,292.95 |
$4,169 |
22.8× |
| CT scan of leg combo (73702) |
$2,891.90 |
$5,258 |
17.1× |
| CT scans face/jaw combo (70488) |
$2,675.75 |
$4,865 |
15.9× |
| CT soft tissue neck w contrast (70491) |
$2,300.10 |
$4,182 |
13.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,046.55 |
$3,721 |
20.4× |
| CT thoracic spine w contrast (72129) |
$2,474.45 |
$4,499 |
14.7× |
| CT thoracic spine w/o contrast (72128) |
$2,443.10 |
$4,442 |
24.3× |
| CT thoracic spine w/wo cont (72130) |
$2,892.45 |
$5,259 |
17.1× |
| CT thorax w/o contrast (71250) |
$2,683.45 |
$4,879 |
26.7× |
| CT unlisted procedure (76497) |
$944.90 |
$1,718 |
11.3× |
| CT upper ext wo (73200) |
$2,628.45 |
$4,779 |
26.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,148.20 |
$5,724 |
18.7× |
| CT upper extremity with contrast (73201) |
$2,763.75 |
$5,025 |
8.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,737.35 |
$4,977 |
16.2× |
| Cta Abdomen (74175) |
$3,808.20 |
$6,924 |
22.6× |
| CTA pelvis (72191) |
$3,801.05 |
$6,911 |
22.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$377.30 |
$686 |
1.6× |
| Dilation ureters/urethra rs&i (74485) |
$1,401.40 |
$2,548 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$1,860.10 |
$3,382 |
1.0× |
| Diskography lumbar (72295) |
$1,860.10 |
$3,382 |
1.0× |
| Dxa Bone Density Axial (77080) |
$539.55 |
$981 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$519.75 |
$945 |
6.2× |
| Echograp Trans R Pros Study (76873) |
$1,009.80 |
$1,836 |
10.0× |
| Esophageal Motility Study (78258) |
$867.35 |
$1,577 |
2.3× |
| Esophagram (74220) |
$750.20 |
$1,364 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$733.15 |
$1,333 |
7.3× |
| Fluoroscopy up to 1 hr (76000) |
$676.50 |
$1,230 |
2.9× |
| Follow-Up Angiography (75898) |
$2,116.40 |
$3,848 |
0.7× |
| Foot 2 views (73620) |
$319 |
$580 |
3.8× |
| Forearm 2 views (73090) |
$319 |
$580 |
3.8× |
| Gastric emptying imaging study (78264) |
$1,448.15 |
$2,633 |
3.8× |
| Gastric Mucosa Imaging (78261) |
$780.45 |
$1,419 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,241.35 |
$2,257 |
3.2× |
Hand 2 views (73120)
range across 2 matching MRF lines |
$284.90–$339.90 |
$518–$618 |
varies |
| Heart Image (Pet) Multiple (78492) |
$3,835.15 |
$6,973 |
2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,032.70 |
$5,514 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,978.25 |
$5,415 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,774.30 |
$3,226 |
3.4× |
| Hepatobiliary System Imaging (78226) |
$1,725.90 |
$3,138 |
4.5× |
| Ht Musc Image Planar Mult (78454) |
$2,009.15 |
$3,653 |
1.6× |
| Ht Muscle Image Spect Sing (78451) |
$1,361.80 |
$2,476 |
1.1× |
| Hysterosalpingogram (74740) |
$754.05 |
$1,371 |
3.3× |
| Image fusion (77399) |
$207.90 |
$378 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$5,456 |
$9,920 |
8.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,171.40 |
$3,948 |
3.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,571.90 |
$2,858 |
3.0× |
| Intracavitary radiation source applic simple (77761) |
$1,388.20 |
$2,524 |
2.6× |
| Joint Survey Single View (77077) |
$131.45 |
$239 |
1.3× |
| K Flow/Funct Image Multiple (78709) |
$1,408.55 |
$2,561 |
2.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,310.65 |
$2,383 |
2.5× |
| K Flow/Funct Image W/O Drug (78707) |
$1,308.45 |
$2,379 |
2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,151.70 |
$2,094 |
3.0× |
| Knee 3 Views (73562) |
$440 |
$800 |
5.3× |
| Leveen/Shunt Patency Exam (78291) |
$285.45 |
$519 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$499.40 |
$908 |
1.3× |
| Liver imaging static only (78201) |
$287.10 |
$522 |
0.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,490.50 |
$2,710 |
2.9× |
| Lymph System Imaging (78195) |
$1,394.25 |
$2,535 |
2.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,232.15 |
$9,513 |
1.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,615.80 |
$4,756 |
0.9× |
| Magnetic Image Jaw Joint (70336) |
$2,171.40 |
$3,948 |
9.5× |
| Mammary ductogram or galactogram multiple (77054) |
$473.55 |
$861 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$382.25 |
$695 |
1.7× |
| Meckels Divert Exam (78290) |
$420.75 |
$765 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$379.50 |
$690 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,076.25 |
$3,775 |
6.2× |
| MRA head w/o contrast (70544) |
$1,483.35 |
$2,697 |
6.5× |
| MRA head with contrast (70545) |
$2,055.35 |
$3,737 |
6.1× |
| MRA neck w contrast (70548) |
$1,862.85 |
$3,387 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,020.70 |
$3,674 |
6.0× |
| MRA neck w/o contrast (70547) |
$1,566.95 |
$2,849 |
6.8× |
| MRI abdomen w contrast (74182) |
$2,577.30 |
$4,686 |
7.7× |
| MRI abdomen w/o contrast (74181) |
$1,911.80 |
$3,476 |
8.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,346.85 |
$4,267 |
3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,512.40 |
$4,568 |
7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,325.40 |
$4,228 |
3.1× |
| MRI bone marrow blood supply (77084) |
$1,342.55 |
$2,441 |
5.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,080.65 |
$3,783 |
9.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,373.90 |
$2,498 |
6.0× |
| MRI cardiac w/o contrast (75557) |
$2,022.90 |
$3,678 |
8.8× |
| MRI cervical spine w contrast (72142) |
$2,147.20 |
$3,904 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$1,775.40 |
$3,228 |
7.7× |
| MRI chest w/o contrast (71550) |
$1,846.35 |
$3,357 |
8.0× |
| MRI chest wo w contrast (71552) |
$2,449.70 |
$4,454 |
7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,229.70 |
$4,054 |
6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,314.40 |
$4,208 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,104.85 |
$3,827 |
9.2× |
| MRI lumbar spine w contrast (72149) |
$2,522.30 |
$4,586 |
7.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,236.20 |
$5,884 |
9.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,488.30 |
$2,706 |
6.5× |
| MRI orbit face neck w contrast (70542) |
$2,120.25 |
$3,855 |
6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,016.75 |
$5,485 |
9.0× |
| MRI pelvis w contrast (72196) |
$3,186.15 |
$5,793 |
9.5× |
| MRI pelvis w/o & w contrast (72197) |
$3,202.10 |
$5,822 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,058.65 |
$3,743 |
9.0× |
| MRI spectroscopy (76390) |
$3,090.45 |
$5,619 |
36.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,975.05 |
$3,591 |
8.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,325.40 |
$4,228 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,262.15 |
$4,113 |
9.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,346.85 |
$4,267 |
7.0× |
| MRI, abdomen, combo (74183) |
$2,812.15 |
$5,113 |
8.4× |
| MRI, dorsal spine combo (72157) |
$3,436.40 |
$6,248 |
10.2× |
| MRI, dorsal spine contrast (72147) |
$2,483.80 |
$4,516 |
7.4× |
| MRI, joint upper extrem (73221) |
$2,035 |
$3,700 |
8.9× |
| MRI, joint upper extrem combo (73223) |
$2,346.85 |
$4,267 |
7.0× |
| MRI, lumbar spine combo (72158) |
$3,742.20 |
$6,804 |
11.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,480.40 |
$6,328 |
2.8× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$609.95 |
$1,109 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,707.10 |
$4,922 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$851.95 |
$1,549 |
1.0× |
| Neck soft tissue (70360) |
$205.15 |
$373 |
2.5× |
| Nm csf leak detection (78650) |
$818.40 |
$1,488 |
0.7× |
| Nm myocard infarct spect (78469) |
$914.10 |
$1,662 |
1.8× |
| Nm whole blood volume (78122) |
$527.45 |
$959 |
1.0× |
| Nonvascular Shunt X-Ray (75809) |
$254.10 |
$462 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,339.60 |
$6,072 |
2.5× |
| Nuclear Rx Intra-Arterial (79445) |
$475.20 |
$864 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$752.40 |
$1,368 |
3.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$316.80 |
$576 |
3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,429.45 |
$2,599 |
2.7× |
| Parathyroid Planar Imaging (78070) |
$894.30 |
$1,626 |
2.3× |
Parathyroid planar imaging w/wo subtraction (78071)
range across 2 matching MRF lines |
$977.90–$989.45 |
$1,778–$1,799 |
varies |
| Pelvis 1 or 2 views (72170) |
$330.55 |
$601 |
3.3× |
| Peritoneogram Rs&I (74190) |
$614.35 |
$1,117 |
1.2× |
| Pet Image W/Ct Lmtd (78814) |
$3,598.65 |
$6,543 |
2.6× |
| PET image w/CT, full body (78816) |
$4,299.90 |
$7,818 |
3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,946.80 |
$7,176 |
2.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$5,229.95 |
$9,509 |
4.2× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) |
$798.60 |
$1,452 |
0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,144.35 |
$5,717 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$778.25 |
$1,415 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$780.45 |
$1,419 |
7.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$685.85 |
$1,247 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$376.75 |
$685 |
4.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$371.80 |
$676 |
4.4× |
| Radex elbow complete minimum 3 views (73080) |
$322.30 |
$586 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$524.70 |
$954 |
5.2× |
| Radex fingr minimum 2 views (73140) |
$282.70 |
$514 |
3.4× |
| Radex foot complete minimum 3 views (73630) |
$370.15 |
$673 |
4.4× |
| Radex Hand Minimum 3 Views (73130) |
$394.90 |
$718 |
4.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$198.55 |
$361 |
2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$336.60 |
$612 |
3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$391.05 |
$711 |
4.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$429 |
$780 |
5.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$386.65 |
$703 |
4.6× |
| Radex shoulder complete minimum 2 views (73030) |
$488.40 |
$888 |
5.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$249.70 |
$454 |
3.0× |
| Radex Spine 1 View Specify Level (72020) |
$224.95 |
$409 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$310.75 |
$565 |
3.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$222.20 |
$404 |
2.7× |
| Radex Toe Minimum 2 Views (73660) |
$322.30 |
$586 |
3.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$177.65 |
$323 |
1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$342.10 |
$622 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$387.20 |
$704 |
3.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$67,460.80 |
$122,656 |
9.5× |
| Radiation treatment delivery level 1 (77402) |
$451 |
$820 |
4.6× |
| Radiation treatment delivery level 2 (77407) |
$458.70 |
$834 |
1.2× |
| Radiation treatment delivery level 3 (77412) |
$854.70 |
$1,554 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$470.25 |
$855 |
4.7× |
| Radiologic exam colon double contrast study (74280) |
$1,263.35 |
$2,297 |
7.5× |
| Radiologic exam colon single contrast study (74270) |
$893.20 |
$1,624 |
5.3× |
| Radiologic exam knee complete 4/more views (73564) |
$467.50 |
$850 |
4.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$427.90 |
$778 |
4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,149.50 |
$2,090 |
6.8× |
| Radiologic exam swallow function contrast study (74230) |
$715 |
$1,300 |
4.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$824.45 |
$1,499 |
4.9× |
| Radiologic examination femur 1 view (73551) |
$473.55 |
$861 |
5.7× |
| Radiologic examination femur minimum 2 views (73552) |
$473.55 |
$861 |
5.7× |
| Radiologic examination knee 1/2 views (73560) |
$385 |
$700 |
4.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$104.50 |
$190 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$322.30 |
$586 |
3.9× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$569.25 |
$1,035 |
2.5× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$527.45 |
$959 |
1.4× |
| Renal Cyst Study (74470) |
$364.65 |
$663 |
0.7× |
| Ribs bilateral 3 views (71110) |
$539.55 |
$981 |
5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$469.70 |
$854 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$771.65 |
$1,403 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,262.25 |
$2,295 |
2.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,262.25 |
$2,295 |
2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,575.20 |
$2,864 |
3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,197.80 |
$3,996 |
1.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,471.70 |
$4,494 |
11.0× |
| Rp Therapy Intravenous Administration (79101) |
$474.65 |
$863 |
2.1× |
| Scapula (73010) |
$371.80 |
$676 |
3.7× |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines |
$41.80–$83.60 |
$76–$152 |
varies |
| Sella turcica (70240) |
$219.45 |
$399 |
2.6× |
| Shoulder 1 view (73020) |
$253.55 |
$461 |
3.0× |
| Shoulder Arthrography (73040) |
$788.15 |
$1,433 |
2.3× |
| Sialogram (70390) |
$458.15 |
$833 |
2.0× |
| Skull less than 4 views (70250) |
$510.40 |
$928 |
5.1× |
| Special dosimetry (77331) |
$726.55 |
$1,321 |
5.6× |
| Special Physics Consult (77370) |
$1,240.80 |
$2,256 |
9.6× |
| Special teletherapy port plan (77321) |
$1,235.85 |
$2,247 |
3.4× |
| Special treatment procedure (77470) |
$2,476.10 |
$4,502 |
4.7× |
| Speech evaluation, complex (70371) |
$751.30 |
$1,366 |
3.3× |
| Sternoclavicular joints (71130) |
$215.05 |
$391 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$2,616.90 |
$4,758 |
0.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$707.30 |
$1,286 |
7.2× |
| Tbs technical calculation only (77091) |
$128.15 |
$233 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,969.90 |
$7,218 |
11.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,100.90 |
$5,638 |
8.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$484 |
$880 |
2.1× |
| Testicular Imaging W/Flow (78761) |
$548.90 |
$998 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,107.05 |
$3,831 |
5.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,214.40 |
$2,208 |
3.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,153.35 |
$2,097 |
8.9× |
| Thoracic spine 2 views (72070) |
$265.65 |
$483 |
2.6× |
| Thoracic spine 3 views (72072) |
$435.05 |
$791 |
4.3× |
| Thoracolumbar 2 views (72080) |
$424.60 |
$772 |
5.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$289.30 |
$526 |
0.8× |
| Thyroid Met Imaging Body (78018) |
$1,394.25 |
$2,535 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$203.50 |
$370 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$971.30 |
$1,766 |
2.5× |
| Tx Devices Design & Construction Complex (77334) |
$1,768.80 |
$3,216 |
4.9× |
| Tx devices design & construction intermediate (77333) |
$1,053.25 |
$1,915 |
8.1× |
| Tx devices design & construction simple (77332) |
$990 |
$1,800 |
7.7× |
| Ultrasound Breast Limited (76642) |
$566.50 |
$1,030 |
6.8× |
| Ultrasound Exam Aaa Screen (76706) |
$384.45 |
$699 |
3.8× |
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines |
$762.30–$899.25 |
$1,386–$1,635 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$494.45 |
$899 |
4.9× |
| Unlis px ther radiol clinical tx planning (77299) |
$207.90 |
$378 |
1.6× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$230.45 |
$419 |
0.6× |
| Unlisted us procedure (76999) |
$678.15 |
$1,233 |
8.1× |
| Upper gi w/o kub (74240) |
$799.15 |
$1,453 |
4.7× |
| Urethrocystogram voiding (74455) |
$933.90 |
$1,698 |
4.1× |
| Urethrocystography retrograde (74450) |
$803 |
$1,460 |
3.5× |
| Us bone density measurement (76977) |
$83.60 |
$152 |
0.8× |
| Us breast unilateral complete (76641) |
$566.50 |
$1,030 |
5.6× |
| Us chest (76604) |
$477.95 |
$869 |
4.8× |
| Us complete joint (76881) |
$719.40 |
$1,308 |
7.2× |
| Us exam, pelvic, limited (76857) |
$557.15 |
$1,013 |
5.5× |
| Us head (76506) |
$603.35 |
$1,097 |
6.0× |
| Us kidney transplant (76776) |
$1,467.40 |
$2,668 |
14.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$547.80 |
$996 |
5.4× |
| Us ob limited 1 or more fetuses (76815) |
$558.80 |
$1,016 |
5.6× |
| Us ob transvaginal (76817) |
$751.85 |
$1,367 |
7.5× |
| Us pelvic non ob complete (76856) |
$953.15 |
$1,733 |
9.5× |
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines |
$730.95–$794.75 |
$1,329–$1,445 |
varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$730.95 |
$1,329 |
7.3× |
| Us retroperitoneal complete (76770) |
$779.35 |
$1,417 |
7.8× |
| Us retroperitoneal limited (76775) |
$572.55 |
$1,041 |
5.7× |
| Us scrotum and contents (76870) |
$843.15 |
$1,533 |
8.4× |
| Us spinal canal and contents (76800) |
$552.75 |
$1,005 |
5.5× |
Us thyroid (76536)
range across 2 matching MRF lines |
$736.45–$736.47 |
$1,339–$1,339.04 |
varies |
| Vascular Flow Imaging (78445) |
$470.80 |
$856 |
1.2× |
| Vein X-Ray Chest (75827) |
$2,708.20 |
$4,924 |
1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,032.70 |
$5,514 |
1.0× |
Venogram Sinus/Jugular (75860)
range across 2 matching MRF lines |
$4,525.95–$4,526.50 |
$8,229–$8,230 |
varies |
| Venography caval inferior serialography rs&i (75825) |
$2,708.20 |
$4,924 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,707.75 |
$3,105 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,040.05 |
$1,891 |
0.7× |
| Venography Renal Bilateral (75833) |
$3,023.35 |
$5,497 |
1.0× |
| Venography Renal Unilateral (75831) |
$2,116.40 |
$3,848 |
0.7× |
| Venous sampling by catheter (75893) |
$3,526.05 |
$6,411 |
0.7× |
| Wrist 2 views (73100) |
$290.95 |
$529 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$282.70 |
$514 |
3.4× |
| X-ray antegrade pyelogram tube (74425) |
$1,669.80 |
$3,036 |
5.0× |
| X-Ray Aorta Leg Arteries (75630) |
$2,815.45 |
$5,119 |
0.9× |
| X-Ray Bend Only L-S Spine (72120) |
$378.95 |
$689 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$288.75 |
$525 |
3.4× |
| X-Ray Exam Breast Specimen (76098) |
$312.95 |
$569 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$247.50 |
$450 |
3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$309.65 |
$563 |
3.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$387.20 |
$704 |
3.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$385 |
$700 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$495 |
$900 |
5.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$618.75 |
$1,125 |
6.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$539.55 |
$981 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$539.55 |
$981 |
5.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$593.45 |
$1,079 |
5.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$770.55 |
$1,401 |
7.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$494.45 |
$899 |
5.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$748.55 |
$1,361 |
7.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$443.85 |
$807 |
4.4× |
| X-ray eye for foreign body (70030) |
$262.90 |
$478 |
3.1× |
| X-ray humerus (73060) |
$333.85 |
$607 |
4.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,065.35 |
$1,937 |
6.3× |
| X-ray IV pyelogram+tomography (74415) |
$1,466.30 |
$2,666 |
8.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$275 |
$500 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$220.55 |
$401 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$437.25 |
$795 |
4.3× |
| X-ray nose-rectum child f.b. (76010) |
$350.35 |
$637 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$716.65 |
$1,303 |
7.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$506.55 |
$921 |
5.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$348.15 |
$633 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$373.45 |
$679 |
4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$593.45 |
$1,079 |
7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$561 |
$1,020 |
5.6× |
| X-ray thoracic spine 4 vw (72074) |
$452.10 |
$822 |
4.5× |
| X-Ray Tmj Unilat (70328) |
$111.10 |
$202 |
1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,034.55 |
$1,881 |
3.1× |
| X-Rays Bone Length Studies (77073) |
$248.60 |
$452 |
2.5× |
| X-Rays Bone Survey Complete (77075) |
$904.75 |
$1,645 |
9.0× |
| Xr c-spine 4 or 5 views (72050) |
$534.60 |
$972 |
5.3× |
| Xr facial bones less than 3 views (70140) |
$358.05 |
$651 |
4.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$271.70 |
$494 |
2.7× |
| Xr orbits complete 4 views (70200) |
$466.95 |
$849 |
4.6× |