3-D radiotherapy plan dose-volume histograms (77295)
range across 2 matching MRF lines |
$6,918–$9,535.80 |
$11,530–$15,893 |
varies |
| Abdomen 1 View (74018) |
$276.60 |
$461 |
3.0× |
| Abdomen 2 views (74019) |
$311.40 |
$519 |
2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,030.80 |
$1,718 |
2.4× |
| Adrenal Cortex & Medulla Img (78075) |
$1,670.40 |
$2,784 |
1.2× |
| Angio pulmonary bilat (75743) |
$3,712.20 |
$6,187 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,982.20 |
$6,637 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$6,166.80 |
$10,278 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$4,398.60 |
$7,331 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,674.20 |
$4,457 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,197.20 |
$3,662 |
0.7× |
| Ankle 2 views (73600) |
$246 |
$410 |
2.7× |
| Aortography thoracic serialography rs&i (75605) |
$3,826.20 |
$6,377 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$5,380.20 |
$8,967 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,699.40 |
$4,499 |
0.8× |
| Artery X-Rays Pelvis (75736) |
$3,789.60 |
$6,316 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,789.60 |
$6,316 |
0.6× |
| Arthrogram ankle (73615) |
$718.20 |
$1,197 |
1.9× |
| Arthrogram hip (73525) |
$718.20 |
$1,197 |
1.9× |
| Arthrogram Wrist (73115) |
$718.20 |
$1,197 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$641.40 |
$1,069 |
4.5× |
| Bone age studies (77072) |
$179.40 |
$299 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$2,719.20 |
$4,532 |
6.4× |
| Bone Imaging Limited Area (78300) |
$868.80 |
$1,448 |
2.1× |
| Bone Imaging Multiple Areas (78305) |
$1,485 |
$2,475 |
3.5× |
| Bone Imaging Whole Body (78306) |
$2,218.20 |
$3,697 |
5.2× |
| Bone survey infant (77076) |
$354 |
$590 |
3.2× |
| Brachytx isodose complex (77318) |
$2,340.60 |
$3,901 |
5.9× |
| Brachytx isodose intermed (77317) |
$1,296 |
$2,160 |
3.3× |
| Brachytx Isodose Plan Simple (77316) |
$772.80 |
$1,288 |
2.0× |
| Brain Image W/Flow < 4 Views (78601) |
$1,258.80 |
$2,098 |
3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,906.40 |
$9,844 |
3.9× |
| Cat Scan Follow-Up Study (76380) |
$379.20 |
$632 |
4.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,345.20 |
$2,242 |
2.3× |
| Cerebrospinal Fluid Scan (78630) |
$1,750.20 |
$2,917 |
3.0× |
| Chest 1 view (71045) |
$153.60 |
$256 |
1.7× |
| Chest 2 views (71046) |
$289.80 |
$483 |
3.1× |
| Chest 3 views (71047) |
$352.20 |
$587 |
3.8× |
| Chest 4 or more views (71048) |
$442.20 |
$737 |
4.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$241.80 |
$403 |
2.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$764.40 |
$1,274 |
0.9× |
| Clavicle complete (73000) |
$305.40 |
$509 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,153.20 |
$1,922 |
10.4× |
| Continuing medical physics consltj pr wk (77336) |
$748.20 |
$1,247 |
5.3× |
| Contrast Exam Abdominl Aorta (75625) |
$4,010.40 |
$6,684 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$298.80 |
$498 |
0.8× |
| Contrast X-Ray Of Elbow (73085) |
$718.20 |
$1,197 |
1.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$718.20 |
$1,197 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,539.40 |
$5,899 |
9.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,292 |
$3,820 |
9.1× |
| CT abdomen w contrast (74160) |
$1,505.40 |
$2,509 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,763.40 |
$2,939 |
9.5× |
| CT abdomen w/o contrast (74150) |
$1,153.20 |
$1,922 |
10.4× |
| CT Angio Abdomen and Pelvis (74174) |
$2,980.20 |
$4,967 |
8.1× |
| CT Angio Chest (71275) |
$1,733.40 |
$2,889 |
9.3× |
CT Angio Head (70496)
range across 2 matching MRF lines |
$1,084.80–$1,733.40 |
$1,808–$2,889 |
varies |
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines |
$1,989.60–$2,222.40 |
$3,316–$3,704 |
varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,354.80 |
$2,258 |
7.3× |
| CT Angio Neck (70498) |
$1,733.40 |
$2,889 |
9.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,354.80 |
$2,258 |
7.3× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,680 |
$2,800 |
9.1× |
| CT cervical spine w/ contrast (72126) |
$1,300.80 |
$2,168 |
3.5× |
| CT cervical spine w/o contrast (72125) |
$1,192.80 |
$1,988 |
10.8× |
| CT cervical spine w/wo cont (72127) |
$1,624.80 |
$2,708 |
8.8× |
| CT chest w contrast (71260) |
$1,505.40 |
$2,509 |
8.1× |
| CT chest w/wo contrast (71270) |
$1,705.20 |
$2,842 |
9.2× |
| CT head/brain with contrast (70460) |
$1,300.80 |
$2,168 |
7.0× |
| CT head/brain without and with contrast (70470) |
$1,624.80 |
$2,708 |
8.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,004 |
$3,340 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$925.80 |
$1,543 |
10.1× |
| CT iac w contrast (70481) |
$1,300.80 |
$2,168 |
7.0× |
| CT l-spine w&w/o contrast (72133) |
$1,624.80 |
$2,708 |
8.8× |
| CT lower ext w/o (73700) |
$1,082.40 |
$1,804 |
9.8× |
CT lower extremity w/contrast material (73701)
range across 2 matching MRF lines |
$1,192.80–$1,789.20 |
$1,988–$2,982 |
varies |
| CT lumbar spine w contrast (72132) |
$1,300.80 |
$2,168 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$1,192.80 |
$1,988 |
10.8× |
| CT maxillofacial w contrast (70487) |
$1,354.80 |
$2,258 |
7.3× |
| CT maxillofacial wo contrast (70486) |
$1,029.60 |
$1,716 |
9.3× |
| CT neck tissue combo (70492) |
$1,733.40 |
$2,889 |
9.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,624.80 |
$2,708 |
8.8× |
| CT orbits w/o contrast (70480) |
$1,029.60 |
$1,716 |
9.3× |
| CT pelvis w&w/o contrast (72194) |
$1,733.40 |
$2,889 |
9.3× |
| CT pelvis w/o contrast (72192) |
$1,139.40 |
$1,899 |
10.3× |
| CT scan of leg combo (73702) |
$1,624.80 |
$2,708 |
8.8× |
| CT scans face/jaw combo (70488) |
$1,680 |
$2,800 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,354.80 |
$2,258 |
7.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,029.60 |
$1,716 |
9.3× |
| CT thoracic spine w contrast (72129) |
$1,300.80 |
$2,168 |
7.0× |
| CT thoracic spine w/o contrast (72128) |
$1,192.80 |
$1,988 |
10.8× |
| CT thoracic spine w/wo cont (72130) |
$1,624.80 |
$2,708 |
8.8× |
| CT thorax w/o contrast (71250) |
$1,153.20 |
$1,922 |
10.4× |
| CT upper ext wo (73200) |
$1,082.40 |
$1,804 |
9.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,624.80 |
$2,708 |
8.8× |
| CT upper extremity with contrast (73201) |
$1,192.80 |
$1,988 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,990.20 |
$3,317 |
10.7× |
| Cta Abdomen (74175) |
$1,354.80 |
$2,258 |
7.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,700 |
$4,500 |
7.3× |
| CTA pelvis (72191) |
$1,624.80 |
$2,708 |
8.8× |
| Dilation ureters/urethra rs&i (74485) |
$3,060 |
$5,100 |
1.4× |
| Discography Cerv/Thor Spine (72285) |
$1,492.80 |
$2,488 |
0.7× |
| Diskography lumbar (72295) |
$3,089.40 |
$5,149 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$603.60 |
$1,006 |
5.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$965.40 |
$1,609 |
8.7× |
| Dxa Bone Density Axial (77080) |
$648.60 |
$1,081 |
5.9× |
| Dxa bone density study (77085) |
$878.40 |
$1,464 |
7.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$200.40 |
$334 |
2.2× |
| Echo exam of fetal heart (76825) |
$1,351.20 |
$2,252 |
2.3× |
| Echo exam uterus (76831) |
$425.40 |
$709 |
1.7× |
| Echo Guide For Artery Repair (76936) |
$390 |
$650 |
1.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$663 |
$1,105 |
2.6× |
| Echograp Trans R Pros Study (76873) |
$969.60 |
$1,616 |
8.8× |
| Esophagram (74220) |
$362.40 |
$604 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$1,375.80 |
$2,293 |
12.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$891.60 |
$1,486 |
8.1× |
| Fluoroscopy up to 1 hr (76000) |
$630.60 |
$1,051 |
2.5× |
| Follow-Up Angiography (75898) |
$2,197.20 |
$3,662 |
0.7× |
Foot 2 views (73620)
range across 2 matching MRF lines |
$167.40–$246 |
$279–$410 |
varies |
| Forearm 2 views (73090) |
$289.80 |
$483 |
3.1× |
| Gastric emptying imaging study (78264) |
$1,470 |
$2,450 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$749.40 |
$1,249 |
1.8× |
| Gated Heart Planar Single (78472) |
$2,233.80 |
$3,723 |
5.3× |
| Hand 2 views (73120) |
$246 |
$410 |
2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$5,764.20 |
$9,607 |
7.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$5,293.20 |
$8,822 |
7.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,725.60 |
$7,876 |
6.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,810.40 |
$4,684 |
0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,009 |
$5,015 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$2,761.80 |
$4,603 |
4.8× |
| Hepatobiliary System Imaging (78226) |
$1,978.80 |
$3,298 |
4.7× |
| Ht Musc Image Planar Mult (78454) |
$2,148.60 |
$3,581 |
1.6× |
| Ht Muscle Image Spect Sing (78451) |
$2,792.40 |
$4,654 |
2.0× |
| Hysterosalpingogram (74740) |
$466.80 |
$778 |
1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$395.40 |
$659 |
4.3× |
| Infant hip ultrasound, limited static exam (76886) |
$300.60 |
$501 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$3,303.60 |
$5,506 |
4.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,508 |
$4,180 |
3.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,379.60 |
$3,966 |
4.1× |
| Intracavitary radiation source applic simple (77761) |
$2,247.60 |
$3,746 |
3.8× |
| Joint Survey Single View (77077) |
$352.20 |
$587 |
3.2× |
| K Flow/Funct Image Multiple (78709) |
$1,974.60 |
$3,291 |
3.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,665 |
$2,775 |
2.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,582.80 |
$2,638 |
2.8× |
| Kidney Imaging Morphol (78700) |
$2,274 |
$3,790 |
5.4× |
Knee 3 Views (73562)
range across 2 matching MRF lines |
$344.40–$516.60 |
$574–$861 |
varies |
| Leveen/Shunt Patency Exam (78291) |
$787.20 |
$1,312 |
1.9× |
| Liver & Spleen Imaging Static Only (78215) |
$1,116.60 |
$1,861 |
2.6× |
| Liver imaging static only (78201) |
$1,117.20 |
$1,862 |
1.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,949.80 |
$6,583 |
6.9× |
| Lung perfusion differential (78597) |
$2,632.80 |
$4,388 |
6.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,632.80 |
$4,388 |
4.6× |
| Lung Ventilation Imaging (78579) |
$876.60 |
$1,461 |
2.1× |
| Lymph System Imaging (78195) |
$1,531.80 |
$2,553 |
2.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,837.40 |
$4,729 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$2,416.80 |
$4,028 |
9.6× |
| Mammary ductogram or galactogram multiple (77054) |
$521.40 |
$869 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$471 |
$785 |
1.9× |
| Meckels Divert Exam (78290) |
$853.80 |
$1,423 |
2.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$747.60 |
$1,246 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$9,173.40 |
$15,289 |
23.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,710.40 |
$6,184 |
10.1× |
| MRA head w/o contrast (70544) |
$1,965 |
$3,275 |
7.8× |
| MRA head with contrast (70545) |
$2,045.40 |
$3,409 |
5.5× |
| MRA neck w contrast (70548) |
$2,045.40 |
$3,409 |
5.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,709.80 |
$6,183 |
10.1× |
| MRA neck w/o contrast (70547) |
$1,965 |
$3,275 |
7.8× |
| MRI abdomen w contrast (74182) |
$2,469.60 |
$4,116 |
6.7× |
| MRI abdomen w/o contrast (74181) |
$2,363.40 |
$3,939 |
9.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,469.60 |
$4,116 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,626.40 |
$6,044 |
9.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,469.60 |
$4,116 |
3.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,806.40 |
$6,344 |
15.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$3,010.20 |
$5,017 |
11.9× |
| MRI cervical spine w contrast (72142) |
$2,549.40 |
$4,249 |
6.9× |
| MRI cervical spine w/o cont (72141) |
$2,368.80 |
$3,948 |
9.4× |
| MRI chest w/o contrast (71550) |
$2,363.40 |
$3,939 |
9.4× |
| MRI chest with contrast (71551) |
$2,469.60 |
$4,116 |
3.0× |
| MRI chest wo w contrast (71552) |
$3,710.40 |
$6,184 |
10.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,469.60 |
$4,116 |
6.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,626.40 |
$6,044 |
9.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,363.40 |
$3,939 |
9.4× |
| MRI lumbar spine w contrast (72149) |
$2,549.40 |
$4,249 |
6.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,794.40 |
$6,324 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,363.40 |
$3,939 |
9.4× |
| MRI orbit face neck w contrast (70542) |
$2,469.60 |
$4,116 |
6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,710.40 |
$6,184 |
10.1× |
| MRI pelvis w contrast (72196) |
$2,469.60 |
$4,116 |
6.7× |
| MRI pelvis w/o & w contrast (72197) |
$3,710.40 |
$6,184 |
10.1× |
| MRI pelvis w/o contrast (72195) |
$2,363.40 |
$3,939 |
9.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,368.80 |
$3,948 |
9.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,469.60 |
$4,116 |
6.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,363.40 |
$3,939 |
9.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,710.40 |
$6,184 |
10.1× |
| MRI, abdomen, combo (74183) |
$3,963 |
$6,605 |
10.7× |
| MRI, dorsal spine combo (72157) |
$3,794.40 |
$6,324 |
10.3× |
| MRI, dorsal spine contrast (72147) |
$2,549.40 |
$4,249 |
6.9× |
| MRI, joint upper extrem (73221) |
$2,363.40 |
$3,939 |
9.4× |
| MRI, joint upper extrem combo (73223) |
$3,710.40 |
$6,184 |
10.1× |
| MRI, lumbar spine combo (72158) |
$3,794.40 |
$6,324 |
10.3× |
| Myelogram cervical (72240) |
$1,145.40 |
$1,909 |
1.4× |
| Myelogram Lumbar (72265) |
$1,090.80 |
$1,818 |
1.3× |
| Myelography thoracic (72255) |
$1,145.40 |
$1,909 |
1.4× |
| Myelograpy 2/more regions rs&i (72270) |
$1,294.80 |
$2,158 |
1.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$790.80 |
$1,318 |
1.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,426.40 |
$9,044 |
4.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,290 |
$2,150 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,356.60 |
$7,261 |
3.2× |
| N-invas est c ffr sw aly CTA (75580) |
$4,257 |
$7,095 |
4.7× |
| Neck soft tissue (70360) |
$210 |
$350 |
2.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,671 |
$2,785 |
4.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$340.80 |
$568 |
0.8× |
| Nm csf leak detection (78650) |
$1,345.20 |
$2,242 |
1.0× |
| Nm myocard infarct spect (78469) |
$1,202.40 |
$2,004 |
2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,897.80 |
$13,163 |
5.4× |
| Nuclear Rx Intra-Arterial (79445) |
$1,294.20 |
$2,157 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$1,740 |
$2,900 |
7.0× |
| Ob us nuchal meas 1 gest (76813) |
$331.80 |
$553 |
3.0× |
| Panoramic X-ray of jaws (70355) |
$250.20 |
$417 |
2.7× |
| Parathyroid Planar Imaging (78070) |
$1,491 |
$2,485 |
3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,581.80 |
$4,303 |
6.1× |
| Pelvis 1 or 2 views (72170) |
$262.20 |
$437 |
2.4× |
| Pet Image W/Ct Lmtd (78814) |
$5,530.20 |
$9,217 |
3.7× |
| PET image w/CT, full body (78816) |
$5,906.40 |
$9,844 |
3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,906.40 |
$9,844 |
3.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$5,530.20 |
$9,217 |
4.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,440.20 |
$4,067 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$876.60 |
$1,461 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$459 |
$765 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$440.40 |
$734 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$305.40 |
$509 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$231 |
$385 |
2.5× |
| Radex elbow complete minimum 3 views (73080) |
$290.40 |
$484 |
3.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$460.20 |
$767 |
4.2× |
| Radex fingr minimum 2 views (73140) |
$246 |
$410 |
2.7× |
| Radex foot complete minimum 3 views (73630) |
$305.40 |
$509 |
3.3× |
| Radex Hand Minimum 3 Views (73130) |
$305.40 |
$509 |
3.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$231 |
$385 |
2.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$225.60 |
$376 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$409.20 |
$682 |
4.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$231 |
$385 |
2.5× |
| Radex shoulder complete minimum 2 views (73030) |
$305.40 |
$509 |
3.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$247.20 |
$412 |
2.7× |
| Radex Spine 1 View Specify Level (72020) |
$262.20 |
$437 |
2.8× |
| Radex Sternum Minimum 2 Views (71120) |
$231 |
$385 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$364.80 |
$608 |
4.0× |
| Radex Toe Minimum 2 Views (73660) |
$231 |
$385 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$250.80 |
$418 |
2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$305.40 |
$509 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$507 |
$845 |
4.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,089.20 |
$33,482 |
2.6× |
| Radiation treatment delivery level 1 (77402) |
$540 |
$900 |
5.0× |
| Radiation treatment delivery level 2 (77407) |
$2,145 |
$3,575 |
5.3× |
| Radiation treatment delivery level 3 (77412) |
$2,400 |
$4,000 |
4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$364.80 |
$608 |
3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$344.40 |
$574 |
3.1× |
| Radiologic exam colon double contrast study (74280) |
$605.40 |
$1,009 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$516 |
$860 |
2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$400.20 |
$667 |
2.2× |
| Radiologic exam knee complete 4/more views (73564) |
$352.20 |
$587 |
3.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$305.40 |
$509 |
2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$502.20 |
$837 |
2.7× |
| Radiologic exam swallow function contrast study (74230) |
$262.20 |
$437 |
1.4× |
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines |
$581.40–$667.20 |
$969–$1,112 |
varies |
| Radiologic examination femur 1 view (73551) |
$270 |
$450 |
2.9× |
| Radiologic examination femur minimum 2 views (73552) |
$315 |
$525 |
3.4× |
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines |
$231–$346.50 |
$385–$577.50 |
varies |
| Radiologic Examination Osseous Survey Limited (77074) |
$569.40 |
$949 |
5.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$304.20 |
$507 |
3.3× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) |
$1,520.40 |
$2,534 |
6.2× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$1,669.80 |
$2,783 |
6.8× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,567.20 |
$2,612 |
6.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,710.60 |
$2,851 |
4.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,508.40 |
$2,514 |
3.7× |
| Renal Cyst Study (74470) |
$474 |
$790 |
0.8× |
| Ribs bilateral 3 views (71110) |
$304.20 |
$507 |
2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,206.60 |
$2,011 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,612.80 |
$2,688 |
3.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,888.80 |
$3,148 |
3.3× |
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802)
range across 2 matching MRF lines |
$2,017.20–$2,808.60 |
$3,362–$4,681 |
varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,893 |
$3,155 |
3.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,619 |
$4,365 |
10.6× |
| Rp Therapy Intravenous Administration (79101) |
$806.40 |
$1,344 |
3.3× |
| Salivary Gland Imaging Serial Images (78231) |
$948.60 |
$1,581 |
2.2× |
| Scapula (73010) |
$231 |
$385 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$45 |
$75 |
1.9× |
| Sella turcica (70240) |
$192.60 |
$321 |
2.1× |
| Shoulder 1 view (73020) |
$193.20 |
$322 |
2.1× |
| Shoulder Arthrography (73040) |
$718.20 |
$1,197 |
1.9× |
| Sialogram (70390) |
$337.20 |
$562 |
1.3× |
| Skull less than 4 views (70250) |
$438 |
$730 |
4.0× |
| Special dosimetry (77331) |
$423 |
$705 |
3.0× |
| Special Physics Consult (77370) |
$967.80 |
$1,613 |
6.8× |
| Special teletherapy port plan (77321) |
$2,480.40 |
$4,134 |
6.3× |
| Special treatment procedure (77470) |
$1,919.40 |
$3,199 |
3.3× |
Stereotactic Body Radiation Delivery (77373)
range across 3 matching MRF lines |
$5,876.40–$26,386.20 |
$9,794–$43,977 |
varies |
| Sternoclavicular joints (71130) |
$305.40 |
$509 |
3.3× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$150 |
$250 |
1.4× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$120 |
$200 |
1.1× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$60 |
$100 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,480.40 |
$4,134 |
6.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,026 |
$1,710 |
2.6× |
| Testicular Imaging W/Flow (78761) |
$805.80 |
$1,343 |
1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,094.60 |
$3,491 |
5.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,787.40 |
$2,979 |
4.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,178.40 |
$1,964 |
8.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$515.40 |
$859 |
2.8× |
| Thoracic spine 2 views (72070) |
$231 |
$385 |
2.1× |
| Thoracic spine 3 views (72072) |
$305.40 |
$509 |
2.8× |
| Thoracolumbar 2 views (72080) |
$457.80 |
$763 |
5.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$448.20 |
$747 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$894.60 |
$1,491 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$1,978.80 |
$3,298 |
3.4× |
| Thyroid Uptake Measurement (78012) |
$2,233.20 |
$3,722 |
5.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,233.80 |
$3,723 |
5.3× |
| Tx Devices Design & Construction Complex (77334) |
$1,307.40 |
$2,179 |
3.3× |
| Tx devices design & construction intermediate (77333) |
$1,057.80 |
$1,763 |
7.4× |
Tx devices design & construction simple (77332)
range across 6 matching MRF lines |
$618–$1,147.80 |
$1,030–$1,913 |
varies |
Ultrasound Breast Limited (76642)
range across 6 matching MRF lines |
$356.40–$534.60 |
$594–$891 |
varies |
| Ultrasound Elastography Parenchyma (76981) |
$255 |
$425 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$549 |
$915 |
5.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$549 |
$915 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$560.40 |
$934 |
5.1× |
| Umbilical-artery Doppler (OB) (76820) |
$459.60 |
$766 |
4.2× |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$217.80–$762.60 |
$363–$1,271 |
varies |
| Unlisted magnetic resonance procedure (76498) |
$2,469.60 |
$4,116 |
26.8× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$414.60 |
$691 |
1.0× |
| Unlisted us procedure (76999) |
$253.20 |
$422 |
2.8× |
Upper gi w/o kub (74240)
range across 2 matching MRF lines |
$437.40–$496.80 |
$729–$828 |
varies |
| Ureteral Reflux Study (78740) |
$790.20 |
$1,317 |
1.9× |
| Urethrocystogram voiding (74455) |
$474.60 |
$791 |
1.9× |
| Urethrocystography retrograde (74450) |
$283.20 |
$472 |
1.1× |
Us breast unilateral complete (76641)
range across 8 matching MRF lines |
$475.20–$993.60 |
$792–$1,656 |
varies |
| Us chest (76604) |
$557.40 |
$929 |
5.0× |
| Us complete joint (76881) |
$534 |
$890 |
4.8× |
| Us exam, pelvic, limited (76857) |
$534 |
$890 |
4.8× |
| Us head (76506) |
$557.40 |
$929 |
5.0× |
| Us kidney transplant (76776) |
$332.40 |
$554 |
3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$374.40 |
$624 |
3.4× |
| Us ob detailed single fetus (76811) |
$711.60 |
$1,186 |
2.8× |
| Us ob limited 1 or more fetuses (76815) |
$459.60 |
$766 |
4.2× |
Us ob transvaginal (76817)
range across 4 matching MRF lines |
$420–$559.80 |
$700–$933 |
varies |
| Us pelvic non ob complete (76856) |
$559.80 |
$933 |
5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$595.80 |
$993 |
5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$495.60 |
$826 |
4.5× |
| Us retroperitoneal complete (76770) |
$574.20 |
$957 |
5.2× |
| Us retroperitoneal limited (76775) |
$549 |
$915 |
5.0× |
| Us scrotum and contents (76870) |
$534 |
$890 |
4.8× |
| Us spinal canal and contents (76800) |
$352.20 |
$587 |
3.2× |
| Us thyroid (76536) |
$557.40 |
$929 |
5.0× |
| Us transrectal (76872) |
$474.60 |
$791 |
4.3× |
| Vascular Flow Imaging (78445) |
$616.80 |
$1,028 |
1.5× |
| Vein X-Ray Chest (75827) |
$2,520.60 |
$4,201 |
1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,452.80 |
$4,088 |
0.7× |
| Vein X-Ray Spleen/Liver (75810) |
$2,197.20 |
$3,662 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$2,586 |
$4,310 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$4,939.20 |
$8,232 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,613 |
$4,355 |
0.8× |
| Venography extremity bilateral rs&i (75822) |
$1,558.20 |
$2,597 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,080 |
$1,800 |
0.6× |
| Venography Renal Bilateral (75833) |
$3,009 |
$5,015 |
0.9× |
| Venography Renal Unilateral (75831) |
$2,837.40 |
$4,729 |
0.8× |
| Venous sampling by catheter (75893) |
$3,789.60 |
$6,316 |
0.6× |
| Venous thrombosis imaging (78457) |
$1,059.60 |
$1,766 |
1.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,206.60 |
$2,011 |
2.9× |
| Vertebral fracture assessment via dxa (77086) |
$230.40 |
$384 |
2.5× |
| Wrist 2 views (73100) |
$246 |
$410 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$268.80 |
$448 |
2.9× |
| X-ray antegrade pyelogram tube (74425) |
$808.80 |
$1,348 |
2.2× |
| X-Ray Aorta Leg Arteries (75630) |
$5,661 |
$9,435 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$305.40 |
$509 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$246 |
$410 |
2.7× |
| X-Ray Exam Breast Specimen (76098) |
$440.40 |
$734 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$291 |
$485 |
3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$381 |
$635 |
3.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$438 |
$730 |
4.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$146.40 |
$244 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$305.40 |
$509 |
3.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$381.60 |
$636 |
3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$225.60 |
$376 |
2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$258.60 |
$431 |
2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$344.40 |
$574 |
3.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$396.60 |
$661 |
3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$305.40 |
$509 |
3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$442.20 |
$737 |
4.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$364.80 |
$608 |
3.3× |
| X-ray eye for foreign body (70030) |
$340.20 |
$567 |
3.7× |
| X-ray humerus (73060) |
$289.80 |
$483 |
3.1× |
| X-ray IV pyelogram (ivp) (74400) |
$595.20 |
$992 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$287.40 |
$479 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$231 |
$385 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$305.40 |
$509 |
2.8× |
| X-ray nose-rectum child f.b. (76010) |
$199.20 |
$332 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$430.80 |
$718 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$290.40 |
$484 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$276.60 |
$461 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$409.20 |
$682 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$460.20 |
$767 |
4.2× |
| X-ray thoracic spine 4 vw (72074) |
$366.60 |
$611 |
3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$474.60 |
$791 |
1.3× |
| X-Rays Bone Length Studies (77073) |
$305.40 |
$509 |
2.8× |
| X-Rays Bone Survey Complete (77075) |
$710.40 |
$1,184 |
6.4× |
| Xr c-spine 4 or 5 views (72050) |
$397.20 |
$662 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$333.60 |
$556 |
3.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$225.60 |
$376 |
2.0× |
| Xr orbits complete 4 views (70200) |
$364.80 |
$608 |
3.3× |
| Xr Tomogram Single Plane (76100) |
$534 |
$890 |
4.8× |