| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,904.50 |
$3,809 |
1.5× |
| Abdomen 1 View (74018) |
$164.50 |
$329 |
2.1× |
| Abdomen 2 views (74019) |
$242 |
$484 |
2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$522 |
$1,044 |
1.4× |
| Angio pulmonary bilat (75743) |
$1,912 |
$3,824 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,912 |
$3,824 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$1,912 |
$3,824 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,912 |
$3,824 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,912 |
$3,824 |
0.7× |
| Ankle 2 views (73600) |
$118 |
$236 |
1.5× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$1,912 |
$3,824 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,912 |
$3,824 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$2,887 |
$5,774 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,912 |
$3,824 |
0.7× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,912 |
$3,824 |
0.4× |
| Artery X-Rays Spine (75705) |
$2,665.50 |
$5,331 |
0.5× |
| Arthrogram ankle (73615) |
$438.50 |
$877 |
1.4× |
| Arthrogram hip (73525) |
$438.50 |
$877 |
1.4× |
| Arthrogram Wrist (73115) |
$438.50 |
$877 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$179.50 |
$359 |
1.5× |
| Bone age studies (77072) |
$108 |
$216 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$660.50 |
$1,321 |
1.8× |
| Bone Imaging Limited Area (78300) |
$376.50 |
$753 |
1.0× |
| Bone Imaging Whole Body (78306) |
$582 |
$1,164 |
1.6× |
| Bone marrow imaging limited area (78102) |
$376.50 |
$753 |
1.0× |
| Bone survey infant (77076) |
$122 |
$244 |
1.3× |
| Brachytx isodose complex (77318) |
$358.50 |
$717 |
1.1× |
| Brachytx isodose intermed (77317) |
$313.50 |
$627 |
0.9× |
| Brachytx Isodose Plan Simple (77316) |
$213 |
$426 |
0.6× |
| Brain Image W/Flow < 4 Views (78601) |
$537 |
$1,074 |
1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$571.50 |
$1,143 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,911.50 |
$3,823 |
1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,371.50 |
$4,743 |
7.5× |
| Cat Scan Follow-Up Study (76380) |
$745.50 |
$1,491 |
9.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$485.50 |
$971 |
1.0× |
| Cerebrospinal Fluid Scan (78630) |
$570 |
$1,140 |
1.2× |
| Chest 1 view (71045) |
$150 |
$300 |
1.9× |
| Chest 2 views (71046) |
$204 |
$408 |
2.6× |
| Chest 3 views (71047) |
$204 |
$408 |
2.6× |
| Chest 4 or more views (71048) |
$220.50 |
$441 |
2.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,632 |
$3,264 |
2.3× |
| Clavicle complete (73000) |
$153 |
$306 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$240.50 |
$481 |
2.5× |
| Continuing medical physics consltj pr wk (77336) |
$221.50 |
$443 |
1.8× |
| Contrast Exam Abdominl Aorta (75625) |
$1,912 |
$3,824 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$711.50 |
$1,423 |
2.3× |
| Contrast X-Ray Of Elbow (73085) |
$438.50 |
$877 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$438.50 |
$877 |
1.4× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$323.50 |
$647 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,634 |
$5,268 |
8.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,631.50 |
$3,263 |
7.6× |
| CT abdomen w contrast (74160) |
$2,346.50 |
$4,693 |
14.8× |
| CT abdomen w wo contrast (74170) |
$2,521 |
$5,042 |
15.9× |
| CT abdomen w/o contrast (74150) |
$1,067.50 |
$2,135 |
11.3× |
| CT Angio Abdomen and Pelvis (74174) |
$2,696.50 |
$5,393 |
8.6× |
| CT Angio Chest (71275) |
$1,847 |
$3,694 |
11.7× |
| CT Angio Head (70496) |
$2,761 |
$5,522 |
17.4× |
| CT angio hrt w/3d image (75574) |
$1,490 |
$2,980 |
4.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,328 |
$4,656 |
14.7× |
| CT Angio Neck (70498) |
$1,904 |
$3,808 |
12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,904 |
$3,808 |
12.0× |
| CT cervical spine w/ contrast (72126) |
$951.50 |
$1,903 |
3.0× |
| CT cervical spine w/o contrast (72125) |
$818 |
$1,636 |
8.7× |
| CT cervical spine w/wo cont (72127) |
$983 |
$1,966 |
6.2× |
| CT chest w contrast (71260) |
$1,165.50 |
$2,331 |
7.4× |
| CT chest w/wo contrast (71270) |
$1,295.50 |
$2,591 |
8.2× |
| CT head/brain with contrast (70460) |
$984.50 |
$1,969 |
6.2× |
| CT head/brain without and with contrast (70470) |
$1,046 |
$2,092 |
6.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$915 |
$1,830 |
2.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$59.50 |
$119 |
0.8× |
| CT hrt w/3d image congen (75573) |
$827.50 |
$1,655 |
2.6× |
| CT iac w contrast (70481) |
$845 |
$1,690 |
5.3× |
| CT l-spine w&w/o contrast (72133) |
$1,045.50 |
$2,091 |
6.6× |
| CT lower ext w/o (73700) |
$805 |
$1,610 |
8.5× |
| CT lower extremity w/contrast material (73701) |
$1,989.50 |
$3,979 |
12.6× |
| CT lumbar spine w contrast (72132) |
$951.50 |
$1,903 |
3.0× |
| CT lumbar spine w/o contrast (72131) |
$892 |
$1,784 |
9.5× |
| CT maxillofacial w contrast (70487) |
$845 |
$1,690 |
5.3× |
| CT maxillofacial wo contrast (70486) |
$782.50 |
$1,565 |
8.3× |
| CT neck tissue combo (70492) |
$986.50 |
$1,973 |
6.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$988 |
$1,976 |
6.2× |
| CT orbits w/o contrast (70480) |
$782.50 |
$1,565 |
8.3× |
| CT pelvis w&w/o contrast (72194) |
$1,337 |
$2,674 |
8.4× |
| CT pelvis w/o contrast (72192) |
$1,087.50 |
$2,175 |
11.5× |
| CT scan of leg combo (73702) |
$2,006 |
$4,012 |
12.7× |
| CT scans face/jaw combo (70488) |
$983 |
$1,966 |
6.2× |
| CT soft tissue neck w contrast (70491) |
$906 |
$1,812 |
5.7× |
| CT soft tissue neck w/o contrast (70490) |
$824 |
$1,648 |
8.7× |
| CT thoracic spine w contrast (72129) |
$951.50 |
$1,903 |
6.0× |
| CT thoracic spine w/o contrast (72128) |
$818 |
$1,636 |
8.7× |
| CT thoracic spine w/wo cont (72130) |
$1,148.50 |
$2,297 |
7.3× |
| CT thorax w/o contrast (71250) |
$849.50 |
$1,699 |
9.0× |
| CT unlisted procedure (76497) |
$486 |
$972 |
6.2× |
| CT upper ext wo (73200) |
$805 |
$1,610 |
8.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,116 |
$4,232 |
13.4× |
| CT upper extremity with contrast (73201) |
$3,227 |
$6,454 |
10.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,524 |
$3,048 |
9.6× |
| Cta Abdomen (74175) |
$1,381 |
$2,762 |
8.7× |
| CTA pelvis (72191) |
$1,061.50 |
$2,123 |
6.7× |
| Dilation ureters/urethra rs&i (74485) |
$1,943.50 |
$3,887 |
1.0× |
| Discography Cerv/Thor Spine (72285) |
$1,668.50 |
$3,337 |
0.9× |
| Diskography lumbar (72295) |
$1,668.50 |
$3,337 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$343 |
$686 |
3.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$393.50 |
$787 |
4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$139 |
$278 |
1.5× |
| Dxa Bone Density Axial (77080) |
$449.50 |
$899 |
4.8× |
| Dxa bone density study (77085) |
$225.50 |
$451 |
2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$450 |
$900 |
5.7× |
| Echo exam of fetal heart (76825) |
$466.50 |
$933 |
0.9× |
| Echo exam uterus (76831) |
$364.50 |
$729 |
1.7× |
| Echo Guide For Artery Repair (76936) |
$549 |
$1,098 |
2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$393.50 |
$787 |
1.8× |
| Echograp Trans R Pros Study (76873) |
$389.50 |
$779 |
4.1× |
| Esophagram (74220) |
$316 |
$632 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$437 |
$874 |
4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$180.50 |
$361 |
1.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$288.50 |
$577 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$165 |
$330 |
0.8× |
| Follow-Up Angiography (75898) |
$648.50 |
$1,297 |
0.2× |
| Foot 2 views (73620) |
$118 |
$236 |
1.5× |
| Forearm 2 views (73090) |
$118 |
$236 |
1.5× |
| Gastric emptying imaging study (78264) |
$556.50 |
$1,113 |
1.5× |
| Gated Heart Planar Single (78472) |
$735 |
$1,470 |
2.0× |
| Hand 2 views (73120) |
$118 |
$236 |
1.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$908.50 |
$1,817 |
1.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$908.50 |
$1,817 |
1.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$908.50 |
$1,817 |
1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,916 |
$3,832 |
0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,912 |
$3,824 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$515 |
$1,030 |
1.1× |
| Hepatobiliary System Imaging (78226) |
$515 |
$1,030 |
1.4× |
| Ht Muscle Image Spect Sing (78451) |
$1,437.50 |
$2,875 |
1.2× |
| Hysterosalpingogram (74740) |
$753 |
$1,506 |
3.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$443 |
$886 |
5.6× |
| Infusion Ivp (74410) |
$418 |
$836 |
2.6× |
| Interstitial radiation source applic complex (77778) |
$1,584.50 |
$3,169 |
2.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,199 |
$2,398 |
1.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,199 |
$2,398 |
2.4× |
| Intracavitary radiation source applic simple (77761) |
$1,199 |
$2,398 |
2.4× |
| Joint Survey Single View (77077) |
$70 |
$140 |
0.7× |
| K Flow/Funct Image Multiple (78709) |
$677.50 |
$1,355 |
1.4× |
| K Flow/Funct Image W/Drug (78708) |
$651.50 |
$1,303 |
1.3× |
| K Flow/Funct Image W/O Drug (78707) |
$620 |
$1,240 |
1.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$353 |
$706 |
1.0× |
| Knee 3 Views (73562) |
$118 |
$236 |
1.5× |
| Liver & Spleen Imaging Static Only (78215) |
$376.50 |
$753 |
1.0× |
| Liver imaging static only (78201) |
$1,285.50 |
$2,571 |
2.6× |
| Liver imaging w/vascular flow (78202) |
$1,285.50 |
$2,571 |
2.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$736.50 |
$1,473 |
1.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$596.50 |
$1,193 |
1.2× |
| Lung Ventilation Imaging (78579) |
$298.50 |
$597 |
0.8× |
| Lymph System Imaging (78195) |
$603 |
$1,206 |
1.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$785 |
$1,570 |
0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$736.50 |
$1,473 |
1.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,540.50 |
$5,081 |
0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$785 |
$1,570 |
0.3× |
| Magnetic Image Jaw Joint (70336) |
$1,076 |
$2,152 |
5.0× |
| Magnetic Resonance Elastography (76391) |
$278.50 |
$557 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$521.50 |
$1,043 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$417 |
$834 |
1.9× |
| Meckels Divert Exam (78290) |
$426.50 |
$853 |
1.2× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$102 |
$204 |
0.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$748 |
$1,496 |
2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$28.50 |
$57 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$80.50 |
$161 |
0.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,680 |
$3,360 |
5.3× |
| MRA head w/o contrast (70544) |
$675 |
$1,350 |
3.1× |
| MRA head with contrast (70545) |
$1,275.50 |
$2,551 |
4.0× |
| MRA neck w contrast (70548) |
$1,275.50 |
$2,551 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,775 |
$3,550 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,217.50 |
$2,435 |
5.7× |
| MRI abdomen w contrast (74182) |
$1,380 |
$2,760 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,150.50 |
$2,301 |
5.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,817 |
$5,634 |
4.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,967 |
$3,934 |
6.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,083.50 |
$8,167 |
5.8× |
| MRI bone marrow blood supply (77084) |
$1,292 |
$2,584 |
6.0× |
| MRI brain functional w/physician admnistration (70555) |
$2,407 |
$4,814 |
11.2× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,606 |
$3,212 |
7.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,285 |
$2,570 |
6.0× |
| MRI cardiac w/o contrast (75557) |
$2,047.50 |
$4,095 |
9.5× |
| MRI cervical spine w contrast (72142) |
$1,566.50 |
$3,133 |
5.0× |
| MRI cervical spine w/o cont (72141) |
$1,233.50 |
$2,467 |
5.7× |
| MRI chest w/o contrast (71550) |
$912 |
$1,824 |
4.2× |
| MRI chest with contrast (71551) |
$1,150.50 |
$2,301 |
1.6× |
| MRI chest wo w contrast (71552) |
$1,468.50 |
$2,937 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,468.50 |
$2,937 |
4.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,681.50 |
$3,363 |
5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$912 |
$1,824 |
4.2× |
| MRI lumbar spine w contrast (72149) |
$1,664.50 |
$3,329 |
5.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,335 |
$4,670 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,083 |
$2,166 |
5.0× |
| MRI orbit face neck w contrast (70542) |
$1,260 |
$2,520 |
4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,382 |
$2,764 |
4.4× |
| MRI pelvis w contrast (72196) |
$1,831 |
$3,662 |
5.8× |
| MRI pelvis w/o & w contrast (72197) |
$2,584.50 |
$5,169 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$1,468.50 |
$2,937 |
6.8× |
| MRI spectroscopy (76390) |
$1,118 |
$2,236 |
14.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,310.50 |
$2,621 |
6.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,842 |
$5,684 |
9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,468.50 |
$2,937 |
6.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,396.50 |
$4,793 |
7.6× |
| MRI, abdomen, combo (74183) |
$1,468.50 |
$2,937 |
4.7× |
| MRI, dorsal spine combo (72157) |
$2,481 |
$4,962 |
7.9× |
| MRI, dorsal spine contrast (72147) |
$1,664.50 |
$3,329 |
5.3× |
| MRI, joint upper extrem (73221) |
$1,468.50 |
$2,937 |
6.8× |
| MRI, joint upper extrem combo (73223) |
$2,481.50 |
$4,963 |
7.9× |
| MRI, lumbar spine combo (72158) |
$2,481 |
$4,962 |
7.9× |
| Myelogram cervical (72240) |
$1,038.50 |
$2,077 |
1.5× |
| Myelogram Lumbar (72265) |
$1,038.50 |
$2,077 |
1.5× |
| Myelography thoracic (72255) |
$961.50 |
$1,923 |
1.4× |
| Myelograpy 2/more regions rs&i (72270) |
$1,549 |
$3,098 |
2.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,602 |
$3,204 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,993 |
$3,986 |
1.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,491.50 |
$2,983 |
1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$1,898.50 |
$3,797 |
1.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$1,630.50 |
$3,261 |
0.8× |
| Neck soft tissue (70360) |
$173 |
$346 |
2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$342 |
$684 |
0.9× |
| Nm csf leak detection (78650) |
$1,285.50 |
$2,571 |
1.1× |
| Nm myocard infarct spect (78469) |
$985.50 |
$1,971 |
2.0× |
| Nm unlisted gi procedure (78299) |
$515 |
$1,030 |
1.4× |
| Nonvascular Shunt X-Ray (75809) |
$689 |
$1,378 |
7.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,006.50 |
$4,013 |
1.6× |
| Nuclear Rx Intra-Arterial (79445) |
$479 |
$958 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$567 |
$1,134 |
2.7× |
| Ob us nuchal meas 1 gest (76813) |
$145 |
$290 |
1.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$278.50 |
$557 |
3.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$312 |
$624 |
3.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$89 |
$178 |
3.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$449.50 |
$899 |
4.8× |
| Optic foramina (70190) |
$126.50 |
$253 |
1.6× |
| Panoramic X-ray of jaws (70355) |
$122 |
$244 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$376.50 |
$753 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$383.50 |
$767 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$118 |
$236 |
1.3× |
| Peritoneogram Rs&I (74190) |
$701 |
$1,402 |
1.4× |
| Pet Image Skull-Thigh (78812) |
$2,598.50 |
$5,197 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$2,548.50 |
$5,097 |
2.0× |
| PET image w/CT, full body (78816) |
$2,977.50 |
$5,955 |
2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,548.50 |
$5,097 |
2.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,750.50 |
$3,501 |
1.5× |
| PET whole body (78813) |
$2,598.50 |
$5,197 |
2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,912 |
$3,824 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$372.50 |
$745 |
1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$287 |
$574 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$710 |
$1,420 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$118 |
$236 |
1.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$118 |
$236 |
1.5× |
| Radex elbow complete minimum 3 views (73080) |
$147 |
$294 |
1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$123 |
$246 |
1.3× |
| Radex fingr minimum 2 views (73140) |
$118 |
$236 |
1.5× |
| Radex foot complete minimum 3 views (73630) |
$153 |
$306 |
1.9× |
| Radex Hand Minimum 3 Views (73130) |
$118 |
$236 |
1.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$118 |
$236 |
1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$202.50 |
$405 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$108 |
$216 |
1.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$118 |
$236 |
1.5× |
| Radex shoulder complete minimum 2 views (73030) |
$118 |
$236 |
1.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$122.50 |
$245 |
1.6× |
| Radex Spine 1 View Specify Level (72020) |
$108 |
$216 |
1.4× |
| Radex Sternum Minimum 2 Views (71120) |
$106 |
$212 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$127 |
$254 |
1.6× |
| Radex Toe Minimum 2 Views (73660) |
$118 |
$236 |
1.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$118 |
$236 |
1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$118 |
$236 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$290 |
$580 |
3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,502 |
$17,004 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$709 |
$1,418 |
7.7× |
| Radiation treatment delivery level 2 (77407) |
$741 |
$1,482 |
2.1× |
| Radiation treatment delivery level 3 (77412) |
$771.50 |
$1,543 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$158.50 |
$317 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$242 |
$484 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$637 |
$1,274 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$468.50 |
$937 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$316 |
$632 |
2.0× |
| Radiologic exam knee complete 4/more views (73564) |
$153 |
$306 |
1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$132 |
$264 |
1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$389.50 |
$779 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$346 |
$692 |
2.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$81 |
$162 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$939.50 |
$1,879 |
5.9× |
| Radiologic examination femur 1 view (73551) |
$118 |
$236 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$118 |
$236 |
1.5× |
| Radiologic examination knee 1/2 views (73560) |
$118 |
$236 |
1.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$175 |
$350 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$118 |
$236 |
1.5× |
| Radiopharm Dacryocystography (78660) |
$420 |
$840 |
1.2× |
| Ribs bilateral 3 views (71110) |
$176 |
$352 |
1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$670 |
$1,340 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$919 |
$1,838 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,285.50 |
$2,571 |
2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,039 |
$2,078 |
2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,437.50 |
$2,875 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,715 |
$3,430 |
1.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,636.50 |
$3,273 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$783.50 |
$1,567 |
3.7× |
| Scapula (73010) |
$153 |
$306 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$45.50 |
$91 |
1.9× |
| Sella turcica (70240) |
$23.50 |
$47 |
0.3× |
| Shoulder 1 view (73020) |
$118 |
$236 |
1.5× |
| Shoulder Arthrography (73040) |
$438.50 |
$877 |
1.4× |
| Sialogram (70390) |
$430.50 |
$861 |
2.0× |
| Skull less than 4 views (70250) |
$116 |
$232 |
1.2× |
| Special dosimetry (77331) |
$112.50 |
$225 |
0.9× |
| Special Physics Consult (77370) |
$299 |
$598 |
2.5× |
| Special teletherapy port plan (77321) |
$401 |
$802 |
1.2× |
| Special treatment procedure (77470) |
$716.50 |
$1,433 |
1.4× |
| Stereotactic Body Radiation Delivery (77373) |
$2,486.50 |
$4,973 |
1.5× |
| Sternoclavicular joints (71130) |
$102.50 |
$205 |
1.3× |
| Superior sagittal sinus venogram (75870) |
$1,023.50 |
$2,047 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$347 |
$694 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$223.50 |
$447 |
0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$478 |
$956 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$418.50 |
$837 |
1.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$299 |
$598 |
2.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$489 |
$978 |
3.1× |
| Thoracic spine 2 views (72070) |
$118 |
$236 |
1.3× |
| Thoracic spine 3 views (72072) |
$129.50 |
$259 |
1.4× |
| Thoracolumbar 2 views (72080) |
$118 |
$236 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$376.50 |
$753 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$707 |
$1,414 |
1.4× |
| Thyroid Uptake Measurement (78012) |
$376.50 |
$753 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$376.50 |
$753 |
1.0× |
| Tx Devices Design & Construction Complex (77334) |
$514 |
$1,028 |
1.5× |
| Tx devices design & construction intermediate (77333) |
$234 |
$468 |
1.9× |
| Tx devices design & construction simple (77332) |
$197 |
$394 |
1.6× |
| Ultrasound Breast Limited (76642) |
$337 |
$674 |
4.3× |
| Ultrasound elastography first target lesion (76982) |
$175.50 |
$351 |
1.9× |
| Ultrasound Elastography Parenchyma (76981) |
$416 |
$832 |
4.4× |
| Ultrasound Exam Aaa Screen (76706) |
$404.50 |
$809 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$347.50 |
$695 |
3.7× |
| Umbilical-artery Doppler (OB) (76820) |
$139 |
$278 |
1.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$147 |
$294 |
1.9× |
| Unlisted magnetic resonance procedure (76498) |
$489.50 |
$979 |
6.2× |
| Unlisted us procedure (76999) |
$488 |
$976 |
6.2× |
| Upper gi w/o kub (74240) |
$1,118 |
$2,236 |
7.1× |
| Urethrocystogram voiding (74455) |
$711.50 |
$1,423 |
3.3× |
| Urethrocystography retrograde (74450) |
$820.50 |
$1,641 |
3.8× |
| Us breast unilateral complete (76641) |
$337 |
$674 |
3.6× |
| Us chest (76604) |
$337 |
$674 |
3.6× |
| Us complete joint (76881) |
$311.50 |
$623 |
3.3× |
| Us exam, pelvic, limited (76857) |
$311.50 |
$623 |
3.3× |
| Us head (76506) |
$311.50 |
$623 |
3.3× |
| Us kidney transplant (76776) |
$419 |
$838 |
4.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$311.50 |
$623 |
3.3× |
| Us ob detailed single fetus (76811) |
$470 |
$940 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$337 |
$674 |
3.6× |
| Us ob transvaginal (76817) |
$311.50 |
$623 |
3.3× |
| Us pelvic non ob complete (76856) |
$405.50 |
$811 |
4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$377 |
$754 |
4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$229 |
$458 |
2.4× |
| Us retroperitoneal complete (76770) |
$441.50 |
$883 |
4.7× |
| Us retroperitoneal limited (76775) |
$404.50 |
$809 |
4.3× |
| Us scrotum and contents (76870) |
$486.50 |
$973 |
5.2× |
| Us spinal canal and contents (76800) |
$96.50 |
$193 |
1.0× |
| Us thyroid (76536) |
$311.50 |
$623 |
3.3× |
| Us transrectal (76872) |
$386 |
$772 |
4.1× |
| Vein X-Ray Chest (75827) |
$1,912 |
$3,824 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,440.50 |
$2,881 |
0.5× |
| Vein X-Ray Skull Epidural (75872) |
$1,023.50 |
$2,047 |
1.8× |
| Vein X-Ray Spleen/Liver (75810) |
$1,912 |
$3,824 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$816.50 |
$1,633 |
0.3× |
| Venography Adrenal Unilateral (75840) |
$1,912 |
$3,824 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,329 |
$4,658 |
0.8× |
| Venography extremity bilateral rs&i (75822) |
$1,261.50 |
$2,523 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,202 |
$2,404 |
0.8× |
| Venography Renal Bilateral (75833) |
$1,912 |
$3,824 |
0.7× |
| Venography Renal Unilateral (75831) |
$1,912 |
$3,824 |
0.7× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,421.50 |
$4,843 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$99 |
$198 |
1.3× |
| Wrist 2 views (73100) |
$118 |
$236 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$153 |
$306 |
1.9× |
| X-ray antegrade pyelogram tube (74425) |
$753 |
$1,506 |
2.4× |
| X-Ray Aorta Leg Arteries (75630) |
$1,912 |
$3,824 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$142.50 |
$285 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$118 |
$236 |
1.5× |
| X-Ray Exam Breast Specimen (76098) |
$451.50 |
$903 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$56.50 |
$113 |
0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$179.50 |
$359 |
1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$203 |
$406 |
2.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$94.50 |
$189 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$118 |
$236 |
1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$118 |
$236 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$153 |
$306 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$164.50 |
$329 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$172 |
$344 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$182.50 |
$365 |
1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$118 |
$236 |
1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$175 |
$350 |
1.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$164.50 |
$329 |
1.7× |
| X-ray eye for foreign body (70030) |
$203.50 |
$407 |
2.6× |
| X-ray head for orthodontia (70350) |
$98.50 |
$197 |
1.3× |
| X-ray humerus (73060) |
$118 |
$236 |
1.5× |
| X-ray IV pyelogram (ivp) (74400) |
$767 |
$1,534 |
4.8× |
| X-ray IV pyelogram+tomography (74415) |
$756 |
$1,512 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$104.50 |
$209 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$153 |
$306 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$118 |
$236 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$173 |
$346 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$190.50 |
$381 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$205.50 |
$411 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$106 |
$212 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$111.50 |
$223 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$146 |
$292 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$147 |
$294 |
1.6× |
| X-ray thoracic spine 4 vw (72074) |
$139 |
$278 |
1.5× |
| X-Ray Tmj Unilat (70328) |
$100.50 |
$201 |
1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$711.50 |
$1,423 |
2.3× |
| X-Rays Bone Length Studies (77073) |
$153.50 |
$307 |
1.6× |
| X-Rays Bone Survey Complete (77075) |
$307 |
$614 |
3.3× |
| Xr c-spine 4 or 5 views (72050) |
$143 |
$286 |
1.5× |
| Xr facial bones less than 3 views (70140) |
$96 |
$192 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$91 |
$182 |
1.0× |
| Xr myelogram posterior fossa (70010) |
$1,311.50 |
$2,623 |
4.2× |
| Xr orbits complete 4 views (70200) |
$189 |
$378 |
2.0× |
| Xr Tomogram Single Plane (76100) |
$242 |
$484 |
2.6× |