| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,477.29 |
$11,193.21 |
3.1× |
| Acute gi blood loss imaging (78278) |
$1,569.56 |
$3,923.88 |
3.7× |
| Angiography internal mammary rs&i (75756) |
$4,265.93 |
$10,664.82 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$10,038.72 |
$25,096.79 |
3.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,201.12 |
$8,002.79 |
0.5× |
| Angiography, adrenal, bilateral, selective, radiological supervision and interpretation Age Under 21 (75733) |
$5,687.88 |
$14,219.70 |
1.7× |
| Angiography, adrenal, unilateral, selective, radiological supervision and interpretation Age Under 21 (75731) |
$2,843.96 |
$7,109.90 |
0.9× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$6,284.92 |
$15,712.29 |
1.9× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$3,032.25 |
$7,580.61 |
0.9× |
Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736)
unusually low — confirm this is the full procedure |
$2,702.88 |
$6,757.20 |
0.5× |
| Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation Age Under 21 (75741) |
$5,019.37 |
$12,548.41 |
1.5× |
| Angiography, spinal, selective, radiological supervision and interpretation Age Under 21 (75705) |
$4,602.14 |
$11,505.33 |
0.8× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,353.02 |
$3,382.53 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,594.16 |
$3,985.40 |
0.5× |
| Ankle 2 views (73600) |
$320.09 |
$800.22 |
3.5× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$5,698.40 |
$14,245.98 |
1.7× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$3,241.44 |
$8,103.60 |
1.0× |
| Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605) |
$3,015.61 |
$7,539.02 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$460.01 |
$1,150.01 |
3.2× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$703.12 |
$1,757.79 |
1.7× |
| Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) |
$998.16 |
$2,495.40 |
1.7× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$5,563.24 |
$13,908.10 |
3.7× |
| Cholecystography, oral contrast Age Under 21 (74290) |
$490.75 |
$1,226.86 |
2.7× |
| Cineradiography/videoradiography (76120) |
$389.49 |
$973.72 |
3.5× |
| Clavicle complete (73000) |
$389.60 |
$973.99 |
4.2× |
| Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) |
$413.48 |
$1,033.69 |
1.6× |
| Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including… (74262) |
$613.46 |
$1,533.65 |
3.3× |
| Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material Age Under… (74261) |
$521.45 |
$1,303.61 |
4.7× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$5,084.68 |
$12,711.69 |
13.8× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,832.82 |
$7,082.05 |
15.3× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,711.46 |
$6,778.65 |
14.7× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$2,711.46 |
$6,778.65 |
14.7× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,958.92 |
$4,897.30 |
10.6× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$2,601.84 |
$6,504.60 |
14.1× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,862 |
$7,155 |
15.5× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,838.73 |
$4,596.82 |
9.9× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,678.78 |
$6,696.93 |
14.5× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,613.50 |
$4,033.74 |
14.6× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$2,318.74 |
$5,796.83 |
12.5× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,465.08 |
$6,162.68 |
13.3× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,157.81 |
$2,894.51 |
6.3× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$851.04 |
$2,127.60 |
7.7× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,728.56 |
$4,321.38 |
9.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,634.02 |
$4,085.03 |
14.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,428.42 |
$6,071.06 |
13.1× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,013.36 |
$5,033.39 |
10.9× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,841.63 |
$4,604.07 |
10.0× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$3,140.61 |
$7,851.51 |
17.0× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$618.41 |
$1,546.01 |
4.4× |
| Csf shunt evaluation (78645) |
$1,367.10 |
$3,417.73 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,476.01 |
$11,190.01 |
12.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,340.54 |
$8,351.35 |
13.3× |
| CT abdomen w & w/o contrast (74170) |
$2,506.57 |
$6,266.42 |
13.5× |
| CT abdomen w/contrast (74160) |
$2,118.40 |
$5,295.99 |
11.4× |
| CT abdomen w/o contrast (74150) |
$1,859.74 |
$4,649.33 |
16.9× |
| CT angio hrt w/3d image (75574) |
$2,295.30 |
$5,738.23 |
6.2× |
| CT cervical spine w/contrast (72126) |
$2,295.16 |
$5,737.88 |
6.2× |
| CT cervical spine w/o contrast (72125) |
$1,966.46 |
$4,916.15 |
17.8× |
| CT chest w/contrast (71260) |
$1,679.50 |
$4,198.74 |
9.1× |
| CT extremity upper w & w/o contrast (73202) |
$2,318.74 |
$5,796.83 |
12.5× |
| CT extremity upper w/o contrast (73200) |
$1,537.77 |
$3,844.42 |
13.9× |
| CT head/brain with contrast (70460) |
$1,634.66 |
$4,086.63 |
8.8× |
| CT head/brain without and with contrast (70470) |
$2,125.37 |
$5,313.41 |
11.5× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$1,090.71 |
$2,726.77 |
3.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,950.99 |
$4,877.47 |
5.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$973.84 |
$2,434.59 |
10.6× |
| CT l-spine w/contrast (72132) |
$2,416.36 |
$6,040.89 |
6.6× |
| CT limited/localized follow up study (76380) |
$693.16 |
$1,732.89 |
7.6× |
| CT lower extremity w/dye (73701) |
$1,968.42 |
$4,921.04 |
10.6× |
| CT lumbar spine w/o contrast (72131) |
$1,937.81 |
$4,844.52 |
17.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,591.54 |
$3,978.84 |
8.6× |
| CT neck w/contrast (70491) |
$1,629.76 |
$4,074.39 |
8.8× |
| CT neck w/o contrast (70490) |
$1,583.78 |
$3,959.45 |
14.4× |
| CT pelvis w & w/o contrast (72194) |
$2,506.57 |
$6,266.42 |
13.5× |
| CT pelvis w/o contrast (72192) |
$1,881.69 |
$4,704.21 |
17.1× |
| CT thoracic spine w/contrast (72129) |
$2,367.03 |
$5,917.56 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$1,995.64 |
$4,989.10 |
18.1× |
| CT thorax lung cancer scr c- (71271) |
$398.18 |
$995.45 |
3.6× |
| CT thorax w/o contrast (71250) |
$1,458.10 |
$3,645.25 |
13.2× |
| CT upper extremity w/dye (73201) |
$1,833.96 |
$4,584.90 |
5.0× |
| CTA head w contrast (70496) |
$2,521.29 |
$6,303.21 |
13.6× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$963.85 |
$2,409.61 |
2.6× |
| Dilation ureters/urethra rs&i (74485) |
$3,599.19 |
$8,997.96 |
1.6× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$2,062.19 |
$5,155.47 |
1.0× |
| Diskography lumbar s&i (72295) |
$2,062.19 |
$5,155.47 |
1.0× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Age Under 21 (76827) |
$491.76 |
$1,229.40 |
4.5× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$326.48 |
$816.18 |
3.0× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$175.72 |
$439.28 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$567.31 |
$1,418.27 |
5.1× |
| Dxa bone density/peripheral (77081) |
$175.72 |
$439.28 |
1.9× |
| Fetal biophys profile w/o nst (76819) |
$661.58 |
$1,653.94 |
6.0× |
| Fetal biophysical profile non-stress testing (76818) |
$1,049.41 |
$2,623.51 |
9.5× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$591.92 |
$1,479.80 |
2.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,262.15 |
$5,655.36 |
3.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$1,809.71 |
$4,524.26 |
4.3× |
| Gated heart planar single (78472) |
$2,196.76 |
$5,491.89 |
5.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,265.58 |
$13,163.93 |
7.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,429.65 |
$13,574.11 |
7.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,595.23 |
$13,988.06 |
7.6× |
| Heart infarct image (78466) |
$998.16 |
$2,495.40 |
2.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,696.21 |
$4,240.52 |
0.5× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Age Under… (75889) |
$1,884.69 |
$4,711.71 |
0.6× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,890.45 |
$4,726.11 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,718.58 |
$4,296.43 |
4.1× |
| Ht muscle image spect sing (78451) |
$4,042.80 |
$10,106.99 |
3.0× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$609.41 |
$1,523.51 |
1.4× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$5,601.96 |
$14,004.90 |
3.8× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$7,515.34 |
$18,788.34 |
10.2× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,101.48 |
$2,753.70 |
2.6× |
| Intracavitary radiation source application - complex (77763) |
$3,160.04 |
$7,900.09 |
4.3× |
| Intraoperative radiation treatment delivery, electrons, single treatment session (77425) |
$4,965.92 |
$12,414.78 |
0.6× |
| Intraoperative radiation treatment delivery, x-ray, single treatment session (77424) |
$4,965.92 |
$12,414.78 |
0.6× |
| Isodose brachytherapy complex 10+ sources (77318) |
$3,005.08 |
$7,512.70 |
7.6× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$2,341.75 |
$5,854.36 |
5.9× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$1,721.89 |
$4,304.71 |
4.4× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$2,461.99 |
$6,154.97 |
6.2× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$1,454.72 |
$3,636.78 |
3.7× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$2,826.60 |
$7,066.49 |
4.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,920.53 |
$4,801.32 |
3.4× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,824.36 |
$4,560.89 |
3.2× |
| Leveen/shunt patency exam (78291) |
$1,043.23 |
$2,608.07 |
2.5× |
| Liver and spleen imaging (78215) |
$1,204.12 |
$3,010.30 |
2.9× |
| Lung perf&ventilat diferentl (78598) |
$1,883.36 |
$4,708.38 |
3.3× |
| Lung perfusion imaging (78580) |
$1,466.06 |
$3,665.15 |
3.5× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$4,021.94 |
$10,054.84 |
10.9× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$3,309.90 |
$8,274.76 |
9.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$2,932.40 |
$7,330.98 |
11.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$4,117.26 |
$10,293.14 |
11.2× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$2,916.76 |
$7,291.88 |
7.9× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,857.44 |
$7,143.60 |
11.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$3,309.90 |
$8,274.76 |
9.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,117.26 |
$10,293.14 |
11.2× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,972.70 |
$4,931.75 |
5.4× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$3,228 |
$8,069.99 |
8.8× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$2,618.49 |
$6,546.22 |
7.1× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$1,049.28 |
$2,623.20 |
4.2× |
| Mammary ductogram single (77053) |
$823.13 |
$2,057.81 |
3.3× |
| Mandible min 4v (70110) |
$624.87 |
$1,562.16 |
5.7× |
| Med physic dos eval rad exps (76145) |
$588.68 |
$1,471.70 |
1.5× |
| Mr safety determination physician/other qhp (76016) |
$551.20 |
$1,378 |
6.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$551.20 |
$1,378 |
8.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$551.20 |
$1,378 |
18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$551.20 |
$1,378 |
5.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$551.20 |
$1,378 |
2.2× |
| MRA head w/o contrast (70544) |
$1,337.88 |
$3,344.69 |
5.3× |
| MRA neck w/ contrast (70548) |
$2,078.56 |
$5,196.38 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,832.03 |
$4,580.07 |
7.3× |
| MRI abdomen w/contrast (74182) |
$2,380.05 |
$5,950.11 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,656.37 |
$4,140.92 |
6.6× |
| MRI abdomen w/wo contrast (74183) |
$2,748.26 |
$6,870.63 |
7.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,111.80 |
$7,779.50 |
3.8× |
| MRI breast c- bilateral (77047) |
$3,255.95 |
$8,139.86 |
12.9× |
| MRI breast without contrast material unilateral (77046) |
$1,627.98 |
$4,069.94 |
6.5× |
| MRI c-spine w&w/o cont (72156) |
$3,647.96 |
$9,119.89 |
9.9× |
| MRI cervical spine w/contrast (72142) |
$2,272.59 |
$5,681.47 |
6.2× |
| MRI chest w/contrast (71551) |
$2,636.29 |
$6,590.72 |
3.2× |
| MRI chest w/o contrast (71550) |
$2,325.32 |
$5,813.28 |
9.2× |
| MRI chest w/wo contrast (71552) |
$3,270.03 |
$8,175.07 |
8.9× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,142.60 |
$10,356.50 |
11.3× |
| MRI joint upr extrem w/dye (73222) |
$3,144.58 |
$7,861.42 |
3.8× |
| MRI joint upr extrem w/o dye (73221) |
$2,759.08 |
$6,897.68 |
11.0× |
| MRI lumbar spine w/contrast (72149) |
$2,662.38 |
$6,655.95 |
7.2× |
| MRI lumbar spine w/wo contrast (72158) |
$3,647.96 |
$9,119.89 |
9.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,985.77 |
$7,464.41 |
8.1× |
| MRI pelvis w & w/o contrast (72197) |
$3,137.32 |
$7,843.28 |
8.5× |
| MRI pelvis w/contrast (72196) |
$2,313.46 |
$5,783.64 |
6.3× |
| MRI pelvis w/o contrast (72195) |
$1,805.93 |
$4,514.81 |
7.2× |
| MRI spectroscopy (76390) |
$1,422.64 |
$3,556.59 |
15.5× |
| MRI spine cervical w/o contrast (72141) |
$2,249.40 |
$5,623.50 |
8.9× |
| MRI t-spine w&w/o cont (72157) |
$3,355.70 |
$8,389.23 |
9.1× |
| MRI thoracic spine w/contrast (72147) |
$2,413.76 |
$6,034.39 |
6.6× |
| MRI thoracic spine w/o contrst (72146) |
$2,035.58 |
$5,088.95 |
8.1× |
| MRI tmj (70336) |
$3,532.62 |
$8,831.52 |
14.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,650.01 |
$6,625.01 |
10.5× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$8,392.75 |
$20,981.86 |
21.2× |
| Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) |
$1,458.09 |
$3,645.21 |
1.8× |
| Myocardial spect multiple studies (78452) |
$4,461.76 |
$11,154.39 |
3.3× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$6,749.58 |
$16,873.94 |
7.5× |
| Nm bone 3 phase (78315) |
$1,853.82 |
$4,634.53 |
4.4× |
| Nm bone imaging whole body (78306) |
$2,123.70 |
$5,309.24 |
5.0× |
| Nm csf cisternogram (78630) |
$1,732.42 |
$4,331.04 |
3.0× |
| Nm csf leak detection (78650) |
$2,134.62 |
$5,336.54 |
1.6× |
| Nm gastric emptying (78264) |
$1,575.69 |
$3,939.21 |
3.7× |
| Nm lung ventilation imaging (78579) |
$1,308.98 |
$3,272.45 |
3.1× |
| Nm lymph system (78195) |
$1,969.10 |
$4,922.73 |
3.4× |
| Nm myocard infarct spect (78469) |
$998.16 |
$2,495.40 |
1.7× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,451 |
$3,627.49 |
3.4× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,465.26 |
$3,663.14 |
3.5× |
| Ob us limited fetus(s) (76815) |
$477.36 |
$1,193.38 |
4.3× |
| Panoramic X-ray of jaws (70355) |
$371.32 |
$928.30 |
4.0× |
| Parathyrd planar w/spect&CT (78072) |
$3,340.88 |
$8,352.18 |
5.8× |
| Parathyroid planar imaging (78070) |
$2,020.76 |
$5,051.88 |
4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,938.03 |
$7,345.07 |
7.0× |
| Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation Age… (75885) |
$5,019.37 |
$12,548.41 |
1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,087.41 |
$10,218.52 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$3,223.42 |
$8,058.55 |
2.1× |
| PET imaging for CT attenuation whole body (78816) |
$4,504.06 |
$11,260.15 |
3.0× |
| PET imaging whole body (78813) |
$4,396.40 |
$10,990.99 |
2.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,604.75 |
$6,511.87 |
0.8× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,207.74 |
$5,519.34 |
3.9× |
| Quant differential pulm perfusion w/wo imaging (78597) |
$1,308.98 |
$3,272.45 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$798.02 |
$1,995.04 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$352.44 |
$881.09 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$591.01 |
$1,477.52 |
5.4× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$642.34 |
$1,605.85 |
5.8× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$721.61 |
$1,804.02 |
6.5× |
| Radex hip unilateral with pelvis 1 view (73501) |
$296.16 |
$740.40 |
3.2× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$532.78 |
$1,331.92 |
5.8× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$487.22 |
$1,218.04 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$533.58 |
$1,333.94 |
4.8× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$688.41 |
$1,721.01 |
6.2× |
| Radex spine cervical 2 or 3 views (72040) |
$545.36 |
$1,363.38 |
5.9× |
| Radex spine cervical 4 or 5 views (72050) |
$671.13 |
$1,677.81 |
6.1× |
| Radex spine cervical 6 or more views (72052) |
$878.80 |
$2,196.99 |
8.0× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$301.43 |
$753.57 |
3.3× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) |
$7,749.56 |
$19,373.90 |
1.0× |
| Radiation tx delivery lvl 1 (77402) |
$545.89 |
$1,364.71 |
5.1× |
| Radiation tx delivery lvl 2 (77407) |
$664.07 |
$1,660.16 |
1.6× |
| Radiation tx delivery lvl 3 (77412) |
$853.98 |
$2,134.93 |
1.5× |
| Radiologic exam abdomen 3+ views (74021) |
$501.60 |
$1,253.98 |
4.5× |
| Radiologic exam chest 3 views (71047) |
$494.21 |
$1,235.51 |
5.4× |
| Radiologic exam chest 4+ views (71048) |
$501.94 |
$1,254.83 |
4.6× |
| Radiologic exam colon double contrast study (74280) |
$1,296.90 |
$3,242.24 |
7.0× |
| Radiologic exam colon single contrast study (74270) |
$1,187.19 |
$2,967.96 |
6.4× |
| Radiologic exam esophagus double contrast study (74221) |
$741.85 |
$1,854.62 |
4.0× |
| Radiologic exam esophagus single contrast study (74220) |
$769.81 |
$1,924.51 |
4.2× |
| Radiologic exam small int single contrast study (74250) |
$886.24 |
$2,215.58 |
4.8× |
| Radiologic exam swallow function contrast study (74230) |
$188.34 |
$470.83 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,132.79 |
$2,831.96 |
6.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$983.61 |
$2,459.01 |
5.3× |
| Radiologic examination femur 1 view (73551) |
$299.96 |
$749.89 |
3.3× |
| Radiologic examination femur minimum 2 views (73552) |
$470.77 |
$1,176.92 |
5.1× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$195.31 |
$488.26 |
2.1× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$497.40 |
$1,243.50 |
5.4× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$668.90 |
$1,672.25 |
6.1× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$394.44 |
$986.08 |
4.3× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$480.80 |
$1,202 |
5.2× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$330.06 |
$825.13 |
3.6× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$495.58 |
$1,238.96 |
5.4× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$478.78 |
$1,196.95 |
5.2× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$380.46 |
$951.14 |
4.1× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$556.57 |
$1,391.41 |
5.0× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$531.98 |
$1,329.95 |
5.8× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$343.08 |
$857.68 |
3.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$510.17 |
$1,275.41 |
5.6× |
| Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and… (74470) |
$976.67 |
$2,441.66 |
1.7× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$898.94 |
$2,247.35 |
8.2× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$555.15 |
$1,387.86 |
5.0× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$203.57 |
$508.92 |
1.8× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$874.50 |
$2,186.26 |
2.4× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$510.84 |
$1,277.10 |
5.6× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) |
$860.90 |
$2,152.25 |
7.8× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$346.57 |
$866.42 |
3.8× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$471.28 |
$1,178.20 |
4.3× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$639.04 |
$1,597.60 |
5.8× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$108.10 |
$270.23 |
1.0× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$753.95 |
$1,884.86 |
6.8× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$205.49 |
$513.72 |
1.9× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$477.68 |
$1,194.18 |
5.2× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$502.33 |
$1,255.81 |
5.5× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$453.36 |
$1,133.41 |
4.9× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$495.46 |
$1,238.66 |
5.4× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$686.20 |
$1,715.50 |
6.2× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$469.66 |
$1,174.15 |
5.1× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$373.26 |
$933.13 |
4.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$260.96 |
$652.39 |
2.4× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,731.54 |
$4,328.85 |
3.0× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$2,970.31 |
$7,425.77 |
12.1× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$1,221.72 |
$3,054.29 |
5.0× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion (79403) |
$1,710.04 |
$4,275.08 |
6.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$5,265.58 |
$13,163.93 |
12.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$5,429.65 |
$13,574.11 |
13.3× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$1,055.59 |
$2,638.97 |
4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,282.62 |
$3,206.55 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,690.79 |
$4,226.97 |
4.0× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,476.64 |
$8,691.60 |
6.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,078.79 |
$7,696.96 |
5.4× |
| Rp loclzj tum spect 2 areas (78831) |
$2,315.22 |
$5,788.03 |
1.7× |
| Rp loclzj tum spect w/CT 1 (78830) |
$1,904.70 |
$4,761.75 |
1.4× |
| Rp loclzj tum spect w/CT 2 (78832) |
$2,546.73 |
$6,366.82 |
1.7× |
| Scapula complete (73010) |
$415.95 |
$1,039.86 |
3.8× |
| Screening digital breast tomosynthesis bi (77063) |
$16 |
$40 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$632.26 |
$1,580.64 |
5.7× |
| Simulation intermediate (77285) |
$1,239.82 |
$3,099.54 |
3.1× |
| Special dosimetry (77331) |
$1,006.06 |
$2,515.13 |
7.1× |
| Special physics consult (77370) |
$1,297.59 |
$3,243.97 |
9.2× |
| Special teletherapy port plan (77321) |
$1,198.71 |
$2,996.77 |
3.0× |
| Special treatment procedure (77470) |
$1,895.79 |
$4,739.46 |
3.3× |
| Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) |
$4,148.66 |
$10,371.65 |
2.2× |
| Surface application of low dose rate radionuclide source (77789) |
$424.66 |
$1,061.65 |
3.9× |
| Testicular imaging with vascular flow Age Under 21 (78761) |
$775.46 |
$1,938.65 |
1.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,642.84 |
$4,107.08 |
4.2× |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$316.30 |
$790.74 |
1.7× |
| Thyroid imaging with vascular flow (78013) |
$852.56 |
$2,131.38 |
2.0× |
| Thyroid met imaging body (78018) |
$2,921.25 |
$7,303.11 |
5.1× |
| Thyroid uptake single/multiple quant measurement (78012) |
$497.06 |
$1,242.64 |
1.2× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,141.68 |
$2,854.20 |
2.7× |
| Tr simulation simple (77280) |
$1,006.06 |
$2,515.13 |
7.1× |
| Treatment device complex (77334) |
$1,044.43 |
$2,611.06 |
2.6× |
| Treatment device intermediate (77333) |
$887.88 |
$2,219.68 |
6.3× |
| Treatment device simple (77332) |
$879.28 |
$2,198.20 |
6.2× |
| Ultrasound breast limited (76642) |
$458.94 |
$1,147.32 |
5.0× |
| Ultrasound, abdomen limited (76705) |
$779.46 |
$1,948.65 |
7.1× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$1,043.90 |
$2,609.76 |
9.5× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$983.38 |
$2,458.45 |
8.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$1,225.74 |
$3,064.33 |
4.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$648.43 |
$1,621.07 |
5.9× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$601.73 |
$1,504.31 |
5.5× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$1,314 |
$3,285 |
11.9× |
| Umbilical-artery Doppler (OB) (76820) |
$183.44 |
$458.59 |
1.7× |
| Unlisted fluoroscopic procedure (76496) |
$700.02 |
$1,750.03 |
7.6× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$512.82 |
$1,282.05 |
5.6× |
| Unlisted procedure, clinical brachytherapy (77799) |
$2,636.18 |
$6,590.45 |
24.5× |
| Ureteral reflux study (78740) |
$768 |
$1,919.98 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$1,344.02 |
$3,360.05 |
5.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$1,585.49 |
$3,963.71 |
8.6× |
| Urography antegrade rs&i (74425) |
$777.43 |
$1,943.56 |
2.1× |
| Us abdominal aorta real time screen study aaa (76706) |
$350.60 |
$876.48 |
3.2× |
| Us breast uni real time with image complete (76641) |
$458.94 |
$1,147.32 |
4.2× |
| Us chest (76604) |
$674.92 |
$1,687.30 |
6.1× |
| Us compl joint r-t w/image documentation (76881) |
$1,043.90 |
$2,609.76 |
9.5× |
| Us encephalogram (76506) |
$523.37 |
$1,308.42 |
4.7× |
| Us exam, pelvic, limited (76857) |
$604.30 |
$1,510.73 |
5.5× |
| Us guided compression repair (76936) |
$1,097.88 |
$2,744.70 |
4.8× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$563.79 |
$1,409.46 |
6.1× |
| US OB Follow-Up/Repeat (76816) |
$610.66 |
$1,526.65 |
5.5× |
| Us ob transvaginal (76817) |
$583.68 |
$1,459.19 |
5.3× |
| Us retroperitoneal complete (76770) |
$1,097.12 |
$2,742.79 |
9.9× |
| Us retroperitoneal ltd (76775) |
$947 |
$2,367.48 |
8.6× |
| Us scrotum (76870) |
$907.64 |
$2,269.08 |
8.2× |
| Us soft tissue head/neck (76536) |
$821.42 |
$2,053.55 |
7.4× |
| Us spinal canal (76800) |
$572.19 |
$1,430.47 |
5.2× |
| Us transrectal (76872) |
$274.13 |
$685.31 |
2.5× |
| Venogram sinus/jugular (75860) |
$1,647.18 |
$4,117.94 |
0.5× |
| Venography adrenal unilateral selective rs&i (75840) |
$5,019.37 |
$12,548.41 |
1.5× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$2,376.80 |
$5,942 |
25.9× |
| Venography renal unilateral selective rs&i (75831) |
$5,019.37 |
$12,548.41 |
1.5× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$1,618.77 |
$4,046.91 |
0.5× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$2,323.72 |
$5,809.29 |
1.4× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$2,044.39 |
$5,110.96 |
1.2× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,022.20 |
$2,555.49 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,019.37 |
$12,548.41 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$398.89 |
$997.21 |
4.3× |
| X-ray exam hips bi 3-4 views (73522) |
$505.04 |
$1,262.58 |
4.6× |
| X-ray exam of finger(s) (73140) |
$441.44 |
$1,103.60 |
4.8× |
| X-ray exam of knee 1 or 2 (73560) |
$460.24 |
$1,150.60 |
5.0× |
| X-ray exam ribs bil 3 views (71110) |
$721.67 |
$1,804.16 |
6.5× |
| X-ray exam ribs uni 2 views (71100) |
$463.47 |
$1,158.67 |
5.0× |
| X-ray heel (73650) |
$396.66 |
$991.64 |
4.3× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$502.67 |
$1,256.66 |
4.6× |
| X-ray retrograde pyelogram (74420) |
$1,173.18 |
$2,932.95 |
3.2× |
| Xr abdomen 1 view (74018) |
$329.92 |
$824.79 |
3.6× |
| Xr abdomen 2 views (74019) |
$476.11 |
$1,190.26 |
4.3× |
| Xr arthrogram elbow (73085) |
$678.66 |
$1,696.64 |
1.8× |
| Xr arthrogram hip (73525) |
$1,173.34 |
$2,933.34 |
3.2× |
| Xr arthrogram knee (73580) |
$599.38 |
$1,498.46 |
1.6× |
| Xr arthrogram wrist (73115) |
$1,319.85 |
$3,299.61 |
3.6× |
| Xr bone age studies (77072) |
$429.80 |
$1,074.49 |
3.9× |
| Xr bone length study (77073) |
$257.58 |
$643.94 |
2.3× |
| Xr bone survey infant (77076) |
$390.17 |
$975.42 |
3.5× |
| Xr bone survey ltd (77074) |
$576.50 |
$1,441.24 |
5.2× |
| Xr chest 1 view (71045) |
$362.28 |
$905.70 |
3.9× |
| Xr chest 2 views (71046) |
$423.17 |
$1,057.91 |
4.6× |
| Xr eye foreign body (70030) |
$371.65 |
$929.12 |
4.0× |
| Xr facial bones 3+ views (70150) |
$592.58 |
$1,481.43 |
5.4× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$286.67 |
$716.66 |
3.1× |
| Xr forearm 2 views (73090) |
$458.66 |
$1,146.63 |
5.0× |
| Xr hand 2v (73120) |
$379.57 |
$948.92 |
3.4× |
| Xr hysterosalpingogram (74740) |
$1,059.32 |
$2,648.30 |
4.2× |
| Xr myelogram c-spine (72240) |
$930.97 |
$2,327.41 |
1.1× |
| Xr myelogram l-spine (72265) |
$930.97 |
$2,327.41 |
1.1× |
| Xr myelogram t-spine (72255) |
$869.45 |
$2,173.62 |
1.1× |
| Xr neck soft tissue (70360) |
$382.44 |
$956.08 |
4.2× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$534.30 |
$1,335.74 |
5.8× |
| Xr osseous survey complete (77075) |
$693.57 |
$1,733.92 |
6.3× |
| Xr pelvis 1-2 views (72170) |
$353.46 |
$883.63 |
3.2× |
| Xr pelvis min 3 view (72190) |
$397.12 |
$992.78 |
3.6× |
| Xr peritoneogram (74190) |
$932.02 |
$2,330.04 |
1.6× |
| Xr sacrum/coccyx 2+ views (72220) |
$464.99 |
$1,162.46 |
5.1× |
| Xr sella turcica (70240) |
$226.92 |
$567.29 |
2.5× |
| Xr shoulder 1 view (73020) |
$313.40 |
$783.48 |
3.4× |
| Xr sialogram (70390) |
$826.98 |
$2,067.44 |
3.3× |
| Xr sinuses 3+ views (70220) |
$664.26 |
$1,660.65 |
7.2× |
| Xr skull min 4 view (70260) |
$766.02 |
$1,915.05 |
6.9× |
| Xr spine 1 view (72020) |
$368.23 |
$920.57 |
4.0× |
| Xr spine thoracic 3v (72072) |
$617.50 |
$1,543.74 |
5.6× |
| Xr sternum 2+ views (71120) |
$416.39 |
$1,040.97 |
4.5× |
| Xr stress view joint (77071) |
$327.68 |
$819.19 |
3.6× |
| Xr surgical specimen (76098) |
$469.61 |
$1,174.02 |
0.8× |
| Xr t-spine 2 views (72070) |
$503.36 |
$1,258.38 |
4.6× |
| Xr tibia/fibula 2 views (73590) |
$524.72 |
$1,311.80 |
5.7× |
| Xr tmj bilateral (70330) |
$731.65 |
$1,829.12 |
8.0× |
| Xr tmj unilateral (70328) |
$108.10 |
$270.23 |
1.2× |
| Xr venogram renal bilat (75833) |
$10,038.72 |
$25,096.79 |
3.0× |
| Xr wrist 2 views (73100) |
$360.36 |
$900.90 |
3.9× |