| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,475 |
$9,800 |
1.0× |
| Abdomen 1 View (74018) |
$92 |
$587 |
1.0× |
| Abdomen 2 views (74019) |
$111 |
$646 |
1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$426 |
$1,338 |
1.0× |
| Adrenal Cortex & Medulla Img (78075) |
$1,380 |
$2,921 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,367 |
$8,962 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,367 |
$5,167 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,367 |
$3,957 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,367 |
$11,350 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,367 |
$11,017 |
1.0× |
| Ankle 2 views (73600) |
$92 |
$371 |
1.0× |
| Aortography thoracic serialography rs&i (75605) |
$5,933 |
$4,413 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$5,933 |
$4,456 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,933 |
$4,456 |
1.0× |
| Arthrogram ankle (73615) |
$372 |
$903 |
1.0× |
| Arthrogram hip (73525) |
$372 |
$1,399 |
1.0× |
| Arthrogram Wrist (73115) |
$372 |
$1,148 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$143 |
$1,323 |
1.0× |
| Bone age studies (77072) |
$111 |
$334 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$426 |
$4,371 |
1.0× |
| Bone Imaging Multiple Areas (78305) |
$426 |
$1,884 |
1.0× |
| Bone Imaging Whole Body (78306) |
$426 |
$4,268 |
1.0× |
| Brain Flow Imaging Only (78610) |
$579 |
$3,221 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$579 |
$6,014 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,524 |
$6,032 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$372 |
$1,384 |
1.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$835 |
$2,785 |
1.0× |
| Cerebrospinal Fluid Scan (78630) |
$579 |
$1,910 |
1.0× |
| Chest 1 view (71045) |
$92 |
$587 |
1.0× |
Chest 2 views (71046)
range across 3 matching MRF lines |
$92 |
$604–$646 |
1.0× |
| Chest 3 views (71047) |
$92 |
$709 |
1.0× |
| Chest 4 or more views (71048) |
$111 |
$780 |
1.0× |
| Clavicle complete (73000) |
$92 |
$651 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$111 |
$99 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$143 |
$1,618 |
1.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,367 |
$5,641 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$372 |
$1,521 |
1.0× |
| Contrast X-Ray Of Elbow (73085) |
$372 |
$903 |
1.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$372 |
$1,256 |
1.0× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$187 |
$713 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$372 |
$10,828 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$254 |
$8,446 |
1.0× |
| CT abdomen w contrast (74160) |
$187 |
$3,394 |
1.0× |
| CT abdomen w wo contrast (74170) |
$187 |
$5,675 |
1.0× |
| CT abdomen w/o contrast (74150) |
$111 |
$2,608 |
1.0× |
| CT Angio Abdomen and Pelvis (74174) |
$372 |
$4,341 |
1.0× |
| CT Angio Chest (71275) |
$187 |
$3,613 |
1.0× |
| CT Angio Head (70496) |
$187 |
$2,448 |
1.0× |
| CT angio hrt w/3d image (75574) |
$372 |
$1,580 |
1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$187 |
$2,773 |
1.0× |
| CT Angio Neck (70498) |
$187 |
$2,399 |
1.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$187 |
$2,328 |
1.0× |
| CT cervical spine w/ contrast (72126) |
$372 |
$3,776 |
1.0× |
| CT cervical spine w/o contrast (72125) |
$111 |
$3,351 |
1.0× |
| CT cervical spine w/wo cont (72127) |
$187 |
$5,050 |
1.0× |
| CT chest w contrast (71260) |
$187 |
$5,336 |
1.0× |
| CT chest w/wo contrast (71270) |
$187 |
$5,869 |
1.0× |
| CT head/brain with contrast (70460) |
$187 |
$4,574 |
1.0× |
| CT head/brain without and with contrast (70470) |
$187 |
$5,034 |
1.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$372 |
$678 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$92 |
$49 |
1.0× |
| CT iac w contrast (70481) |
$187 |
$4,726 |
1.0× |
| CT l-spine w&w/o contrast (72133) |
$187 |
$5,416 |
1.0× |
| CT lower ext w/o (73700) |
$111 |
$2,750 |
1.0× |
| CT lower extremity w/contrast material (73701) |
$187 |
$3,557 |
1.0× |
| CT lumbar spine w contrast (72132) |
$372 |
$4,388 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$111 |
$3,408 |
1.0× |
| CT maxillofacial w contrast (70487) |
$187 |
$3,157 |
1.0× |
| CT maxillofacial wo contrast (70486) |
$111 |
$2,134 |
1.0× |
| CT neck tissue combo (70492) |
$187 |
$3,914 |
1.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$187 |
$5,200 |
1.0× |
| CT orbits w/o contrast (70480) |
$111 |
$4,165 |
1.0× |
| CT pelvis w&w/o contrast (72194) |
$187 |
$3,870 |
1.0× |
| CT pelvis w/o contrast (72192) |
$111 |
$2,618 |
1.0× |
CT scan of leg combo (73702)
range across 10 matching MRF lines |
$187 |
$3,831–$4,513 |
1.0× |
| CT scans face/jaw combo (70488) |
$187 |
$3,585 |
1.0× |
| CT soft tissue neck w contrast (70491) |
$187 |
$3,169 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$111 |
$2,457 |
1.0× |
| CT thoracic spine w contrast (72129) |
$187 |
$3,523 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$111 |
$3,202 |
1.0× |
| CT thoracic spine w/wo cont (72130) |
$187 |
$3,803 |
1.0× |
| CT thorax w/o contrast (71250) |
$111 |
$2,848 |
1.0× |
| CT upper ext wo (73200) |
$111 |
$2,278 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$187 |
$3,831 |
1.0× |
| CT upper extremity with contrast (73201) |
$372 |
$2,910 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$187 |
$1,459 |
1.0× |
| Cta Abdomen (74175) |
$187 |
$2,984 |
1.0× |
| CTA pelvis (72191) |
$187 |
$1,709 |
1.0× |
| Dilation ureters/urethra rs&i (74485) |
$2,229 |
$2,157 |
1.0× |
Dxa Bone Density Axial (77080)
range across 3 matching MRF lines |
$111 |
$31–$1,011 |
1.0× |
| Dxa bone density study (77085) |
$111 |
$1,328 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$92 |
$551 |
1.0× |
| Echo exam uterus (76831) |
$254 |
$675 |
1.0× |
| Echo Guide For Artery Repair (76936) |
$230 |
$779 |
1.0× |
| Esophagram (74220) |
$187 |
$945 |
1.0× |
| Fetal Biophys Profile W/Nst (76818) |
$111 |
$1,396 |
1.0× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$254 |
$978–$1,021 |
1.0× |
| Follow-Up Angiography (75898) |
$3,367 |
$831 |
1.0× |
| Foot 2 views (73620) |
$92 |
$711 |
1.0× |
| Forearm 2 views (73090) |
$92 |
$379 |
1.0× |
| Gastric emptying imaging study (78264) |
$426 |
$3,673 |
1.0× |
| Gastroesophageal Reflux Exam (78262) |
$426 |
$6,807 |
1.0× |
| Gated Heart Planar Single (78472) |
$426 |
$9,857 |
1.0× |
| Hand 2 views (73120) |
$111 |
$774 |
1.0× |
| Heart first pass single,planar (78481) |
$579 |
$6,293 |
1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,367 |
$11,186 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$579 |
$4,882 |
1.0× |
| Hepatobiliary System Imaging (78226) |
$426 |
$2,317 |
1.0× |
| Ht Muscle Image Spect Sing (78451) |
$1,380 |
$3,205 |
1.0× |
| Hysterosalpingogram (74740) |
$254 |
$2,136 |
1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$92 |
$574 |
1.0× |
| Infant hip ultrasound, limited static exam (76886) |
$92 |
$405 |
1.0× |
| Joint Survey Single View (77077) |
$111 |
$397 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$579 |
$2,093 |
1.0× |
| K Flow/Funct Image W/O Drug (78707) |
$579 |
$2,239 |
1.0× |
| Kidney Imaging Morphol (78700) |
$426 |
$2,178 |
1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$426 |
$2,721 |
1.0× |
| Knee 3 Views (73562) |
$92 |
$946 |
1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$426 |
$2,566 |
1.0× |
| Liver imaging static only (78201) |
$579 |
$2,194 |
1.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$579 |
$2,615 |
1.0× |
| Lung perfusion differential (78597) |
$426 |
$1,137 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$579 |
$2,587 |
1.0× |
| Lung Ventilation Imaging (78579) |
$426 |
$1,573 |
1.0× |
| Lymph System Imaging (78195) |
$579 |
$3,803 |
1.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,678 |
$3,386 |
1.0× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$668 |
$1,921 |
1.0× |
| Meckels Divert Exam (78290) |
$426 |
$2,090 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$399 |
$3,156 |
1.0× |
| Mr safety determination physician/other qhp (76016) |
$92 |
$309 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$86 |
1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$101 |
$322 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$62 |
$208 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$254 |
$847 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$372 |
$6,444 |
1.0× |
| MRA head w/o contrast (70544) |
$254 |
$5,083 |
1.0× |
| MRA head with contrast (70545) |
$372 |
$5,458 |
1.0× |
| MRA neck w contrast (70548) |
$372 |
$3,411 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$372 |
$4,248 |
1.0× |
| MRA neck w/o contrast (70547) |
$254 |
$2,451 |
1.0× |
| MRI abdomen w contrast (74182) |
$372 |
$5,740 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$254 |
$4,058 |
1.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$835 |
$5,112 |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$372 |
$6,906 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$835 |
$8,001 |
1.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$254 |
$1,735 |
1.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$254 |
$1,735 |
1.0× |
| MRI cervical spine w contrast (72142) |
$372 |
$4,763 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$254 |
$3,794 |
1.0× |
| MRI chest w/o contrast (71550) |
$254 |
$3,314 |
1.0× |
| MRI chest with contrast (71551) |
$835 |
$3,314 |
1.0× |
| MRI chest wo w contrast (71552) |
$372 |
$4,540 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$372 |
$4,732 |
1.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$372 |
$5,204 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$254 |
$2,944 |
1.0× |
| MRI lumbar spine w contrast (72149) |
$372 |
$4,943 |
1.0× |
Mri Neck Spine W/O & W/Dye (72156)
range across 2 matching MRF lines |
$372 |
$5,972–$18,044 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$254 |
$5,727 |
1.0× |
| MRI orbit face neck w contrast (70542) |
$372 |
$6,294 |
1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$372 |
$7,540 |
1.0× |
| MRI pelvis w contrast (72196) |
$372 |
$5,358 |
1.0× |
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines |
$372 |
$8,097–$9,697 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$254 |
$3,867 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$254 |
$2,980 |
1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$372 |
$4,554 |
1.0× |
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 3 matching MRF lines |
$254 |
$4,225–$4,947 |
1.0× |
Mri Uppr Extremity W/O&W/Dye (73220)
range across 3 matching MRF lines |
$372 |
$5,480–$5,572 |
1.0× |
| MRI, abdomen, combo (74183) |
$372 |
$7,271 |
1.0× |
| MRI, dorsal spine combo (72157) |
$372 |
$6,170 |
1.0× |
| MRI, dorsal spine contrast (72147) |
$372 |
$4,484 |
1.0× |
MRI, joint upper extrem (73221)
range across 10 matching MRF lines |
$254 |
$1,749–$4,947 |
1.0× |
| MRI, joint upper extrem combo (73223) |
$372 |
$10,616 |
1.0× |
| MRI, lumbar spine combo (72158) |
$372 |
$5,902 |
1.0× |
| Myelograpy 2/more regions rs&i (72270) |
$835 |
$2,198 |
1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,380 |
$1,747 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,380 |
$12,968 |
1.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,524 |
$6,037 |
1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,524 |
$6,037 |
1.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,348 |
$9,413 |
1.0× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$1,618 |
$9,413 |
1.0× |
| Neck soft tissue (70360) |
$92 |
$393 |
1.0× |
| Nm csf leak detection (78650) |
$1,380 |
$3,951 |
1.0× |
| Nonvascular Shunt X-Ray (75809) |
$111 |
$353 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,475 |
$14,219 |
1.0× |
| Nuclear Rx Intra-Arterial (79445) |
$248 |
$783 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$248 |
$2,771 |
1.0× |
| Panoramic X-ray of jaws (70355) |
$92 |
$523 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$426 |
$1,790 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$426 |
$2,291 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$111 |
$425 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$1,524 |
$9,892 |
1.0× |
| PET image w/CT, full body (78816) |
$1,524 |
$14,189 |
1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,524 |
$14,026 |
1.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,380 |
$3,765 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$426 |
$1,653 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$582 |
$1,274 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$92 |
$734 |
1.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$92 |
$581 |
1.0× |
| Radex elbow complete minimum 3 views (73080) |
$92 |
$888 |
1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$111 |
$1,281 |
1.0× |
| Radex fingr minimum 2 views (73140) |
$92 |
$527 |
1.0× |
| Radex foot complete minimum 3 views (73630) |
$92 |
$760 |
1.0× |
| Radex Hand Minimum 3 Views (73130) |
$92 |
$846 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$92 |
$833 |
1.0× |
| Radex shoulder complete minimum 2 views (73030) |
$92 |
$911 |
1.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$92 |
$380 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$92 |
$318 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$92 |
$658 |
1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$92 |
$456 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$92 |
$626 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$92 |
$877 |
1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,854 |
$17,320 |
1.0× |
| Radiation treatment delivery level 1 (77402) |
$108 |
$851 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$589 |
$2,012 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$111 |
$1,023 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$111 |
$709 |
1.0× |
| Radiologic exam colon double contrast study (74280) |
$187 |
$1,277 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$187 |
$958 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$187 |
$763 |
1.0× |
| Radiologic exam knee complete 4/more views (73564) |
$111 |
$1,038 |
1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$111 |
$498 |
1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$187 |
$938 |
1.0× |
| Radiologic exam swallow function contrast study (74230) |
$187 |
$1,464 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$187 |
$1,448 |
1.0× |
Radiologic examination femur minimum 2 views (73552)
range across 5 matching MRF lines |
$92 |
$651–$854 |
1.0× |
| Radiologic examination knee 1/2 views (73560) |
$92 |
$464 |
1.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$111 |
$736 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$92 |
$715 |
1.0× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$426 |
$1,112–$2,057 |
1.0× |
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801)
range across 2 matching MRF lines |
$426 |
$1,112–$2,881 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$579 |
$6,644 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$579 |
$3,648 |
1.0× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines |
$579 |
$3,640–$3,749 |
1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,380 |
$5,320 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$248 |
$2,694 |
1.0× |
Scapula (73010)
range across 2 matching MRF lines |
$111 |
$444–$712 |
1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$21 |
$163 |
0.9× |
| Shoulder 1 view (73020) |
$92 |
$304 |
1.0× |
| Shoulder Arthrography (73040) |
$372 |
$1,560 |
1.0× |
| Skull less than 4 views (70250) |
$111 |
$532 |
1.0× |
| Special dosimetry (77331) |
$143 |
$1,714 |
1.0× |
| Special Physics Consult (77370) |
$143 |
$1,244 |
1.0× |
| Special teletherapy port plan (77321) |
$399 |
$2,047 |
1.0× |
| Special treatment procedure (77470) |
$589 |
$3,736 |
1.0× |
| Stereotactic Body Radiation Delivery (77373) |
$1,906 |
$5,355 |
1.0× |
| Sternoclavicular joints (71130) |
$92 |
$844 |
1.0× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$92 |
$328 |
1.0× |
| Tbs technical calculation only (77091) |
$92 |
$328 |
1.0× |
Telethx isodose pln cplx w/basic dosimetry (77307)
range across 2 matching MRF lines |
$399 |
$605–$2,970 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$399 |
$1,114 |
1.0× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$254 |
$1,396 |
1.0× |
| Testicular Imaging W/Flow (78761) |
$426 |
$1,030 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$399 |
$4,298 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$143 |
$1,938 |
1.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$187 |
$575 |
1.0× |
| Thoracic spine 2 views (72070) |
$111 |
$1,077 |
1.0× |
| Thoracic spine 3 views (72072) |
$111 |
$1,111 |
1.0× |
| Thoracolumbar 2 views (72080) |
$92 |
$927 |
1.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$426 |
$1,865 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$426 |
$2,027 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$579 |
$3,353 |
1.0× |
| Thyroid Uptake Measurement (78012) |
$426 |
$1,763 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$426 |
$3,263 |
1.0× |
| Tx Devices Design & Construction Complex (77334) |
$399 |
$2,482 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$143 |
$1,768 |
1.0× |
| Tx devices design & construction simple (77332) |
$143 |
$502 |
1.0× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$92 |
$1,112–$1,670 |
1.0× |
| Ultrasound elastography first target lesion (76982) |
$111 |
$955 |
1.0× |
| Ultrasound Elastography Parenchyma (76981) |
$111 |
$955 |
1.0× |
| Ultrasound Exam Aaa Screen (76706) |
$111 |
$245 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$111 |
$1,838 |
1.0× |
| Umbilical-artery Doppler (OB) (76820) |
$111 |
$826 |
1.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$92 |
$1,361 |
1.0× |
| Upper gi w/o kub (74240) |
$187 |
$1,179 |
1.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$11 |
$86 |
1.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$94 |
$421 |
1.0× |
| Ureteral Reflux Study (78740) |
$426 |
$878 |
1.0× |
| Urethrocystogram voiding (74455) |
$254 |
$1,439 |
1.0× |
| Urethrocystography retrograde (74450) |
$254 |
$1,358 |
1.0× |
Us breast unilateral complete (76641)
range across 6 matching MRF lines |
$111 |
$648–$2,183 |
1.0× |
| Us chest (76604) |
$111 |
$803 |
1.0× |
Us complete joint (76881)
range across 3 matching MRF lines |
$111 |
$1,569–$2,355 |
1.0× |
| Us exam, pelvic, limited (76857) |
$111 |
$686 |
1.0× |
| Us head (76506) |
$111 |
$1,399 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$111 |
$1,103 |
1.0× |
| Us ob detailed single fetus (76811) |
$254 |
$918 |
1.0× |
| Us ob limited 1 or more fetuses (76815) |
$111 |
$1,025 |
1.0× |
| Us ob transvaginal (76817) |
$111 |
$1,413 |
1.0× |
| Us pelvic non ob complete (76856) |
$111 |
$2,106 |
1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$111 |
$1,624 |
1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$111 |
$1,059 |
1.0× |
| Us retroperitoneal complete (76770) |
$111 |
$1,397 |
1.0× |
Us retroperitoneal limited (76775)
range across 3 matching MRF lines |
$111 |
$1,171–$1,397 |
1.0× |
| Us scrotum and contents (76870) |
$111 |
$1,821 |
1.0× |
| Us spinal canal and contents (76800) |
$111 |
$363 |
1.0× |
| Us thyroid (76536) |
$111 |
$2,122 |
1.0× |
| Us transrectal (76872) |
$111 |
$3,984.60 |
1.0× |
| Vascular Flow Imaging (78445) |
$426 |
$1,582 |
1.0× |
| Vein X-Ray Chest (75827) |
$1,678 |
$2,526 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,367 |
$3,771 |
1.0× |
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines |
$1,678 |
$2,277–$2,360 |
1.0× |
Venography extremity unilateral rs&i (75820)
range across 4 matching MRF lines |
$1,678 |
$1,999–$5,598 |
1.0× |
| Venous thrombosis imaging (78457) |
$579 |
$1,511 |
1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$426 |
$2,269 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$92 |
$285 |
1.0× |
| Wrist 2 views (73100) |
$92 |
$419 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$92 |
$983 |
1.0× |
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines |
$372 |
$1,284–$1,327 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,367 |
$5,712 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$92 |
$649 |
1.0× |
| X-Ray Exam Breast Specimen (76098) |
$582 |
$597 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$92 |
$942 |
1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$111 |
$1,698 |
1.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$92 |
$293 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$92 |
$857 |
1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$111 |
$617 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$111 |
$742 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$111 |
$888 |
1.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$111 |
$1,715 |
1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$92 |
$1,000 |
1.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$111 |
$1,710 |
1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$111 |
$602 |
1.0× |
| X-ray humerus (73060) |
$92 |
$381 |
1.0× |
| X-ray IV pyelogram (ivp) (74400) |
$187 |
$949 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$111 |
$893 |
1.0× |
| X-ray nose-rectum child f.b. (76010) |
$92 |
$591 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$111 |
$905 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$111 |
$524 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$92 |
$1,064 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$92 |
$846 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$111 |
$773 |
1.0× |
| X-ray thoracic spine 4 vw (72074) |
$111 |
$1,334 |
1.0× |
| X-Ray Tmj Unilat (70328) |
$92 |
$304 |
1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$372 |
$1,050 |
1.0× |
| X-Rays Bone Length Studies (77073) |
$111 |
$406 |
1.0× |
| X-Rays Bone Survey Complete (77075) |
$111 |
$1,603 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$111 |
$1,199 |
1.0× |
| Xr facial bones less than 3 views (70140) |
$92 |
$290 |
1.0× |
| Xr orbits complete 4 views (70200) |
$111 |
$706 |
1.0× |