| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,944.90 |
$9,944.90 |
6.0× |
| Abdomen 2 views (74019) |
$48 |
$48 |
0.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$4,670.14 |
$4,670.14 |
9.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$19,935.87 |
$19,935.87 |
5.3× |
| Angiography extremity bilateral rs&i (75716) |
$19,935.87 |
$19,935.87 |
5.3× |
| Angiography extremity unilateral rs&i (75710) |
$19,935.87 |
$19,935.87 |
5.3× |
| Angiography internal mammary rs&i (75756) |
$11,365.82 |
$11,365.82 |
3.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$19,935.87 |
$19,935.87 |
3.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$19,935.87 |
$19,935.87 |
5.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$19,935.87 |
$19,935.87 |
5.3× |
| Angiography Spinal Selective Rs&I (75705) |
$18,532.70 |
$18,532.70 |
2.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$19,935.87 |
$19,935.87 |
3.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$6,883.25 |
$6,883.25 |
1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$13,758.53 |
$13,758.53 |
3.6× |
| Ankle 2 views (73600) |
$46.50 |
$46.50 |
0.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,743.47 |
$1,743.47 |
4.2× |
| Aortogram thoracic (75605) |
$19,935.87 |
$19,935.87 |
3.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$19,935.87 |
$19,935.87 |
5.3× |
| Aortography abdominal serialography rs&i (75625) |
$19,935.87 |
$19,935.87 |
5.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$19,935.87 |
$19,935.87 |
5.3× |
| Artery X-Rays Adrenal Gland (75731) |
$19,935.87 |
$19,935.87 |
5.3× |
| Arthrogram elbow (73085) |
$5,522.04 |
$5,522.04 |
13.2× |
| Arthrogram hip (73525) |
$5,522.04 |
$5,522.04 |
13.2× |
| Arthrogram shoulder (73040) |
$2,799.52 |
$2,799.52 |
6.7× |
| Arthrogram wrist (73115) |
$5,259.08 |
$5,259.08 |
12.6× |
| Arthrography knee lt (73580) |
$5,522.04 |
$5,522.04 |
13.2× |
| Basic radiation dosimetry calculation (77300) |
$1,498.88 |
$1,498.88 |
9.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$5,149.71 |
$5,149.71 |
10.7× |
| Bone &/joint imaging whole body (78306) |
$115 |
$115 |
0.2× |
| Bone age studies (77072) |
$42 |
$42 |
0.3× |
| Bone Imaging 3 Phase (78315) |
$4,670.93 |
$4,670.93 |
9.7× |
| Bone Marrow Imaging Limited Area (78102) |
$5,379.06 |
$5,379.06 |
11.2× |
| Bone survey complete (77075) |
$1,565.79 |
$1,565.79 |
12.5× |
| Brachytx isodose complex (77318) |
$6,058.11 |
$6,058.11 |
13.5× |
| Brachytx isodose intermed (77317) |
$6,058.11 |
$6,058.11 |
13.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,430.96 |
$1,430.96 |
3.2× |
| Brain image w/flow 4 + views (78606) |
$10,923.41 |
$10,923.41 |
16.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$19,582.30 |
$19,582.30 |
11.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,726.30 |
$5,726.30 |
13.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,179.03 |
$2,179.03 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$47 |
$47 |
0.5× |
| Chest 1 view (71045) |
$487.21 |
$487.21 |
4.7× |
| Chest 3 views (71047) |
$482.71 |
$482.71 |
4.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,005.82 |
$1,005.82 |
4.8× |
| Cineradiography/videoradiography (76120) |
$538.58 |
$538.58 |
4.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$10,137.38 |
$10,137.38 |
10.8× |
| Clavicle complete (73000) |
$30 |
$30 |
0.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$261 |
$261 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$1,589.38 |
$1,589.38 |
9.9× |
| Corpora cavernosography (74445) |
$1,743.47 |
$1,743.47 |
13.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$160 |
$160 |
0.4× |
| CT abdomen and pelvis without contrast (74176) |
$775.50 |
$775.50 |
2.7× |
| CT abdomen w contrast (74160) |
$32 |
$32 |
0.2× |
| CT abdomen w wo contrast (74170) |
$27 |
$27 |
0.1× |
| CT abdomen w/o contrast (74150) |
$18 |
$18 |
0.1× |
| CT angio hrt w/3d image (75574) |
$2,946.11 |
$2,946.11 |
7.0× |
| CT angiography upper extremity lt (73206) |
$3,600.62 |
$3,600.62 |
17.1× |
| CT c-spine w/o contrast (72125) |
$1,381.50 |
$1,381.50 |
11.0× |
| CT cervical spine w&w/o contrast (72127) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT cervical spine with contrast (72126) |
$6,271.94 |
$6,271.94 |
15.0× |
| CT chest w/wo contrast (71270) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT chest with contrast (71260) |
$955.50 |
$955.50 |
4.5× |
| CT colonography w/o cntrst (74261) |
$338.28 |
$338.28 |
2.7× |
| CT head/brain with contrast (70460) |
$3,140.47 |
$3,140.47 |
14.9× |
| CT head/brain without and with contrast (70470) |
$33 |
$33 |
0.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$5,683.22 |
$5,683.22 |
13.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$717.50 |
$717.50 |
6.9× |
| CT hrt w/3d image congen (75573) |
$5,683.22 |
$5,683.22 |
13.6× |
| CT iac w contrast (70481) |
$3,155.97 |
$3,155.97 |
15.0× |
| CT limited/localized follow up study (76380) |
$1,161.85 |
$1,161.85 |
11.1× |
| CT lower ext w/o (73700) |
$429.50 |
$429.50 |
3.4× |
| CT lower extremity w wo contrast (73702) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT lower extremity with contrast (73701) |
$6,271.94 |
$6,271.94 |
29.8× |
| CT lumbar spine w & w/o contrast (72133) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT lumbar spine w/o contrast (72131) |
$278.50 |
$278.50 |
2.2× |
| CT lumbar spine with contrast (72132) |
$6,271.94 |
$6,271.94 |
15.0× |
| CT maxillofacial w contrast (70487) |
$3,170.97 |
$3,170.97 |
15.1× |
| CT maxillofacial w/o contrast (70486) |
$510.50 |
$510.50 |
4.1× |
| CT maxillofacial w/wo contrast (70488) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT neck soft tissue w contrast (70491) |
$169 |
$169 |
0.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT orbits w/o contrast (70480) |
$40 |
$40 |
0.3× |
| CT pelvis w & w/o contrast (72194) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT pelvis w/o contrast (72192) |
$2,160.58 |
$2,160.58 |
17.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$1,530.83 |
$1,530.83 |
14.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,529.22 |
$3,529.22 |
16.8× |
| CT soft tissue neck w/o contrast (70490) |
$46 |
$46 |
0.4× |
| CT thoracic spine w/contrast (72129) |
$6,271.94 |
$6,271.94 |
29.8× |
| CT thoracic spine w/o contrast (72128) |
$94.50 |
$94.50 |
0.8× |
| CT thoracic spine w/wo contrast (72130) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT thorax w/o contrast (71250) |
$541.50 |
$541.50 |
4.3× |
| CT unlisted procedure (76497) |
$318.89 |
$318.89 |
3.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$7,042.44 |
$7,042.44 |
33.5× |
| CT upper extremity w/o contrast rt (73200) |
$131.50 |
$131.50 |
1.0× |
| CT upper extremity with contrast (73201) |
$6,271.94 |
$6,271.94 |
15.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$7,189.25 |
$7,189.25 |
34.2× |
| Cta Abdomen (74175) |
$18 |
$18 |
0.1× |
| CTA abdomen pelvis (74174) |
$414.50 |
$414.50 |
1.0× |
| CTA chest (71275) |
$5,400.21 |
$5,400.21 |
25.7× |
| Cta Head (70496) |
$778 |
$778 |
3.7× |
| CTA lwr ext w&w/o contrast (73706) |
$3,610.12 |
$3,610.12 |
17.2× |
| Cta Neck (70498) |
$779.50 |
$779.50 |
3.7× |
| Cta Pelvis (72191) |
$3,600.12 |
$3,600.12 |
17.1× |
| Cystography minimum 3 views rs&i (74430) |
$3,571.87 |
$3,571.87 |
8.5× |
| Dacryocystography (70170) |
$4,375.81 |
$4,375.81 |
15.3× |
| Diskogram cervical (72285) |
$36,279.08 |
$36,279.08 |
15.5× |
| Diskography lumbar (72295) |
$36,279.08 |
$36,279.08 |
15.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$823.81 |
$823.81 |
6.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,369.64 |
$1,369.64 |
10.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$361.84 |
$361.84 |
2.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$785 |
$785 |
6.3× |
| Dxa bone density study axial skeleton (77085) |
$169 |
$169 |
1.3× |
| Echo exam of fetal heart (76825) |
$2,504.14 |
$2,504.14 |
3.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$2,172.15 |
$2,172.15 |
7.6× |
| Echoencephalography real time imaging (76506) |
$1,300.21 |
$1,300.21 |
10.4× |
| Esophagus (74220) |
$224 |
$224 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$1,805.42 |
$1,805.42 |
14.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$958 |
$958 |
7.6× |
| Fluoroscopy up to 1 hr (76000) |
$1,780.70 |
$1,780.70 |
6.2× |
| Foot 2 views (73620) |
$31 |
$31 |
0.3× |
| Forearm 2 views (73090) |
$158 |
$158 |
1.5× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$626.92 |
$626.92 |
2.2× |
| Gated Heart Planar Single (78472) |
$6,364.34 |
$6,364.34 |
13.3× |
| Hand 2 views (73120) |
$44 |
$44 |
0.4× |
| Hand 3 views (73130) |
$95.50 |
$95.50 |
0.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$6,170.35 |
$6,170.35 |
7.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$7,246.21 |
$7,246.21 |
8.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$7,973.61 |
$7,973.61 |
9.5× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,160.53 |
$1,160.53 |
2.5× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,160.53 |
$1,160.53 |
2.5× |
| Heart Infarct Image (78466) |
$6,364.34 |
$6,364.34 |
13.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$19,935.87 |
$19,935.87 |
5.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$45 |
$45 |
0.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,698.70 |
$2,698.70 |
5.6× |
| Ht muscle image spect sing (78451) |
$14,631.72 |
$14,631.72 |
9.4× |
| Humerus Min 2 Views Left (73060) |
$124 |
$124 |
1.2× |
| Hysterosalpingogram (74740) |
$3,894.81 |
$3,894.81 |
13.6× |
| Interstitial radiation source applic complex (77778) |
$11,620.49 |
$11,620.49 |
13.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,191.54 |
$4,191.54 |
5.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$4,625.90 |
$4,625.90 |
7.0× |
| Intracavitary radiation source applic simple (77761) |
$2,806.89 |
$2,806.89 |
4.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$934.42 |
$934.42 |
7.5× |
| Kidney imaging morphology (78700) |
$6,135.90 |
$6,135.90 |
12.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$6,764.82 |
$6,764.82 |
10.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$6,135.90 |
$6,135.90 |
9.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$6,135.90 |
$6,135.90 |
9.4× |
| Knee 3 views (73562) |
$65.50 |
$65.50 |
0.6× |
| Liver & spleen imaging static only (78215) |
$5,489.27 |
$5,489.27 |
11.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$5,489.27 |
$5,489.27 |
11.5× |
| Liver imaging static only (78201) |
$7,644.93 |
$7,644.93 |
11.7× |
| Lung perf&ventilat diferentl (78598) |
$6,111.69 |
$6,111.69 |
9.4× |
| Lung perfusion differential (78597) |
$2,302.28 |
$2,302.28 |
4.8× |
| Lung Ventilation Imaging (78579) |
$4,296.37 |
$4,296.37 |
9.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,835.53 |
$3,835.53 |
1.0× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$3,835.53 |
$3,835.53 |
5.1× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$3,835.53 |
$3,835.53 |
2.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,835.53 |
$3,835.53 |
1.0× |
| Lymphoscintigraphy (78195) |
$5,379.06 |
$5,379.06 |
8.3× |
| Meckels Diverticulum (78290) |
$5,148.87 |
$5,148.87 |
10.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,118.02 |
$2,118.02 |
4.7× |
| Mr elastography (76391) |
$566.48 |
$566.48 |
2.0× |
| Mr safety determination physician/other qhp (76016) |
$421 |
$421 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$117 |
$117 |
3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$439 |
$439 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,155.88 |
$1,155.88 |
4.0× |
| MRA head w & w/o contrast (70546) |
$5,485.15 |
$5,485.15 |
13.1× |
| MRA head w/o contrast (70544) |
$131 |
$131 |
0.5× |
| MRA head with contrast (70545) |
$8,801.43 |
$8,801.43 |
21.0× |
| MRA neck w contrast (70548) |
$8,952.80 |
$8,952.80 |
21.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,678.80 |
$5,678.80 |
13.6× |
| MRA neck w/o contrast (70547) |
$3,731.74 |
$3,731.74 |
13.0× |
| MRI abdomen w contrast (74182) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$609 |
$609 |
1.5× |
| MRI abdomen w/o contrast (74181) |
$3,718.24 |
$3,718.24 |
13.0× |
| MRI any jnt lwr ext with con lt (73722) |
$8,952.80 |
$8,952.80 |
9.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$8,952.80 |
$8,952.80 |
9.5× |
| MRI breast w/o contrast bilateral (77047) |
$10,650.11 |
$10,650.11 |
37.2× |
| MRI breast w/o contrast unilat (77046) |
$10,159.16 |
$10,159.16 |
35.5× |
| MRI c-spine with contrast (72142) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI cardiac w/o cont stress (75559) |
$7,380.47 |
$7,380.47 |
11.3× |
| MRI cardiac w/o contrast (75557) |
$7,380.47 |
$7,380.47 |
25.8× |
| MRI cervical spine w/o contrast (72141) |
$204.50 |
$204.50 |
0.7× |
| MRI chest w/o & w/contrast material (71552) |
$11,305.60 |
$11,305.60 |
27.0× |
| MRI chest w/o contrast (71550) |
$7,380.47 |
$7,380.47 |
25.8× |
| MRI chest with contrast (71551) |
$8,952.80 |
$8,952.80 |
9.5× |
| MRI fetal sngl/1st gestation (74712) |
$4,670.09 |
$4,670.09 |
16.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$39 |
$39 |
0.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$7,380.47 |
$7,380.47 |
25.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$32 |
$32 |
0.1× |
| MRI orbit/face/neck w/contrast (70542) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI pelvis w contrast (72196) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$11,305.60 |
$11,305.60 |
27.0× |
| MRI pelvis w/o contrast (72195) |
$41.50 |
$41.50 |
0.1× |
| MRI scan of arm joint before and after contrast (73223) |
$11,305.60 |
$11,305.60 |
27.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$11,305.60 |
$11,305.60 |
12.0× |
| MRI scan of leg joint before and after contrast (73723) |
$5,665.80 |
$5,665.80 |
13.5× |
| MRI spectroscopy (76390) |
$2,179.31 |
$2,179.31 |
20.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,703.30 |
$5,703.30 |
13.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,740.30 |
$5,740.30 |
13.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$8,952.80 |
$8,952.80 |
21.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,703.80 |
$5,703.80 |
13.6× |
| MRI thoracic spine w/o contrast (72146) |
$77.50 |
$77.50 |
0.3× |
| MRI tmj (70336) |
$7,380.47 |
$7,380.47 |
25.8× |
| MRI upper ext joint w/o contrast (73221) |
$160 |
$160 |
0.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$11,305.60 |
$11,305.60 |
27.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$30 |
$30 |
0.1× |
| Myelogram Cervical (72240) |
$10,137.38 |
$10,137.38 |
10.8× |
| Myelogram Lumbar (72265) |
$10,137.38 |
$10,137.38 |
10.8× |
| Myelogram thoracic (72255) |
$10,137.38 |
$10,137.38 |
10.8× |
| Myelography 2 or more regions (72270) |
$10,137.38 |
$10,137.38 |
10.8× |
| Myocardial Spect Multiple Studies (78452) |
$14,197.17 |
$14,197.17 |
9.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$5,540.53 |
$5,540.53 |
5.4× |
| Neck soft tissue (70360) |
$118 |
$118 |
1.1× |
| Nm bone marrow multiple (78103) |
$5,379.06 |
$5,379.06 |
11.2× |
| Nm cisternogram (78630) |
$12,043.09 |
$12,043.09 |
18.5× |
| Nm csf leak detection (78650) |
$10,923.41 |
$10,923.41 |
7.0× |
| Nm gastric emptying study (78264) |
$57 |
$57 |
0.1× |
| Nm gastroesophageal reflux study (78262) |
$5,148.87 |
$5,148.87 |
10.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,949.40 |
$9,949.40 |
6.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$9,343.59 |
$9,343.59 |
6.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$9,343.59 |
$9,343.59 |
6.0× |
| Nuclear Rx Oral Admin (79005) |
$4,117.10 |
$4,117.10 |
14.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,286.43 |
$1,286.43 |
10.3× |
| Osseous survey infant (77076) |
$1,565.79 |
$1,565.79 |
12.5× |
| Osseous survey limited (77074) |
$786.40 |
$786.40 |
6.3× |
| Parathyrd planar w/spect&CT (78072) |
$5,506.36 |
$5,506.36 |
8.5× |
| Parathyrd planar w/wo subtrj (78071) |
$2,764.18 |
$2,764.18 |
5.8× |
| Parathyroid imaging (78070) |
$4,614.71 |
$4,614.71 |
9.6× |
| Pelvis 1 or 2 views (72170) |
$409.50 |
$409.50 |
3.3× |
| Peritoneogram rs&i (74190) |
$2,135.93 |
$2,135.93 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$21,062.93 |
$21,062.93 |
12.3× |
| PET imaging for CT attenuation whole body (78816) |
$10,839.25 |
$10,839.25 |
6.3× |
| Pr heart first pass single,planar (78481) |
$6,364.34 |
$6,364.34 |
9.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,688.80 |
$5,688.80 |
13.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$19,935.87 |
$19,935.87 |
5.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$14,446.46 |
$14,446.46 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,896.94 |
$3,896.94 |
8.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$6,111.69 |
$6,111.69 |
9.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,135.93 |
$2,135.93 |
3.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$788.90 |
$788.90 |
7.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$29 |
$29 |
0.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$62 |
$62 |
0.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$934.42 |
$934.42 |
7.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,505.57 |
$1,505.57 |
12.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$64,551.80 |
$64,551.80 |
7.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,884.40 |
$2,884.40 |
4.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$971.22 |
$971.22 |
7.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,928.43 |
$1,928.43 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$472.21 |
$472.21 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$801 |
$801 |
7.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$110 |
$110 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$728 |
$728 |
7.0× |
| Radiologic exam colon single contrast study (74270) |
$1,821.63 |
$1,821.63 |
8.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$84 |
$84 |
0.4× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$626.92 |
$626.92 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$26 |
$26 |
0.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$81 |
$81 |
0.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$36 |
$36 |
0.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$934.42 |
$934.42 |
9.0× |
| Radiological examination surgical specimen (76098) |
$1,689.91 |
$1,689.91 |
2.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$19,935.87 |
$19,935.87 |
5.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$19,935.87 |
$19,935.87 |
5.3× |
| Ribs bilateral 3 views (71110) |
$934.42 |
$934.42 |
7.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$10,622.78 |
$10,622.78 |
22.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$10,622.78 |
$10,622.78 |
16.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,119.18 |
$5,119.18 |
7.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,846.97 |
$7,846.97 |
4.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,917.35 |
$6,917.35 |
4.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$4,539.08 |
$4,539.08 |
16.2× |
| Rp Therapy Intravenous Administration (79101) |
$4,117.10 |
$4,117.10 |
14.7× |
| Sacroiliac Joints < 3 Views (72200) |
$633.06 |
$633.06 |
5.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$3,203.79 |
$3,203.79 |
11.2× |
| Scanogram (77073) |
$934.42 |
$934.42 |
7.5× |
| Scapula complete (73010) |
$473.71 |
$473.71 |
3.8× |
| Screening digital breast tomosynthesis (77063) |
$1,465 |
$1,465 |
62.7× |
| Sella turcica (70240) |
$934.42 |
$934.42 |
9.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$764.34 |
$764.34 |
6.1× |
| Sialogram (70390) |
$4,375.81 |
$4,375.81 |
15.3× |
| Simulation intermediate (77285) |
$5,678.01 |
$5,678.01 |
12.6× |
| Small bowel series (74250) |
$937.82 |
$937.82 |
4.5× |
| Spec medical radj physics consltj (77370) |
$1,108.88 |
$1,108.88 |
6.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$3,133.67 |
$3,133.67 |
7.0× |
| Special dosimetry (77331) |
$2,194.76 |
$2,194.76 |
13.6× |
| Special treatment procedure (77470) |
$3,477.58 |
$3,477.58 |
5.2× |
| Speech evaluation complex (70371) |
$1,780.70 |
$1,780.70 |
6.2× |
| Spine thoracic 3 views (72072) |
$470.71 |
$470.71 |
3.8× |
| Splenoportograpy rs&i (75810) |
$19,935.87 |
$19,935.87 |
5.3× |
| Stereotactic body radiation delivery (77373) |
$44,966.48 |
$44,966.48 |
21.0× |
| Superior sagittal sinus venogram (75870) |
$7,051.78 |
$7,051.78 |
1.9× |
| Tbs Technical Calculation Only (77091) |
$364.76 |
$364.76 |
3.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,144.35 |
$1,144.35 |
2.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,194.70 |
$2,194.70 |
4.9× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$5,522.04 |
$5,522.04 |
19.3× |
| Testicular Imaging With Vascular Flow (78761) |
$6,135.90 |
$6,135.90 |
12.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,921 |
$2,921 |
6.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,211.88 |
$1,211.88 |
7.5× |
| Therapeutic Enema (74283) |
$855.11 |
$855.11 |
4.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$5,475.82 |
$5,475.82 |
8.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,565.43 |
$2,565.43 |
5.4× |
| Thyroid uptake measurement (78012) |
$1,949.71 |
$1,949.71 |
4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,001.96 |
$2,001.96 |
4.2× |
| Tmj unilateral (70328) |
$934.42 |
$934.42 |
9.0× |
| Tomogram (76100) |
$1,565.79 |
$1,565.79 |
12.5× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$364.76 |
$364.76 |
3.5× |
| Treatment device intermediate (77333) |
$2,365.61 |
$2,365.61 |
14.7× |
| Treatment devices simple (77332) |
$2,101.02 |
$2,101.02 |
13.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$20,043.43 |
$20,043.43 |
30.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$6,037.11 |
$6,037.11 |
12.6× |
| Tx devices design & construction complex (77334) |
$2,386.52 |
$2,386.52 |
5.3× |
| Ultrasound elastography first target lesion (76982) |
$756.66 |
$756.66 |
6.0× |
| Ultrasound, abdomen limited (76705) |
$570 |
$570 |
4.5× |
| Umbilical-artery Doppler (OB) (76820) |
$645.84 |
$645.84 |
5.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$4,375.27 |
$4,375.27 |
41.9× |
| Unlisted fluoroscopic procedure (76496) |
$1,656.59 |
$1,656.59 |
15.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,469.04 |
$1,469.04 |
14.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$6,444.92 |
$6,444.92 |
52.7× |
| Unlisted Ultrasound Procedure (76999) |
$634.76 |
$634.76 |
6.1× |
| Upper Extremity Infant (73092) |
$474.71 |
$474.71 |
3.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$6,135.90 |
$6,135.90 |
12.8× |
| Urethrocystography retrograde rs&i (74450) |
$3,571.87 |
$3,571.87 |
12.5× |
| Urethrocystography voiding (74455) |
$3,571.87 |
$3,571.87 |
12.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$3,571.87 |
$3,571.87 |
17.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$3,571.87 |
$3,571.87 |
17.0× |
| Us abdl aorta screen aaa (76706) |
$22 |
$22 |
0.2× |
| Us breast unilateral complete (76641) |
$46 |
$46 |
0.4× |
| Us breast unilateral limited (76642) |
$469.82 |
$469.82 |
4.5× |
| Us chest (76604) |
$31 |
$31 |
0.2× |
| Us compl joint r-t w/image documentation (76881) |
$31 |
$31 |
0.2× |
| Us elastography parenchyma (76981) |
$459.33 |
$459.33 |
3.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$1,651.26 |
$1,651.26 |
13.2× |
| Us guided compression repair (76936) |
$2,255.15 |
$2,255.15 |
8.7× |
| Us infant hips dynamic (76885) |
$55 |
$55 |
0.5× |
| Us kidney transplant (76776) |
$1,020.96 |
$1,020.96 |
8.1× |
| Us ob detailed single fetus (76811) |
$2,072.14 |
$2,072.14 |
7.2× |
| Us ob transvaginal (76817) |
$897.22 |
$897.22 |
7.2× |
| Us pelvic non ob complete (76856) |
$151 |
$151 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$33 |
$33 |
0.3× |
| Us pregnancy ltd (76815) |
$1,293.32 |
$1,293.32 |
10.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$2,267.03 |
$2,267.03 |
18.1× |
| Us retroperitoneal complete (76770) |
$592 |
$592 |
4.7× |
| Us retroperitoneal limited (76775) |
$1,031.46 |
$1,031.46 |
8.2× |
| Us scrotum and contents (76870) |
$93 |
$93 |
0.7× |
| Us soft tissue head/neck (76536) |
$136 |
$136 |
1.1× |
| Us spinal canal and contents (76800) |
$1,027.96 |
$1,027.96 |
8.2× |
| Us transrectal (76872) |
$1,042.96 |
$1,042.96 |
8.3× |
| Us transrectal prostate volume (76873) |
$2,074.31 |
$2,074.31 |
16.6× |
| Us xtr non-vasc lmtd (76882) |
$102 |
$102 |
0.8× |
| Vascular flow imaging (78445) |
$4,163.59 |
$4,163.59 |
8.7× |
| Vasogram (74440) |
$3,571.87 |
$3,571.87 |
12.5× |
| Venogram extremity bilateral (75822) |
$13,758.53 |
$13,758.53 |
7.3× |
| Venogram orbital (75880) |
$7,051.78 |
$7,051.78 |
9.4× |
| Venography caval inferior serialography rs&i (75825) |
$19,935.87 |
$19,935.87 |
5.3× |
| Venography caval superior serialography rs&i (75827) |
$7,051.78 |
$7,051.78 |
3.7× |
| Venography epidural rs&i (75872) |
$7,051.78 |
$7,051.78 |
9.4× |
| Venography extremity unilateral rs&i (75820) |
$13,598.39 |
$13,598.39 |
7.2× |
| Venography Renal Bilateral (75833) |
$19,935.87 |
$19,935.87 |
5.3× |
| Venography renal unilateral selective rs&i (75831) |
$19,935.87 |
$19,935.87 |
5.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$7,051.78 |
$7,051.78 |
1.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$19,935.87 |
$19,935.87 |
3.0× |
| Vertebral fracture assessment via dxa (77086) |
$304.12 |
$304.12 |
2.9× |
| Wrist 2 views (73100) |
$493.21 |
$493.21 |
4.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$12 |
$12 |
0.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$469.71 |
$469.71 |
4.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$19.50 |
$19.50 |
0.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,946.24 |
$2,946.24 |
14.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$468.46 |
$468.46 |
4.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$91 |
$91 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,565.79 |
$1,565.79 |
12.5× |
| X-ray exam hip uni 1 view (73501) |
$902.06 |
$902.06 |
8.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$55 |
$55 |
0.5× |
| X-ray exam hip uni 4/> views (73503) |
$902.06 |
$902.06 |
7.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$789.90 |
$789.90 |
6.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$17 |
$17 |
0.1× |
| X-ray exam of femur 1 (73551) |
$934.42 |
$934.42 |
9.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,438.07 |
$1,438.07 |
6.8× |
| X-ray eye for foreign body (70030) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$472.21 |
$472.21 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$177.50 |
$177.50 |
1.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$11,664.99 |
$11,664.99 |
4.7× |
| X-ray head for orthodontia (70350) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$14 |
$14 |
0.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$3,571.87 |
$3,571.87 |
17.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$11 |
$11 |
0.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$18 |
$18 |
0.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$12 |
$12 |
0.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$48 |
$48 |
0.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$12 |
$12 |
0.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$1,565.79 |
$1,565.79 |
12.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$23 |
$23 |
0.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$11 |
$11 |
0.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$94 |
$94 |
0.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$4,375.81 |
$4,375.81 |
6.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$3,239.79 |
$3,239.79 |
7.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$11.50 |
$11.50 |
0.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$135.50 |
$135.50 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$32.50 |
$32.50 |
0.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$25.50 |
$25.50 |
0.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$36.50 |
$36.50 |
0.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$179 |
$179 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$472.71 |
$472.71 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$9 |
$9 |
0.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$484.71 |
$484.71 |
3.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$477.51 |
$477.51 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$934.42 |
$934.42 |
9.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$17 |
$17 |
0.2× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$626.92 |
$626.92 |
6.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$31 |
$31 |
0.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$23 |
$23 |
0.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$104 |
$104 |
1.0× |
| Xr arthrogram ankle (73615) |
$5,522.04 |
$5,522.04 |
13.2× |
| Xr c-spine 6 or more views (72052) |
$65 |
$65 |
0.5× |
| Xr chest 4+ views (71048) |
$9 |
$9 |
0.1× |
| Xr Cholecystography Oral Contrast (74290) |
$1,821.63 |
$1,821.63 |
8.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$934.42 |
$934.42 |
7.5× |
| Xr optic foramina (70190) |
$934.42 |
$934.42 |
9.0× |
| Xr shoulder 1 view (73020) |
$483.71 |
$483.71 |
4.6× |
| Xr spine cervical 4 or 5 views (72050) |
$45 |
$45 |
0.4× |
| Xr tibia/fibula 2 views (73590) |
$158 |
$158 |
1.5× |
| Xr tmj bilateral (70330) |
$934.42 |
$934.42 |
9.0× |
| Xray knee 1 or 2 views rt (73560) |
$86 |
$86 |
0.8× |