| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,824.40 |
$12,748 |
2.6× |
| Abdomen 2 views (74019) |
$259.20 |
$864 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$856.20 |
$2,854 |
2.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,205.20 |
$10,684 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,083.10 |
$10,277 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,097.30 |
$6,991 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,382.70 |
$4,609 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,464.20 |
$8,214 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,041.70 |
$10,139 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,232 |
$7,440 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,729.70 |
$9,099 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,729.70 |
$9,099 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,163.70 |
$3,879 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,236 |
$4,120 |
0.4× |
| Ankle 2 views (73600) |
$194.40 |
$648 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$512.40 |
$1,708 |
1.4× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,213.40 |
$7,378 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,104.10 |
$10,347 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,860.20 |
$9,534 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,982.30 |
$9,941 |
0.9× |
| Arthrogram elbow (73085) |
$690.60 |
$2,302 |
1.9× |
| Arthrogram hip (73525) |
$651.30 |
$2,171 |
1.8× |
| Arthrogram shoulder (73040) |
$391.50 |
$1,305 |
1.1× |
| Arthrogram wrist (73115) |
$574.20 |
$1,914 |
1.6× |
| Arthrography knee lt (73580) |
$719.40 |
$2,398 |
2.0× |
| Basic radiation dosimetry calculation (77300) |
$429.30 |
$1,431 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$572.40 |
$1,908 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$800.70 |
$2,669 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,021.20 |
$3,404 |
2.4× |
| Bone age studies (77072) |
$124.50 |
$415 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$1,218.30 |
$4,061 |
2.9× |
| Bone Marrow Imaging Limited Area (78102) |
$1,161 |
$3,870 |
2.8× |
| Bone survey complete (77075) |
$808.20 |
$2,694 |
7.3× |
| Brachytx isodose complex (77318) |
$1,772.70 |
$5,909 |
4.5× |
| Brachytx isodose intermed (77317) |
$1,211.10 |
$4,037 |
3.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$990.60 |
$3,302 |
2.5× |
| Brain image w/flow 4 + views (78606) |
$836.70 |
$2,789 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,722.80 |
$9,076 |
1.8× |
| Brain Imaging Vascular Flow Only (78610) |
$693.30 |
$2,311 |
1.2× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$50.10 |
$167 |
4.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,782.30 |
$5,941 |
4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,490.10 |
$4,967 |
4.0× |
| Cardiac shunt detection (78428) |
$948.90 |
$3,163 |
2.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,199.10 |
$3,997 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$283.80 |
$946 |
3.1× |
| Chest 1 view (71045) |
$209.70 |
$699 |
2.3× |
| Chest 3 views (71047) |
$228.90 |
$763 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$394.20 |
$1,314 |
2.1× |
| Clavicle complete (73000) |
$192.90 |
$643 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,025.40 |
$3,418 |
9.3× |
| Continuing medical physics consltj pr wk (77336) |
$539.70 |
$1,799 |
3.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,418.70 |
$14,729 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,334.50 |
$11,115 |
13.2× |
| CT abdomen w contrast (74160) |
$2,245.50 |
$7,485 |
12.1× |
| CT abdomen w wo contrast (74170) |
$2,438.40 |
$8,128 |
13.2× |
| CT abdomen w/o contrast (74150) |
$1,561.80 |
$5,206 |
14.2× |
| CT angio hrt w/3d image (75574) |
$950.70 |
$3,169 |
2.6× |
| CT angiography upper extremity lt (73206) |
$1,441.20 |
$4,804 |
7.8× |
| CT c-spine w/o contrast (72125) |
$1,710.90 |
$5,703 |
15.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,092.50 |
$6,975 |
11.3× |
| CT cervical spine with contrast (72126) |
$1,916.40 |
$6,388 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,616.70 |
$5,389 |
8.7× |
| CT chest with contrast (71260) |
$1,260.60 |
$4,202 |
6.8× |
| CT head/brain with contrast (70460) |
$1,770.30 |
$5,901 |
9.6× |
| CT head/brain without and with contrast (70470) |
$2,022.30 |
$6,741 |
10.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$537.30 |
$1,791 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$181.80 |
$606 |
2.0× |
| CT hrt w/3d image congen (75573) |
$594.90 |
$1,983 |
1.6× |
| CT iac w contrast (70481) |
$1,485 |
$4,950 |
8.0× |
| CT limited/localized follow up study (76380) |
$543.30 |
$1,811 |
5.9× |
| CT lower ext w/o (73700) |
$812.10 |
$2,707 |
7.4× |
| CT lower extremity w wo contrast (73702) |
$1,259.70 |
$4,199 |
6.8× |
| CT lower extremity with contrast (73701) |
$1,022.10 |
$3,407 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,812.30 |
$6,041 |
9.8× |
| CT lumbar spine w/o contrast (72131) |
$1,120.50 |
$3,735 |
10.2× |
| CT lumbar spine with contrast (72132) |
$1,517.40 |
$5,058 |
4.1× |
| CT maxillofacial w contrast (70487) |
$1,316.70 |
$4,389 |
7.1× |
| CT maxillofacial w/o contrast (70486) |
$1,165.20 |
$3,884 |
10.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,654.80 |
$5,516 |
8.9× |
| CT neck soft tissue w contrast (70491) |
$921.60 |
$3,072 |
5.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,755.30 |
$5,851 |
9.5× |
| CT orbits w/o contrast (70480) |
$1,140.30 |
$3,801 |
10.3× |
| CT pelvis w & w/o contrast (72194) |
$1,604.70 |
$5,349 |
8.7× |
| CT pelvis w/o contrast (72192) |
$976.50 |
$3,255 |
8.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,307.10 |
$4,357 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$573.30 |
$1,911 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$1,789.20 |
$5,964 |
9.7× |
| CT thoracic spine w/o contrast (72128) |
$1,654.80 |
$5,516 |
15.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,993.50 |
$6,645 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,074.90 |
$3,583 |
9.7× |
| CT unlisted procedure (76497) |
$538.32 |
$1,794.40 |
5.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,098.60 |
$3,662 |
5.9× |
| CT upper extremity w/o contrast rt (73200) |
$858.60 |
$2,862 |
7.8× |
| CT upper extremity with contrast (73201) |
$968.40 |
$3,228 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,228.70 |
$7,429 |
12.0× |
| Cta Abdomen (74175) |
$2,560.20 |
$8,534 |
13.8× |
| CTA abdomen pelvis (74174) |
$4,639.50 |
$15,465 |
12.6× |
| CTA chest (71275) |
$2,311.80 |
$7,706 |
12.5× |
| Cta Head (70496) |
$2,323.20 |
$7,744 |
12.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,130.30 |
$7,101 |
11.5× |
| Cta Neck (70498) |
$2,016.90 |
$6,723 |
10.9× |
| Cta Pelvis (72191) |
$1,684.80 |
$5,616 |
9.1× |
| Cystography minimum 3 views rs&i (74430) |
$572.70 |
$1,909 |
1.6× |
| Diskogram cervical (72285) |
$2,889.90 |
$9,633 |
1.4× |
| Diskography lumbar (72295) |
$2,454 |
$8,180 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$103.80 |
$346 |
0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$119.70 |
$399 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$282.30 |
$941 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$117.60 |
$392 |
1.3× |
| Echoencephalography real time imaging (76506) |
$456.30 |
$1,521 |
4.1× |
| Esophageal motility (78258) |
$842.40 |
$2,808 |
2.0× |
| Esophagus (74220) |
$450 |
$1,500 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$281.10 |
$937 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$178.20 |
$594 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$485.10 |
$1,617 |
1.9× |
| Foot 2 views (73620) |
$207.60 |
$692 |
2.3× |
| Forearm 2 views (73090) |
$219.90 |
$733 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,083.60 |
$3,612 |
2.6× |
| Hand 2 views (73120) |
$181.80 |
$606 |
1.6× |
| Hand 3 views (73130) |
$323.40 |
$1,078 |
3.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,577.70 |
$5,259 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,801.50 |
$6,005 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,620.30 |
$5,401 |
3.8× |
| Ht muscle image spect sing (78451) |
$2,541.30 |
$8,471 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$230.70 |
$769 |
2.5× |
| Hysterosalpingogram (74740) |
$531 |
$1,770 |
2.1× |
| Image fusion (77399) |
$308.11 |
$1,027.01 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$2,376.60 |
$7,922 |
3.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,129.80 |
$3,766 |
1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$819.30 |
$2,731 |
1.4× |
| Intracavitary radiation source applic simple (77761) |
$552.90 |
$1,843 |
0.9× |
| Kidney imaging morphology (78700) |
$846 |
$2,820 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,564.20 |
$5,214 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,554.30 |
$5,181 |
2.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,578.60 |
$5,262 |
2.8× |
| Knee 3 views (73562) |
$330.30 |
$1,101 |
3.6× |
| Liver & spleen imaging static only (78215) |
$714.30 |
$2,381 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$547.50 |
$1,825 |
1.3× |
| Liver imaging static only (78201) |
$648.30 |
$2,161 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$974.40 |
$3,248 |
1.7× |
| Lung Ventilation Imaging (78579) |
$537.60 |
$1,792 |
1.3× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,684.10 |
$8,947 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$504.30 |
$1,681 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,556.30 |
$8,521 |
0.8× |
| Lymphoscintigraphy (78195) |
$1,194.90 |
$3,983 |
2.1× |
| Mammary ductogram or galactogram multiple (77054) |
$687.30 |
$2,291 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$455.10 |
$1,517 |
1.8× |
| Meckels Diverticulum (78290) |
$529.50 |
$1,765 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$972.90 |
$3,243 |
2.5× |
| Mr safety determination physician/other qhp (76016) |
$86.70 |
$289 |
0.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$62.10 |
$207 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$22.20 |
$74 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$95.40 |
$318 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$251.40 |
$838 |
1.0× |
| MRA head w & w/o contrast (70546) |
$2,974.50 |
$9,915 |
8.1× |
| MRA head w/o contrast (70544) |
$1,982.10 |
$6,607 |
7.9× |
| MRA head with contrast (70545) |
$2,132.40 |
$7,108 |
5.8× |
| MRA neck w contrast (70548) |
$1,463.70 |
$4,879 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,647.90 |
$5,493 |
4.5× |
| MRA neck w/o contrast (70547) |
$1,190.70 |
$3,969 |
4.7× |
| MRI abdomen w contrast (74182) |
$2,158.50 |
$7,195 |
5.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,532.60 |
$8,442 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$1,971.90 |
$6,573 |
7.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,170.50 |
$7,235 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,964.10 |
$6,547 |
2.4× |
| MRI bone marrow blood supply (77084) |
$1,129.80 |
$3,766 |
4.5× |
| MRI breast w/o contrast bilateral (77047) |
$543 |
$1,810 |
2.2× |
| MRI breast w/o contrast unilat (77046) |
$528 |
$1,760 |
2.1× |
| MRI c-spine with contrast (72142) |
$2,235.90 |
$7,453 |
6.1× |
| MRI cardiac w/o contrast (75557) |
$1,178.10 |
$3,927 |
4.7× |
| MRI cervical spine w/o contrast (72141) |
$1,987.80 |
$6,626 |
7.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,722.90 |
$5,743 |
4.7× |
| MRI chest w/o contrast (71550) |
$1,385.40 |
$4,618 |
5.5× |
| MRI chest with contrast (71551) |
$1,520.10 |
$5,067 |
1.8× |
| MRI fetal sngl/1st gestation (74712) |
$1,114.50 |
$3,715 |
4.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,316.40 |
$4,388 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,992.30 |
$6,641 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,897.50 |
$6,325 |
7.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,213.50 |
$4,045 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,549.20 |
$5,164 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,335 |
$4,450 |
3.6× |
| MRI pelvis w contrast (72196) |
$2,321.70 |
$7,739 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,879.70 |
$9,599 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$2,050.20 |
$6,834 |
8.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,373 |
$7,910 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,751.60 |
$9,172 |
7.5× |
| MRI spectroscopy (76390) |
$1,014 |
$3,380 |
11.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,598.30 |
$8,661 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,140.50 |
$7,135 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,466 |
$8,220 |
6.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,125.50 |
$7,085 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,884.50 |
$9,615 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,840.50 |
$6,135 |
7.3× |
| MRI tmj (70336) |
$1,717.20 |
$5,724 |
6.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,698.30 |
$5,661 |
6.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,530.60 |
$5,102 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,231.50 |
$4,105 |
4.9× |
| Myelogram Cervical (72240) |
$709.50 |
$2,365 |
0.9× |
| Myelogram Lumbar (72265) |
$713.10 |
$2,377 |
0.9× |
| Myelogram thoracic (72255) |
$660.90 |
$2,203 |
0.8× |
| Myelography 2 or more regions (72270) |
$900.90 |
$3,003 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,417.20 |
$4,724 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,557.70 |
$11,859 |
2.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,682.90 |
$8,943 |
1.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,085.20 |
$10,284 |
2.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,381 |
$11,270 |
1.5× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$4,416.60 |
$14,722 |
1.9× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$3,555.60 |
$11,852 |
2.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$925.80 |
$3,086 |
1.0× |
| Neck soft tissue (70360) |
$220.80 |
$736 |
2.4× |
| Nm adrenal scan (78075) |
$809.10 |
$2,697 |
0.6× |
| Nm cisternogram (78630) |
$1,253.10 |
$4,177 |
2.2× |
| Nm csf leak detection (78650) |
$1,278.60 |
$4,262 |
0.9× |
| Nm gastric emptying study (78264) |
$1,398 |
$4,660 |
3.3× |
| Nm gastroesophageal reflux study (78262) |
$748.20 |
$2,494 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,573.20 |
$15,244 |
3.1× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$4,206.60 |
$14,022 |
2.8× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,305.50 |
$7,685 |
1.5× |
| Nuclear medicine study of digestive tracts (78299) |
$354.79 |
$1,182.63 |
0.8× |
| Nuclear medicine study of endocrine organs (78099) |
$409.66 |
$1,365.52 |
1.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,989.30 |
$6,631 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$1,161.30 |
$3,871 |
4.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$239.40 |
$798 |
2.2× |
| Orthopantogram (70355) |
$158.70 |
$529 |
1.7× |
| Osseous survey infant (77076) |
$665.40 |
$2,218 |
6.0× |
| Osseous survey limited (77074) |
$432.30 |
$1,441 |
3.9× |
| Parathyrd planar w/spect&CT (78072) |
$670.80 |
$2,236 |
1.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,077.60 |
$3,592 |
2.6× |
| Parathyroid imaging (78070) |
$985.80 |
$3,286 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$158.10 |
$527 |
1.4× |
| Perineogram (74775) |
$450.60 |
$1,502 |
1.8× |
| Peritoneogram rs&i (74190) |
$352.20 |
$1,174 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$3,326.10 |
$11,087 |
2.2× |
| PET imaging CT for attenuation limited area (78814) |
$2,626.80 |
$8,756 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,485.40 |
$11,618 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,961.60 |
$9,872 |
8.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,580.10 |
$5,267 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,296 |
$4,320 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,074 |
$3,580 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,120.80 |
$3,736 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$523.50 |
$1,745 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$207 |
$690 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$384.90 |
$1,283 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$230.10 |
$767 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$284.70 |
$949 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$466.50 |
$1,555 |
4.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,086.80 |
$36,956 |
1.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$832.50 |
$2,775 |
1.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$475.20 |
$1,584 |
4.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$504 |
$1,680 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$233.70 |
$779 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$247.80 |
$826 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$272.10 |
$907 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$219.30 |
$731 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$614.40 |
$2,048 |
3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$498.90 |
$1,663 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$447.90 |
$1,493 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$392.40 |
$1,308 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$120.90 |
$403 |
1.3× |
| Radiological examination surgical specimen (76098) |
$818.10 |
$2,727 |
1.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,577.70 |
$5,259 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,999.80 |
$6,666 |
0.6× |
| Ribs bilateral 3 views (71110) |
$339.60 |
$1,132 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,193.10 |
$3,977 |
2.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,349.70 |
$4,499 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,634.70 |
$5,449 |
2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,420.70 |
$8,069 |
1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,471.70 |
$8,239 |
1.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,031.30 |
$6,771 |
1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$912.90 |
$3,043 |
3.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$432.90 |
$1,443 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$991.20 |
$3,304 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$213.90 |
$713 |
1.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$335.10 |
$1,117 |
1.3× |
| Scanogram (77073) |
$476.40 |
$1,588 |
4.3× |
| Scapula complete (73010) |
$216.90 |
$723 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$29.10 |
$97 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$491.10 |
$1,637 |
4.5× |
| Sialogram (70390) |
$465 |
$1,550 |
1.8× |
| Simulation intermediate (77285) |
$828.90 |
$2,763 |
2.1× |
| Small bowel series (74250) |
$456.90 |
$1,523 |
2.5× |
| Spec medical radj physics consltj (77370) |
$1,126.20 |
$3,754 |
7.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,040.70 |
$3,469 |
2.6× |
| Special dosimetry (77331) |
$358.80 |
$1,196 |
2.5× |
| Special treatment procedure (77470) |
$1,767.30 |
$5,891 |
3.0× |
| Spine thoracic 3 views (72072) |
$227.10 |
$757 |
2.1× |
| Splenoportograpy rs&i (75810) |
$2,501.70 |
$8,339 |
0.8× |
| Stereotactic body radiation delivery (77373) |
$11,742 |
$39,140 |
6.2× |
| Superior sagittal sinus venogram (75870) |
$1,163.70 |
$3,879 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,503.60 |
$5,012 |
3.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$828 |
$2,760 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$846 |
$2,820 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,621.80 |
$5,406 |
4.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$807.60 |
$2,692 |
5.7× |
| Therapeutic Enema (74283) |
$568.20 |
$1,894 |
3.1× |
| Thoracolumbar 2 views (72080) |
$258.90 |
$863 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,614.90 |
$5,383 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$602.70 |
$2,009 |
1.4× |
| Thyroid uptake measurement (78012) |
$560.70 |
$1,869 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,113.30 |
$3,711 |
2.6× |
| Tmj unilateral (70328) |
$172.20 |
$574 |
1.9× |
| Tomogram (76100) |
$173.70 |
$579 |
1.6× |
| Treatment device intermediate (77333) |
$619.80 |
$2,066 |
4.4× |
| Treatment devices simple (77332) |
$331.20 |
$1,104 |
2.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,190.90 |
$7,303 |
3.8× |
| Tx devices design & construction complex (77334) |
$982.20 |
$3,274 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$471 |
$1,570 |
4.3× |
| Umbilical-artery Doppler (OB) (76820) |
$231.90 |
$773 |
2.1× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) |
$359.18 |
$1,197.24 |
0.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$340.43 |
$1,134.75 |
3.7× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) |
$359.18 |
$1,197.24 |
0.9× |
| Unlisted magnetic resonance procedure (76498) |
$234.88 |
$782.94 |
2.6× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$355.86 |
$1,186.17 |
0.8× |
| Unlisted Ultrasound Procedure (76999) |
$159.62 |
$532.03 |
1.7× |
| Upper Extremity Infant (73092) |
$157.50 |
$525 |
1.4× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$291.90 |
$973 |
3.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$846 |
$2,820 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$662.40 |
$2,208 |
2.6× |
| Urethrocystography voiding (74455) |
$577.20 |
$1,924 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$592.80 |
$1,976 |
3.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$641.10 |
$2,137 |
3.5× |
| Us abdl aorta screen aaa (76706) |
$369.30 |
$1,231 |
3.3× |
| Us breast unilateral complete (76641) |
$122.70 |
$409 |
1.1× |
| Us breast unilateral limited (76642) |
$120.90 |
$403 |
1.3× |
| Us chest (76604) |
$393.60 |
$1,312 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$249.30 |
$831 |
2.3× |
| Us elastography parenchyma (76981) |
$118.80 |
$396 |
1.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$255.30 |
$851 |
2.3× |
| Us guided compression repair (76936) |
$858.60 |
$2,862 |
3.8× |
| Us infant hips dynamic (76885) |
$340.20 |
$1,134 |
3.7× |
| Us infant hips limited static (76886) |
$226.80 |
$756 |
2.5× |
| Us kidney transplant (76776) |
$636.90 |
$2,123 |
5.8× |
| Us ob detailed single fetus (76811) |
$534.30 |
$1,781 |
2.1× |
| Us ob transvaginal (76817) |
$405.30 |
$1,351 |
3.7× |
| Us pelvic non ob complete (76856) |
$554.10 |
$1,847 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$354.30 |
$1,181 |
3.2× |
| Us pregnancy ltd (76815) |
$335.70 |
$1,119 |
3.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$437.40 |
$1,458 |
4.0× |
| Us retroperitoneal complete (76770) |
$630.90 |
$2,103 |
5.7× |
| Us retroperitoneal limited (76775) |
$419.40 |
$1,398 |
3.8× |
| Us scrotum and contents (76870) |
$395.40 |
$1,318 |
3.6× |
| Us soft tissue head/neck (76536) |
$395.40 |
$1,318 |
3.6× |
| Us spinal canal and contents (76800) |
$222.90 |
$743 |
2.0× |
| Us transrectal prostate volume (76873) |
$267.90 |
$893 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$335.70 |
$1,119 |
3.0× |
| Us, eye b-scan (76512) |
$159.90 |
$533 |
1.4× |
| Venogram extremity bilateral (75822) |
$1,179.90 |
$3,933 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,097.30 |
$6,991 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$2,223.30 |
$7,411 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,126.80 |
$3,756 |
0.7× |
| Venography Renal Bilateral (75833) |
$1,612.80 |
$5,376 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$1,517.40 |
$5,058 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,608.60 |
$5,362 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,729.70 |
$9,099 |
0.5× |
| Wrist 2 views (73100) |
$186 |
$620 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$314.40 |
$1,048 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$202.20 |
$674 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$333.90 |
$1,113 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$745.20 |
$2,484 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$194.40 |
$648 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$326.40 |
$1,088 |
3.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$438.30 |
$1,461 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$154.80 |
$516 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$283.20 |
$944 |
3.1× |
| X-ray exam hip uni 4/> views (73503) |
$297.30 |
$991 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$286.20 |
$954 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$572.70 |
$1,909 |
5.2× |
| X-ray exam of femur 1 (73551) |
$117.90 |
$393 |
1.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$695.40 |
$2,318 |
3.8× |
| X-ray eye for foreign body (70030) |
$216.30 |
$721 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$329.40 |
$1,098 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$219.60 |
$732 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$329.70 |
$1,099 |
3.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,616.40 |
$5,388 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$188.40 |
$628 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$115.20 |
$384 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$381.30 |
$1,271 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$215.10 |
$717 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$183 |
$610 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$397.80 |
$1,326 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$604.50 |
$2,015 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$273.60 |
$912 |
2.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$183.30 |
$611 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$334.20 |
$1,114 |
3.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$194.70 |
$649 |
1.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$318 |
$1,060 |
2.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$335.70 |
$1,119 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$230.40 |
$768 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$295.80 |
$986 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$418.80 |
$1,396 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$299.70 |
$999 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$232.50 |
$775 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$277.20 |
$924 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$211.80 |
$706 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$122.40 |
$408 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$504.30 |
$1,681 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$290.10 |
$967 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$225.60 |
$752 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$241.50 |
$805 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$210.60 |
$702 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$210.60 |
$702 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$238.50 |
$795 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$182.10 |
$607 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$327.60 |
$1,092 |
3.6× |
| Xr arthrogram ankle (73615) |
$448.80 |
$1,496 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$674.10 |
$2,247 |
6.1× |
| Xr chest 4+ views (71048) |
$244.80 |
$816 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$199.80 |
$666 |
2.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$225 |
$750 |
2.0× |
| Xr shoulder 1 view (73020) |
$120.60 |
$402 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$399 |
$1,330 |
3.6× |
| Xr tibia/fibula 2 views (73590) |
$224.70 |
$749 |
2.4× |
| Xr tmj bilateral (70330) |
$300 |
$1,000 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$237.60 |
$792 |
2.6× |