| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,384.50 |
$9,670 |
2.3× |
| Abdomen 1 View (74018) |
$313.25 |
$895 |
3.4× |
| Abdomen 2 views (74019) |
$329 |
$940 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,411.85 |
$6,891 |
5.7× |
| Adrenal Cortex & Medulla Img (78075) |
$1,136.80 |
$3,248 |
0.8× |
| Angio internal mammary (75756) |
$2,031.75 |
$5,805 |
0.6× |
| Angio pulmonary bilat (75743) |
$4,014.15 |
$11,469 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,362.45 |
$9,607 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$4,040.40 |
$11,544 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,813.95 |
$10,897 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,722.95 |
$10,637 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,533.70 |
$4,382 |
0.5× |
| Ankle 2 views (73600) |
$225.05 |
$643 |
2.5× |
| Aortography thoracic serialography rs&i (75605) |
$3,454.50 |
$9,870 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$4,014.15 |
$11,469 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,029.30 |
$5,798 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$4,014.15 |
$11,469 |
0.7× |
| Artery X-Rays Spine (75705) |
$3,184.65 |
$9,099 |
0.5× |
| Arthrogram ankle (73615) |
$476 |
$1,360 |
1.3× |
| Arthrogram hip (73525) |
$505.75 |
$1,445 |
1.4× |
| Arthrogram Wrist (73115) |
$581.70 |
$1,662 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$551.60 |
$1,576 |
3.9× |
| Bone age studies (77072) |
$175.70 |
$502 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$2,841.65 |
$8,119 |
6.7× |
| Bone Imaging Limited Area (78300) |
$1,374.10 |
$3,926 |
3.3× |
| Bone Imaging Whole Body (78306) |
$2,716.70 |
$7,762 |
6.4× |
| Bone marrow imaging; whole body (78104) |
$1,125.60 |
$3,216 |
2.7× |
| Bone survey infant (77076) |
$311.50 |
$890 |
2.8× |
| Brachytx isodose complex (77318) |
$1,779.05 |
$5,083 |
4.5× |
| Brachytx isodose intermed (77317) |
$1,061.90 |
$3,034 |
2.7× |
| Brachytx Isodose Plan Simple (77316) |
$974.75 |
$2,785 |
2.5× |
| Brain Flow Imaging Only (78610) |
$1,027.25 |
$2,935 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,019.90 |
$2,914 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,771.65 |
$7,919 |
1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,345.05 |
$3,843 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,193.10 |
$6,266 |
6.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,399.95 |
$6,857 |
2.9× |
| Cardiac Shunt Detection (78428) |
$764.40 |
$2,184 |
1.8× |
Cardiovasc nucl exam unlisted (78499)
range across 3 matching MRF lines |
$314.76–$1,150 |
$899.31–$3,285.69 |
varies |
| Cat Scan Follow-Up Study (76380) |
$91.35 |
$261 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,198.75 |
$3,425 |
2.1× |
| Cerebrospinal Fluid Scan (78630) |
$927.50 |
$2,650 |
1.6× |
| Chest 1 view (71045) |
$316.05 |
$903 |
3.4× |
| Chest 2 views (71046) |
$435.75 |
$1,245 |
4.7× |
| Chest 3 views (71047) |
$443.10 |
$1,266 |
4.8× |
| Chest 4 or more views (71048) |
$518 |
$1,480 |
4.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$258.65 |
$739 |
2.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$964.95 |
$2,757 |
8.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$673.05 |
$1,923 |
0.8× |
| Clavicle complete (73000) |
$240.80 |
$688 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,894.55 |
$5,413 |
17.2× |
| Continuing medical physics consltj pr wk (77336) |
$931 |
$2,660 |
6.6× |
| Contrast Exam Abdominl Aorta (75625) |
$2,465.75 |
$7,045 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$662.90 |
$1,894 |
1.8× |
| Contrast X-Ray Of Elbow (73085) |
$837.55 |
$2,393 |
2.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$778.40 |
$2,224 |
2.1× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$532.35 |
$1,521 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,517.05 |
$15,763 |
15.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,569.60 |
$13,056 |
18.2× |
| CT abdomen w contrast (74160) |
$1,975.75 |
$5,645 |
10.7× |
| CT abdomen w wo contrast (74170) |
$2,368.80 |
$6,768 |
12.8× |
| CT abdomen w/o contrast (74150) |
$1,716.40 |
$4,904 |
15.6× |
| CT Angio Abdomen and Pelvis (74174) |
$5,792.85 |
$16,551 |
15.7× |
| CT Angio Chest (71275) |
$2,975.70 |
$8,502 |
16.1× |
| CT Angio Head (70496) |
$2,954.70 |
$8,442 |
16.0× |
| CT angio hrt w/3d image (75574) |
$1,598.45 |
$4,567 |
4.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,458.40 |
$7,024 |
13.3× |
| CT Angio Neck (70498) |
$3,131.45 |
$8,947 |
16.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,226 |
$6,360 |
12.0× |
| CT cervical spine w/ contrast (72126) |
$2,306.15 |
$6,589 |
6.3× |
| CT cervical spine w/o contrast (72125) |
$2,259.25 |
$6,455 |
20.5× |
| CT cervical spine w/wo cont (72127) |
$2,536.80 |
$7,248 |
13.7× |
| CT chest w contrast (71260) |
$2,719.50 |
$7,770 |
14.7× |
| CT chest w/wo contrast (71270) |
$2,846.90 |
$8,134 |
15.4× |
| CT colonography screening (74263) |
$1,213.45 |
$3,467 |
4.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$686 |
$1,960 |
6.2× |
| CT head/brain with contrast (70460) |
$2,152.50 |
$6,150 |
11.6× |
| CT head/brain without and with contrast (70470) |
$2,367.75 |
$6,765 |
12.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$910.70 |
$2,602 |
2.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$189.35 |
$541 |
2.1× |
| CT hrt w/3d image congen (75573) |
$556.50 |
$1,590 |
1.5× |
| CT iac w contrast (70481) |
$1,113.70 |
$3,182 |
6.0× |
| CT l-spine w&w/o contrast (72133) |
$1,462.30 |
$4,178 |
7.9× |
| CT lower ext w/o (73700) |
$1,746.85 |
$4,991 |
15.8× |
| CT lower extremity w/contrast material (73701) |
$1,920.10 |
$5,486 |
10.4× |
| CT lumbar spine w contrast (72132) |
$1,243.20 |
$3,552 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$1,093.40 |
$3,124 |
9.9× |
| CT maxillofacial w contrast (70487) |
$1,845.55 |
$5,273 |
10.0× |
| CT maxillofacial wo contrast (70486) |
$1,487.85 |
$4,251 |
13.5× |
| CT neck tissue combo (70492) |
$1,956.50 |
$5,590 |
10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,225 |
$3,500 |
6.6× |
| CT orbits w/o contrast (70480) |
$1,060.50 |
$3,030 |
9.6× |
| CT pelvis w&w/o contrast (72194) |
$2,220.05 |
$6,343 |
12.0× |
| CT pelvis w/o contrast (72192) |
$2,072 |
$5,920 |
18.8× |
| CT scan of leg combo (73702) |
$2,066.05 |
$5,903 |
11.2× |
| CT scans face/jaw combo (70488) |
$2,030 |
$5,800 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$1,609.30 |
$4,598 |
8.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,069.95 |
$3,057 |
9.7× |
| CT thoracic spine w contrast (72129) |
$1,277.15 |
$3,649 |
6.9× |
| CT thoracic spine w/o contrast (72128) |
$1,257.20 |
$3,592 |
11.4× |
| CT thoracic spine w/wo cont (72130) |
$1,429.75 |
$4,085 |
7.7× |
| CT thorax w/o contrast (71250) |
$1,894.55 |
$5,413 |
17.2× |
| CT upper ext wo (73200) |
$1,558.55 |
$4,453 |
14.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,119.95 |
$6,057 |
11.5× |
| CT upper extremity with contrast (73201) |
$2,026.15 |
$5,789 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,881.60 |
$5,376 |
10.2× |
| Cta Abdomen (74175) |
$2,487.10 |
$7,106 |
13.4× |
| CTA pelvis (72191) |
$2,220.05 |
$6,343 |
12.0× |
| Dilation ureters/urethra rs&i (74485) |
$1,071 |
$3,060 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,701.35 |
$4,861 |
0.8× |
| Diskography lumbar (72295) |
$1,792.70 |
$5,122 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$207.90 |
$594 |
1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$387.80 |
$1,108 |
3.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$220.50 |
$630 |
2.0× |
| Dxa Bone Density Axial (77080) |
$114.45 |
$327 |
1.0× |
| Echo exam of fetal heart (76825) |
$378.35 |
$1,081 |
0.7× |
| Echo exam uterus (76831) |
$330.40 |
$944 |
1.3× |
| Echo Guide For Artery Repair (76936) |
$1,224.30 |
$3,498 |
5.4× |
| Echograp Trans R Pros Study (76873) |
$268.80 |
$768 |
2.4× |
| Esophageal Motility Study (78258) |
$942.90 |
$2,694 |
2.2× |
| Esophagram (74220) |
$706.65 |
$2,019 |
3.8× |
| Fetal Biophys Profile W/Nst (76818) |
$485.80 |
$1,388 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$403.90 |
$1,154 |
3.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,132.20 |
$6,092 |
8.5× |
| Fluoroscopy up to 1 hr (76000) |
$1,339.45 |
$3,827 |
5.3× |
| Follow-Up Angiography (75898) |
$3,471.65 |
$9,919 |
1.0× |
| Foot 2 views (73620) |
$225.05 |
$643 |
2.5× |
| Forearm 2 views (73090) |
$142.45 |
$407 |
1.6× |
| Gastric emptying imaging study (78264) |
$3,351.95 |
$9,577 |
7.9× |
| Gastroesophageal Reflux Exam (78262) |
$864.85 |
$2,471 |
2.1× |
| Gated Heart Planar Single (78472) |
$1,005.55 |
$2,873 |
2.4× |
| Gated Heart, Multiple (78473) |
$1,164.10 |
$3,326 |
2.8× |
| GI Endoscopic US S&I (76975) |
$398.30 |
$1,138 |
1.6× |
| Hand 2 views (73120) |
$225.05 |
$643 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,618.50 |
$18,910 |
9.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,196.40 |
$17,704 |
8.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,388.25 |
$15,395 |
7.3× |
| Heart first pass single,planar (78481) |
$2,133.60 |
$6,096 |
3.7× |
| Heart Image (Pet) Multiple (78492) |
$4,391.80 |
$12,548 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,269.05 |
$6,483 |
0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,269.05 |
$6,483 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$3,155.60 |
$9,016 |
5.5× |
| Hepatobiliary System Imaging (78226) |
$3,005.45 |
$8,587 |
7.1× |
| Ht Musc Image Planar Mult (78454) |
$1,588.30 |
$4,538 |
1.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,271.85 |
$6,491 |
1.7× |
| Hysterosalpingogram (74740) |
$607.60 |
$1,736 |
2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$581.35 |
$1,661 |
6.3× |
| Interstitial radiation source applic complex (77778) |
$1,489.25 |
$4,255 |
2.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,092.70 |
$3,122 |
1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,040.90 |
$2,974 |
1.8× |
| Intracavitary radiation source applic simple (77761) |
$991.20 |
$2,832 |
1.7× |
| Joint Survey Single View (77077) |
$355.95 |
$1,017 |
3.2× |
| K Flow/Funct Image Multiple (78709) |
$991.55 |
$2,833 |
1.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,906.10 |
$5,446 |
3.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,906.10 |
$5,446 |
3.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$905.45 |
$2,587 |
2.1× |
| Kidney Imaging Morphol (78700) |
$381.85 |
$1,091 |
0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,024.45 |
$2,927 |
2.4× |
| Knee 3 Views (73562) |
$409.15 |
$1,169 |
4.5× |
| Leveen/Shunt Patency Exam (78291) |
$659.05 |
$1,883 |
1.6× |
| Liver & Spleen Imaging Static Only (78215) |
$861.70 |
$2,462 |
2.0× |
| Liver imaging static only (78201) |
$1,127 |
$3,220 |
2.0× |
| Liver imaging w/vascular flow (78202) |
$1,240.75 |
$3,545 |
2.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,015.95 |
$8,617 |
5.3× |
| Lung perfusion differential (78597) |
$1,850.10 |
$5,286 |
4.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,847.25 |
$8,135 |
5.0× |
| Lung Ventilation Imaging (78579) |
$974.05 |
$2,783 |
2.3× |
| Lymph System Imaging (78195) |
$1,852.90 |
$5,294 |
3.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,001 |
$2,860 |
0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$913.85 |
$2,611 |
1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,366.75 |
$3,905 |
0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,445.40 |
$9,844 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$1,705.20 |
$4,872 |
6.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$2,747.85 |
$7,851 |
14.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$2,482.90 |
$7,094 |
4.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,885.05 |
$8,243 |
15.6× |
| Magnetic Resonance Elastography (76391) |
$371.70 |
$1,062 |
1.5× |
| Mammary ductogram or galactogram multiple (77054) |
$575.05 |
$1,643 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$390.25 |
$1,115 |
1.6× |
| Meckels Divert Exam (78290) |
$1,013.25 |
$2,895 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,614.10 |
$10,326 |
9.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,141.20 |
$11,832 |
11.3× |
| MRA head w/o contrast (70544) |
$2,538.90 |
$7,254 |
10.1× |
| MRA head with contrast (70545) |
$2,731.40 |
$7,804 |
7.4× |
| MRA neck w contrast (70548) |
$2,798.60 |
$7,996 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,148.55 |
$11,853 |
11.3× |
| MRA neck w/o contrast (70547) |
$2,538.90 |
$7,254 |
10.1× |
| MRI abdomen w contrast (74182) |
$2,088.45 |
$5,967 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,506.05 |
$4,303 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,369.50 |
$6,770 |
2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,110.80 |
$8,888 |
8.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,719.50 |
$7,770 |
3.3× |
| MRI bone marrow blood supply (77084) |
$1,310.05 |
$3,743 |
5.2× |
| MRI brain functional w/physician admnistration (70555) |
$2,000.60 |
$5,716 |
7.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,396.45 |
$6,847 |
9.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,332.75 |
$6,665 |
9.3× |
| MRI cardiac w/o contrast (75557) |
$1,954.05 |
$5,583 |
7.8× |
| MRI cervical spine w contrast (72142) |
$2,594.90 |
$7,414 |
7.1× |
| MRI cervical spine w/o cont (72141) |
$2,422.35 |
$6,921 |
9.6× |
| MRI chest w/o contrast (71550) |
$2,418.50 |
$6,910 |
9.6× |
| MRI chest with contrast (71551) |
$2,748.55 |
$7,853 |
3.3× |
| MRI chest wo w contrast (71552) |
$3,293.15 |
$9,409 |
8.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,874.60 |
$5,356 |
5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,363.90 |
$6,754 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,598.80 |
$4,568 |
6.4× |
| MRI lumbar spine w contrast (72149) |
$3,117.80 |
$8,908 |
8.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,906.75 |
$8,305 |
7.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,329.60 |
$6,656 |
9.3× |
| MRI orbit face neck w contrast (70542) |
$2,736.65 |
$7,819 |
7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,400.95 |
$9,717 |
9.2× |
| MRI pelvis w contrast (72196) |
$2,026.50 |
$5,790 |
5.5× |
| MRI pelvis w/o & w contrast (72197) |
$3,735.55 |
$10,673 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$1,723.05 |
$4,923 |
6.8× |
| MRI spectroscopy (76390) |
$978.60 |
$2,796 |
10.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,566.90 |
$7,334 |
10.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,107 |
$6,020 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,971.20 |
$5,632 |
7.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,399.25 |
$6,855 |
6.5× |
| MRI, abdomen, combo (74183) |
$3,091.90 |
$8,834 |
8.4× |
| MRI, dorsal spine combo (72157) |
$3,003.35 |
$8,581 |
8.2× |
| MRI, dorsal spine contrast (72147) |
$2,833.60 |
$8,096 |
7.7× |
| MRI, joint upper extrem (73221) |
$2,266.95 |
$6,477 |
9.0× |
| MRI, joint upper extrem combo (73223) |
$2,982.70 |
$8,522 |
8.1× |
| MRI, lumbar spine combo (72158) |
$3,094.35 |
$8,841 |
8.4× |
| Myelogram cervical (72240) |
$669.20 |
$1,912 |
0.8× |
| Myelogram Lumbar (72265) |
$711.20 |
$2,032 |
0.9× |
| Myelograpy 2/more regions rs&i (72270) |
$790.65 |
$2,259 |
1.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$637.70 |
$1,822 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,723.65 |
$10,639 |
2.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,512.70 |
$4,322 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$4,835.60 |
$13,816 |
3.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$3,580.50 |
$10,230 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,741.25 |
$4,975 |
1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,604 |
$7,440 |
1.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$2,604 |
$7,440 |
1.1× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,886.10 |
$8,246 |
1.8× |
| N-invas est c ffr sw aly CTA (75580) |
$1,083.60 |
$3,096 |
1.2× |
| Neck soft tissue (70360) |
$260.40 |
$744 |
2.8× |
| Nervous system nuclear exam (78699) |
$307.25 |
$877.83 |
0.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$483 |
$1,380 |
1.1× |
| Nm csf leak detection (78650) |
$1,616.30 |
$4,618 |
1.2× |
Nm unlisted gi procedure (78299)
range across 2 matching MRF lines |
$272.15–$334.76 |
$777.57–$956.43 |
varies |
| Nm whole blood volume (78122) |
$2,161.95 |
$6,177 |
3.8× |
| Nonvascular Shunt X-Ray (75809) |
$310.80 |
$888 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,852.85 |
$8,151 |
2.0× |
Nuclear medicine study of endocrine organs (78099)
range across 2 matching MRF lines |
$510.15–$639.61 |
$1,457.55–$1,827.45 |
varies |
| Nuclear Rx Intra-Arterial (79445) |
$1,271.20 |
$3,632 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$2,801.75 |
$8,005 |
11.4× |
| Ob us nuchal meas 1 gest (76813) |
$278.60 |
$796 |
2.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$171.15 |
$489 |
1.6× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$278.95 |
$797 |
2.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$416.85 |
$1,191 |
3.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$139.30 |
$398 |
1.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$111.65 |
$319 |
1.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$265.65 |
$759 |
2.4× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$24.50 |
$70 |
0.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$158.90 |
$454 |
1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$4,779.60 |
$13,656 |
8.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,594.55 |
$7,413 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$256.55 |
$733 |
2.3× |
| Peritoneogram Rs&I (74190) |
$1,157.80 |
$3,308 |
2.0× |
| Pet Image Skull-Thigh (78812) |
$5,078.85 |
$14,511 |
3.4× |
| Pet Image W/Ct Lmtd (78814) |
$5,322.10 |
$15,206 |
3.5× |
| PET image w/CT, full body (78816) |
$5,958.75 |
$17,025 |
4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,718.30 |
$16,338 |
3.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,926.30 |
$11,218 |
2.9× |
| Pet Myocardial Sngl Study (78491) |
$3,787.35 |
$10,821 |
2.5× |
| PET whole body (78813) |
$5,332.95 |
$15,237 |
3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,269.05 |
$6,483 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,345.05 |
$3,843 |
3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$340.55 |
$973 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$421.40 |
$1,204 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$406.35 |
$1,161 |
4.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$201.25 |
$575 |
2.2× |
| Radex elbow complete minimum 3 views (73080) |
$361.20 |
$1,032 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$254.80 |
$728 |
2.3× |
| Radex fingr minimum 2 views (73140) |
$244.65 |
$699 |
2.7× |
| Radex foot complete minimum 3 views (73630) |
$430.85 |
$1,231 |
4.7× |
| Radex Hand Minimum 3 Views (73130) |
$415.10 |
$1,186 |
4.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$205.80 |
$588 |
2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$108.15 |
$309 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$260.40 |
$744 |
2.8× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$571.90 |
$1,634 |
6.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$284.90 |
$814 |
3.1× |
| Radex shoulder complete minimum 2 views (73030) |
$321.30 |
$918 |
3.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$138.25 |
$395 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$276.15 |
$789 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$213.50 |
$610 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$159.25 |
$455 |
1.7× |
| Radex Toe Minimum 2 Views (73660) |
$220.85 |
$631 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$155.75 |
$445 |
1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$415.10 |
$1,186 |
4.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$515.55 |
$1,473 |
4.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,302.65 |
$46,579 |
2.1× |
| Radiation treatment delivery level 1 (77402) |
$542.85 |
$1,551 |
5.0× |
| Radiation treatment delivery level 2 (77407) |
$662.90 |
$1,894 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$962.50 |
$2,750 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$359.10 |
$1,026 |
3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$339.50 |
$970 |
3.1× |
| Radiologic exam colon double contrast study (74280) |
$791 |
$2,260 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$584.85 |
$1,671 |
3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$745.50 |
$2,130 |
4.0× |
| Radiologic exam knee complete 4/more views (73564) |
$483 |
$1,380 |
4.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$501.55 |
$1,433 |
4.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$796.25 |
$2,275 |
4.3× |
| Radiologic exam swallow function contrast study (74230) |
$468.65 |
$1,339 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$814.45 |
$2,327 |
4.4× |
| Radiologic examination femur 1 view (73551) |
$240.10 |
$686 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$276.15 |
$789 |
3.0× |
| Radiologic examination knee 1/2 views (73560) |
$276.15 |
$789 |
3.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$486.15 |
$1,389 |
4.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$264.25 |
$755 |
2.9× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$2,486.40 |
$7,104 |
4.3× |
| Renal Cyst Study (74470) |
$1,048.95 |
$2,997 |
1.8× |
| Ribs bilateral 3 views (71110) |
$324.80 |
$928 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,076.95 |
$3,077 |
2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,629.55 |
$7,513 |
4.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,939 |
$5,540 |
3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,210.30 |
$3,458 |
2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,866.15 |
$8,189 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,496.80 |
$12,848 |
3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$4,340.35 |
$12,401 |
3.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$558.95 |
$1,597 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$2,075.50 |
$5,930 |
8.4× |
| Scapula (73010) |
$256.55 |
$733 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$32.20 |
$92 |
1.4× |
| Shoulder 1 view (73020) |
$96.95 |
$277 |
1.1× |
| Shoulder Arthrography (73040) |
$1,029.35 |
$2,941 |
2.8× |
| Sialogram (70390) |
$419.65 |
$1,199 |
1.7× |
| Skull less than 4 views (70250) |
$295.75 |
$845 |
2.7× |
| Special dosimetry (77331) |
$355.95 |
$1,017 |
2.5× |
| Special Physics Consult (77370) |
$1,400.70 |
$4,002 |
9.9× |
| Special teletherapy port plan (77321) |
$1,663.20 |
$4,752 |
4.2× |
| Special treatment procedure (77470) |
$4,587.45 |
$13,107 |
7.9× |
| Speech evaluation, complex (70371) |
$628.60 |
$1,796 |
2.5× |
| Spleen Imaging (78185) |
$671.65 |
$1,919 |
1.6× |
| Srs Multisource (77371) |
$31,191.65 |
$89,119 |
4.0× |
| Stereotactic Body Radiation Delivery (77373) |
$16,158.45 |
$46,167 |
8.6× |
| Sternoclavicular joints (71130) |
$240.80 |
$688 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$1,641.50 |
$4,690 |
0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$2,691.15 |
$7,689 |
25.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,602.65 |
$4,579 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$769.30 |
$2,198 |
1.9× |
| Testicular Imaging W/Flow (78761) |
$807.45 |
$2,307 |
1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,682.40 |
$7,664 |
6.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,961.75 |
$5,605 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,428.70 |
$4,082 |
10.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$415.45 |
$1,187 |
2.2× |
| Thoracic spine 2 views (72070) |
$262.85 |
$751 |
2.4× |
| Thoracic spine 3 views (72072) |
$275.45 |
$787 |
2.5× |
| Thoracolumbar 2 views (72080) |
$236.25 |
$675 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$956.90 |
$2,734 |
2.3× |
| Thyroid Met Imaging Body (78018) |
$3,319.05 |
$9,483 |
5.8× |
| Thyroid Uptake Measurement (78012) |
$752.50 |
$2,150 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,733.20 |
$4,952 |
4.1× |
| Tx Devices Design & Construction Complex (77334) |
$1,337 |
$3,820 |
3.4× |
| Tx devices design & construction intermediate (77333) |
$740.60 |
$2,116 |
5.2× |
| Tx devices design & construction simple (77332) |
$580.30 |
$1,658 |
4.1× |
| Ultrasound Breast Limited (76642) |
$471.10 |
$1,346 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$152.60 |
$436 |
1.4× |
| Ultrasound Elastography Parenchyma (76981) |
$153.65 |
$439 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$405.30 |
$1,158 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$587.65 |
$1,679 |
5.3× |
| Umbilical-artery Doppler (OB) (76820) |
$210 |
$600 |
1.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$783.42 |
$2,238.34 |
8.5× |
| Unlisted fluoroscopic procedure (76496) |
$474.10 |
$1,354.56 |
5.2× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$591.76 |
$1,690.74 |
1.4× |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$385.27–$3,445.15 |
$1,100.77–$9,843.26 |
varies |
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999)
range across 3 matching MRF lines |
$178.12–$1,829.70 |
$508.90–$5,227.70 |
varies |
| Unlisted respiratory px dx nuclear medicine (78599) |
$733.69 |
$2,096.25 |
1.7× |
| Unlisted us procedure (76999) |
$93.07 |
$265.91 |
1.0× |
| Upper gi w/o kub (74240) |
$713.65 |
$2,039 |
3.9× |
| Ureteral Reflux Study (78740) |
$1,207.15 |
$3,449 |
2.9× |
| Urethrocystogram voiding (74455) |
$623 |
$1,780 |
2.5× |
| Urethrocystography retrograde (74450) |
$1,055.95 |
$3,017 |
4.2× |
| Us bone density measurement (76977) |
$94.85 |
$271 |
0.9× |
| Us breast unilateral complete (76641) |
$484.40 |
$1,384 |
4.4× |
| Us chest (76604) |
$379.40 |
$1,084 |
3.4× |
| Us complete joint (76881) |
$756 |
$2,160 |
6.9× |
| Us exam, pelvic, limited (76857) |
$498.40 |
$1,424 |
4.5× |
| Us head (76506) |
$433.30 |
$1,238 |
3.9× |
| Us kidney transplant (76776) |
$472.50 |
$1,350 |
4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$301 |
$860 |
2.7× |
| Us ob detailed single fetus (76811) |
$716.80 |
$2,048 |
2.8× |
| Us ob limited 1 or more fetuses (76815) |
$364.35 |
$1,041 |
3.3× |
| Us ob transvaginal (76817) |
$478.80 |
$1,368 |
4.3× |
| Us pelvic non ob complete (76856) |
$757.40 |
$2,164 |
6.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$477.40 |
$1,364 |
4.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$232.75 |
$665 |
2.1× |
| Us retroperitoneal complete (76770) |
$506.80 |
$1,448 |
4.6× |
| Us retroperitoneal limited (76775) |
$484.75 |
$1,385 |
4.4× |
| Us scrotum and contents (76870) |
$682.50 |
$1,950 |
6.2× |
| Us spinal canal and contents (76800) |
$618.80 |
$1,768 |
5.6× |
| Us thyroid (76536) |
$633.50 |
$1,810 |
5.7× |
| Us transrectal (76872) |
$298.55 |
$853 |
2.7× |
| Vein X-Ray Chest (75827) |
$2,208.15 |
$6,309 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,031.75 |
$5,805 |
0.6× |
| Vein X-Ray Spleen/Liver (75810) |
$3,421.60 |
$9,776 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$2,077.95 |
$5,937 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$2,669.80 |
$7,628 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,269.05 |
$6,483 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,126.65 |
$3,219 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,010.45 |
$2,887 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,465.05 |
$7,043 |
0.7× |
| Venography Renal Unilateral (75831) |
$2,269.05 |
$6,483 |
0.7× |
| Venous sampling by catheter (75893) |
$4,014.15 |
$11,469 |
0.7× |
| Venous thrombosis imaging (78457) |
$517.65 |
$1,479 |
0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$751.45 |
$2,147 |
1.8× |
| Wrist 2 views (73100) |
$217 |
$620 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$173.95 |
$497 |
1.9× |
| X-ray antegrade pyelogram tube (74425) |
$422.10 |
$1,206 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$2,269.05 |
$6,483 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$284.90 |
$814 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$225.05 |
$643 |
2.5× |
| X-Ray Exam Breast Specimen (76098) |
$291.20 |
$832 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$250.60 |
$716 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$480.20 |
$1,372 |
4.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$491.05 |
$1,403 |
4.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$222.95 |
$637 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$460.60 |
$1,316 |
5.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$483.70 |
$1,382 |
4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$283.15 |
$809 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$479.85 |
$1,371 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$501.55 |
$1,433 |
4.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$588.70 |
$1,682 |
5.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$331.45 |
$947 |
3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$471.10 |
$1,346 |
4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$308.70 |
$882 |
2.8× |
| X-ray eye for foreign body (70030) |
$303.80 |
$868 |
3.3× |
| X-ray humerus (73060) |
$211.75 |
$605 |
2.3× |
| X-ray IV pyelogram (ivp) (74400) |
$742.35 |
$2,121 |
4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$166.25 |
$475 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$225.40 |
$644 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$500.50 |
$1,430 |
4.5× |
| X-ray nose-rectum child f.b. (76010) |
$440.30 |
$1,258 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$328.30 |
$938 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$361.20 |
$1,032 |
3.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$264.25 |
$755 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$264.25 |
$755 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$158.20 |
$452 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$339.15 |
$969 |
3.1× |
| X-Ray Stress View (77071) |
$96.95 |
$277 |
1.1× |
| X-ray thoracic spine 4 vw (72074) |
$288.05 |
$823 |
2.6× |
| X-Ray Tmj Unilat (70328) |
$104.65 |
$299 |
1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$392.35 |
$1,121 |
1.1× |
| X-Rays Bone Length Studies (77073) |
$438.90 |
$1,254 |
4.0× |
| X-Rays Bone Survey Complete (77075) |
$551.25 |
$1,575 |
5.0× |
| Xr c-spine 4 or 5 views (72050) |
$456.75 |
$1,305 |
4.1× |
| Xr facial bones less than 3 views (70140) |
$243.60 |
$696 |
2.7× |
| Xr orbits complete 4 views (70200) |
$339.85 |
$971 |
3.1× |
| Xr Tomogram Single Plane (76100) |
$468.30 |
$1,338 |
4.2× |