| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,459.60 |
$18,649 |
4.2× |
| Abdomen 1 View (74018) |
$184.40 |
$461 |
1.6× |
| Abdomen 2 views (74019) |
$315.20 |
$788 |
2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,367.60 |
$3,419 |
2.7× |
| Adrenal Cortex & Medulla Img (78075) |
$724 |
$1,810 |
0.4× |
| Angio internal mammary (75756) |
$1,944.80 |
$4,862 |
0.5× |
| Angio pulmonary bilat (75743) |
$2,730.40 |
$6,826 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,755.60 |
$6,889 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,274.80 |
$5,687 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,280 |
$5,700 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,521.60 |
$6,304 |
0.6× |
| Ankle 2 views (73600) |
$16.80 |
$42 |
0.2× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,251.20 |
$5,628 |
0.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,123.20 |
$5,308 |
0.5× |
| Artery X-Rays Abdomen (75726) |
$5,011.60 |
$12,529 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$4,182.80 |
$10,457 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$4,560 |
$11,400 |
0.6× |
| Artery X-Rays Spine (75705) |
$4,740 |
$11,850 |
0.7× |
| Arthrogram ankle (73615) |
$686 |
$1,715 |
1.5× |
| Arthrogram hip (73525) |
$467.20 |
$1,168 |
1.0× |
| Arthrogram Wrist (73115) |
$670 |
$1,675 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$820 |
$2,050 |
4.7× |
| Bone age studies (77072) |
$508 |
$1,270 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$1,685.60 |
$4,214 |
3.3× |
| Bone Imaging Limited Area (78300) |
$576.40 |
$1,441 |
1.1× |
| Bone Imaging Whole Body (78306) |
$1,655.60 |
$4,139 |
3.2× |
| Bone marrow imaging limited area (78102) |
$1,774.80 |
$4,437 |
3.5× |
| Bone survey infant (77076) |
$762 |
$1,905 |
5.7× |
| Brachytx isodose complex (77318) |
$422.80 |
$1,057 |
0.9× |
| Brachytx Isodose Plan Simple (77316) |
$221.20 |
$553 |
0.5× |
| Brain Image W/Flow < 4 Views (78601) |
$1,389.20 |
$3,473 |
2.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,920.40 |
$4,801 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,974.40 |
$7,436 |
1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,725.60 |
$4,314 |
3.8× |
| Cardiac Shunt Detection (78428) |
$256.80 |
$642 |
0.5× |
| Cat Scan Follow-Up Study (76380) |
$796 |
$1,990 |
7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$653.60 |
$1,634 |
0.9× |
| Cerebrospinal Fluid Scan (78630) |
$1,804.40 |
$4,511 |
2.6× |
| Chest 1 view (71045) |
$257.20 |
$643 |
2.3× |
| Chest 2 views (71046) |
$321.60 |
$804 |
2.9× |
| Chest 3 views (71047) |
$485.20 |
$1,213 |
4.3× |
| Chest 4 or more views (71048) |
$510.40 |
$1,276 |
3.8× |
| Clavicle complete (73000) |
$16.80 |
$42 |
0.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$130 |
$325 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$436.40 |
$1,091 |
2.5× |
| Contrast Exam Abdominl Aorta (75625) |
$2,251.20 |
$5,628 |
0.6× |
| Contrast X-Ray Bladder (74430) |
$302.40 |
$756 |
0.7× |
| Contrast X-Ray Of Elbow (73085) |
$341.60 |
$854 |
0.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,071.60 |
$2,679 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,536 |
$3,840 |
3.4× |
| CT abdomen and pelvis without contrast (74176) |
$840.80 |
$2,102 |
2.7× |
| CT abdomen w contrast (74160) |
$1,026.80 |
$2,567 |
4.6× |
| CT abdomen w wo contrast (74170) |
$1,109.60 |
$2,774 |
4.9× |
| CT abdomen w/o contrast (74150) |
$989.20 |
$2,473 |
7.4× |
| CT Angio Abdomen and Pelvis (74174) |
$1,597.60 |
$3,994 |
3.6× |
| CT Angio Chest (71275) |
$3,648.80 |
$9,122 |
16.2× |
| CT Angio Head (70496) |
$749.60 |
$1,874 |
3.3× |
| CT angio hrt w/3d image (75574) |
$2,755.20 |
$6,888 |
6.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,489.60 |
$8,724 |
15.5× |
| CT Angio Neck (70498) |
$701.20 |
$1,753 |
3.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,851.60 |
$9,629 |
17.1× |
| CT cervical spine w/ contrast (72126) |
$1,654 |
$4,135 |
3.7× |
| CT cervical spine w/o contrast (72125) |
$1,532 |
$3,830 |
11.4× |
| CT cervical spine w/wo cont (72127) |
$1,776 |
$4,440 |
7.9× |
| CT chest w contrast (71260) |
$1,557.60 |
$3,894 |
6.9× |
| CT chest w/wo contrast (71270) |
$2,160 |
$5,400 |
9.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,990 |
$4,975 |
14.8× |
| CT head/brain with contrast (70460) |
$1,101.20 |
$2,753 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,337.60 |
$3,344 |
5.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,079.60 |
$7,699 |
6.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$928 |
$2,320 |
8.3× |
| CT hrt w/3d image congen (75573) |
$2,464.80 |
$6,162 |
5.5× |
| CT iac w contrast (70481) |
$711.20 |
$1,778 |
3.2× |
| CT l-spine w&w/o contrast (72133) |
$1,488 |
$3,720 |
6.6× |
| CT lower ext w/o (73700) |
$1,583.20 |
$3,958 |
11.8× |
| CT lower extremity w/contrast material (73701) |
$2,188 |
$5,470 |
9.7× |
| CT lumbar spine w contrast (72132) |
$1,104 |
$2,760 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$828.80 |
$2,072 |
6.2× |
| CT maxillofacial w contrast (70487) |
$614.80 |
$1,537 |
2.7× |
| CT maxillofacial wo contrast (70486) |
$571.20 |
$1,428 |
4.2× |
| CT neck tissue combo (70492) |
$1,913.20 |
$4,783 |
8.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$762.40 |
$1,906 |
3.4× |
| CT orbits w/o contrast (70480) |
$581.60 |
$1,454 |
4.3× |
| CT pelvis w&w/o contrast (72194) |
$1,290.40 |
$3,226 |
5.7× |
| CT pelvis w/o contrast (72192) |
$927.20 |
$2,318 |
6.9× |
| CT scan of leg combo (73702) |
$2,744.80 |
$6,862 |
12.2× |
| CT scans face/jaw combo (70488) |
$780 |
$1,950 |
3.5× |
| CT soft tissue neck w contrast (70491) |
$1,370 |
$3,425 |
6.1× |
| CT soft tissue neck w/o contrast (70490) |
$804 |
$2,010 |
6.0× |
| CT thoracic spine w contrast (72129) |
$1,079.60 |
$2,699 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$833.20 |
$2,083 |
6.2× |
| CT thoracic spine w/wo cont (72130) |
$1,330.40 |
$3,326 |
5.9× |
| CT thorax w/o contrast (71250) |
$989.20 |
$2,473 |
7.4× |
| CT unlisted procedure (76497) |
$1,709.60 |
$4,274 |
15.3× |
| CT upper ext wo (73200) |
$2,286 |
$5,715 |
17.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,532 |
$3,830 |
6.8× |
| CT upper extremity with contrast (73201) |
$1,303.60 |
$3,259 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,101.60 |
$2,754 |
4.9× |
| Cta Abdomen (74175) |
$664.80 |
$1,662 |
2.9× |
| CTA pelvis (72191) |
$1,317.20 |
$3,293 |
5.8× |
| Dilation ureters/urethra rs&i (74485) |
$1,228 |
$3,070 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$60.80 |
$152 |
0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$72.80 |
$182 |
0.5× |
| Dxa Bone Density Axial (77080) |
$363.60 |
$909 |
2.7× |
| Dxa bone density study (77085) |
$393.60 |
$984 |
2.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$357.20 |
$893 |
3.2× |
| Echo exam of fetal heart (76825) |
$303.60 |
$759 |
0.4× |
| Echo exam uterus (76831) |
$67.20 |
$168 |
0.2× |
| Echo Guide For Artery Repair (76936) |
$207.20 |
$518 |
0.7× |
| Echograp Trans R Pros Study (76873) |
$119.60 |
$299 |
0.9× |
| Esophagram (74220) |
$548.80 |
$1,372 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$1,076 |
$2,690 |
8.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$778.40 |
$1,946 |
5.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,744 |
$6,860 |
8.9× |
| Fluoroscopy up to 1 hr (76000) |
$403.60 |
$1,009 |
1.3× |
| Follow-Up Angiography (75898) |
$6,326.40 |
$15,816 |
1.6× |
| Foot 2 views (73620) |
$14.80 |
$37 |
0.1× |
| Forearm 2 views (73090) |
$15.20 |
$38 |
0.1× |
| Gastric emptying imaging study (78264) |
$1,660 |
$4,150 |
3.2× |
| Gated Heart Planar Single (78472) |
$1,052.80 |
$2,632 |
2.0× |
| GI Endoscopic US S&I (76975) |
$1,048 |
$2,620 |
3.4× |
| Hand 2 views (73120) |
$16 |
$40 |
0.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,516 |
$16,290 |
7.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,621.20 |
$9,053 |
4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,966.80 |
$7,417 |
3.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,280 |
$5,700 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,280 |
$5,700 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$3,972.80 |
$9,932 |
5.7× |
| Hepatobiliary System Imaging (78226) |
$3,613.20 |
$9,033 |
7.0× |
| Ht Musc Image Planar Mult (78454) |
$1,359.20 |
$3,398 |
0.8× |
| Ht Muscle Image Spect Sing (78451) |
$1,619.60 |
$4,049 |
1.0× |
| Hysterosalpingogram (74740) |
$377.20 |
$943 |
1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$818.80 |
$2,047 |
7.3× |
| Infant hip ultrasound, limited static exam (76886) |
$762.80 |
$1,907 |
6.8× |
| Interstitial radiation source applic complex (77778) |
$3,920.80 |
$9,802 |
4.4× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$6,775.60 |
$16,939 |
0.7× |
| Joint Survey Single View (77077) |
$143.20 |
$358 |
1.1× |
| K Flow/Funct Image Multiple (78709) |
$2,151.60 |
$5,379 |
3.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,762 |
$4,405 |
2.5× |
| K Flow/Funct Image W/O Drug (78707) |
$1,326 |
$3,315 |
1.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$473.60 |
$1,184 |
0.9× |
| Knee 3 Views (73562) |
$21.20 |
$53 |
0.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$1,426.40 |
$3,566 |
2.8× |
| Leveen/Shunt Patency Exam (78291) |
$279.60 |
$699 |
0.5× |
| Liver & Spleen Imaging Static Only (78215) |
$233.60 |
$584 |
0.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$233.60 |
$584 |
0.5× |
| Liver imaging static only (78201) |
$590.40 |
$1,476 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$848.40 |
$2,121 |
1.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,685.20 |
$4,213 |
2.4× |
| Lung perfusion differential (78597) |
$508 |
$1,270 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,540.40 |
$6,351 |
3.6× |
| Lung Ventilation Imaging (78579) |
$1,596 |
$3,990 |
3.1× |
| Lymph System Imaging (78195) |
$3,010.80 |
$7,527 |
4.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$3,109.60 |
$7,774 |
1.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$346 |
$865 |
0.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,108 |
$5,270 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,091.20 |
$5,228 |
0.5× |
| Magnetic Image Jaw Joint (70336) |
$893.20 |
$2,233 |
2.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,512 |
$6,280 |
11.1× |
| Magnetic Resonance Elastography (76391) |
$208 |
$520 |
0.7× |
| Mammary ductogram or galactogram multiple (77054) |
$399.20 |
$998 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$304 |
$760 |
1.0× |
| Meckels Divert Exam (78290) |
$1,885.60 |
$4,714 |
3.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,800.40 |
$4,501 |
3.7× |
| Mr safety determination physician/other qhp (76016) |
$59.60 |
$149 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$16.80 |
$42 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$62 |
$155 |
0.5× |
| Mr safety implt pos&/immoblj (76019) |
$40.40 |
$101 |
0.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$162.40 |
$406 |
0.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,870.40 |
$7,176 |
6.4× |
| MRA head w/o contrast (70544) |
$1,762.40 |
$4,406 |
5.7× |
| MRA head with contrast (70545) |
$1,935.20 |
$4,838 |
4.3× |
| MRA neck w contrast (70548) |
$1,935.20 |
$4,838 |
4.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,810.40 |
$7,026 |
6.3× |
| MRA neck w/o contrast (70547) |
$1,834 |
$4,585 |
6.0× |
| MRI abdomen w contrast (74182) |
$1,532 |
$3,830 |
3.4× |
| MRI abdomen w/o contrast (74181) |
$1,464.40 |
$3,661 |
4.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,889.60 |
$4,724 |
1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,196.80 |
$5,492 |
4.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,618 |
$4,045 |
1.6× |
| MRI brain functional w/o physician admnistration (70554) |
$2,152.40 |
$5,381 |
7.0× |
| MRI brain functional w/physician admnistration (70555) |
$1,778 |
$4,445 |
5.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$367.20 |
$918 |
1.2× |
| MRI cardiac w/o cont stress (75559) |
$292.40 |
$731 |
0.4× |
| MRI cardiac w/o contrast (75557) |
$1,632.40 |
$4,081 |
5.3× |
| MRI cervical spine w contrast (72142) |
$1,654 |
$4,135 |
3.7× |
| MRI cervical spine w/o cont (72141) |
$1,532 |
$3,830 |
5.0× |
| MRI chest w/o contrast (71550) |
$1,008 |
$2,520 |
3.3× |
| MRI chest with contrast (71551) |
$1,532 |
$3,830 |
1.5× |
| MRI chest wo w contrast (71552) |
$2,040.80 |
$5,102 |
4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,186.40 |
$5,466 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,142.80 |
$7,857 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,773.20 |
$4,433 |
5.8× |
| MRI lumbar spine w contrast (72149) |
$1,654 |
$4,135 |
3.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,776 |
$4,440 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$878.80 |
$2,197 |
2.9× |
| MRI orbit face neck w contrast (70542) |
$1,128.80 |
$2,822 |
2.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,823.20 |
$4,558 |
4.1× |
| MRI pelvis w contrast (72196) |
$1,733.60 |
$4,334 |
3.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,471.20 |
$6,178 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$1,667.60 |
$4,169 |
5.4× |
| MRI spectroscopy (76390) |
$1,584.80 |
$3,962 |
14.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,532 |
$3,830 |
5.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,711.60 |
$4,279 |
3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,112.80 |
$2,782 |
3.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,155.20 |
$5,388 |
4.8× |
| MRI, abdomen, combo (74183) |
$2,179.60 |
$5,449 |
4.9× |
| MRI, dorsal spine combo (72157) |
$1,776 |
$4,440 |
4.0× |
| MRI, dorsal spine contrast (72147) |
$1,654 |
$4,135 |
3.7× |
| MRI, joint upper extrem (73221) |
$1,527.20 |
$3,818 |
5.0× |
| MRI, joint upper extrem combo (73223) |
$1,768 |
$4,420 |
3.9× |
| MRI, lumbar spine combo (72158) |
$1,776 |
$4,440 |
4.0× |
| Myelogram cervical (72240) |
$679.60 |
$1,699 |
0.7× |
| Myelogram Lumbar (72265) |
$664.40 |
$1,661 |
0.7× |
| Myelography thoracic (72255) |
$639.20 |
$1,598 |
0.6× |
| Myelograpy 2/more regions rs&i (72270) |
$803.20 |
$2,008 |
0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$279.60 |
$699 |
0.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$911.20 |
$2,278 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,331.20 |
$5,828 |
1.4× |
| Neck soft tissue (70360) |
$681.20 |
$1,703 |
6.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$196.40 |
$491 |
0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$279.60 |
$699 |
0.5× |
| Nm myocard infarct spect (78469) |
$1,948 |
$4,870 |
2.8× |
| Nonvascular Shunt X-Ray (75809) |
$246 |
$615 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,209.60 |
$8,024 |
1.8× |
| Nuclear Rx Intra-Arterial (79445) |
$430 |
$1,075 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,640.40 |
$4,101 |
5.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$145.20 |
$363 |
1.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$346 |
$865 |
2.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$551.20 |
$1,378 |
3.2× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$50 |
$125 |
0.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$248.40 |
$621 |
1.8× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$26.80 |
$67 |
0.7× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$275.60 |
$689 |
2.0× |
| Panoramic X-ray of jaws (70355) |
$151.60 |
$379 |
1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,978 |
$4,945 |
2.8× |
| Parathyroid Planar Imaging (78070) |
$700 |
$1,750 |
1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,797.60 |
$4,494 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$15.60 |
$39 |
0.1× |
| Peritoneogram Rs&I (74190) |
$725.20 |
$1,813 |
1.0× |
| Pet Image Skull-Thigh (78812) |
$3,836.80 |
$9,592 |
2.1× |
| Pet Image W/Ct Lmtd (78814) |
$2,872.40 |
$7,181 |
1.6× |
| PET image w/CT, full body (78816) |
$3,199.60 |
$7,999 |
1.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,172.40 |
$7,931 |
1.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,538.80 |
$6,347 |
1.5× |
| PET whole body (78813) |
$4,219.60 |
$10,549 |
2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,575.60 |
$6,439 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,806.40 |
$4,516 |
3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$417.20 |
$1,043 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$396 |
$990 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$19.20 |
$48 |
0.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$15.60 |
$39 |
0.1× |
| Radex elbow complete minimum 3 views (73080) |
$18 |
$45 |
0.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$24.40 |
$61 |
0.2× |
| Radex fingr minimum 2 views (73140) |
$19.60 |
$49 |
0.2× |
| Radex foot complete minimum 3 views (73630) |
$17.60 |
$44 |
0.2× |
| Radex Hand Minimum 3 Views (73130) |
$19.20 |
$48 |
0.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$504.80 |
$1,262 |
4.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$20 |
$50 |
0.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$19.20 |
$48 |
0.2× |
| Radex shoulder complete minimum 2 views (73030) |
$18 |
$45 |
0.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$169.20 |
$423 |
1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,084.40 |
$2,711 |
4.8× |
| Radex Spine 1 View Specify Level (72020) |
$12.80 |
$32 |
0.1× |
| Radex Sternum Minimum 2 Views (71120) |
$305.20 |
$763 |
2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$534 |
$1,335 |
4.8× |
| Radex Toe Minimum 2 Views (73660) |
$16.80 |
$42 |
0.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$442.40 |
$1,106 |
3.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$21.20 |
$53 |
0.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$909.60 |
$2,274 |
6.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,160.80 |
$15,402 |
0.7× |
| Radiation treatment delivery level 1 (77402) |
$98.40 |
$246 |
0.7× |
| Radiation treatment delivery level 2 (77407) |
$196.40 |
$491 |
0.4× |
| Radiation treatment delivery level 3 (77412) |
$196.40 |
$491 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$22.40 |
$56 |
0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$364.40 |
$911 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$1,600.80 |
$4,002 |
7.1× |
| Radiologic exam colon single contrast study (74270) |
$1,162.40 |
$2,906 |
5.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$616 |
$1,540 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$24 |
$60 |
0.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$584.80 |
$1,462 |
4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$538.80 |
$1,347 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$532 |
$1,330 |
2.4× |
| Radiologic exam teeth complete full mouth (70320) |
$551.60 |
$1,379 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$606.80 |
$1,517 |
2.7× |
| Radiologic examination femur 1 view (73551) |
$15.20 |
$38 |
0.1× |
| Radiologic examination femur minimum 2 views (73552) |
$18.40 |
$46 |
0.2× |
| Radiologic examination knee 1/2 views (73560) |
$17.60 |
$44 |
0.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$554.80 |
$1,387 |
4.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$16.40 |
$41 |
0.1× |
| Ribs bilateral 3 views (71110) |
$747.60 |
$1,869 |
5.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,042.40 |
$2,606 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,639.20 |
$4,098 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,639.20 |
$4,098 |
2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,639.20 |
$4,098 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,236.40 |
$5,591 |
1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,639.20 |
$4,098 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$919.20 |
$2,298 |
3.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,781.60 |
$4,454 |
5.9× |
| Scapula (73010) |
$526.40 |
$1,316 |
3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$48.40 |
$121 |
2.1× |
| Shoulder 1 view (73020) |
$12.80 |
$32 |
0.1× |
| Shoulder Arthrography (73040) |
$1,004 |
$2,510 |
2.2× |
| Sialogram (70390) |
$612 |
$1,530 |
2.0× |
| Skull less than 4 views (70250) |
$20 |
$50 |
0.1× |
| Special dosimetry (77331) |
$285.20 |
$713 |
1.6× |
| Special Physics Consult (77370) |
$1,415.60 |
$3,539 |
8.2× |
| Special teletherapy port plan (77321) |
$592.40 |
$1,481 |
1.2× |
| Special treatment procedure (77470) |
$2,977.60 |
$7,444 |
4.2× |
| Stereotactic Body Radiation Delivery (77373) |
$5,754.80 |
$14,387 |
2.5× |
| Sternoclavicular joints (71130) |
$366.40 |
$916 |
3.3× |
| Superior sagittal sinus venogram (75870) |
$6,326.40 |
$15,816 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$275.20 |
$688 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$275.20 |
$688 |
0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,642.80 |
$6,607 |
5.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,592.80 |
$3,982 |
3.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,204.80 |
$3,012 |
7.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$791.60 |
$1,979 |
3.5× |
| Thoracic spine 2 views (72070) |
$18 |
$45 |
0.1× |
| Thoracic spine 3 views (72072) |
$20.40 |
$51 |
0.2× |
| Thoracolumbar 2 views (72080) |
$343.20 |
$858 |
3.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$279.60 |
$699 |
0.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,835.60 |
$4,589 |
3.6× |
| Thyroid Met Imaging Body (78018) |
$1,887.60 |
$4,719 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$1,584 |
$3,960 |
3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,442 |
$8,605 |
6.7× |
| Tx Devices Design & Construction Complex (77334) |
$1,543.20 |
$3,858 |
3.2× |
| Tx devices design & construction intermediate (77333) |
$927.20 |
$2,318 |
5.4× |
| Tx devices design & construction simple (77332) |
$801.60 |
$2,004 |
4.6× |
| Ultrasound Breast Limited (76642) |
$44.80 |
$112 |
0.4× |
| Ultrasound elastography first target lesion (76982) |
$119.60 |
$299 |
0.9× |
| Ultrasound Elastography Parenchyma (76981) |
$145.20 |
$363 |
1.1× |
| Ultrasound Exam Aaa Screen (76706) |
$44.40 |
$111 |
0.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$243.20 |
$608 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$46.40 |
$116 |
0.3× |
| Umbilical-artery Doppler (OB) (76820) |
$72.80 |
$182 |
0.5× |
Unlis px ther radiol clinical tx planning (77299)
range across 2 matching MRF lines |
$82.40–$486.80 |
$206–$1,217 |
varies |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$236.80–$1,364 |
$592–$3,410 |
varies |
Unlisted fluoroscopic procedure (76496)
range across 2 matching MRF lines |
$425.20–$2,102.80 |
$1,063–$5,257 |
varies |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
$1,660.80–$1,673.60 |
$4,152–$4,184 |
varies |
| Unlisted respiratory px dx nuclear medicine (78599) |
$279.60 |
$699 |
0.5× |
| Unlisted us procedure (76999) |
$340 |
$850 |
3.0× |
| Upper gi w/o kub (74240) |
$388.80 |
$972 |
1.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$237.60 |
$594 |
21.5× |
| Urea breath test c-14 isotopic analysis (78268) |
$261.20 |
$653 |
2.8× |
| Urethrocystogram voiding (74455) |
$266.40 |
$666 |
0.9× |
| Urethrocystography retrograde (74450) |
$266.40 |
$666 |
0.9× |
| Us breast unilateral complete (76641) |
$593.60 |
$1,484 |
4.4× |
| Us chest (76604) |
$45.60 |
$114 |
0.3× |
| Us complete joint (76881) |
$61.60 |
$154 |
0.5× |
| Us exam, pelvic, limited (76857) |
$187.60 |
$469 |
1.4× |
| Us head (76506) |
$538.80 |
$1,347 |
4.0× |
| Us kidney transplant (76776) |
$685.60 |
$1,714 |
5.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$31.20 |
$78 |
0.2× |
| Us ob detailed single fetus (76811) |
$96.40 |
$241 |
0.3× |
| Us ob limited 1 or more fetuses (76815) |
$57.60 |
$144 |
0.4× |
| Us ob transvaginal (76817) |
$57.60 |
$144 |
0.4× |
| Us pelvic non ob complete (76856) |
$66 |
$165 |
0.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$66.40 |
$166 |
0.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$57.60 |
$144 |
0.4× |
| Us retroperitoneal complete (76770) |
$373.60 |
$934 |
2.8× |
| Us retroperitoneal limited (76775) |
$29.60 |
$74 |
0.2× |
| Us scrotum and contents (76870) |
$488.40 |
$1,221 |
3.6× |
| Us spinal canal and contents (76800) |
$588.40 |
$1,471 |
4.4× |
| Us thyroid (76536) |
$60 |
$150 |
0.4× |
| Us transrectal (76872) |
$336.80 |
$842 |
2.5× |
| Vein X-Ray Chest (75827) |
$2,125.60 |
$5,314 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,091.20 |
$5,228 |
0.5× |
| Vein X-Ray Spleen/Liver (75810) |
$2,091.20 |
$5,228 |
0.5× |
| Venogram Sinus/Jugular (75860) |
$778 |
$1,945 |
0.2× |
| Venography Adrenal Unilateral (75840) |
$2,251.20 |
$5,628 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,143.20 |
$5,358 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$2,261.20 |
$5,653 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,849.60 |
$4,624 |
0.9× |
| Venography Orbital Rs&I (75880) |
$2,127.20 |
$5,318 |
2.6× |
| Venography Renal Bilateral (75833) |
$2,620.40 |
$6,551 |
0.6× |
| Venography Renal Unilateral (75831) |
$2,280 |
$5,700 |
0.6× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,486.80 |
$6,217 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$335.60 |
$839 |
3.0× |
| Wrist 2 views (73100) |
$17.60 |
$44 |
0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$656.40 |
$1,641 |
5.9× |
| X-ray antegrade pyelogram tube (74425) |
$464.40 |
$1,161 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$4,080 |
$10,200 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$424 |
$1,060 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$15.60 |
$39 |
0.1× |
| X-Ray Exam Breast Specimen (76098) |
$683.60 |
$1,709 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$22 |
$55 |
0.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$693.60 |
$1,734 |
5.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$754 |
$1,885 |
5.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$16.80 |
$42 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$24.40 |
$61 |
0.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$30.80 |
$77 |
0.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$24.80 |
$62 |
0.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$29.20 |
$73 |
0.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$35.20 |
$88 |
0.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$34.40 |
$86 |
0.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$20.40 |
$51 |
0.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$33.20 |
$83 |
0.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$21.60 |
$54 |
0.2× |
| X-ray eye for foreign body (70030) |
$334.80 |
$837 |
3.0× |
| X-ray humerus (73060) |
$16.80 |
$42 |
0.2× |
| X-ray IV pyelogram (ivp) (74400) |
$732.80 |
$1,832 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$20 |
$50 |
0.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$508 |
$1,270 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$20.80 |
$52 |
0.2× |
| X-ray nose-rectum child f.b. (76010) |
$179.60 |
$449 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$28.40 |
$71 |
0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$606.80 |
$1,517 |
4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$469.60 |
$1,174 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$16.80 |
$42 |
0.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$202.40 |
$506 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$889.20 |
$2,223 |
6.6× |
| X-ray thoracic spine 4 vw (72074) |
$24 |
$60 |
0.2× |
| X-Ray Tmj Unilat (70328) |
$320 |
$800 |
2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$302.40 |
$756 |
0.7× |
| X-Rays Bone Length Studies (77073) |
$564.40 |
$1,411 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$806.40 |
$2,016 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$27.60 |
$69 |
0.2× |
| Xr facial bones less than 3 views (70140) |
$544 |
$1,360 |
4.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$98.80 |
$247 |
0.7× |
| Xr orbits complete 4 views (70200) |
$24.80 |
$62 |
0.2× |
| Xr Tomogram Single Plane (76100) |
$319.60 |
$799 |
2.4× |