| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$4,696.92 |
$17,396 |
3.2× |
| Acute gi blood loss imaging (78278) |
$669.06 |
$2,478 |
1.6× |
| Angio extremity unilateral (75710) |
$3,009.15 |
$11,145 |
0.9× |
| Angio pulmonary unilateral (75741) |
$2,729.16 |
$10,108 |
0.8× |
| Angiogram extremity bilateral (75716) |
$4,282.60 |
$15,861.50 |
1.3× |
| Angiogram pelvic (75736) |
$5,878.17 |
$21,771 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,513.32 |
$16,716 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,892.94 |
$18,122 |
0.8× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$843.48 |
$3,124 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,549.88 |
$9,444 |
0.8× |
| Ankle 2 views (73600) |
$157.95 |
$585 |
1.7× |
| Barium enema (74270) |
$632.88 |
$2,344 |
3.5× |
| Basic dosimetry (77300) |
$522.45 |
$1,935 |
3.7× |
| Bilat selctv renal venogram (75833) |
$2,009.61 |
$7,443 |
0.6× |
| Bone age studies (77072) |
$178.20 |
$660 |
1.6× |
| Bone imaging limited area (78300) |
$522.72 |
$1,936 |
1.3× |
| Bone marrow imaging whole body (78104) |
$618.03 |
$2,289 |
1.5× |
| Bone survey complete (77075) |
$443.20 |
$1,641.50 |
4.1× |
| Bowel imaging (78290) |
$514.89 |
$1,907 |
1.2× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$1,601.37 |
$5,931 |
4.1× |
| Brain image w/flow 4 + views (78606) |
$580.50 |
$2,150 |
1.0× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$2,021.76 |
$7,488 |
5.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$321.57 |
$1,191 |
1.8× |
| Cisternogram (78630) |
$481.95 |
$1,785 |
0.8× |
| Clavicle complete (73000) |
$242.19 |
$897 |
2.7× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) |
$216.27 |
$801 |
2.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,210.68 |
$4,484 |
6.6× |
| Continuing medical physics consltj pr wk (77336) |
$522.45 |
$1,935 |
3.7× |
| Contrast exam abdominl aorta (75625) |
$4,266.81 |
$15,803 |
1.3× |
| Contrast exam thoracic aorta (75605) |
$3,127.14 |
$11,582 |
0.5× |
| Corpora cavernosography (74445) |
$267.30 |
$990 |
2.4× |
| Csf shunt evaluation (78645) |
$466.29 |
$1,727 |
0.8× |
| CT - st neck w&wo contr (70492) |
$1,129.41 |
$4,183 |
6.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,203.74 |
$8,162 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,573.83 |
$5,829 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,217.84 |
$4,510.50 |
6.6× |
| CT abdomen w/contrast (74160) |
$1,008.99 |
$3,737 |
5.5× |
| CT abdomen w/o contrast (74150) |
$833.22 |
$3,086 |
7.6× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$1,980.18 |
$7,334 |
5.4× |
| CT angio abdom w/o & w/dye (74175) |
$1,328.40 |
$4,920 |
7.3× |
| CT angio abdominal arteries (75635) |
$1,527.39 |
$5,657 |
8.3× |
| CT angio hrt w/3d image (75574) |
$514.08 |
$1,904 |
1.4× |
| CT angiograph pelv w/o&w/dye (72191) |
$1,461.24 |
$5,412 |
8.0× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$1,502.01 |
$5,563 |
8.2× |
| CT cervical spine w/contrast (72126) |
$1,008.99 |
$3,737 |
2.8× |
| CT cervical spine w/o contrast (72125) |
$822.96 |
$3,048 |
7.5× |
| CT chest w/contrast (71260) |
$1,008.99 |
$3,737 |
5.5× |
| CT colonography w/o cntrst (74261) |
$286.47 |
$1,061 |
2.6× |
| CT extremity upper w & w/o contrast (73202) |
$1,102.41 |
$4,083 |
6.0× |
| CT head/brain with contrast (70460) |
$1,355.94 |
$5,022 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,502.01 |
$5,563 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$514.08 |
$1,904 |
1.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$308.61 |
$1,143 |
3.4× |
| CT hrt w/3d image congen (75573) |
$1,408.05 |
$5,215 |
3.9× |
| CT limited/localized follow up study (76380) |
$399.87 |
$1,481 |
4.4× |
| CT lower ext w/wo contrast (73702) |
$1,129.41 |
$4,183 |
6.2× |
| CT lower extremity w contrast (73701) |
$1,008.99 |
$3,737 |
5.5× |
| CT lower extremity w/o contrast unilateral (73700) |
$744.12 |
$2,756 |
6.8× |
| CT lumbar spine w/contrast (72132) |
$1,008.99 |
$3,737 |
2.8× |
| CT lumbar spine w/o contrast (72131) |
$730.35 |
$2,705 |
6.7× |
| CT lumbar spine w/o then w/ con (72133) |
$1,129.41 |
$4,183 |
6.2× |
| CT maxillofacial area w/o contrast (70486) |
$765.45 |
$2,835 |
7.0× |
| CT maxillofacial w/contrast (70487) |
$1,008.99 |
$3,737 |
5.5× |
| CT maxillofacial w/o then w/ con (70488) |
$1,377 |
$5,100 |
7.5× |
| CT orbit sella ear w/o con (70480) |
$853.74 |
$3,162 |
7.8× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$1,670.22 |
$6,186 |
9.1× |
| CT pelvis w & w/o contrast (72194) |
$1,129.41 |
$4,183 |
6.2× |
| CT pelvis w/o contrast (72192) |
$727.92 |
$2,696 |
6.7× |
| CT soft tissue neck w/contrast (70491) |
$1,055.43 |
$3,909 |
5.8× |
| CT soft tissue neck w/o contrast (70490) |
$774.63 |
$2,869 |
7.1× |
| CT spine cervical w/wo contrast (72127) |
$1,129.41 |
$4,183 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$1,008.99 |
$3,737 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$715.23 |
$2,649 |
6.6× |
| CT thoracic spine w/o then w/ con (72130) |
$1,129.41 |
$4,183 |
6.2× |
| CT thorax lung cancer scr c- (71271) |
$32.94 |
$122 |
0.3× |
| CT thorax w/o contrast (71250) |
$839.70 |
$3,110 |
7.7× |
| CT thorax w/o then w/ contrast (71270) |
$1,318.14 |
$4,882 |
7.2× |
| CT upper extremity w/dye (73201) |
$1,008.99 |
$3,737 |
2.8× |
| CT upper extremity w/o contrast rt (73200) |
$751.41 |
$2,783 |
6.9× |
| CTA chest w/wo contrast (71275) |
$1,391.85 |
$5,155 |
7.6× |
| CTA head w contrast (70496) |
$1,322.73 |
$4,899 |
7.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,004.02 |
$11,126 |
8.2× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$1,328.40 |
$4,920 |
7.3× |
| Cta Neck (70498) |
$1,322.73 |
$4,899 |
7.2× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$1,391.85 |
$5,155 |
7.6× |
| Dilation ureters/urethra rs&i (74485) |
$1,496.61 |
$5,543 |
0.7× |
| Echo exam of eye (76516) |
$122.04 |
$452 |
1.1× |
| Echo exam of eye thickness (76514) |
$120.69 |
$447 |
4.0× |
| Esophogram (74220) |
$348.84 |
$1,292 |
1.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$667.98 |
$2,474 |
2.7× |
| Functional MRI brain by phys/psych (70555) |
$966.33 |
$3,579 |
3.9× |
| Functional MRI brain by tech (70554) |
$1,199.07 |
$4,441 |
4.8× |
| Gastric emptying study (78264) |
$983.88 |
$3,644 |
2.4× |
| Gated heart planar single (78472) |
$844.56 |
$3,128 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,887.46 |
$14,398 |
5.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,901.77 |
$14,451 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,887.46 |
$14,398 |
5.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,378.51 |
$12,513 |
1.0× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$3,009.15 |
$11,145 |
0.9× |
| Hepatobil syst image w/drug (78227) |
$704.70 |
$2,610 |
1.2× |
| Hepatobiliary system imaging (78226) |
$861.57 |
$3,191 |
2.1× |
| Humerus min 2 views (73060) |
$253.80 |
$940 |
2.8× |
| Hysterosalpingography (74740) |
$655.83 |
$2,429 |
2.6× |
| Imrt planning (77301) |
$4,592.43 |
$17,009 |
3.2× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$4,419.63 |
$16,369 |
6.1× |
| Intracavitary radiation source applic complex (77763) |
$1,632.96 |
$6,048 |
2.2× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$1,306.26 |
$4,838 |
3.3× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$1,246.05 |
$4,615 |
3.2× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,771.47 |
$6,561 |
4.5× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$1,310.85 |
$4,855 |
3.4× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,676.97 |
$6,211 |
3.0× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$969.03 |
$3,589 |
1.7× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,036.53 |
$3,839 |
1.8× |
| Liver & spleen; static only (78215) |
$875.07 |
$3,241 |
2.1× |
| Liver & spleen; w vasc flow (78216) |
$712.53 |
$2,639 |
1.7× |
| Lung perfusion differential (78597) |
$393.66 |
$1,458 |
0.9× |
| Lung ventilat&perfus imaging (78582) |
$572.67 |
$2,121 |
1.0× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) |
$994.41 |
$3,683 |
0.6× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) |
$949.32 |
$3,516 |
1.4× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$1,727.46 |
$6,398 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$994.41 |
$3,683 |
0.3× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,264.49 |
$8,387 |
6.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,098.44 |
$7,772 |
5.8× |
| Mlc device(s) for imrt (77338) |
$6,191.64 |
$22,932 |
15.8× |
| Mr safety determination physician/other qhp (76016) |
$142.83 |
$529 |
1.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$96.39 |
$357 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$39.69 |
$147 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$148.77 |
$551 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$391.77 |
$1,451 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,879.47 |
$6,961 |
5.2× |
| MRA head w/o contrast (70544) |
$1,342.71 |
$4,973 |
5.4× |
| MRA neck w/contrast (70548) |
$1,572.75 |
$5,825 |
4.3× |
| MRA neck w/o contrast (70547) |
$1,342.71 |
$4,973 |
5.4× |
| MRA neck w/wo contrast (70549) |
$1,740.56 |
$6,446.50 |
4.8× |
| MRI abdomen w/contrast (74182) |
$1,864.35 |
$6,905 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,253.96 |
$8,348 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,550.34 |
$5,742 |
6.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,903.77 |
$7,051 |
2.3× |
| MRI breast without contrast bilateral (77047) |
$1,966.68 |
$7,284 |
7.9× |
| MRI breast without contrast material unilateral (77046) |
$432 |
$1,600 |
1.7× |
| MRI cardiac w/o contrast (75557) |
$1,199.07 |
$4,441 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,342.71 |
$4,973 |
5.4× |
| MRI cervical spine with contrast (72142) |
$1,665.76 |
$6,169.50 |
4.6× |
| MRI chest w & w/o contrast (71552) |
$2,164.86 |
$8,018 |
5.9× |
| MRI chest w/contrast (71551) |
$1,513.08 |
$5,604 |
1.8× |
| MRI chest w/o contrast (71550) |
$1,342.71 |
$4,973 |
5.4× |
| MRI elastography (76391) |
$453.60 |
$1,680 |
1.8× |
| MRI joint upper ext w/contrast (73222) |
$1,864.62 |
$6,906 |
2.3× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,193.88 |
$8,125.50 |
6.0× |
| MRI joint upr extrem w/o dye (73221) |
$1,538.19 |
$5,697 |
6.2× |
| Mri Lower Extremity W/O Dye (73718) |
$1,577.61 |
$5,843 |
6.3× |
| MRI lumbar spine with contrast (72149) |
$2,002.05 |
$7,415 |
5.5× |
| MRI lumbar w/wo contrast (72158) |
$2,159.06 |
$7,996.50 |
5.9× |
| MRI lwr ext w/o jnts with con rt (73719) |
$1,779.30 |
$6,590 |
4.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,696.54 |
$6,283.50 |
4.7× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$2,196.45 |
$8,135 |
6.0× |
| MRI orbit/face/neck w/o contrast (70540) |
$1,581.12 |
$5,856 |
6.3× |
| MRI pelvis w/ contrast (72196) |
$1,806.84 |
$6,692 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,342.71 |
$4,973 |
5.4× |
| MRI pelvis w/wo contrast (72197) |
$2,111.13 |
$7,819 |
5.8× |
| MRI spectroscopy (76390) |
$581.31 |
$2,153 |
6.4× |
| MRI spine cervical wo/w contrast (72156) |
$2,264.49 |
$8,387 |
6.2× |
| MRI spine thoracic w/contrast (72147) |
$2,002.05 |
$7,415 |
5.5× |
| MRI thoracic spine w wo contrast (72157) |
$2,264.49 |
$8,387 |
6.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,342.71 |
$4,973 |
5.4× |
| MRI tmj (70336) |
$1,342.71 |
$4,973 |
5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,342.71 |
$4,973 |
5.4× |
| Mri Upper Extremity W/Dye (73219) |
$1,787.67 |
$6,621 |
4.9× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$2,264.49 |
$8,387 |
6.2× |
| Myelogram thoracic (72255) |
$1,259.28 |
$4,664 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,287.90 |
$4,770 |
1.6× |
| Myelography lumbosacral (72265) |
$1,283.31 |
$4,753 |
1.6× |
| Myocardial spect single study at rest or stress (78451) |
$1,427.76 |
$5,288 |
1.1× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,972.35 |
$7,305 |
1.3× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,646.62 |
$13,506 |
1.6× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$1,645.11 |
$6,093 |
1.8× |
| Nm adrenal imaging (78075) |
$1,214.73 |
$4,499 |
0.9× |
| Nm bone 3 phase (78315) |
$1,145.88 |
$4,244 |
2.7× |
| Nm bone imaging whole body (78306) |
$1,108.35 |
$4,105 |
2.7× |
| Nm bone marrow scan limited (78102) |
$655.56 |
$2,428 |
1.6× |
| Nm heart perfusion spect stress rest (78452) |
$2,116.80 |
$7,840 |
1.6× |
| Nm lymph system (78195) |
$789.88 |
$2,925.50 |
1.4× |
| Nm thyroid imaging only (78013) |
$795.15 |
$2,945 |
1.9× |
| Nuclear rx IV admin (79101) |
$1,103.76 |
$4,088 |
4.5× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Age Under 21 (76519) |
$116.10 |
$430 |
1.1× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$347.49 |
$1,287 |
3.2× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$266.90 |
$988.50 |
2.4× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter Age Under… (76510) |
$403.92 |
$1,496 |
2.9× |
| Oral radiopharm rx (79005) |
$612.76 |
$2,269.50 |
2.5× |
| Parathyrd planar w/spect&CT (78072) |
$1,342.98 |
$4,974 |
2.4× |
| Parathyroid imaging (78070) |
$529.47 |
$1,961 |
1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,278.99 |
$4,737 |
3.1× |
| PET brain metabolic eval (78608) |
$5,381.64 |
$19,932 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,185.08 |
$19,204 |
3.5× |
| PET imaging CT for attenuation limited area (78814) |
$907.74 |
$3,362 |
0.6× |
| PET imaging for CT attenuation whole body (78816) |
$929.88 |
$3,444 |
0.6× |
| Proton treatment complex (77525) |
$3,150.63 |
$11,669 |
2.4× |
| Proton trmt simple w/comp (77522) |
$2,721.33 |
$10,079 |
2.1× |
| Proton trmt simple w/o comp (77520) |
$1,119.96 |
$4,148 |
1.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,948.94 |
$10,922 |
0.9× |
| Pulmonary perfusion imaging particulate (78580) |
$717.39 |
$2,657 |
1.7× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,665.63 |
$6,169 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,195.02 |
$4,426 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$267.03 |
$989 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$263.79 |
$977 |
2.4× |
| Radex hip unilateral with pelvis 1 view (73501) |
$133.38 |
$494 |
1.5× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$286.47 |
$1,061 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$199.53 |
$739 |
1.8× |
| Radex spine cervical 2 or 3 views (72040) |
$321.03 |
$1,189 |
3.5× |
| Radex spine cervical 4 or 5 views (72050) |
$378.27 |
$1,401 |
3.5× |
| Radex spine cervical 6 or more views (72052) |
$445.77 |
$1,651 |
4.1× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$205.74 |
$762 |
2.3× |
| Radiation delivery stereotactic cranial linear (77372) |
$22,612.77 |
$83,751 |
2.9× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$22,612.77 |
$83,751 |
2.9× |
| Radiation tx delivery lvl 1 (77402) |
$454.95 |
$1,685 |
4.3× |
| Radiation tx delivery lvl 2 (77407) |
$1,719.36 |
$6,368 |
4.3× |
| Radiation tx delivery lvl 3 (77412) |
$1,719.36 |
$6,368 |
3.0× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$239.49 |
$887 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$489.78 |
$1,814 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$495.18 |
$1,834 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$280.53 |
$1,039 |
3.1× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$445.77 |
$1,651 |
4.1× |
| Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) |
$243.54 |
$902 |
2.2× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$382.32 |
$1,416 |
3.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$353.16 |
$1,308 |
0.8× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$1,632.96 |
$6,048 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,165.86 |
$4,318 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$833.49 |
$3,087 |
1.5× |
| Rp loclzj tum spect CT 2area/sep acquisj img (78832) |
$1,285.47 |
$4,761 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,317.87 |
$4,881 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$460.89 |
$1,707 |
1.9× |
| Saline infused sonohysterogram (76831) |
$356.40 |
$1,320 |
1.4× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$61.29 |
$227 |
2.6× |
| Selective spinal angiogram (75705) |
$3,001.86 |
$11,118 |
0.5× |
| Simulation complex (77290) |
$1,461.51 |
$5,413 |
3.7× |
| Simulation intermediate (77285) |
$898.02 |
$3,326 |
2.3× |
| Simulation simple (77280) |
$565.38 |
$2,094 |
4.0× |
| Small bowel series (74250) |
$454.41 |
$1,683 |
2.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$497.88 |
$1,844 |
1.3× |
| Special dosimetry (77331) |
$548.37 |
$2,031 |
3.9× |
| Special physics consult (77370) |
$522.45 |
$1,935 |
3.7× |
| Special treatment procedure (77470) |
$2,366.28 |
$8,764 |
4.1× |
| Speech evaluation complex (70371) |
$108.81 |
$403 |
0.4× |
| Stereotactic body radiation delivery (77373) |
$7,131.78 |
$26,414 |
3.8× |
| Superior sagittal sinus venogram (75870) |
$613.71 |
$2,273 |
0.2× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$295.38 |
$1,094 |
2.8× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$210.33 |
$779 |
5.4× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$420.66 |
$1,558 |
3.9× |
| Thyroid met imaging body (78018) |
$1,134.54 |
$4,202 |
2.0× |
| Thyroid uptake single/multiple quant measurement (78012) |
$455.22 |
$1,686 |
1.1× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,180.71 |
$4,373 |
2.8× |
| Treatment device intermediate (77333) |
$617.76 |
$2,288 |
4.4× |
| Treatment devices complex (77334) |
$1,454.22 |
$5,386 |
3.7× |
| Treatment devices simple (77332) |
$619.92 |
$2,296 |
4.4× |
| Ultrasound breast limited (76642) |
$218.16 |
$808 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$509.76 |
$1,888 |
4.7× |
| Ultrasound, elastography; first target lesion (76982) |
$207.63 |
$769 |
1.9× |
| Unlisted CT procedure (76497) |
$164.43 |
$609 |
1.8× |
| Unlisted diagnostic radiographic procedure (76499) |
$67.77 |
$251 |
0.7× |
| Unlisted fluoroscopic procedure (76496) |
$118.26 |
$438 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$433.89 |
$1,607 |
4.8× |
| Unlisted miscellaneous procedure, diagnostic nuclear medicine UNSCHEDULED (78999) |
$621.27 |
$2,301 |
1.5× |
| Ureteral reflux study (78740) |
$538.65 |
$1,995 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$485.46 |
$1,798 |
1.9× |
| Urethrocystography voiding (74455) |
$498.69 |
$1,847 |
2.0× |
| Urography antegrade (74425) |
$724.28 |
$2,682.50 |
2.0× |
| Urography retrograde w/wo kub (74420) |
$474.39 |
$1,757 |
1.3× |
| Us abdominal aorta real time screen study aaa (76706) |
$353.97 |
$1,311 |
3.2× |
| Us breast uni real time with image complete (76641) |
$218.16 |
$808 |
2.0× |
| Us chest (76604) |
$323.19 |
$1,197 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$365.58 |
$1,354 |
3.3× |
| Us elastography parenchyma (76981) |
$139.59 |
$517 |
1.3× |
| Us guided compression repair (76936) |
$701.46 |
$2,598 |
3.1× |
| Us kidney transplanted (76776) |
$558.09 |
$2,067 |
5.1× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$328.59 |
$1,217 |
3.0× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$312.93 |
$1,159 |
2.9× |
| Us ob limited 1 or more fetuses (76815) |
$324.54 |
$1,202 |
3.0× |
| Us obstetric transvaginal (76817) |
$469.80 |
$1,740 |
4.3× |
| Us pelvic limited or f/u non-ob (76857) |
$384.21 |
$1,423 |
3.5× |
| Us pelvis complete (76856) |
$542.43 |
$2,009 |
5.0× |
| Us retroperitoneal complete (76770) |
$527.98 |
$1,955.50 |
4.8× |
| Us retroperitoneal limited (76775) |
$368.82 |
$1,366 |
3.4× |
| Us scrotum (76870) |
$447.39 |
$1,657 |
4.1× |
| Us soft tissue head/neck (76536) |
$488.97 |
$1,811 |
4.5× |
| Us transrectal (76872) |
$542.43 |
$2,009 |
5.0× |
| Us trgt dyn mbubb 1st les (76978) |
$298.08 |
$1,104 |
0.8× |
| Us unlstd proc (76999) |
$100.98 |
$374 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,662.66 |
$6,158 |
1.0× |
| Venogram ivc w serialography (75825) |
$4,266.81 |
$15,803 |
1.3× |
| Venogram svc w serialography (75827) |
$1,598.40 |
$5,920 |
1.0× |
| Venography ext unilateral (75820) |
$1,082.16 |
$4,008 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,477.44 |
$5,472 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,035.61 |
$11,243 |
0.9× |
| Venous sampling by catheter (75893) |
$3,009.15 |
$11,145 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$150.12 |
$556 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$294.84 |
$1,092 |
3.2× |
| X-ray aorta leg arteries (75630) |
$3,127.14 |
$11,582 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$677.97 |
$2,511 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$279.45 |
$1,035 |
3.1× |
| X-ray exam of finger(s) (73140) |
$226.26 |
$838 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$119.88 |
$444 |
1.3× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$175.23 |
$649 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$183.33 |
$679 |
1.7× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$181.17 |
$671 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$159.57 |
$591 |
1.8× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$262.98 |
$974 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$307.53 |
$1,139 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$116.64 |
$432 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$372.33 |
$1,379 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$445.77 |
$1,651 |
4.1× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$243.54 |
$902 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$434.16 |
$1,608 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$180.09 |
$667 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$299.70 |
$1,110 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$399.60 |
$1,480 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$445.77 |
$1,651 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$271.89 |
$1,007 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$296.46 |
$1,098 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$209.25 |
$775 |
2.3× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$124.20 |
$460 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$279.45 |
$1,035 |
3.1× |
| Xr abdomen 1 view (74018) |
$260.28 |
$964 |
2.9× |
| Xr abdomen 2 views (74019) |
$352.62 |
$1,306 |
3.2× |
| Xr bone density appendicular (77081) |
$68.85 |
$255 |
0.8× |
| Xr bone density axial (77080) |
$373 |
$1,381.50 |
3.4× |
| Xr bone length study (77073) |
$266.49 |
$987 |
2.4× |
| Xr bone survey limited (77074) |
$434.16 |
$1,608 |
4.0× |
| Xr chest 1 view (71045) |
$190.35 |
$705 |
2.1× |
| Xr chest 2 views (71046) |
$230.85 |
$855 |
2.5× |
| Xr chest 3 views (71047) |
$199.53 |
$739 |
2.2× |
| Xr cystogram 3+ views (74430) |
$472.50 |
$1,750 |
1.3× |
| Xr facial bones 3 views (70150) |
$336.69 |
$1,247 |
3.1× |
| Xr mandible 4 views (70110) |
$227.34 |
$842 |
2.1× |
| Xr myelogram c-spine (72240) |
$1,164.51 |
$4,313 |
1.4× |
| Xr nasal bones (70160) |
$251.91 |
$933 |
2.8× |
| Xr pelvis 3 views (72190) |
$333.18 |
$1,234 |
3.1× |
| Xr spine 1 view (72020) |
$235.17 |
$871 |
2.6× |
| Xr sternum 2 views (71120) |
$279.45 |
$1,035 |
3.1× |
| Xr surgical specimen (76098) |
$789.88 |
$2,925.50 |
1.4× |
| Xray elbow 2 views (73070) |
$203.31 |
$753 |
2.2× |
| Xray forearm 2 views (73090) |
$253.80 |
$940 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$249.21 |
$923 |
2.7× |
| Xray neck soft tissue (70360) |
$254.61 |
$943 |
2.8× |
| Xray orbits complete min 4 views (70200) |
$378 |
$1,400 |
3.5× |
| Xray pelvis 1 or 2 views (72170) |
$260.82 |
$966 |
2.4× |
| Xray ribs bilateral 3 views (71110) |
$376.92 |
$1,396 |
3.5× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$241.11 |
$893 |
2.2× |
| Xray scapula complete (73010) |
$271.89 |
$1,007 |
2.5× |
| Xray shoulder 1 view (73020) |
$119.88 |
$444 |
1.3× |
| Xray spine thoracic 2 views (72070) |
$321.03 |
$1,189 |
2.9× |
| Xray tibia-fibula 2 views bil (73590) |
$279.45 |
$1,035 |
3.1× |
| Xray tmj open - closed unilat (70328) |
$107.46 |
$398 |
1.2× |
| Xray tmj's bilateral open-clsc (70330) |
$115.83 |
$429 |
1.3× |