| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,696.92 |
$17,396 |
3.2× |
| Abdomen 2 views (74019) |
$352.62 |
$1,306 |
3.2× |
| Acute gi blood loss imaging (78278) |
$669.06 |
$2,478 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$4,282.60 |
$15,861.50 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,009.15 |
$11,145 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,878.17 |
$21,771 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,513.32 |
$16,716 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,729.16 |
$10,108 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$3,001.86 |
$11,118 |
0.5× |
| 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× |
| Aortogram thoracic (75605) |
$3,127.14 |
$11,582 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,127.14 |
$11,582 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$4,266.81 |
$15,803 |
1.3× |
| Basic dosimetry (77300) |
$522.45 |
$1,935 |
3.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$522.72 |
$1,936 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$1,108.35 |
$4,105 |
2.7× |
| Bone age studies (77072) |
$178.20 |
$660 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,145.88 |
$4,244 |
2.7× |
| Bone Marrow Imaging Limited Area (78102) |
$655.56 |
$2,428 |
1.6× |
| Bone survey complete (77075) |
$443.20 |
$1,641.50 |
4.1× |
| Bowel imaging (78290) |
$514.89 |
$1,907 |
1.2× |
| Brachytx isodose complex (77318) |
$1,601.37 |
$5,931 |
4.1× |
| Brachytx isodose intermed (77317) |
$1,306.26 |
$4,838 |
3.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,246.05 |
$4,615 |
3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$580.50 |
$2,150 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,381.64 |
$19,932 |
3.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$844.56 |
$3,128 |
2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,021.76 |
$7,488 |
5.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$466.29 |
$1,727 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$321.03 |
$1,189 |
3.5× |
| Chest 1 view (71045) |
$190.35 |
$705 |
2.1× |
| Chest xray 3 views (71047) |
$199.53 |
$739 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$321.57 |
$1,191 |
1.8× |
| Clavicle complete (73000) |
$242.19 |
$897 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$32.94 |
$122 |
0.3× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$216.27 |
$801 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$522.45 |
$1,935 |
3.7× |
| Corpora cavernosography (74445) |
$267.30 |
$990 |
2.4× |
| 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 contrast (74160) |
$1,008.99 |
$3,737 |
5.5× |
| CT abdomen w wo contrast (74170) |
$1,217.84 |
$4,510.50 |
6.6× |
| CT abdomen w/o contrast (74150) |
$833.22 |
$3,086 |
7.6× |
| CT angio hrt w/3d image (75574) |
$514.08 |
$1,904 |
1.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,328.40 |
$4,920 |
7.3× |
| CT angiography upper extremity lt (73206) |
$1,391.85 |
$5,155 |
7.6× |
| CT c-spine w/contrast (72126) |
$1,008.99 |
$3,737 |
2.8× |
| CT c-spine w/o contrast (72125) |
$822.96 |
$3,048 |
7.5× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$1,502.01 |
$5,563 |
8.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,129.41 |
$4,183 |
6.2× |
| CT chest w contrast (71260) |
$1,008.99 |
$3,737 |
5.5× |
| CT chest w/wo contrast (71270) |
$1,318.14 |
$4,882 |
7.2× |
| CT colonography w/o cntrst (74261) |
$286.47 |
$1,061 |
2.6× |
| 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 iac w contrast (70481) |
$1,210.68 |
$4,484 |
6.6× |
| CT limited/localized follow up study (76380) |
$399.87 |
$1,481 |
4.4× |
| CT lower ext w/o (73700) |
$744.12 |
$2,756 |
6.8× |
| CT lower extremity w wo contrast (73702) |
$1,129.41 |
$4,183 |
6.2× |
| CT lower extremity w/contrast material (73701) |
$1,008.99 |
$3,737 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,129.41 |
$4,183 |
6.2× |
| 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 maxillofacial w contrast (70487) |
$1,008.99 |
$3,737 |
5.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,377 |
$5,100 |
7.5× |
| CT maxillofacial wo contrast (70486) |
$765.45 |
$2,835 |
7.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,670.22 |
$6,186 |
9.1× |
| CT orbits w/o contrast (70480) |
$853.74 |
$3,162 |
7.8× |
| CT pelvis w/o contrast (72192) |
$727.92 |
$2,696 |
6.7× |
| CT pelvis w/wo contrast (72194) |
$1,129.41 |
$4,183 |
6.2× |
| CT scan of arm combo (73202) |
$1,102.41 |
$4,083 |
6.0× |
| CT soft tissue neck w contrast (70491) |
$1,055.43 |
$3,909 |
5.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,129.41 |
$4,183 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$774.63 |
$2,869 |
7.1× |
| 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/wo contrast (72130) |
$1,129.41 |
$4,183 |
6.2× |
| CT thorax w/o contrast (71250) |
$839.70 |
$3,110 |
7.7× |
| CT unlisted procedure (76497) |
$164.43 |
$609 |
1.8× |
| CT upper ext wo (73200) |
$751.41 |
$2,783 |
6.9× |
| CT upper extremity with contrast (73201) |
$1,008.99 |
$3,737 |
2.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,527.39 |
$5,657 |
8.3× |
| Cta Abdomen (74175) |
$1,328.40 |
$4,920 |
7.3× |
| CTA abdomen pelvis (74174) |
$1,980.18 |
$7,334 |
5.4× |
| CTA chest (71275) |
$1,391.85 |
$5,155 |
7.6× |
| Cta Head (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 Neck (70498) |
$1,322.73 |
$4,899 |
7.2× |
| Cta Pelvis (72191) |
$1,461.24 |
$5,412 |
8.0× |
| Cystography minimum 3 views rs&i (74430) |
$472.50 |
$1,750 |
1.3× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,496.61 |
$5,543 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$373 |
$1,381.50 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$68.85 |
$255 |
0.8× |
| Esophagus (74220) |
$348.84 |
$1,292 |
1.9× |
| Facial bones min 3 views (70150) |
$336.69 |
$1,247 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$667.98 |
$2,474 |
2.7× |
| Foot 2 views (73620) |
$175.23 |
$649 |
1.9× |
| Forearm 2 views (73090) |
$253.80 |
$940 |
2.8× |
| 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× |
| Hand 2 views (73120) |
$183.33 |
$679 |
1.7× |
| 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 Hemodyn Eval Rs&I (75889) |
$3,009.15 |
$11,145 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,378.51 |
$12,513 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$704.70 |
$2,610 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$861.57 |
$3,191 |
2.1× |
| Hysterosalpingogram (74740) |
$655.83 |
$2,429 |
2.6× |
| Interstitial radiation source applic complex (77778) |
$4,419.63 |
$16,369 |
6.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,632.96 |
$6,048 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$969.03 |
$3,589 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,036.53 |
$3,839 |
1.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,676.97 |
$6,211 |
3.0× |
| Knee 3 views (73562) |
$262.98 |
$974 |
2.9× |
| Liver & spleen imaging static only (78215) |
$875.07 |
$3,241 |
2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$712.53 |
$2,639 |
1.7× |
| Lung perfusion differential (78597) |
$393.66 |
$1,458 |
0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,727.46 |
$6,398 |
0.5× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$994.41 |
$3,683 |
0.3× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$994.41 |
$3,683 |
0.6× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$949.32 |
$3,516 |
1.4× |
| Lymphoscintigraphy (78195) |
$789.88 |
$2,925.50 |
1.4× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,864.62 |
$6,906 |
2.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,787.67 |
$6,621 |
4.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,264.49 |
$8,387 |
6.2× |
| Magnetic Resonance Elastography (76391) |
$453.60 |
$1,680 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,191.64 |
$22,932 |
15.8× |
| Mr safety determination physician/other qhp (76016) |
$142.83 |
$529 |
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 implt pos&/immoblj (76019) |
$96.39 |
$357 |
1.6× |
| 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 &W/Contrast Material (70549) |
$1,740.56 |
$6,446.50 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,342.71 |
$4,973 |
5.4× |
| 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 jt lower extrem w/contrast material (73722) |
$1,903.77 |
$7,051 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,264.49 |
$8,387 |
6.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,966.68 |
$7,284 |
7.9× |
| MRI breast wo contrast unilateral (77046) |
$432 |
$1,600 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,665.76 |
$6,169.50 |
4.6× |
| 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 chest w/o & w/contrast material (71552) |
$2,164.86 |
$8,018 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,342.71 |
$4,973 |
5.4× |
| MRI chest with contrast (71551) |
$1,513.08 |
$5,604 |
1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,779.30 |
$6,590 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,098.44 |
$7,772 |
5.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,577.61 |
$5,843 |
6.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,581.12 |
$5,856 |
6.3× |
| MRI orbit face neck w contrast (70542) |
$1,696.54 |
$6,283.50 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,196.45 |
$8,135 |
6.0× |
| MRI pelvis w/contrast (72196) |
$1,806.84 |
$6,692 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,111.13 |
$7,819 |
5.8× |
| MRI pelvis w/o contrast (72195) |
$1,342.71 |
$4,973 |
5.4× |
| MRI spectroscopy (76390) |
$581.31 |
$2,153 |
6.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,264.49 |
$8,387 |
6.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,002.05 |
$7,415 |
5.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,159.06 |
$7,996.50 |
5.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,002.05 |
$7,415 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,264.49 |
$8,387 |
6.2× |
| MRI temporomandibular joint (70336) |
$1,342.71 |
$4,973 |
5.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,342.71 |
$4,973 |
5.4× |
| MRI up ext w/o contrast (73218) |
$1,342.71 |
$4,973 |
5.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,538.19 |
$5,697 |
6.2× |
| MRI, joint upper extrem combo (73223) |
$2,193.88 |
$8,125.50 |
6.0× |
| Myelogram Cervical (72240) |
$1,164.51 |
$4,313 |
1.4× |
| Myelogram Lumbar (72265) |
$1,283.31 |
$4,753 |
1.6× |
| Myelogram thoracic (72255) |
$1,259.28 |
$4,664 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,287.90 |
$4,770 |
1.6× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$1,972.35 |
$7,305 |
1.3× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$3,646.62 |
$13,506 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,116.80 |
$7,840 |
1.6× |
| Myocardial spect single study at rest or stress (78451) |
$1,427.76 |
$5,288 |
1.1× |
| N-invas est c ffr sw aly CTA (75580) |
$1,645.11 |
$6,093 |
1.8× |
| Neck soft tissue (70360) |
$254.61 |
$943 |
2.8× |
| Nm adrenal scan (78075) |
$1,214.73 |
$4,499 |
0.9× |
| Nm bone marrow wb (78104) |
$618.03 |
$2,289 |
1.5× |
| Nm cisternogram (78630) |
$481.95 |
$1,785 |
0.8× |
| Nm gastric emptying study (78264) |
$983.88 |
$3,644 |
2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,592.43 |
$17,009 |
3.2× |
| Nuclear Rx Oral Admin (79005) |
$612.76 |
$2,269.50 |
2.5× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$122.04 |
$452 |
1.1× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (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 and quantitative A-scan performed during the same patient encounter… (76510) |
$403.92 |
$1,496 |
2.9× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$120.69 |
$447 |
4.0× |
| Osseous survey limited (77074) |
$434.16 |
$1,608 |
4.0× |
| Parathyrd planar w/spect&CT (78072) |
$1,342.98 |
$4,974 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$529.47 |
$1,961 |
1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,278.99 |
$4,737 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$260.82 |
$966 |
2.4× |
| PET image w/CT, skull-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 trmt simple w/comp (77522) |
$2,721.33 |
$10,079 |
2.1× |
| Proton tx delivery complex (77525) |
$3,150.63 |
$11,669 |
2.4× |
| Proton tx delivery simple w/o compensation (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× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$572.67 |
$2,121 |
1.0× |
| 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 Ankle Compl Minimum 3 Views (73610) |
$294.84 |
$1,092 |
3.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$181.17 |
$671 |
2.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$279.45 |
$1,035 |
3.1× |
| 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 fingr minimum 2 views (73140) |
$226.26 |
$838 |
2.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$279.45 |
$1,035 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$279.45 |
$1,035 |
3.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$133.38 |
$494 |
1.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$199.53 |
$739 |
1.8× |
| Radex Humerus Minimum 2 Views (73060) |
$253.80 |
$940 |
2.8× |
| Radex Kne 1/2 Views (73560) |
$249.21 |
$923 |
2.7× |
| Radex Kne Compl 4/More Views (73564) |
$307.53 |
$1,139 |
2.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$227.34 |
$842 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$251.91 |
$933 |
2.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$333.18 |
$1,234 |
3.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$299.70 |
$1,110 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$115.83 |
$429 |
1.3× |
| Radex Toe Minimum 2 Views (73660) |
$209.25 |
$775 |
2.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$279.45 |
$1,035 |
3.1× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$22,612.77 |
$83,751 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$22,612.77 |
$83,751 |
2.9× |
| Radiation treatment delivery level 1 (77402) |
$454.95 |
$1,685 |
4.3× |
| Radiation treatment delivery level 2 (77407) |
$1,719.36 |
$6,368 |
4.3× |
| Radiation treatment delivery level 3 (77412) |
$1,719.36 |
$6,368 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$260.28 |
$964 |
2.9× |
| Radiologic exam chest 2 views (71046) |
$230.85 |
$855 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$632.88 |
$2,344 |
3.5× |
| 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 tibia & fibula 2 views (73590) |
$279.45 |
$1,035 |
3.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$243.54 |
$902 |
2.2× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$243.54 |
$902 |
2.2× |
| Radiological examination surgical specimen (76098) |
$789.88 |
$2,925.50 |
1.4× |
| Ribs bilateral 3 views (71110) |
$376.92 |
$1,396 |
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 1d img/1 ar img>2+d (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× |
| Rp Therapy Intravenous Administration (79101) |
$1,103.76 |
$4,088 |
4.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$356.40 |
$1,320 |
1.4× |
| Scapula (73010) |
$271.89 |
$1,007 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$61.29 |
$227 |
2.6× |
| Shoulder 1 view (73020) |
$119.88 |
$444 |
1.3× |
| Simulation intermediate (77285) |
$898.02 |
$3,326 |
2.3× |
| 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× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$295.38 |
$1,094 |
2.8× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$420.66 |
$1,558 |
3.9× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$210.33 |
$779 |
5.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,771.47 |
$6,561 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,310.85 |
$4,855 |
3.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,461.51 |
$5,413 |
3.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$565.38 |
$2,094 |
4.0× |
| Thoracolumbar 2 views (72080) |
$205.74 |
$762 |
2.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,134.54 |
$4,202 |
2.0× |
| Thyroid imaging w/blood flow (78013) |
$795.15 |
$2,945 |
1.9× |
| Thyroid uptake 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× |
| Tmj unilateral (70328) |
$107.46 |
$398 |
1.2× |
| Treatment device complex (77334) |
$1,454.22 |
$5,386 |
3.7× |
| Treatment device intermediate (77333) |
$617.76 |
$2,288 |
4.4× |
| Treatment devices simple (77332) |
$619.92 |
$2,296 |
4.4× |
| Ultrasound breast complete (76641) |
$218.16 |
$808 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$207.63 |
$769 |
1.9× |
| Ultrasound Exam Aaa Screen (76706) |
$353.97 |
$1,311 |
3.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$298.08 |
$1,104 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$509.76 |
$1,888 |
4.7× |
| 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 px dx nuclear medicine (78999) |
$621.27 |
$2,301 |
1.5× |
| Unlisted ultrasound procedure (76999) |
$100.98 |
$374 |
1.1× |
| Ureteral reflux study (78740) |
$538.65 |
$1,995 |
1.3× |
| Urethrocystogram voiding (74455) |
$498.69 |
$1,847 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$485.46 |
$1,798 |
1.9× |
| Us breast unilateral limited (76642) |
$218.16 |
$808 |
2.4× |
| Us chest (76604) |
$323.19 |
$1,197 |
3.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$701.46 |
$2,598 |
3.1× |
| 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 lmtd joint/oth 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 (76815) |
$324.54 |
$1,202 |
3.0× |
| Us ob transvaginal (76817) |
$469.80 |
$1,740 |
4.3× |
| Us pelvic non ob complete (76856) |
$542.43 |
$2,009 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$384.21 |
$1,423 |
3.5× |
| Us retroperitoneal complete (76770) |
$527.98 |
$1,955.50 |
4.8× |
| Us retroperitoneal limited (76775) |
$368.82 |
$1,366 |
3.4× |
| Us scrotum and contents (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, eye b-scan (76512) |
$266.90 |
$988.50 |
2.4× |
| Us,transplanted kidney, real time/ doppler (76776) |
$558.09 |
$2,067 |
5.1× |
| Venogram extremity bilateral (75822) |
$1,662.66 |
$6,158 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,082.16 |
$4,008 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$4,266.81 |
$15,803 |
1.3× |
| Venography caval superior serialography rs&i (75827) |
$1,598.40 |
$5,920 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,009.61 |
$7,443 |
0.6× |
| 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× |
| Wrist 2 views (73100) |
$124.20 |
$460 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$445.77 |
$1,651 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$150.12 |
$556 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$677.97 |
$2,511 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.31 |
$753 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$286.47 |
$1,061 |
3.2× |
| X-ray exam of femur 2/> (73552) |
$280.53 |
$1,039 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$119.88 |
$444 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$159.57 |
$591 |
1.8× |
| 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 Orbits - Xr Orbits Complete 4+ Views (70200) |
$378 |
$1,400 |
3.5× |
| X-ray retrograde pyelogram (74420) |
$474.39 |
$1,757 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$241.11 |
$893 |
2.2× |
| 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 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 Spine One View - Xr Spine (72020) |
$235.17 |
$871 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$296.46 |
$1,098 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$279.45 |
$1,035 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$321.03 |
$1,189 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$382.32 |
$1,416 |
3.5× |
| Xr bone length studies (77073) |
$266.49 |
$987 |
2.4× |
| Xr c-spine 4 or 5 views (72050) |
$378.27 |
$1,401 |
3.5× |
| Xr c-spine 6 or more views (72052) |
$445.77 |
$1,651 |
4.1× |
| Xr chest 4+ views (71048) |
$239.49 |
$887 |
2.2× |
| Xr urogram antegrade (74425) |
$724.28 |
$2,682.50 |
2.0× |