| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,317.20 |
$8,862 |
3.8× |
| Abdomen 2 views (74019) |
$336.60 |
$561 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,083.60 |
$1,806 |
2.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,011 |
$6,685 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$2,923.20 |
$4,872 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$2,634.60 |
$4,391 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,896.20 |
$9,827 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,548.40 |
$5,914 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,376.80 |
$5,628 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$5,724.60 |
$9,541 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,042.40 |
$8,404 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,162.60 |
$5,271 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,919 |
$4,865 |
0.9× |
| Ankle 2 views (73600) |
$250.20 |
$417 |
2.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,214.40 |
$2,024 |
3.5× |
| Aortogram thoracic (75605) |
$5,724.60 |
$9,541 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,006.20 |
$6,677 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,156.60 |
$5,261 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,743.20 |
$4,572 |
0.9× |
| Arthrogram elbow (73085) |
$1,214.40 |
$2,024 |
3.5× |
| Arthrogram hip (73525) |
$1,214.40 |
$2,024 |
3.5× |
| Arthrogram shoulder (73040) |
$799.20 |
$1,332 |
2.3× |
| Arthrogram wrist (73115) |
$1,214.40 |
$2,024 |
3.5× |
| Arthrography knee lt (73580) |
$1,477.80 |
$2,463 |
4.2× |
| Basic radiation dosimetry calculation (77300) |
$568.80 |
$948 |
4.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$898.20 |
$1,497 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$982.80 |
$1,638 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,452 |
$2,420 |
3.6× |
| Bone age studies (77072) |
$220.20 |
$367 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,461 |
$2,435 |
3.6× |
| Bone Marrow Imaging Limited Area (78102) |
$661.80 |
$1,103 |
1.7× |
| Bone survey complete (77075) |
$673.20 |
$1,122 |
6.4× |
| Brachytx isodose complex (77318) |
$1,879.20 |
$3,132 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,665.60 |
$2,776 |
4.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,476.60 |
$2,461 |
3.9× |
| Brain image w/flow 4 + views (78606) |
$1,390.80 |
$2,318 |
2.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,087.80 |
$1,813 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,964.80 |
$6,608 |
2.8× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$220.80 |
$368 |
20.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,917 |
$3,195 |
5.5× |
| Cardiac shunt detection (78428) |
$1,363.20 |
$2,272 |
3.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,287.60 |
$2,146 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$294.60 |
$491 |
3.4× |
| Chest 1 view (71045) |
$226.80 |
$378 |
2.6× |
| Chest 3 views (71047) |
$291 |
$485 |
3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$471.60 |
$786 |
2.7× |
| Clavicle complete (73000) |
$261 |
$435 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$335.40 |
$559 |
3.2× |
| Continuing medical physics consltj pr wk (77336) |
$642 |
$1,070 |
4.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,416.80 |
$4,028 |
6.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,357.20 |
$2,262 |
5.7× |
| CT abdomen w contrast (74160) |
$1,446 |
$2,410 |
8.2× |
| CT abdomen w wo contrast (74170) |
$1,650 |
$2,750 |
9.4× |
| CT abdomen w/o contrast (74150) |
$1,018.80 |
$1,698 |
9.7× |
| CT angio hrt w/3d image (75574) |
$1,233.60 |
$2,056 |
3.5× |
| CT angiography upper extremity lt (73206) |
$1,603.20 |
$2,672 |
9.1× |
| CT c-spine w/o contrast (72125) |
$874.20 |
$1,457 |
8.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,860 |
$3,100 |
10.6× |
| CT cervical spine with contrast (72126) |
$1,825.80 |
$3,043 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,358.40 |
$2,264 |
7.7× |
| CT chest with contrast (71260) |
$1,192.20 |
$1,987 |
6.8× |
| CT colonography w/o cntrst (74261) |
$769.80 |
$1,283 |
7.4× |
| CT head/brain with contrast (70460) |
$1,106.40 |
$1,844 |
6.3× |
| CT head/brain without and with contrast (70470) |
$1,205.40 |
$2,009 |
6.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,074 |
$1,790 |
3.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$229.20 |
$382 |
2.6× |
| CT hrt w/3d image congen (75573) |
$1,333.20 |
$2,222 |
3.8× |
| CT iac w contrast (70481) |
$1,686.60 |
$2,811 |
9.6× |
| CT limited/localized follow up study (76380) |
$648 |
$1,080 |
7.4× |
| CT lower ext w/o (73700) |
$855 |
$1,425 |
8.2× |
| CT lower extremity w wo contrast (73702) |
$1,383.60 |
$2,306 |
7.9× |
| CT lower extremity with contrast (73701) |
$1,360.80 |
$2,268 |
7.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,685.40 |
$2,809 |
9.6× |
| CT lumbar spine w/o contrast (72131) |
$1,096.80 |
$1,828 |
10.5× |
| CT lumbar spine with contrast (72132) |
$1,621.80 |
$2,703 |
4.6× |
| CT maxillofacial w contrast (70487) |
$1,507.20 |
$2,512 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$674.40 |
$1,124 |
6.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,923 |
$3,205 |
10.9× |
| CT neck soft tissue w contrast (70491) |
$1,226.40 |
$2,044 |
7.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,744.20 |
$2,907 |
9.9× |
| CT orbits w/o contrast (70480) |
$701.40 |
$1,169 |
6.7× |
| CT pelvis w & w/o contrast (72194) |
$1,470.60 |
$2,451 |
8.4× |
| CT pelvis w/o contrast (72192) |
$1,018.80 |
$1,698 |
9.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$470.40 |
$784 |
5.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,609.20 |
$2,682 |
9.2× |
| CT soft tissue neck w/o contrast (70490) |
$969 |
$1,615 |
9.3× |
| CT thoracic spine w/contrast (72129) |
$1,536 |
$2,560 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$765.60 |
$1,276 |
7.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,651.20 |
$2,752 |
9.4× |
| CT thorax w/o contrast (71250) |
$782.40 |
$1,304 |
7.5× |
| CT unlisted procedure (76497) |
$4,567.80 |
$7,613 |
52.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,424.40 |
$2,374 |
8.1× |
| CT upper extremity w/o contrast rt (73200) |
$949.80 |
$1,583 |
9.1× |
| CT upper extremity with contrast (73201) |
$1,343.40 |
$2,239 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,480.80 |
$2,468 |
8.4× |
| Cta Abdomen (74175) |
$1,855.80 |
$3,093 |
10.6× |
| CTA abdomen pelvis (74174) |
$2,301 |
$3,835 |
6.6× |
| CTA chest (71275) |
$1,468.80 |
$2,448 |
8.4× |
| Cta Head (70496) |
$1,764 |
$2,940 |
10.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,789.20 |
$2,982 |
10.2× |
| Cta Neck (70498) |
$1,521 |
$2,535 |
8.7× |
| Cta Pelvis (72191) |
$1,753.80 |
$2,923 |
10.0× |
| Cystography minimum 3 views rs&i (74430) |
$686.40 |
$1,144 |
2.0× |
| Diskography lumbar (72295) |
$4,221.60 |
$7,036 |
2.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$367.80 |
$613 |
3.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$426 |
$710 |
4.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$271.20 |
$452 |
2.6× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$372.30 |
$620.50 |
3.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$296.40 |
$494 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$196.20 |
$327 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$253.20 |
$422 |
2.4× |
| Echo exam of fetal heart (76825) |
$1,014.60 |
$1,691 |
1.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,014.60 |
$1,691 |
4.2× |
| Echoencephalography real time imaging (76506) |
$438.60 |
$731 |
4.2× |
| Esophageal motility (78258) |
$999.60 |
$1,666 |
2.5× |
| Esophagus (74220) |
$435.60 |
$726 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$534 |
$890 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$385.80 |
$643 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$549 |
$915 |
2.3× |
| Foot 2 views (73620) |
$231 |
$385 |
2.6× |
| Forearm 2 views (73090) |
$273.60 |
$456 |
3.1× |
| Functional MRI brain by phys/psych (70555) |
$1,195.80 |
$1,993 |
5.0× |
| Functional MRI brain by tech (70554) |
$1,701 |
$2,835 |
7.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,767.60 |
$2,946 |
3.3× |
| Gastric mucosa imaging (78261) |
$1,363.20 |
$2,272 |
3.4× |
| Gated Heart Planar Single (78472) |
$1,150.80 |
$1,918 |
2.9× |
| Hand 2 views (73120) |
$323.40 |
$539 |
3.1× |
| Hand 3 views (73130) |
$285.60 |
$476 |
3.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,043.80 |
$5,073 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,634.20 |
$6,057 |
5.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,141.80 |
$1,903 |
3.0× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$849.60 |
$1,416 |
2.2× |
| Heart Infarct Image (78466) |
$739.80 |
$1,233 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,517.40 |
$2,529 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,258.20 |
$2,097 |
3.1× |
| Ht muscle image spect sing (78451) |
$3,519.60 |
$5,866 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$273.60 |
$456 |
3.1× |
| Hysterosalpingogram (74740) |
$673.20 |
$1,122 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$3,569.40 |
$5,949 |
5.1× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$11,893.20 |
$19,822 |
1.6× |
| Kidney imaging morphology (78700) |
$999.60 |
$1,666 |
2.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,365 |
$2,275 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,407.60 |
$2,346 |
2.6× |
| Knee 3 views (73562) |
$270 |
$450 |
3.1× |
| Liver & spleen imaging static only (78215) |
$1,031.40 |
$1,719 |
2.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,158 |
$1,930 |
2.9× |
| Liver imaging w/vascular flow (78202) |
$3,417 |
$5,695 |
6.3× |
| Lung perf&ventilat diferentl (78598) |
$1,352.40 |
$2,254 |
2.5× |
| Lung perfusion differential (78597) |
$1,110.60 |
$1,851 |
2.8× |
| Lung Ventilation Imaging (78579) |
$999.60 |
$1,666 |
2.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,587.20 |
$4,312 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,468.20 |
$2,447 |
2.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,511.60 |
$4,186 |
0.8× |
| Lymphoscintigraphy (78195) |
$1,365 |
$2,275 |
2.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$289.20 |
$482 |
3.3× |
| Meckels Diverticulum (78290) |
$999.60 |
$1,666 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,049 |
$3,415 |
5.5× |
| Mr elastography (76391) |
$1,320 |
$2,200 |
5.5× |
| Mr safety determination physician/other qhp (76016) |
$393.60 |
$656 |
4.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$265.80 |
$443 |
4.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$109.80 |
$183 |
3.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$410.40 |
$684 |
4.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,080.60 |
$1,801 |
4.5× |
| MRA head w & w/o contrast (70546) |
$2,318.40 |
$3,864 |
6.6× |
| MRA head w/o contrast (70544) |
$1,459.20 |
$2,432 |
6.1× |
| MRA head with contrast (70545) |
$2,005.80 |
$3,343 |
5.7× |
| MRA neck w contrast (70548) |
$2,182.80 |
$3,638 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,266.80 |
$3,778 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,464 |
$2,440 |
6.1× |
| MRI abdomen w contrast (74182) |
$1,953 |
$3,255 |
5.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,971.80 |
$4,953 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$1,659 |
$2,765 |
6.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,053.80 |
$3,423 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,256 |
$3,760 |
2.9× |
| MRI bone marrow blood supply (77084) |
$886.80 |
$1,478 |
3.7× |
| MRI breast w/o contrast bilateral (77047) |
$1,835.40 |
$3,059 |
7.7× |
| MRI breast w/o contrast unilat (77046) |
$1,390.80 |
$2,318 |
5.8× |
| MRI c-spine with contrast (72142) |
$2,310 |
$3,850 |
6.6× |
| MRI cardiac w/o cont stress (75559) |
$2,080.80 |
$3,468 |
3.8× |
| MRI cardiac w/o contrast (75557) |
$1,155 |
$1,925 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,437.60 |
$2,396 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,745 |
$4,575 |
7.9× |
| MRI chest w/o contrast (71550) |
$1,443 |
$2,405 |
6.0× |
| MRI chest with contrast (71551) |
$2,009.40 |
$3,349 |
2.6× |
| MRI fetal sngl/1st gestation (74712) |
$1,663.80 |
$2,773 |
7.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,779.60 |
$2,966 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,603.80 |
$2,673 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,518.60 |
$2,531 |
6.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,449.80 |
$4,083 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,875.60 |
$3,126 |
5.4× |
| MRI pelvis w contrast (72196) |
$2,086.80 |
$3,478 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,773.20 |
$4,622 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$1,553.40 |
$2,589 |
6.5× |
| MRI scan of arm joint before and after contrast (73223) |
$2,571 |
$4,285 |
7.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,539.20 |
$4,232 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,240.40 |
$3,734 |
6.4× |
| MRI spectroscopy (76390) |
$1,962.60 |
$3,271 |
22.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,368.80 |
$3,948 |
6.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,044.80 |
$3,408 |
5.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,716.80 |
$4,528 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,347.80 |
$3,913 |
6.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,680.20 |
$4,467 |
7.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,464 |
$2,440 |
6.1× |
| MRI tmj (70336) |
$1,611 |
$2,685 |
6.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,464 |
$2,440 |
6.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,507.40 |
$4,179 |
7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,735.80 |
$2,893 |
7.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,710.40 |
$6,184 |
2.9× |
| Myocardial infarct spect (78469) |
$1,143 |
$1,905 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,840 |
$6,400 |
3.0× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,329.60 |
$7,216 |
3.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,329.60 |
$7,216 |
3.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$6,751.80 |
$11,253 |
3.1× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$8,251.80 |
$13,753 |
3.7× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$8,251.80 |
$13,753 |
5.4× |
| Neck soft tissue (70360) |
$235.80 |
$393 |
2.7× |
| Nm bone marrow wb (78104) |
$1,037.40 |
$1,729 |
2.6× |
| Nm cisternogram (78630) |
$1,511.40 |
$2,519 |
2.8× |
| Nm csf leak detection (78650) |
$3,417 |
$5,695 |
2.6× |
| Nm gastric emptying study (78264) |
$1,367.40 |
$2,279 |
3.4× |
| Nm gastroesophageal reflux study (78262) |
$1,363.20 |
$2,272 |
3.4× |
| Nm peritoneal-venous shunt patency (78291) |
$999.60 |
$1,666 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,838.20 |
$11,397 |
4.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$3,792.60 |
$6,321 |
2.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$3,731.40 |
$6,219 |
2.9× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,820 |
$4,700 |
2.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$3,622.20 |
$6,037 |
2.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,123.20 |
$1,872 |
2.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,445.40 |
$2,409 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$1,054.80 |
$1,758 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$348.60 |
$581 |
3.3× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$225 |
$375 |
2.1× |
| Orthopantogram (70355) |
$234.60 |
$391 |
2.7× |
| Osseous survey infant (77076) |
$368.40 |
$614 |
3.5× |
| Osseous survey limited (77074) |
$421.20 |
$702 |
4.0× |
| Parathyrd planar w/spect&CT (78072) |
$1,362.60 |
$2,271 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,155 |
$1,925 |
2.9× |
| Parathyroid imaging (78070) |
$1,029 |
$1,715 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$333.60 |
$556 |
3.2× |
| Peritoneogram rs&i (74190) |
$1,251 |
$2,085 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$4,592.40 |
$7,654 |
3.2× |
| PET imaging CT for attenuation limited area (78814) |
$3,964.80 |
$6,608 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,879.80 |
$8,133 |
3.4× |
| Pr gi endoscopic ultrasound (76975) |
$766.80 |
$1,278 |
3.2× |
| Pr heart first pass single,planar (78481) |
$2,185.20 |
$3,642 |
4.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,201.40 |
$3,669 |
6.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,006.60 |
$5,011 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,919 |
$4,865 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,059.60 |
$1,766 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,332.60 |
$2,221 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,011 |
$1,685 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$241.80 |
$403 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$407.40 |
$679 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$328.20 |
$547 |
3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$712.20 |
$1,187 |
6.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,127.20 |
$25,212 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$982.20 |
$1,637 |
1.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$453 |
$755 |
4.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$556.20 |
$927 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$323.40 |
$539 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$259.20 |
$432 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$349.20 |
$582 |
3.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$284.40 |
$474 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$537 |
$895 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$546.60 |
$911 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$581.40 |
$969 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$563.40 |
$939 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$297 |
$495 |
3.4× |
| Radiological examination surgical specimen (76098) |
$478.80 |
$798 |
0.9× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,611.40 |
$6,019 |
1.1× |
| Ribs bilateral 3 views (71110) |
$364.80 |
$608 |
3.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,060.80 |
$1,768 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,417 |
$5,695 |
6.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,824 |
$3,040 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,816.60 |
$6,361 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,329 |
$7,215 |
3.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,359.20 |
$3,932 |
1.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$753.60 |
$1,256 |
3.2× |
| Rp Therapy Intravenous Administration (79101) |
$807.60 |
$1,346 |
3.5× |
| Sacroiliac Joints < 3 Views (72200) |
$304.80 |
$508 |
2.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$628.80 |
$1,048 |
2.6× |
| Salivary gland imaging serial images (78231) |
$1,363.20 |
$2,272 |
3.4× |
| Scanogram (77073) |
$311.40 |
$519 |
3.0× |
| Scapula complete (73010) |
$291.60 |
$486 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$51 |
$85 |
2.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$228 |
$380 |
2.2× |
| Simulation intermediate (77285) |
$1,246.80 |
$2,078 |
3.3× |
| Small bowel series (74250) |
$548.40 |
$914 |
3.1× |
| Spec medical radj physics consltj (77370) |
$852.60 |
$1,421 |
6.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$868.80 |
$1,448 |
2.3× |
| Special dosimetry (77331) |
$423.60 |
$706 |
3.1× |
| Special treatment procedure (77470) |
$2,171.40 |
$3,619 |
3.9× |
| Spine thoracic 3 views (72072) |
$355.80 |
$593 |
3.4× |
| Spleen imaging only (78185) |
$1,363.20 |
$2,272 |
3.4× |
| Splenoportograpy rs&i (75810) |
$7,236 |
$12,060 |
2.3× |
| Stereotactic body radiation delivery (77373) |
$11,059.80 |
$18,433 |
6.2× |
| Superior sagittal sinus venogram (75870) |
$2,491.20 |
$4,152 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,260.80 |
$3,768 |
6.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$857.40 |
$1,429 |
2.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,153.40 |
$3,589 |
5.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$670.20 |
$1,117 |
5.0× |
| Therapeutic Enema (74283) |
$758.40 |
$1,264 |
4.3× |
| Thoracolumbar 2 views (72080) |
$265.20 |
$442 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,699.80 |
$2,833 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$999.60 |
$1,666 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,162.80 |
$1,938 |
2.9× |
| Treatment device intermediate (77333) |
$658.20 |
$1,097 |
4.9× |
| Treatment devices simple (77332) |
$529.80 |
$883 |
3.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,519.60 |
$5,866 |
6.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,000.80 |
$1,668 |
2.5× |
| Tx devices design & construction complex (77334) |
$1,221.60 |
$2,036 |
3.3× |
| Ultrasound scan of cornea to determine thickness (76514) |
$87.60 |
$146 |
3.0× |
| Ultrasound scan to determine eye length and lens power (76519) |
$267.60 |
$446 |
2.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$666 |
$1,110 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$559.20 |
$932 |
5.3× |
| Umbilical-artery Doppler (OB) (76820) |
$264.60 |
$441 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$2,543.40 |
$4,239 |
29.2× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$999.60 |
$1,666 |
2.5× |
| Unlisted Ultrasound Procedure (76999) |
$480.60 |
$801 |
5.5× |
| Upper Extremity Infant (73092) |
$324 |
$540 |
3.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,080 |
$1,800 |
2.7× |
| Urethrocystography retrograde rs&i (74450) |
$610.20 |
$1,017 |
2.6× |
| Urethrocystography voiding (74455) |
$679.20 |
$1,132 |
2.8× |
| Us abdl aorta screen aaa (76706) |
$284.40 |
$474 |
2.7× |
| Us breast unilateral complete (76641) |
$527.40 |
$879 |
5.0× |
| Us breast unilateral limited (76642) |
$345 |
$575 |
4.0× |
| Us chest (76604) |
$436.80 |
$728 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$477.60 |
$796 |
4.6× |
| Us elastography parenchyma (76981) |
$371.40 |
$619 |
3.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$388.20 |
$647 |
3.7× |
| Us guided compression repair (76936) |
$734.40 |
$1,224 |
3.4× |
| Us infant hips dynamic (76885) |
$378.60 |
$631 |
4.3× |
| Us infant hips limited static (76886) |
$300.60 |
$501 |
3.4× |
| Us kidney transplant (76776) |
$638.40 |
$1,064 |
6.1× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$369 |
$615 |
3.5× |
| Us ob detailed single fetus (76811) |
$672.60 |
$1,121 |
2.8× |
| Us ob transvaginal (76817) |
$407.40 |
$679 |
3.9× |
| Us pelvic non ob complete (76856) |
$706.20 |
$1,177 |
6.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$415.20 |
$692 |
4.0× |
| Us pregnancy ltd (76815) |
$388.20 |
$647 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$538.20 |
$897 |
5.1× |
| Us retroperitoneal complete (76770) |
$621 |
$1,035 |
5.9× |
| Us retroperitoneal limited (76775) |
$495 |
$825 |
4.7× |
| Us scrotum and contents (76870) |
$648 |
$1,080 |
6.2× |
| Us soft tissue head/neck (76536) |
$598.80 |
$998 |
5.7× |
| Us spinal canal and contents (76800) |
$477.60 |
$796 |
4.6× |
| Us transrectal (76872) |
$502.50 |
$837.50 |
4.8× |
| Us transrectal prostate volume (76873) |
$655.20 |
$1,092 |
6.3× |
| Us xtr non-vasc lmtd (76882) |
$452.40 |
$754 |
4.3× |
| Us, eye b-scan (76512) |
$338.40 |
$564 |
3.2× |
| Venogram extremity bilateral (75822) |
$1,650.60 |
$2,751 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,426 |
$5,710 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,839.60 |
$3,066 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,567.20 |
$2,612 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,829 |
$4,715 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,730 |
$4,550 |
0.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,491.20 |
$4,152 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,724 |
$9,540 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$162 |
$270 |
1.9× |
| Wrist 2 views (73100) |
$231 |
$385 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$407.40 |
$679 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$288 |
$480 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$314.40 |
$524 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$799.80 |
$1,333 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$243 |
$405 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$303.60 |
$506 |
3.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$659.40 |
$1,099 |
6.3× |
| X-ray exam hip uni 1 view (73501) |
$216 |
$360 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$287.40 |
$479 |
3.3× |
| X-ray exam hip uni 4/> views (73503) |
$413.40 |
$689 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$438 |
$730 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$610.20 |
$1,017 |
5.8× |
| X-ray exam of femur 1 (73551) |
$212.40 |
$354 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$335.40 |
$559 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$250.80 |
$418 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$280.20 |
$467 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$4,574.40 |
$7,624 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$205.80 |
$343 |
2.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$834.60 |
$1,391 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$243 |
$405 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$335.40 |
$559 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$220.80 |
$368 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$525.60 |
$876 |
6.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$354.60 |
$591 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$489 |
$815 |
4.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$354.60 |
$591 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$243 |
$405 |
2.8× |
| X-ray of voice box or throat (70370) |
$292.20 |
$487 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$326.40 |
$544 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$364.80 |
$608 |
3.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,214.40 |
$2,024 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$246 |
$410 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$372.60 |
$621 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$432 |
$720 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$324 |
$540 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$279 |
$465 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$297.60 |
$496 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$387 |
$645 |
4.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$204 |
$340 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$349.80 |
$583 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$314.40 |
$524 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$240.60 |
$401 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$254.40 |
$424 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$247.80 |
$413 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$324 |
$540 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$368.40 |
$614 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$219.60 |
$366 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$298.80 |
$498 |
3.4× |
| Xr arthrogram ankle (73615) |
$1,326.60 |
$2,211 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$555 |
$925 |
5.3× |
| Xr chest 4+ views (71048) |
$378.60 |
$631 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$213.60 |
$356 |
2.5× |
| Xr shoulder 1 view (73020) |
$194.40 |
$324 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$463.80 |
$773 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$275.40 |
$459 |
3.2× |
| Xr tmj bilateral (70330) |
$315 |
$525 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$238.20 |
$397 |
2.7× |