| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,075 |
$8,300 |
1.5× |
| Abdomen 1 View (74018) |
$97 |
$388 |
1.1× |
| Abdomen 2 views (74019) |
$97 |
$388 |
0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$623.75 |
$2,495 |
1.6× |
Angio internal mammary (75756)
range across 3 matching MRF lines |
$54.50–$162 |
$109–$324 |
varies |
| Angio pulmonary bilat (75743) |
$664.50 |
$2,658 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$2,375 |
$9,500 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,898.50 |
$7,594 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,898.25 |
$7,593 |
0.6× |
| Ankle 2 views (73600) |
$97 |
$388 |
1.1× |
| Aortography thoracic serialography rs&i (75605) |
$3,272.50 |
$13,090 |
0.6× |
Aortography thoracic w/o serialography rs&i (75600)
range across 3 matching MRF lines |
$23–$173 |
$46–$346 |
varies |
| Artery X-Rays Abdomen (75726) |
$3,183.75 |
$12,735 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$3,730.75 |
$14,923 |
0.7× |
| Artery X-Rays Spine (75705) |
$3,272.50 |
$13,090 |
0.6× |
| Arthrogram ankle (73615) |
$92.25 |
$369 |
0.3× |
| Arthrogram hip (73525) |
$103.75 |
$415 |
0.3× |
| Arthrogram Wrist (73115) |
$132.50 |
$530 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$311.75 |
$1,247 |
2.3× |
| Bone age studies (77072) |
$65.50 |
$262 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$485.75 |
$1,943 |
1.2× |
| Bone Imaging Multiple Areas (78305) |
$343.25 |
$1,373 |
0.9× |
| Bone Imaging Whole Body (78306) |
$485.75 |
$1,943 |
1.2× |
| Bone marrow imaging limited area (78102) |
$302 |
$1,208 |
0.8× |
| Bone survey infant (77076) |
$195.25 |
$781 |
1.9× |
| Brachytx isodose complex (77318) |
$508.25 |
$2,033 |
1.4× |
| Brachytx isodose intermed (77317) |
$400.25 |
$1,601 |
1.1× |
| Brachytx Isodose Plan Simple (77316) |
$267.25 |
$1,069 |
0.7× |
| Brain Image W/Flow < 4 Views (78601) |
$533.25 |
$2,133 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$902.25 |
$3,609 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$131.25 |
$525 |
0.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$600.50 |
$2,402 |
0.8× |
| Cat Scan Follow-Up Study (76380) |
$393.50 |
$1,574 |
4.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$633.25 |
$2,533 |
1.2× |
| Cerebrospinal Fluid Scan (78630) |
$419.75 |
$1,679 |
0.8× |
| Chest 1 view (71045) |
$45 |
$180 |
0.5× |
Chest 2 views (71046)
range across 2 matching MRF lines |
$16.75–$53.25 |
$67–$213 |
varies |
| Chest 3 views (71047) |
$49.25 |
$197 |
0.6× |
| Chest 4 or more views (71048) |
$101.75 |
$407 |
1.0× |
| Clavicle complete (73000) |
$97 |
$388 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$111 |
$444 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$188.75 |
$755 |
1.4× |
| Contrast Exam Abdominl Aorta (75625) |
$664.50 |
$2,658 |
0.2× |
| Contrast X-Ray Bladder (74430) |
$111 |
$444 |
0.3× |
| Contrast X-Ray Of Elbow (73085) |
$80 |
$320 |
0.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$239.50 |
$958 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$843.25 |
$3,373 |
2.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,315.50 |
$5,262 |
5.5× |
| CT abdomen w contrast (74160) |
$788.25 |
$3,153 |
4.5× |
| CT abdomen w wo contrast (74170) |
$788.25 |
$3,153 |
4.5× |
| CT abdomen w/o contrast (74150) |
$788.25 |
$3,153 |
7.6× |
| CT Angio Abdomen and Pelvis (74174) |
$1,405 |
$5,620 |
4.0× |
| CT Angio Chest (71275) |
$843.25 |
$3,373 |
4.8× |
| CT Angio Head (70496) |
$843.25 |
$3,373 |
4.8× |
| CT angio hrt w/3d image (75574) |
$1,029.25 |
$4,117 |
3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$870.50 |
$3,482 |
5.0× |
| CT Angio Neck (70498) |
$843.25 |
$3,373 |
4.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$857.75 |
$3,431 |
4.9× |
| CT cervical spine w/ contrast (72126) |
$594.50 |
$2,378 |
1.7× |
CT cervical spine w/o contrast (72125)
range across 2 matching MRF lines |
$66–$544.50 |
$264–$2,178 |
varies |
| CT cervical spine w/wo cont (72127) |
$766.50 |
$3,066 |
4.4× |
| CT chest w contrast (71260) |
$741.50 |
$2,966 |
4.2× |
| CT chest w/wo contrast (71270) |
$741.50 |
$2,966 |
4.2× |
| CT head/brain with contrast (70460) |
$602.50 |
$2,410 |
3.4× |
| CT head/brain without and with contrast (70470) |
$843.25 |
$3,373 |
4.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$222 |
$888 |
0.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$97 |
$388 |
1.1× |
| CT iac w contrast (70481) |
$676.50 |
$2,706 |
3.9× |
| CT l-spine w&w/o contrast (72133) |
$565 |
$2,260 |
3.2× |
| CT lower ext w/o (73700) |
$537.50 |
$2,150 |
5.2× |
| CT lower extremity w/contrast material (73701) |
$564 |
$2,256 |
3.2× |
| CT lumbar spine w contrast (72132) |
$565 |
$2,260 |
1.6× |
| CT lumbar spine w/o contrast (72131) |
$565 |
$2,260 |
5.4× |
| CT maxillofacial w contrast (70487) |
$573.75 |
$2,295 |
3.3× |
| CT maxillofacial wo contrast (70486) |
$573.75 |
$2,295 |
5.5× |
| CT neck tissue combo (70492) |
$809.25 |
$3,237 |
4.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$676.50 |
$2,706 |
3.9× |
| CT orbits w/o contrast (70480) |
$676.50 |
$2,706 |
6.5× |
| CT pelvis w&w/o contrast (72194) |
$647.75 |
$2,591 |
3.7× |
| CT pelvis w/o contrast (72192) |
$647.75 |
$2,591 |
6.2× |
| CT scan of leg combo (73702) |
$764.25 |
$3,057 |
4.4× |
| CT scans face/jaw combo (70488) |
$573.75 |
$2,295 |
3.3× |
| CT soft tissue neck w contrast (70491) |
$809.25 |
$3,237 |
4.6× |
| CT soft tissue neck w/o contrast (70490) |
$809.25 |
$3,237 |
7.8× |
| CT thoracic spine w contrast (72129) |
$547.50 |
$2,190 |
3.1× |
| CT thoracic spine w/o contrast (72128) |
$546.50 |
$2,186 |
5.2× |
| CT thoracic spine w/wo cont (72130) |
$722.25 |
$2,889 |
4.1× |
| CT thorax w/o contrast (71250) |
$741.50 |
$2,966 |
7.1× |
| CT unlisted procedure (76497) |
$55.50 |
$222 |
0.6× |
| CT upper ext wo (73200) |
$540 |
$2,160 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$552 |
$2,208 |
3.2× |
| CT upper extremity with contrast (73201) |
$540 |
$2,160 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$843.25 |
$3,373 |
4.8× |
| Cta Abdomen (74175) |
$843.25 |
$3,373 |
4.8× |
| CTA pelvis (72191) |
$1,214 |
$4,856 |
6.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,184 |
$4,736 |
0.6× |
| Diskography lumbar (72295) |
$1,597.25 |
$6,389 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$79.75 |
$319 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$85.75 |
$343 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$94.50 |
$378 |
0.9× |
| Dxa Bone Density Axial (77080) |
$67 |
$268 |
0.6× |
| Dxa bone density study (77085) |
$80.25 |
$321 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$30.75 |
$123 |
0.4× |
| Echo exam of fetal heart (76825) |
$153.50 |
$614 |
0.3× |
| Echo exam uterus (76831) |
$146.25 |
$585 |
0.6× |
| Echo Guide For Artery Repair (76936) |
$75.75 |
$303 |
0.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$168 |
$672 |
0.7× |
| Echograp Trans R Pros Study (76873) |
$82.75 |
$331 |
0.8× |
| Esophageal Motility Study (78258) |
$216 |
$864 |
0.5× |
| Esophagram (74220) |
$140.50 |
$562 |
0.8× |
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines |
$59.25–$188.25 |
$237–$753 |
varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$99.50 |
$398 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$136 |
$544 |
0.6× |
| Follow-Up Angiography (75898) |
$2,164 |
$8,656 |
0.7× |
| Foot 2 views (73620) |
$97 |
$388 |
1.1× |
| Forearm 2 views (73090) |
$97 |
$388 |
1.1× |
| Gastric emptying imaging study (78264) |
$960 |
$3,840 |
2.4× |
| Gastroesophageal Reflux Exam (78262) |
$533.25 |
$2,133 |
1.3× |
| Gated Heart Planar Single (78472) |
$399.50 |
$1,598 |
1.0× |
| Gated Heart, Multiple (78473) |
$835 |
$3,340 |
2.1× |
| Hand 2 views (73120) |
$96.25 |
$385 |
0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,482.75 |
$5,931 |
2.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,190.75 |
$4,763 |
1.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,927.50 |
$7,710 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$51.50 |
$103 |
0.0× |
| Hepatobil Syst Image W/Drug (78227) |
$444 |
$1,776 |
0.8× |
| Hepatobiliary System Imaging (78226) |
$444 |
$1,776 |
1.1× |
| Ht Muscle Image Spect Sing (78451) |
$803 |
$3,212 |
0.6× |
| Hysterosalpingogram (74740) |
$70.75 |
$283 |
0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$212.50 |
$850 |
2.5× |
| Infant hip ultrasound, limited static exam (76886) |
$212.50 |
$850 |
2.5× |
| Interstitial radiation source applic complex (77778) |
$1,265 |
$5,060 |
1.8× |
Intracavitary Radiation Source Applic Intermed (77762)
range across 3 matching MRF lines |
$256–$561 |
$512–$1,122 |
varies |
| Joint Survey Single View (77077) |
$154 |
$616 |
1.5× |
| K Flow/Funct Image Multiple (78709) |
$342 |
$1,368 |
0.6× |
| K Flow/Funct Image W/Drug (78708) |
$328.50 |
$1,314 |
0.6× |
| K Flow/Funct Image W/O Drug (78707) |
$390 |
$1,560 |
0.7× |
| Kidney Imaging Morphol (78700) |
$321.50 |
$1,286 |
0.8× |
| Knee 3 Views (73562) |
$97 |
$388 |
1.1× |
| Leveen/Shunt Patency Exam (78291) |
$208 |
$832 |
0.5× |
| Liver & Spleen Imaging Static Only (78215) |
$499.25 |
$1,997 |
1.3× |
| Liver imaging static only (78201) |
$280.75 |
$1,123 |
0.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$200 |
$800 |
0.4× |
| Lung Ventilation Imaging (78579) |
$268.75 |
$1,075 |
0.7× |
| Lymph System Imaging (78195) |
$440.25 |
$1,761 |
0.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,228.50 |
$8,914 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,228.50 |
$8,914 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$113.50 |
$454 |
0.5× |
| Mammary ductogram or galactogram multiple (77054) |
$81.25 |
$325 |
0.3× |
| Mammary ductogram or galactogram single (77053) |
$62.75 |
$251 |
0.3× |
| Meckels Divert Exam (78290) |
$261 |
$1,044 |
0.7× |
Mlc imrt design & construction per imrt plan (77338)
range across 2 matching MRF lines |
$312.25–$344.50 |
$1,249–$1,378 |
varies |
| Mr safety determination physician/other qhp (76016) |
$54 |
$216 |
0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$56.25 |
$225 |
0.6× |
| Mr safety implt pos&/immoblj (76019) |
$36.50 |
$146 |
0.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$148 |
$592 |
0.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$385.25 |
$1,541 |
1.1× |
| MRA head w/o contrast (70544) |
$202.75 |
$811 |
0.9× |
| MRA head with contrast (70545) |
$431 |
$1,724 |
1.2× |
| MRA neck w contrast (70548) |
$134.50 |
$538 |
0.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$215.75 |
$863 |
0.6× |
| MRA neck w/o contrast (70547) |
$113.50 |
$454 |
0.5× |
| MRI abdomen w contrast (74182) |
$215.75 |
$863 |
0.6× |
| MRI abdomen w/o contrast (74181) |
$113.50 |
$454 |
0.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$594.75 |
$2,379 |
0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$385.25 |
$1,541 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$333 |
$1,332 |
0.4× |
| MRI brain functional w/o physician admnistration (70554) |
$439.75 |
$1,759 |
1.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$88.75 |
$355 |
0.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$134.25 |
$537 |
0.6× |
| MRI cardiac w/o cont stress (75559) |
$406 |
$1,624 |
0.7× |
| MRI cardiac w/o contrast (75557) |
$113.50 |
$454 |
0.5× |
| MRI cervical spine w contrast (72142) |
$215.75 |
$863 |
0.6× |
| MRI cervical spine w/o cont (72141) |
$113.50 |
$454 |
0.5× |
| MRI chest w/o contrast (71550) |
$236 |
$944 |
1.0× |
| MRI chest with contrast (71551) |
$1,050 |
$4,200 |
1.3× |
| MRI chest wo w contrast (71552) |
$236 |
$944 |
0.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$344.75 |
$1,379 |
1.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$215.75 |
$863 |
0.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$113.50 |
$454 |
0.5× |
| MRI lumbar spine w contrast (72149) |
$215.75 |
$863 |
0.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$215.75 |
$863 |
0.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$113.50 |
$454 |
0.5× |
| MRI orbit face neck w contrast (70542) |
$695.75 |
$2,783 |
2.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$215.75 |
$863 |
0.6× |
| MRI pelvis w contrast (72196) |
$385.25 |
$1,541 |
1.1× |
| MRI pelvis w/o & w contrast (72197) |
$210 |
$840 |
0.6× |
| MRI pelvis w/o contrast (72195) |
$113.50 |
$454 |
0.5× |
| MRI thoracic spine w/o contrast (72146) |
$113.50 |
$454 |
0.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$389.50 |
$1,558 |
1.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$113.50 |
$454 |
0.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$215.75 |
$863 |
0.6× |
| MRI, abdomen, combo (74183) |
$215.75 |
$863 |
0.6× |
| MRI, dorsal spine combo (72157) |
$215.75 |
$863 |
0.6× |
| MRI, dorsal spine contrast (72147) |
$215.75 |
$863 |
0.6× |
| MRI, joint upper extrem (73221) |
$113.50 |
$454 |
0.5× |
| MRI, joint upper extrem combo (73223) |
$215.75 |
$863 |
0.6× |
| MRI, lumbar spine combo (72158) |
$215.75 |
$863 |
0.6× |
| Myelogram cervical (72240) |
$153.50 |
$614 |
0.2× |
| Myelogram Lumbar (72265) |
$153.50 |
$614 |
0.2× |
| Myelography thoracic (72255) |
$144.25 |
$577 |
0.2× |
| Myelograpy 2/more regions rs&i (72270) |
$326 |
$1,304 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$686 |
$2,744 |
0.5× |
| N-invas est c ffr sw aly CTA (75580) |
$691 |
$2,764 |
0.8× |
| Neck soft tissue (70360) |
$97 |
$388 |
1.1× |
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808)
range across 2 matching MRF lines |
$20–$221.50 |
$80–$886 |
varies |
| Nm csf leak detection (78650) |
$315.75 |
$1,263 |
0.2× |
| Nonvascular Shunt X-Ray (75809) |
$106 |
$424 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,844.50 |
$11,378 |
2.1× |
| Nuclear Rx Intra-Arterial (79445) |
$241.25 |
$965 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$258.25 |
$1,033 |
1.1× |
| Ob us nuchal meas 1 gest (76813) |
$159.50 |
$638 |
1.5× |
Oph bmtry us echograpy a-scan io lens pwr cal (76519)
range across 3 matching MRF lines |
$30–$68 |
$60–$136 |
varies |
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510)
range across 3 matching MRF lines |
$29.50–$67.50 |
$59–$135 |
varies |
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514)
range across 3 matching MRF lines |
$3.50–$11.50 |
$7–$23 |
varies |
| Panoramic X-ray of jaws (70355) |
$112.25 |
$449 |
1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$329.50 |
$1,318 |
0.6× |
| Parathyroid Planar Imaging (78070) |
$240.50 |
$962 |
0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$297.25 |
$1,189 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$97.25 |
$389 |
0.9× |
| Pet Image W/Ct Lmtd (78814) |
$937 |
$3,748 |
0.7× |
| PET image w/CT, full body (78816) |
$937 |
$3,748 |
0.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$937 |
$3,748 |
0.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$868.75 |
$3,475 |
0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$636.75 |
$2,547 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$204 |
$816 |
0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$146.50 |
$586 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$111.75 |
$447 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$97 |
$388 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$92.50 |
$370 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$101.50 |
$406 |
1.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$107 |
$428 |
1.0× |
| Radex fingr minimum 2 views (73140) |
$97 |
$388 |
1.1× |
| Radex foot complete minimum 3 views (73630) |
$97 |
$388 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$96.25 |
$385 |
1.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$7.50 |
$15 |
0.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$116.50 |
$466 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$97.75 |
$391 |
1.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$101.50 |
$406 |
1.2× |
| Radex shoulder complete minimum 2 views (73030) |
$97 |
$388 |
1.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$58.75 |
$235 |
0.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$145.25 |
$581 |
0.8× |
| Radex Spine 1 View Specify Level (72020) |
$56 |
$224 |
0.6× |
| Radex Sternum Minimum 2 Views (71120) |
$80.75 |
$323 |
0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$107.75 |
$431 |
1.2× |
| Radex Toe Minimum 2 Views (73660) |
$97 |
$388 |
1.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$7.50 |
$15 |
0.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$97 |
$388 |
1.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$20 |
$40 |
0.2× |
Radiation Delivery Stereotactic Cranial Linear (77372)
range across 2 matching MRF lines |
$465.25–$10,199.50 |
$1,861–$40,798 |
varies |
| Radiation treatment delivery level 1 (77402) |
$192.50 |
$770 |
1.9× |
| Radiation treatment delivery level 2 (77407) |
$220.75 |
$883 |
0.6× |
| Radiation treatment delivery level 3 (77412) |
$365 |
$1,460 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$179 |
$716 |
1.7× |
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 3 matching MRF lines |
$12.50–$42.50 |
$25–$85 |
varies |
| Radiologic exam colon double contrast study (74280) |
$316.50 |
$1,266 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$202.75 |
$811 |
1.2× |
| Radiologic exam knee complete 4/more views (73564) |
$97 |
$388 |
0.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$97.25 |
$389 |
0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$140.50 |
$562 |
0.8× |
| Radiologic exam swallow function contrast study (74230) |
$140.50 |
$562 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$132.25 |
$529 |
0.8× |
| Radiologic examination femur 1 view (73551) |
$54 |
$216 |
0.6× |
| Radiologic examination femur minimum 2 views (73552) |
$52 |
$208 |
0.6× |
| Radiologic examination knee 1/2 views (73560) |
$97 |
$388 |
1.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$195 |
$780 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$97 |
$388 |
1.1× |
| Renal Cyst Study (74470) |
$228.75 |
$915 |
0.4× |
| Ribs bilateral 3 views (71110) |
$131.25 |
$525 |
1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$257.75 |
$1,031 |
0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$619.50 |
$2,478 |
1.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$316.25 |
$1,265 |
0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$571.50 |
$2,286 |
1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$799.50 |
$3,198 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$563.75 |
$2,255 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$202.75 |
$811 |
0.9× |
| Scapula (73010) |
$97 |
$388 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$26 |
$104 |
1.1× |
| Shoulder 1 view (73020) |
$97 |
$388 |
1.1× |
| Shoulder Arthrography (73040) |
$132.50 |
$530 |
0.4× |
| Sialogram (70390) |
$58.50 |
$234 |
0.2× |
| Skull less than 4 views (70250) |
$107 |
$428 |
1.0× |
| Special dosimetry (77331) |
$261 |
$1,044 |
1.9× |
| Special Physics Consult (77370) |
$197 |
$788 |
1.5× |
| Special teletherapy port plan (77321) |
$291 |
$1,164 |
0.8× |
| Special treatment procedure (77470) |
$706.25 |
$2,825 |
1.3× |
| Stereotactic Body Radiation Delivery (77373) |
$2,952.50 |
$11,810 |
1.7× |
| Sternoclavicular joints (71130) |
$90 |
$360 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$2,021 |
$8,084 |
0.6× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$3 |
$6 |
0.0× |
| Tbs technical calculation only (77091) |
$27.50 |
$55 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$535 |
$2,140 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$267.25 |
$1,069 |
0.7× |
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines |
$426.25–$505 |
$1,705–$2,020 |
varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$377.25 |
$1,509 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$251.75 |
$1,007 |
1.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$257.75 |
$1,031 |
1.5× |
| Thoracic spine 2 views (72070) |
$112.25 |
$449 |
1.1× |
| Thoracic spine 3 views (72072) |
$116 |
$464 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$303 |
$1,212 |
0.8× |
| Thyroid Met Imaging Body (78018) |
$605 |
$2,420 |
1.1× |
| Thyroid Uptake Measurement (78012) |
$179.75 |
$719 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$455.50 |
$1,822 |
1.1× |
| Tx Devices Design & Construction Complex (77334) |
$325 |
$1,300 |
0.9× |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
$294.25–$367.75 |
$1,177–$1,471 |
varies |
| Tx devices design & construction simple (77332) |
$132.50 |
$530 |
1.0× |
| Ultrasound Breast Limited (76642) |
$77.50 |
$310 |
0.9× |
| Ultrasound Elastography Parenchyma (76981) |
$69 |
$276 |
0.7× |
| Ultrasound Exam Aaa Screen (76706) |
$140.25 |
$561 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$221.75 |
$887 |
2.1× |
| Umbilical-artery Doppler (OB) (76820) |
$94.50 |
$378 |
0.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$40.25 |
$161 |
0.5× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$539.75 |
$2,159 |
1.4× |
| Upper gi w/o kub (74240) |
$191 |
$764 |
1.1× |
| Ureteral Reflux Study (78740) |
$236 |
$944 |
0.6× |
| Urethrocystogram voiding (74455) |
$209.75 |
$839 |
0.9× |
| Urethrocystography retrograde (74450) |
$236.50 |
$946 |
1.0× |
| Us breast unilateral complete (76641) |
$147.75 |
$591 |
1.4× |
| Us chest (76604) |
$74.50 |
$298 |
0.7× |
| Us complete joint (76881) |
$164.25 |
$657 |
1.6× |
| Us exam, pelvic, limited (76857) |
$150 |
$600 |
1.4× |
| Us head (76506) |
$303.75 |
$1,215 |
2.9× |
| Us kidney transplant (76776) |
$415.25 |
$1,661 |
4.0× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
$32–$164.25 |
$128–$657 |
varies |
| Us ob detailed single fetus (76811) |
$297.75 |
$1,191 |
1.3× |
| Us ob limited 1 or more fetuses (76815) |
$94 |
$376 |
0.9× |
| Us ob transvaginal (76817) |
$136 |
$544 |
1.3× |
| Us pelvic non ob complete (76856) |
$252.75 |
$1,011 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$134.75 |
$539 |
1.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$53.25 |
$213 |
0.5× |
| Us retroperitoneal complete (76770) |
$241.75 |
$967 |
2.3× |
| Us retroperitoneal limited (76775) |
$252.75 |
$1,011 |
2.4× |
| Us scrotum and contents (76870) |
$288 |
$1,152 |
2.8× |
| Us spinal canal and contents (76800) |
$237.75 |
$951 |
2.3× |
| Us thyroid (76536) |
$136 |
$544 |
1.3× |
| Us transrectal (76872) |
$283 |
$1,132 |
2.7× |
| Vascular Flow Imaging (78445) |
$270 |
$1,080 |
0.7× |
| Vein X-Ray Chest (75827) |
$665.50 |
$2,662 |
0.4× |
| Vein X-Ray Skull Epidural (75872) |
$398.25 |
$1,593 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,372.75 |
$9,491 |
0.8× |
Venography Adrenal Unilateral (75840)
range across 3 matching MRF lines |
$53.50–$128 |
$107–$256 |
varies |
| Venography caval inferior serialography rs&i (75825) |
$2,063 |
$8,252 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$140.25 |
$561 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$93 |
$372 |
0.1× |
| Venography Orbital Rs&I (75880) |
$398.25 |
$1,593 |
0.6× |
| Venography Renal Bilateral (75833) |
$68.50 |
$137 |
0.0× |
Venography Renal Unilateral (75831)
range across 3 matching MRF lines |
$50.50–$119.50 |
$101–$239 |
varies |
Venous sampling by catheter (75893)
range across 3 matching MRF lines |
$25–$105 |
$50–$210 |
varies |
Venous thrombosis imaging (78457)
range across 3 matching MRF lines |
$35.50–$156 |
$71–$312 |
varies |
| Vertebral fracture assessment via dxa (77086) |
$48 |
$192 |
0.6× |
| Wrist 2 views (73100) |
$97 |
$388 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$109.25 |
$437 |
1.3× |
| X-ray antegrade pyelogram tube (74425) |
$101.25 |
$405 |
0.3× |
| X-Ray Aorta Leg Arteries (75630) |
$821.25 |
$3,285 |
0.3× |
| X-Ray Bend Only L-S Spine (72120) |
$58 |
$232 |
0.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$101.50 |
$406 |
1.2× |
| X-Ray Exam Breast Specimen (76098) |
$350 |
$1,400 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$52 |
$208 |
0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$85 |
$340 |
0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$17 |
$34 |
0.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$52 |
$208 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$52 |
$208 |
0.6× |
X-Ray Exam Hip Uni 4/> Views (73503)
range across 3 matching MRF lines |
$13.50–$60.50 |
$27–$121 |
varies |
| X-Ray Exam Hips Bi 2 Views (73521) |
$85 |
$340 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$85 |
$340 |
0.8× |
X-Ray Exam Hips Bi 5/> Views (73523)
range across 3 matching MRF lines |
$15–$62 |
$30–$124 |
varies |
| X-Ray Exam L-S Spine Bending (72114) |
$136.25 |
$545 |
1.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$118.25 |
$473 |
1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$151.50 |
$606 |
1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$175.25 |
$701 |
1.7× |
| X-ray humerus (73060) |
$97 |
$388 |
1.1× |
| X-ray IV pyelogram (ivp) (74400) |
$247.50 |
$990 |
1.4× |
| X-ray IV pyelogram+tomography (74415) |
$361 |
$1,444 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$179 |
$716 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$97 |
$388 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$136.25 |
$545 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$64.50 |
$258 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$149 |
$596 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$97 |
$388 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$97 |
$388 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$101 |
$404 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$107 |
$428 |
1.0× |
| X-Ray Stress View (77071) |
$54.50 |
$109 |
0.6× |
| X-ray thoracic spine 4 vw (72074) |
$125 |
$500 |
1.2× |
| X-Ray Tmj Unilat (70328) |
$39.75 |
$159 |
0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$192.50 |
$770 |
0.6× |
| X-Rays Bone Length Studies (77073) |
$94 |
$376 |
0.9× |
| X-Rays Bone Survey Complete (77075) |
$210.25 |
$841 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$143.75 |
$575 |
1.4× |
| Xr facial bones less than 3 views (70140) |
$107 |
$428 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$46 |
$184 |
0.4× |
| Xr orbits complete 4 views (70200) |
$116.75 |
$467 |
1.1× |