| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,347.92 |
$9,783 |
1.8× |
| Abdomen 2 views (74019) |
$120.96 |
$504 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$511.92 |
$2,133 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$624 |
$2,600 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,240 |
$13,500 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,480.92 |
$6,170.50 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$1,221.60 |
$5,090 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,704 |
$19,600 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,201.60 |
$13,340 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,792.32 |
$7,468 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,114.88 |
$8,812 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,171.04 |
$9,046 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,398.80 |
$9,995 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$624.72 |
$2,603 |
0.2× |
| Ankle 2 views (73600) |
$74.64 |
$311 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$355.44 |
$1,481 |
1.1× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,354.57 |
$9,810.70 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$977.04 |
$4,071 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$1,680.24 |
$7,001 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,832.64 |
$7,636 |
0.6× |
| Arthrogram elbow (73085) |
$203.76 |
$849 |
0.6× |
| Arthrogram hip (73525) |
$356.88 |
$1,487 |
1.1× |
| Arthrogram shoulder (73040) |
$369.36 |
$1,539 |
1.1× |
| Arthrogram wrist (73115) |
$354.72 |
$1,478 |
1.1× |
| Arthrography knee lt (73580) |
$368.88 |
$1,537 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$230.88 |
$962 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$198 |
$825 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$951.36 |
$3,964 |
2.5× |
| Bone age studies (77072) |
$93.84 |
$391 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$821.76 |
$3,424 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$270.72 |
$1,128 |
0.7× |
| Bone survey complete (77075) |
$361.92 |
$1,508 |
3.6× |
| Brachytx isodose complex (77318) |
$810.96 |
$3,379 |
2.3× |
| Brachytx isodose intermed (77317) |
$578.88 |
$2,412 |
1.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$405.60 |
$1,690 |
1.1× |
| Brain image w/flow 4 + views (78606) |
$536.64 |
$2,236 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,691.76 |
$7,049 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$955.20 |
$3,980 |
2.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$155.28 |
$647 |
0.3× |
| Cervical spine 2 or 3 views (72040) |
$153.12 |
$638 |
1.8× |
| Chest 1 view (71045) |
$99.60 |
$415 |
1.2× |
| Chest 3 views (71047) |
$121.20 |
$505 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$158.16 |
$659 |
0.9× |
| Clavicle complete (73000) |
$94.80 |
$395 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$281.76 |
$1,174 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$309.12 |
$1,288 |
2.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$125.52 |
$523 |
0.7× |
| Corpora cavernosography (74445) |
$1,442.40 |
$6,010 |
14.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,293.60 |
$5,390 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$901.92 |
$3,758 |
3.9× |
| CT abdomen w contrast (74160) |
$521.76 |
$2,174 |
3.1× |
| CT abdomen w wo contrast (74170) |
$674.88 |
$2,812 |
4.0× |
| CT abdomen w/o contrast (74150) |
$452.16 |
$1,884 |
4.5× |
| CT angio hrt w/3d image (75574) |
$1,323.59 |
$5,514.94 |
3.9× |
| CT angiography upper extremity lt (73206) |
$1,014.78 |
$4,228.24 |
6.0× |
| CT c-spine w/o contrast (72125) |
$521.76 |
$2,174 |
5.2× |
| CT cervical spine w&w/o contrast (72127) |
$723.12 |
$3,013 |
4.3× |
| CT cervical spine with contrast (72126) |
$532.32 |
$2,218 |
1.6× |
| CT chest w/wo contrast (71270) |
$764.40 |
$3,185 |
4.5× |
| CT chest with contrast (71260) |
$677.28 |
$2,822 |
4.0× |
| CT colonography screening (74263) |
$1,284 |
$5,350 |
5.6× |
| CT colonography w/dye (74262) |
$1,245.84 |
$5,191 |
7.4× |
| CT colonography w/o cntrst (74261) |
$488.16 |
$2,034 |
4.9× |
| CT head/brain with contrast (70460) |
$487.20 |
$2,030 |
2.9× |
| CT head/brain without and with contrast (70470) |
$613.44 |
$2,556 |
3.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,323.59 |
$5,514.94 |
3.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$80.64 |
$336 |
1.0× |
| CT hrt w/3d image congen (75573) |
$1,323.59 |
$5,514.94 |
3.9× |
| CT iac w contrast (70481) |
$515.28 |
$2,147 |
3.1× |
| CT limited/localized follow up study (76380) |
$358.56 |
$1,494 |
4.3× |
| CT lower ext w/o (73700) |
$534 |
$2,225 |
5.3× |
| CT lower extremity w wo contrast (73702) |
$900.96 |
$3,754 |
5.3× |
| CT lower extremity with contrast (73701) |
$544.80 |
$2,270 |
3.2× |
| CT lumbar spine w & w/o contrast (72133) |
$967.68 |
$4,032 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$488.64 |
$2,036 |
4.9× |
| CT lumbar spine with contrast (72132) |
$719.76 |
$2,999 |
2.1× |
| CT maxillofacial w contrast (70487) |
$596.88 |
$2,487 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$452.16 |
$1,884 |
4.5× |
| CT maxillofacial w/wo contrast (70488) |
$615.36 |
$2,564 |
3.6× |
| CT neck soft tissue w contrast (70491) |
$631.20 |
$2,630 |
3.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,071.36 |
$4,464 |
6.4× |
| CT orbits w/o contrast (70480) |
$479.52 |
$1,998 |
4.8× |
| CT pelvis w & w/o contrast (72194) |
$709.20 |
$2,955 |
4.2× |
| CT pelvis w/o contrast (72192) |
$453.60 |
$1,890 |
4.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$151.99 |
$633.31 |
1.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$881.04 |
$3,671 |
5.2× |
| CT soft tissue neck w/o contrast (70490) |
$555.60 |
$2,315 |
5.5× |
| CT thoracic spine w/contrast (72129) |
$680.88 |
$2,837 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$565.68 |
$2,357 |
5.6× |
| CT thoracic spine w/wo contrast (72130) |
$891.60 |
$3,715 |
5.3× |
| CT thorax w/o contrast (71250) |
$705.60 |
$2,940 |
7.0× |
| CT unlisted procedure (76497) |
$410.64 |
$1,711 |
4.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$927.41 |
$3,864.21 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$556.92 |
$2,320.51 |
5.5× |
| CT upper extremity with contrast (73201) |
$564 |
$2,350 |
1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$978.48 |
$4,077 |
5.8× |
| Cta Abdomen (74175) |
$897.60 |
$3,740 |
5.3× |
| CTA abdomen pelvis (74174) |
$1,128.48 |
$4,702 |
3.4× |
| CTA chest (71275) |
$849.12 |
$3,538 |
5.0× |
| Cta Head (70496) |
$774.24 |
$3,226 |
4.6× |
| CTA lwr ext w&w/o contrast (73706) |
$852 |
$3,550 |
5.1× |
| Cta Neck (70498) |
$749.28 |
$3,122 |
4.4× |
| Cta Pelvis (72191) |
$855.60 |
$3,565 |
5.1× |
| Cystography minimum 3 views rs&i (74430) |
$292.08 |
$1,217 |
0.9× |
| Diskogram cervical (72285) |
$1,020.72 |
$4,253 |
0.5× |
| Diskography lumbar (72295) |
$1,533.84 |
$6,391 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$96.48 |
$402 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$96.24 |
$401 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$155.76 |
$649 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$97.20 |
$405 |
1.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$166.32 |
$693 |
0.7× |
| Echoencephalography real time imaging (76506) |
$161.04 |
$671 |
1.6× |
| Esophagus (74220) |
$218.88 |
$912 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$116.88 |
$487 |
1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$134.40 |
$560 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$151.20 |
$630 |
0.7× |
| Foot 2 views (73620) |
$82.56 |
$344 |
1.0× |
| Forearm 2 views (73090) |
$108.48 |
$452 |
1.3× |
| Functional MRI brain by phys/psych (70555) |
$746.64 |
$3,111 |
3.3× |
| Functional MRI brain by tech (70554) |
$690 |
$2,875 |
3.0× |
| Gated Heart Planar Single (78472) |
$464.64 |
$1,936 |
1.2× |
| Hand 2 views (73120) |
$132.24 |
$551 |
1.3× |
| Hand 3 views (73130) |
$124.80 |
$520 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$807.60 |
$3,365 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,302.48 |
$5,427 |
1.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,587.36 |
$6,614 |
2.4× |
| Heart Infarct Image (78466) |
$472.80 |
$1,970 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,483.44 |
$6,181 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$599.76 |
$2,499 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$557.04 |
$2,321 |
1.4× |
| Ht muscle image spect sing (78451) |
$1,146.48 |
$4,777 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$107.76 |
$449 |
1.3× |
| Hysterosalpingogram (74740) |
$183.72 |
$765.50 |
0.8× |
| Interstitial radiation source applic complex (77778) |
$1,237.92 |
$5,158 |
1.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$948.24 |
$3,951 |
1.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$306 |
$1,275 |
0.6× |
| Intracavitary radiation source applic simple (77761) |
$306 |
$1,275 |
0.6× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$5,078.88 |
$21,162 |
0.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$114.48 |
$477 |
1.1× |
| Kidney imaging morphology (78700) |
$364.80 |
$1,520 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$430.56 |
$1,794 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$536.88 |
$2,237 |
1.0× |
| Knee 3 views (73562) |
$166.08 |
$692 |
2.0× |
| Liver & spleen imaging static only (78215) |
$331.92 |
$1,383 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$348.96 |
$1,454 |
0.9× |
| Liver imaging static only (78201) |
$584.88 |
$2,437 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$314.16 |
$1,309 |
0.6× |
| Lung perfusion differential (78597) |
$311.28 |
$1,297 |
0.8× |
| Lung Ventilation Imaging (78579) |
$447.60 |
$1,865 |
1.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$624.72 |
$2,603 |
0.2× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$284.16 |
$1,184 |
0.5× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$153.60 |
$640 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$308.88 |
$1,287 |
0.1× |
| Lymphoscintigraphy (78195) |
$443.76 |
$1,849 |
0.9× |
| Mammary ductogram or galactogram multiple (77054) |
$127.20 |
$530 |
0.6× |
| Mammary ductogram or galactogram single (77053) |
$234.48 |
$977 |
1.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$41.28 |
$172 |
0.5× |
| Meckels Diverticulum (78290) |
$313.68 |
$1,307 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$444.24 |
$1,851 |
1.2× |
| Mr safety determination physician/other qhp (76016) |
$89.04 |
$371 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$24.72 |
$103 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$92.88 |
$387 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$244.80 |
$1,020 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,364.64 |
$5,686 |
4.1× |
| MRA head w/o contrast (70544) |
$1,228.08 |
$5,117 |
5.4× |
| MRA head with contrast (70545) |
$1,296 |
$5,400 |
3.9× |
| MRA neck w contrast (70548) |
$1,166.88 |
$4,862 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,473.84 |
$6,141 |
4.4× |
| MRA neck w/o contrast (70547) |
$884.40 |
$3,685 |
3.9× |
| MRI abdomen w contrast (74182) |
$1,395.12 |
$5,813 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,473.84 |
$6,141 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$884.40 |
$3,685 |
3.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,161.45 |
$4,839.36 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,020.96 |
$4,254 |
1.4× |
| MRI breast w/o contrast unilat (77046) |
$753.72 |
$3,140.50 |
3.3× |
| MRI c-spine with contrast (72142) |
$1,008.96 |
$4,204 |
3.0× |
| MRI cardiac w/o cont stress (75559) |
$1,231.34 |
$5,130.58 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$610.08 |
$2,542 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$884.40 |
$3,685 |
3.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,070.16 |
$4,459 |
3.2× |
| MRI chest w/o contrast (71550) |
$835.20 |
$3,480 |
3.6× |
| MRI chest with contrast (71551) |
$902.88 |
$3,762 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,020.96 |
$4,254 |
3.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$606.72 |
$2,528 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$835.20 |
$3,480 |
3.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$915.36 |
$3,814 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,400.16 |
$5,834 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,395.12 |
$5,813 |
4.2× |
| MRI pelvis w contrast (72196) |
$1,228.32 |
$5,118 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,473.84 |
$6,141 |
4.4× |
| MRI pelvis w/o contrast (72195) |
$982.56 |
$4,094 |
4.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,141.92 |
$4,758 |
3.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$809.46 |
$3,372.75 |
1.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,192.32 |
$4,968 |
3.6× |
| MRI spectroscopy (76390) |
$904.80 |
$3,770 |
10.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,172.16 |
$4,884 |
3.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,008.96 |
$4,204 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,172.16 |
$4,884 |
3.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$816 |
$3,400 |
2.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,172.16 |
$4,884 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$933.36 |
$3,889 |
4.1× |
| MRI tmj (70336) |
$1,228.32 |
$5,118 |
5.4× |
| MRI upper ext joint w/o contrast (73221) |
$933.36 |
$3,889 |
4.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,364.73 |
$5,686.36 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$909.82 |
$3,790.90 |
4.0× |
| Myelogram Cervical (72240) |
$474.24 |
$1,976 |
0.6× |
| Myelogram Lumbar (72265) |
$439.44 |
$1,831 |
0.6× |
| Myelogram thoracic (72255) |
$265.44 |
$1,106 |
0.4× |
| Myelography 2 or more regions (72270) |
$534.48 |
$2,227 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,491.38 |
$6,214.06 |
1.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$549.36 |
$2,289 |
0.7× |
| Neck soft tissue (70360) |
$182.40 |
$760 |
2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$234.96 |
$979 |
0.6× |
| Nm adrenal scan (78075) |
$658.80 |
$2,745 |
0.5× |
| Nm cisternogram (78630) |
$537.36 |
$2,239 |
1.0× |
| Nm csf leak detection (78650) |
$742.89 |
$3,095.37 |
0.6× |
| Nm gastric emptying study (78264) |
$653.52 |
$2,723 |
1.7× |
| Nm peritoneal-venous shunt patency (78291) |
$309.84 |
$1,291 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,306 |
$13,775 |
2.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$324 |
$1,350 |
0.8× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$368.29 |
$1,534.55 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$687.36 |
$2,864 |
3.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$96.24 |
$401 |
1.0× |
| Osseous survey infant (77076) |
$198.48 |
$827 |
2.0× |
| Osseous survey limited (77074) |
$216.96 |
$904 |
2.2× |
| Parathyrd planar w/spect&CT (78072) |
$330.24 |
$1,376 |
0.6× |
| Parathyrd planar w/wo subtrj (78071) |
$1,215.84 |
$5,066 |
3.2× |
| Parathyroid imaging (78070) |
$363.36 |
$1,514 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$183.60 |
$765 |
1.8× |
| Perineogram (74775) |
$186 |
$775 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$2,235.12 |
$9,313 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$1,784.16 |
$7,434 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$2,235.12 |
$9,313 |
1.6× |
| Pr csf ventriculography (78635) |
$389.04 |
$1,621 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,081.20 |
$4,505 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,399.52 |
$9,998 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,954.64 |
$12,311 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$482.88 |
$2,012 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$494.64 |
$2,061 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$352.32 |
$1,468 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$435.36 |
$1,814 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$133.68 |
$557 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$143.76 |
$599 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$76.80 |
$320 |
0.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,013.08 |
$62,554.50 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$211.92 |
$883 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$144 |
$600 |
1.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$254.88 |
$1,062 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$182.40 |
$760 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$99.60 |
$415 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$136.56 |
$569 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$302.64 |
$1,261 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$445.56 |
$1,856.50 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$263.76 |
$1,099 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$180 |
$750 |
2.2× |
| Radiological examination surgical specimen (76098) |
$163.44 |
$681 |
0.3× |
| Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) |
$3,500.02 |
$14,583.42 |
15.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,995.36 |
$8,314 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,506 |
$6,275 |
0.5× |
| Ribs bilateral 3 views (71110) |
$200.64 |
$836 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$557.28 |
$2,321.99 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$831.60 |
$3,465 |
1.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$785.28 |
$3,272 |
1.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$634.20 |
$2,642.50 |
0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$807.84 |
$3,366 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$712.08 |
$2,967 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$505.44 |
$2,106 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$474 |
$1,975 |
2.1× |
| Rp Therapy Intravenous Administration (79101) |
$418.32 |
$1,743 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$157.68 |
$657 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$600.72 |
$2,503 |
2.6× |
| Scanogram (77073) |
$130.08 |
$542 |
1.3× |
| Scapula complete (73010) |
$122.88 |
$512 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$35.04 |
$146 |
1.5× |
| Sella turcica (70240) |
$28.56 |
$119 |
0.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$197.76 |
$824 |
2.0× |
| Sialogram (70390) |
$112.08 |
$467 |
0.5× |
| Simulation intermediate (77285) |
$398.88 |
$1,662 |
1.1× |
| Small bowel series (74250) |
$264.72 |
$1,103 |
1.6× |
| Spec medical radj physics consltj (77370) |
$269.28 |
$1,122 |
2.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$356.40 |
$1,485 |
1.0× |
| Special dosimetry (77331) |
$218.16 |
$909 |
1.7× |
| Special treatment procedure (77470) |
$382.56 |
$1,594 |
0.7× |
| Speech evaluation complex (70371) |
$70.56 |
$294 |
0.3× |
| Spine thoracic 3 views (72072) |
$148.80 |
$620 |
1.5× |
| Splenoportograpy rs&i (75810) |
$913.20 |
$3,805 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$2,326.08 |
$9,692 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$723.84 |
$3,016 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$67.68 |
$282 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$797.76 |
$3,324 |
2.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$423.36 |
$1,764 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$486 |
$2,025 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$293.76 |
$1,224 |
2.3× |
| Therapeutic Enema (74283) |
$84.48 |
$352 |
0.5× |
| Thoracolumbar 2 views (72080) |
$142.08 |
$592 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$635.04 |
$2,646 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$292.56 |
$1,219 |
0.8× |
| Thyroid uptake measurement (78012) |
$156 |
$650 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$842.16 |
$3,509 |
2.2× |
| Tmj unilateral (70328) |
$64.08 |
$267 |
0.8× |
| Tomogram (76100) |
$191.76 |
$799 |
1.9× |
| Treatment device intermediate (77333) |
$170.88 |
$712 |
1.3× |
| Treatment devices simple (77332) |
$116.40 |
$485 |
0.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,419.84 |
$5,916 |
2.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$384.72 |
$1,603 |
1.0× |
| Tx devices design & construction complex (77334) |
$296.16 |
$1,234 |
0.8× |
| Ultrasound elastography first target lesion (76982) |
$166.56 |
$694 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$280.08 |
$1,167 |
2.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$198.24 |
$826 |
2.4× |
| Unlisted fluoroscopic procedure (76496) |
$273.24 |
$1,138.50 |
3.3× |
| Unlisted magnetic resonance procedure (76498) |
$965.18 |
$4,021.61 |
11.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$192 |
$800 |
0.5× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$1,766.79 |
$7,361.62 |
4.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$120 |
$500 |
1.2× |
| Unlisted Ultrasound Procedure (76999) |
$158.64 |
$661 |
1.9× |
| Upper Extremity Infant (73092) |
$60.24 |
$251 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$172.80 |
$720 |
0.8× |
| Urethrocystography voiding (74455) |
$222.24 |
$926 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$94.80 |
$395 |
0.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$181.20 |
$755 |
1.1× |
| Us abdl aorta screen aaa (76706) |
$174 |
$725 |
1.7× |
| Us breast unilateral complete (76641) |
$215.52 |
$898 |
2.1× |
| Us breast unilateral limited (76642) |
$162.24 |
$676 |
1.9× |
| Us chest (76604) |
$273.12 |
$1,138 |
2.7× |
| Us compl joint r-t w/image documentation (76881) |
$245.52 |
$1,023 |
2.4× |
| Us elastography parenchyma (76981) |
$166.56 |
$694 |
1.7× |
| Us guided compression repair (76936) |
$160.56 |
$669 |
0.8× |
| Us infant hips dynamic (76885) |
$96.96 |
$404 |
1.2× |
| Us kidney transplant (76776) |
$272.64 |
$1,136 |
2.7× |
| Us ob detailed single fetus (76811) |
$216.24 |
$901 |
0.9× |
| Us ob transvaginal (76817) |
$224.64 |
$936 |
2.2× |
| Us pelvic non ob complete (76856) |
$316.08 |
$1,317 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$187.92 |
$783 |
1.9× |
| Us pregnancy ltd (76815) |
$192 |
$800 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$257.28 |
$1,072 |
2.6× |
| Us retroperitoneal complete (76770) |
$297.36 |
$1,239 |
3.0× |
| Us retroperitoneal limited (76775) |
$239.52 |
$998 |
2.4× |
| Us scrotum and contents (76870) |
$282.96 |
$1,179 |
2.8× |
| Us soft tissue head/neck (76536) |
$259.92 |
$1,083 |
2.6× |
| Us spinal canal and contents (76800) |
$351.36 |
$1,464 |
3.5× |
| Us transrectal (76872) |
$792 |
$3,300 |
7.9× |
| Us transrectal prostate volume (76873) |
$283.20 |
$1,180 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$172.80 |
$720 |
1.7× |
| Us, eye b-scan (76512) |
$79.20 |
$330 |
0.8× |
| Vascular flow imaging (78445) |
$275.05 |
$1,146.03 |
0.7× |
| Venogram extremity bilateral (75822) |
$1,077.60 |
$4,490 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$1,505.04 |
$6,271 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,183.20 |
$4,930 |
0.8× |
| Venography epidural rs&i (75872) |
$2,873.76 |
$11,974 |
4.8× |
| Venography extremity unilateral rs&i (75820) |
$888 |
$3,700 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,873.76 |
$11,974 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$1,995.36 |
$8,314 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,629.60 |
$6,790 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,354.57 |
$9,810.70 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$147.36 |
$614 |
1.8× |
| Wrist 2 views (73100) |
$78.24 |
$326 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$174.24 |
$726 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$114 |
$475 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$112.32 |
$468 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$327.12 |
$1,363 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$102 |
$425 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$147.60 |
$615 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$84.48 |
$352 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$112.08 |
$467 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$82.17 |
$342.39 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$188.16 |
$784 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$132.30 |
$551.25 |
1.3× |
| X-ray exam of femur 1 (73551) |
$104.16 |
$434 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$360.24 |
$1,501 |
2.1× |
| X-ray eye for foreign body (70030) |
$75.12 |
$313 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$265.68 |
$1,107 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$126.24 |
$526 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$156.48 |
$652 |
1.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,131.52 |
$13,048 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$94.56 |
$394 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$117.36 |
$489 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$187.20 |
$780 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$101.28 |
$422 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$94.56 |
$394 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$174.72 |
$728 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$195.84 |
$816 |
1.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$174.72 |
$728 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$81.12 |
$338 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$117.12 |
$488 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$127.44 |
$531 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$240 |
$1,000 |
2.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$248.64 |
$1,036 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$106.32 |
$443 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$148.32 |
$618 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$288.48 |
$1,202 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$147.36 |
$614 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$102.24 |
$426 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$194.16 |
$809 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$218.88 |
$912 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$105.36 |
$439 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$237.12 |
$988 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$141.84 |
$591 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$104.64 |
$436 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$122.88 |
$512 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$123.12 |
$513 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$171.36 |
$714 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$198.72 |
$828 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$107.76 |
$449 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$110.40 |
$460 |
1.3× |
| Xr arthrogram ankle (73615) |
$519.12 |
$2,163 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$290.64 |
$1,211 |
2.9× |
| Xr chest 4+ views (71048) |
$71.28 |
$297 |
0.7× |
| Xr Cholecystography Oral Contrast (74290) |
$111.84 |
$466 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$73.44 |
$306 |
0.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$121.44 |
$506 |
1.2× |
| Xr myelogram posterior fossa (70010) |
$777.36 |
$3,239 |
2.3× |
| Xr shoulder 1 view (73020) |
$85.92 |
$358 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$199.20 |
$830 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$131.04 |
$546 |
1.6× |
| Xr tmj bilateral (70330) |
$97.44 |
$406 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$155.52 |
$648 |
1.9× |