| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,456.75 |
$5,827 |
1.2× |
| Abdomen 2 views (74019) |
$142 |
$568 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$473.62 |
$1,894.50 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$617.75 |
$2,471 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$658.50 |
$2,634 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$658.38 |
$2,633.50 |
0.2× |
| Angiography internal mammary rs&i (75756) |
$389.75 |
$1,559 |
0.1× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$792.62 |
$3,170.50 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$617.38 |
$2,469.50 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$352.62 |
$1,410.50 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$352.62 |
$1,410.50 |
0.1× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$621.25 |
$2,485 |
0.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$370.25 |
$1,481 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$617.38 |
$2,469.50 |
0.2× |
| Ankle 2 views (73600) |
$60.38 |
$241.50 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$104.25 |
$417 |
0.3× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$627.38 |
$2,509.50 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$656.38 |
$2,625.50 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$656.25 |
$2,625 |
0.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$590.75 |
$2,363 |
0.2× |
| Artery X-Rays Adrenal Gland (75731) |
$590.75 |
$2,363 |
0.2× |
| Arthrogram elbow (73085) |
$211.75 |
$847 |
0.7× |
| Arthrogram hip (73525) |
$198 |
$792 |
0.6× |
| Arthrogram shoulder (73040) |
$197.75 |
$791 |
0.6× |
| Arthrogram wrist (73115) |
$204.38 |
$817.50 |
0.6× |
| Arthrography knee lt (73580) |
$179.88 |
$719.50 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$120.75 |
$483 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$532.75 |
$2,131 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$668.75 |
$2,675 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$586.75 |
$2,347 |
1.6× |
| Bone age studies (77072) |
$69.38 |
$277.50 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$698.75 |
$2,795 |
1.9× |
| Bone survey complete (77075) |
$221.50 |
$886 |
2.3× |
| Brachytx isodose complex (77318) |
$1,084.50 |
$4,338 |
3.2× |
| Brachytx isodose intermed (77317) |
$991 |
$3,964 |
2.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$413.88 |
$1,655.50 |
1.2× |
| Brain image w/flow 4 + views (78606) |
$266.12 |
$1,064.50 |
0.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$229.62 |
$918.50 |
0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,163.25 |
$4,653 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$196.12 |
$784.50 |
0.4× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$15.88 |
$63.50 |
1.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$959.25 |
$3,837 |
3.0× |
| Cardiac shunt detection (78428) |
$242.75 |
$971 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$81.50 |
$326 |
1.0× |
| Chest 1 view (71045) |
$63.62 |
$254.50 |
0.8× |
| Chest 3 views (71047) |
$52.12 |
$208.50 |
0.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$166.12 |
$664.50 |
1.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$72.62 |
$290.50 |
0.1× |
| Clavicle complete (73000) |
$86.75 |
$347 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$200 |
$800 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$125.12 |
$500.50 |
1.0× |
| Corpora cavernosography (74445) |
$191.38 |
$765.50 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,323.62 |
$5,294.50 |
4.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,066.25 |
$4,265 |
4.9× |
| CT abdomen w contrast (74160) |
$738.38 |
$2,953.50 |
4.6× |
| CT abdomen w wo contrast (74170) |
$886.88 |
$3,547.50 |
5.6× |
| CT abdomen w/o contrast (74150) |
$648.88 |
$2,595.50 |
6.8× |
| CT angio hrt w/3d image (75574) |
$473 |
$1,892 |
1.5× |
| CT angiography upper extremity lt (73206) |
$473 |
$1,892 |
3.0× |
| CT c-spine w/o contrast (72125) |
$311.50 |
$1,246 |
3.3× |
| CT cervical spine w&w/o contrast (72127) |
$426 |
$1,704 |
2.7× |
| CT cervical spine with contrast (72126) |
$354.75 |
$1,419 |
1.1× |
| CT chest w/wo contrast (71270) |
$473 |
$1,892 |
3.0× |
| CT chest with contrast (71260) |
$393.38 |
$1,573.50 |
2.5× |
| CT colonography screening (74263) |
$954.38 |
$3,817.50 |
4.4× |
| CT colonography w/o cntrst (74261) |
$954.38 |
$3,817.50 |
10.1× |
| CT head/brain with contrast (70460) |
$397.12 |
$1,588.50 |
2.5× |
| CT head/brain without and with contrast (70470) |
$477.25 |
$1,909 |
3.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$289.50 |
$1,158 |
0.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$473 |
$1,892 |
6.0× |
| CT hrt w/3d image congen (75573) |
$473 |
$1,892 |
1.5× |
| CT iac w contrast (70481) |
$665 |
$2,660 |
4.2× |
| CT limited/localized follow up study (76380) |
$302.12 |
$1,208.50 |
3.8× |
| CT lower ext w/o (73700) |
$311.50 |
$1,246 |
3.3× |
| CT lower extremity with contrast (73701) |
$354.75 |
$1,419 |
2.2× |
| CT lumbar spine w & w/o contrast (72133) |
$830.50 |
$3,322 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$684.75 |
$2,739 |
7.2× |
| CT lumbar spine with contrast (72132) |
$829.50 |
$3,318 |
2.6× |
| CT maxillofacial w contrast (70487) |
$587.50 |
$2,350 |
3.7× |
| CT maxillofacial w/o contrast (70486) |
$584 |
$2,336 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$798.12 |
$3,192.50 |
5.0× |
| CT neck soft tissue w contrast (70491) |
$597 |
$2,388 |
3.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$708.25 |
$2,833 |
4.5× |
| CT orbits w/o contrast (70480) |
$584 |
$2,336 |
6.2× |
| CT pelvis w & w/o contrast (72194) |
$571 |
$2,284 |
3.6× |
| CT pelvis w/o contrast (72192) |
$417.75 |
$1,671 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$878.50 |
$3,514 |
5.5× |
| CT soft tissue neck w/o contrast (70490) |
$581.75 |
$2,327 |
6.1× |
| CT thoracic spine w/contrast (72129) |
$354.75 |
$1,419 |
2.2× |
| CT thoracic spine w/o contrast (72128) |
$311.50 |
$1,246 |
3.3× |
| CT thoracic spine w/wo contrast (72130) |
$473 |
$1,892 |
3.0× |
| CT thorax w/o contrast (71250) |
$345.88 |
$1,383.50 |
3.6× |
| CT upper extremity w/o contrast rt (73200) |
$500 |
$2,000 |
5.3× |
| CT upper extremity with contrast (73201) |
$569.75 |
$2,279 |
1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$908 |
$3,632 |
5.7× |
| Cta Abdomen (74175) |
$836.25 |
$3,345 |
5.3× |
| CTA abdomen pelvis (74174) |
$1,376.50 |
$5,506 |
4.3× |
| CTA chest (71275) |
$473 |
$1,892 |
3.0× |
| Cta Head (70496) |
$858.25 |
$3,433 |
5.4× |
| CTA lwr ext w&w/o contrast (73706) |
$426 |
$1,704 |
2.7× |
| Cta Neck (70498) |
$858.25 |
$3,433 |
5.4× |
| Cta Pelvis (72191) |
$976.25 |
$3,905 |
6.1× |
| Cystography minimum 3 views rs&i (74430) |
$97.88 |
$391.50 |
0.3× |
| Diskogram cervical (72285) |
$224.38 |
$897.50 |
0.1× |
| Diskography lumbar (72295) |
$427.62 |
$1,710.50 |
0.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$151.25 |
$605 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$139.25 |
$557 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$139.25 |
$557 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$139.25 |
$557 |
1.5× |
| Echo exam of fetal heart (76825) |
$520.75 |
$2,083 |
1.1× |
| Echoencephalography real time imaging (76506) |
$87 |
$348 |
0.9× |
| Esophageal motility (78258) |
$223.12 |
$892.50 |
0.6× |
| Esophagus (74220) |
$95.75 |
$383 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$235.38 |
$941.50 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$51.25 |
$205 |
0.2× |
| Foot 2 views (73620) |
$73.62 |
$294.50 |
0.9× |
| Forearm 2 views (73090) |
$71 |
$284 |
0.9× |
| Gastric mucosa imaging (78261) |
$273.38 |
$1,093.50 |
0.8× |
| Gated Heart Planar Single (78472) |
$676.25 |
$2,705 |
1.9× |
| Hand 2 views (73120) |
$63.50 |
$254 |
0.7× |
| Hand 3 views (73130) |
$83.75 |
$335 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,717.50 |
$6,870 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,717.50 |
$6,870 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,809 |
$7,236 |
2.9× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,717.50 |
$6,870 |
4.9× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,717.50 |
$6,870 |
4.9× |
| Heart Infarct Image (78466) |
$248.12 |
$992.50 |
0.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$720 |
$2,880 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$864.38 |
$3,457.50 |
1.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$864.38 |
$3,457.50 |
2.4× |
| Ht muscle image spect sing (78451) |
$294.12 |
$1,176.50 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$71.81 |
$287.25 |
0.9× |
| Hysterosalpingogram (74740) |
$235.38 |
$941.50 |
1.1× |
| Interstitial radiation source applic complex (77778) |
$1,269 |
$5,076 |
2.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$74.38 |
$297.50 |
0.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$266.62 |
$1,066.50 |
0.7× |
| Kidney imaging morphology (78700) |
$853.12 |
$3,412.50 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,043.12 |
$4,172.50 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$728.12 |
$2,912.50 |
1.5× |
| Knee 3 views (73562) |
$101.75 |
$407 |
1.3× |
| Liver & spleen imaging static only (78215) |
$359.75 |
$1,439 |
1.0× |
| Lung perf&ventilat diferentl (78598) |
$530.50 |
$2,122 |
1.1× |
| Lung Ventilation Imaging (78579) |
$295.88 |
$1,183.50 |
0.8× |
| Lymphoscintigraphy (78195) |
$555.38 |
$2,221.50 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$255.12 |
$1,020.50 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$212.25 |
$849 |
1.0× |
| Meckels Diverticulum (78290) |
$279.38 |
$1,117.50 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$286 |
$1,144 |
0.8× |
| MRA head w & w/o contrast (70546) |
$1,066.12 |
$4,264.50 |
3.4× |
| MRA head w/o contrast (70544) |
$815.75 |
$3,263 |
3.8× |
| MRA head with contrast (70545) |
$937.62 |
$3,750.50 |
3.0× |
| MRA neck w contrast (70548) |
$937.62 |
$3,750.50 |
3.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,066.12 |
$4,264.50 |
3.4× |
| MRA neck w/o contrast (70547) |
$815.75 |
$3,263 |
3.8× |
| MRI abdomen w contrast (74182) |
$920.12 |
$3,680.50 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,045 |
$4,180 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$800.50 |
$3,202 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$845.12 |
$3,380.50 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$895.12 |
$3,580.50 |
1.3× |
| MRI bone marrow blood supply (77084) |
$497.75 |
$1,991 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$743.75 |
$2,975 |
3.4× |
| MRI breast w/o contrast unilat (77046) |
$743.75 |
$2,975 |
3.4× |
| MRI c-spine with contrast (72142) |
$845.12 |
$3,380.50 |
2.7× |
| MRI cardiac w/o cont stress (75559) |
$734.50 |
$2,938 |
1.5× |
| MRI cardiac w/o contrast (75557) |
$734.50 |
$2,938 |
3.4× |
| MRI cervical spine w/o contrast (72141) |
$734.50 |
$2,938 |
3.4× |
| MRI chest w/o & w/contrast material (71552) |
$960 |
$3,840 |
3.0× |
| MRI chest w/o contrast (71550) |
$612.38 |
$2,449.50 |
2.8× |
| MRI chest with contrast (71551) |
$735.38 |
$2,941.50 |
1.0× |
| MRI fetal sngl/1st gestation (74712) |
$791.25 |
$3,165 |
3.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$895.12 |
$3,580.50 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$845.12 |
$3,380.50 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$735.25 |
$2,941 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$815.75 |
$3,263 |
3.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,066 |
$4,264 |
3.4× |
| MRI orbit/face/neck w/contrast (70542) |
$937.62 |
$3,750.50 |
3.0× |
| MRI pelvis w contrast (72196) |
$910.12 |
$3,640.50 |
2.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,033 |
$4,132 |
3.3× |
| MRI pelvis w/o contrast (72195) |
$791.25 |
$3,165 |
3.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,015.50 |
$4,062 |
3.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$959.25 |
$3,837 |
1.3× |
| MRI scan of leg joint before and after contrast (73723) |
$960.50 |
$3,842 |
3.0× |
| MRI spectroscopy (76390) |
$604.25 |
$2,417 |
7.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$959.25 |
$3,837 |
3.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$850.88 |
$3,403.50 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$959.25 |
$3,837 |
3.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$903.88 |
$3,615.50 |
2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$959.25 |
$3,837 |
3.0× |
| MRI thoracic spine w/o contrast (72146) |
$850.75 |
$3,403 |
3.9× |
| MRI tmj (70336) |
$733.25 |
$2,933 |
3.4× |
| MRI upper ext joint w/o contrast (73221) |
$777.75 |
$3,111 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,015.50 |
$4,062 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$777.75 |
$3,111 |
3.6× |
| Myelogram Cervical (72240) |
$379.50 |
$1,518 |
0.5× |
| Myelogram Lumbar (72265) |
$371.88 |
$1,487.50 |
0.5× |
| Myelogram thoracic (72255) |
$371.88 |
$1,487.50 |
0.5× |
| Myelography 2 or more regions (72270) |
$224.75 |
$899 |
0.3× |
| Myocardial infarct spect (78469) |
$407.50 |
$1,630 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$362.50 |
$1,450 |
0.3× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,163.25 |
$4,653 |
0.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$622.75 |
$2,491 |
0.8× |
| Neck soft tissue (70360) |
$87 |
$348 |
1.1× |
| Nm cisternogram (78630) |
$428 |
$1,712 |
0.9× |
| Nm gastric emptying study (78264) |
$910.62 |
$3,642.50 |
2.5× |
| Nm gastroesophageal reflux study (78262) |
$651.25 |
$2,605 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$236.38 |
$945.50 |
0.7× |
| Nm red cell sequestration (78140) |
$476.12 |
$1,904.50 |
1.3× |
| Nm whole blood volume (78122) |
$502.38 |
$2,009.50 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,117.88 |
$4,471.50 |
0.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$815.75 |
$3,263 |
0.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$294.12 |
$1,176.50 |
0.3× |
| Nuclear medicine of heart pumping function (78473) |
$1,264.50 |
$5,058 |
3.5× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$815.75 |
$3,263 |
0.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$294.25 |
$1,177 |
0.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$203.38 |
$813.50 |
0.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$540.25 |
$2,161 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$616.88 |
$2,467.50 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$125.12 |
$500.50 |
1.3× |
| Orthopantogram (70355) |
$100.38 |
$401.50 |
1.3× |
| Osseous survey infant (77076) |
$221.50 |
$886 |
2.3× |
| Osseous survey limited (77074) |
$197.38 |
$789.50 |
2.1× |
| Parathyrd planar w/spect&CT (78072) |
$322.62 |
$1,290.50 |
0.7× |
| Parathyrd planar w/wo subtrj (78071) |
$242.25 |
$969 |
0.7× |
| Parathyroid imaging (78070) |
$708.88 |
$2,835.50 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$91 |
$364 |
1.0× |
| Perineogram (74775) |
$131.75 |
$527 |
0.6× |
| Peritoneogram rs&i (74190) |
$71.25 |
$285 |
0.1× |
| PET image w/CT, skull-thigh (78815) |
$1,250.75 |
$5,003 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,250.75 |
$5,003 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,250.75 |
$5,003 |
1.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$293.62 |
$1,174.50 |
0.2× |
| Platelet survival study (78191) |
$650.75 |
$2,603 |
1.8× |
| Pr gi endoscopic ultrasound (76975) |
$73.75 |
$295 |
0.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$960.50 |
$3,842 |
3.0× |
| Pr red cell survival study (78130) |
$553.50 |
$2,214 |
1.5× |
| Pr sono bone density measure,peripheral (76977) |
$44.88 |
$179.50 |
0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$276.12 |
$1,104.50 |
0.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$506.38 |
$2,025.50 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$266.12 |
$1,064.50 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$510.62 |
$2,042.50 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$144.75 |
$579 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$194 |
$776 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$72.25 |
$289 |
0.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$84.62 |
$338.50 |
0.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$5,591.62 |
$22,366.50 |
0.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$178 |
$712 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$118 |
$472 |
1.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$135.88 |
$543.50 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$69.38 |
$277.50 |
0.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$86.88 |
$347.50 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$79.12 |
$316.50 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$213.75 |
$855 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$295.62 |
$1,182.50 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$189.50 |
$758 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$69.38 |
$277.50 |
0.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$51 |
$204 |
0.6× |
| Radiological examination surgical specimen (76098) |
$88 |
$352 |
0.2× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$360.88 |
$1,443.50 |
1.7× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$293.88 |
$1,175.50 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$317.12 |
$1,268.50 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$627.88 |
$2,511.50 |
0.2× |
| Ribs bilateral 3 views (71110) |
$125.88 |
$503.50 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$692.38 |
$2,769.50 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$968.75 |
$3,875 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$968.75 |
$3,875 |
0.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$968.75 |
$3,875 |
0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$630.75 |
$2,523 |
3.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$257.38 |
$1,029.50 |
1.2× |
| Rp Therapy Intravenous Administration (79101) |
$473 |
$1,892 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$169.62 |
$678.50 |
0.8× |
| Salivary gland imaging (78230) |
$203.38 |
$813.50 |
0.6× |
| Salivary gland imaging serial images (78231) |
$203.38 |
$813.50 |
0.6× |
| Scanogram (77073) |
$68.88 |
$275.50 |
0.7× |
| Scapula complete (73010) |
$74.38 |
$297.50 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$12.50 |
$50 |
0.5× |
| Sella turcica (70240) |
$66.25 |
$265 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$188.50 |
$754 |
2.0× |
| Sialogram (70390) |
$202.62 |
$810.50 |
0.9× |
| Simulation intermediate (77285) |
$305.88 |
$1,223.50 |
0.9× |
| Small bowel series (74250) |
$193.62 |
$774.50 |
1.2× |
| Spec medical radj physics consltj (77370) |
$285.50 |
$1,142 |
2.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$288.75 |
$1,155 |
0.8× |
| Special dosimetry (77331) |
$142 |
$568 |
1.2× |
| Special treatment procedure (77470) |
$361.12 |
$1,444.50 |
0.7× |
| Spine thoracic 3 views (72072) |
$129 |
$516 |
1.4× |
| Spleen imaging only (78185) |
$295.88 |
$1,183.50 |
0.8× |
| Splenoportograpy rs&i (75810) |
$337.25 |
$1,349 |
0.1× |
| Stereotactic body radiation delivery (77373) |
$5,591.62 |
$22,366.50 |
3.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$605.88 |
$2,423.50 |
1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$351 |
$1,404 |
1.0× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$100.62 |
$402.50 |
0.5× |
| Testicular Imaging With Vascular Flow (78761) |
$234.75 |
$939 |
0.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$389.12 |
$1,556.50 |
1.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$182.62 |
$730.50 |
1.5× |
| Therapeutic Enema (74283) |
$172.25 |
$689 |
1.1× |
| Thoracolumbar 2 views (72080) |
$128.75 |
$515 |
1.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$762 |
$3,048 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$122.25 |
$489 |
0.3× |
| Thyroid uptake measurement (78012) |
$94.62 |
$378.50 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$189.75 |
$759 |
0.5× |
| Tmj unilateral (70328) |
$82.62 |
$330.50 |
1.0× |
| Tomogram (76100) |
$165.62 |
$662.50 |
1.7× |
| Treatment device intermediate (77333) |
$215.88 |
$863.50 |
1.8× |
| Treatment devices simple (77332) |
$210.75 |
$843 |
1.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,044.12 |
$4,176.50 |
2.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$226.25 |
$905 |
0.6× |
| Tx devices design & construction complex (77334) |
$286 |
$1,144 |
0.8× |
| Ultrasound elastography first target lesion (76982) |
$87.50 |
$350 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$179.12 |
$716.50 |
1.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$69.62 |
$278.50 |
0.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,066 |
$4,264 |
13.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$978.88 |
$3,915.50 |
2.7× |
| Upper Extremity Infant (73092) |
$53 |
$212 |
0.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$98.75 |
$395 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$539 |
$2,156 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$195.88 |
$783.50 |
0.9× |
| Urethrocystography voiding (74455) |
$191.38 |
$765.50 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$302.50 |
$1,210 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$112.50 |
$450 |
1.2× |
| Us breast unilateral complete (76641) |
$68.75 |
$275 |
0.7× |
| Us breast unilateral limited (76642) |
$68.75 |
$275 |
0.9× |
| Us chest (76604) |
$87 |
$348 |
0.9× |
| Us compl joint r-t w/image documentation (76881) |
$209 |
$836 |
2.2× |
| Us guided compression repair (76936) |
$186 |
$744 |
0.9× |
| Us infant hips dynamic (76885) |
$200.38 |
$801.50 |
2.5× |
| Us kidney transplant (76776) |
$111.62 |
$446.50 |
1.2× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$209 |
$836 |
2.2× |
| Us ob detailed single fetus (76811) |
$125 |
$500 |
0.6× |
| Us ob transvaginal (76817) |
$112.50 |
$450 |
1.2× |
| Us pelvic non ob complete (76856) |
$139.75 |
$559 |
1.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$87.75 |
$351 |
0.9× |
| Us pregnancy ltd (76815) |
$82.75 |
$331 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$82.75 |
$331 |
0.9× |
| Us retroperitoneal complete (76770) |
$173.62 |
$694.50 |
1.8× |
| Us retroperitoneal limited (76775) |
$173.62 |
$694.50 |
1.8× |
| Us scrotum and contents (76870) |
$171.38 |
$685.50 |
1.8× |
| Us soft tissue head/neck (76536) |
$151.50 |
$606 |
1.6× |
| Us spinal canal and contents (76800) |
$70.12 |
$280.50 |
0.7× |
| Us transrectal (76872) |
$161.25 |
$645 |
1.7× |
| Us transrectal prostate volume (76873) |
$225.75 |
$903 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$209 |
$836 |
2.2× |
| Vascular flow imaging (78445) |
$203.38 |
$813.50 |
0.6× |
| Venogram extremity bilateral (75822) |
$263.75 |
$1,055 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$473 |
$1,892 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$425.25 |
$1,701 |
0.3× |
| Venography epidural rs&i (75872) |
$327 |
$1,308 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$201.88 |
$807.50 |
0.1× |
| Venography Renal Bilateral (75833) |
$568.50 |
$2,274 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$431 |
$1,724 |
0.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$606.38 |
$2,425.50 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$633.62 |
$2,534.50 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$87.50 |
$350 |
1.1× |
| Wrist 2 views (73100) |
$63.88 |
$255.50 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$138.50 |
$554 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$89 |
$356 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$90.25 |
$361 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$295.69 |
$1,182.75 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$58 |
$232 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$89.12 |
$356.50 |
1.1× |
| X-ray exam hip uni 1 view (73501) |
$61.25 |
$245 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$93.25 |
$373 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$133.50 |
$534 |
1.4× |
| X-ray exam of femur 1 (73551) |
$34 |
$136 |
0.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$176.68 |
$706.75 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$77 |
$308 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$55 |
$220 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$91.25 |
$365 |
1.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$357.75 |
$1,431 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$76.62 |
$306.50 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$58.38 |
$233.50 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$109.88 |
$439.50 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$58.62 |
$234.50 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$44.62 |
$178.50 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$110.50 |
$442 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$103.62 |
$414.50 |
1.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$87.38 |
$349.50 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$60.50 |
$242 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$116 |
$464 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$114.12 |
$456.50 |
1.2× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$174.75 |
$699 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$111.12 |
$444.50 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$91 |
$364 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$98.38 |
$393.50 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$93 |
$372 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$85.62 |
$342.50 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$139.62 |
$558.50 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$50.75 |
$203 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$158.88 |
$635.50 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$95 |
$380 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$70.25 |
$281 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$68.25 |
$273 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$92.75 |
$371 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$117.25 |
$469 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$154.88 |
$619.50 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$64.88 |
$259.50 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$89.62 |
$358.50 |
1.1× |
| Xr arthrogram ankle (73615) |
$111.38 |
$445.50 |
0.4× |
| Xr c-spine 6 or more views (72052) |
$172.88 |
$691.50 |
1.8× |
| Xr chest 4+ views (71048) |
$124.25 |
$497 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$66.81 |
$267.25 |
0.8× |
| Xr optic foramina (70190) |
$66.25 |
$265 |
0.8× |
| Xr shoulder 1 view (73020) |
$60.62 |
$242.50 |
0.8× |
| Xr spine cervical 4 or 5 views (72050) |
$137.50 |
$550 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$44.62 |
$178.50 |
0.6× |
| Xr tmj bilateral (70330) |
$80.38 |
$321.50 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$63.82 |
$255.25 |
0.8× |