| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,451 |
$9,085 |
3.7× |
| Abdomen 1 View (74018) |
$324.60 |
$541 |
3.5× |
| Abdomen 2 views (74019) |
$391.20 |
$652 |
3.5× |
| Ankle 2 views (73600) |
$379.20 |
$632 |
4.1× |
| Basic radiation dosimetry calculation (77300) |
$513.60 |
$856 |
3.6× |
| Bone age studies (77072) |
$246 |
$410 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$2,062.20 |
$3,437 |
4.8× |
| Bone Imaging Limited Area (78300) |
$1,386.60 |
$2,311 |
3.2× |
| Bone Imaging Whole Body (78306) |
$1,810.20 |
$3,017 |
4.2× |
| Bone survey infant (77076) |
$1,112.40 |
$1,854 |
10.0× |
| Brachytx Isodose Plan Simple (77316) |
$1,327.80 |
$2,213 |
3.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,991.40 |
$8,319 |
3.3× |
| Cat Scan Follow-Up Study (76380) |
$1,999.20 |
$3,332 |
21.5× |
| Chest 1 view (71045) |
$264.60 |
$441 |
2.8× |
| Chest 2 views (71046) |
$348.60 |
$581 |
3.8× |
| Chest 3 views (71047) |
$432.60 |
$721 |
4.7× |
| Chest 4 or more views (71048) |
$450.60 |
$751 |
4.0× |
| Clavicle complete (73000) |
$348.60 |
$581 |
3.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$3,886.20 |
$6,477 |
34.8× |
| Continuing medical physics consltj pr wk (77336) |
$814.80 |
$1,358 |
5.7× |
| Contrast Exam Abdominl Aorta (75625) |
$6,162 |
$10,270 |
1.8× |
| Contrast X-Ray Bladder (74430) |
$377.40 |
$629 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,425.20 |
$9,042 |
14.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,612.20 |
$7,687 |
18.1× |
| CT abdomen w contrast (74160) |
$3,648.60 |
$6,081 |
19.5× |
| CT abdomen w wo contrast (74170) |
$4,182.60 |
$6,971 |
22.3× |
| CT abdomen w/o contrast (74150) |
$1,872.60 |
$3,121 |
16.8× |
| CT Angio Abdomen and Pelvis (74174) |
$5,989.20 |
$9,982 |
16.1× |
| CT Angio Chest (71275) |
$2,368.20 |
$3,947 |
12.6× |
| CT Angio Head (70496) |
$4,323 |
$7,205 |
23.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$5,446.80 |
$9,078 |
29.1× |
| CT Angio Neck (70498) |
$4,310.40 |
$7,184 |
23.0× |
| CT cervical spine w/ contrast (72126) |
$3,462 |
$5,770 |
9.3× |
| CT cervical spine w/o contrast (72125) |
$2,719.80 |
$4,533 |
24.4× |
| CT chest w contrast (71260) |
$2,793 |
$4,655 |
14.9× |
| CT colonography screening (74263) |
$6,319.20 |
$10,532 |
24.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$7,549.20 |
$12,582 |
67.6× |
| CT head/brain without and with contrast (70470) |
$2,659.80 |
$4,433 |
14.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,752.40 |
$6,254 |
10.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,560 |
$2,600 |
16.8× |
| CT iac w contrast (70481) |
$4,302 |
$7,170 |
23.0× |
| CT lower ext w/o (73700) |
$2,698.20 |
$4,497 |
24.2× |
| CT lower extremity w/contrast material (73701) |
$3,492.60 |
$5,821 |
18.6× |
| CT lumbar spine w/o contrast (72131) |
$2,698.20 |
$4,497 |
24.2× |
| CT maxillofacial w contrast (70487) |
$2,311.80 |
$3,853 |
12.3× |
| CT maxillofacial wo contrast (70486) |
$2,006.40 |
$3,344 |
18.0× |
| CT neck tissue combo (70492) |
$3,403.80 |
$5,673 |
18.2× |
| CT orbits w/o contrast (70480) |
$3,514.20 |
$5,857 |
31.5× |
| CT pelvis w/o contrast (72192) |
$1,895.40 |
$3,159 |
17.0× |
| CT soft tissue neck w contrast (70491) |
$2,778 |
$4,630 |
14.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,087.40 |
$3,479 |
18.7× |
| CT thoracic spine w contrast (72129) |
$3,492.60 |
$5,821 |
18.6× |
| CT thoracic spine w/o contrast (72128) |
$2,712 |
$4,520 |
24.3× |
| CT thorax w/o contrast (71250) |
$2,087.40 |
$3,479 |
18.7× |
| CT unlisted procedure (76497) |
$4,680 |
$7,800 |
50.4× |
| CT upper ext wo (73200) |
$2,689.80 |
$4,483 |
24.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,746.40 |
$11,244 |
36.0× |
| Cta Abdomen (74175) |
$4,680 |
$7,800 |
25.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$154.20 |
$257 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$285 |
$475 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$348.60 |
$581 |
3.1× |
| Dxa Bone Density Axial (77080) |
$497.40 |
$829 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$370.80 |
$618 |
4.0× |
| Echo exam of fetal heart (76825) |
$761.40 |
$1,269 |
1.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$614.40 |
$1,024 |
2.4× |
| Esophagram (74220) |
$1,065 |
$1,775 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$412.20 |
$687 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$558 |
$930 |
2.2× |
| Forearm 2 views (73090) |
$330.60 |
$551 |
3.6× |
| Gastric emptying imaging study (78264) |
$2,060.40 |
$3,434 |
4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,718.40 |
$7,864 |
6.3× |
| Hepatobil Syst Image W/Drug (78227) |
$2,794.80 |
$4,658 |
4.8× |
| Hepatobiliary System Imaging (78226) |
$2,043.60 |
$3,406 |
4.8× |
| Ht Muscle Image Spect Sing (78451) |
$3,345 |
$5,575 |
2.4× |
| Hysterosalpingogram (74740) |
$1,029 |
$1,715 |
4.0× |
| Infant hip ultrasound, limited static exam (76886) |
$613.20 |
$1,022 |
6.6× |
| K Flow/Funct Image W/Drug (78708) |
$2,302.20 |
$3,837 |
4.0× |
| K Flow/Funct Image W/O Drug (78707) |
$1,813.80 |
$3,023 |
3.1× |
| Knee 3 Views (73562) |
$469.20 |
$782 |
5.0× |
| Lung perfusion differential (78597) |
$1,454.40 |
$2,424 |
3.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,960.80 |
$3,268 |
3.4× |
| Magnetic Image Jaw Joint (70336) |
$4,444.20 |
$7,407 |
17.4× |
| Meckels Divert Exam (78290) |
$2,066.40 |
$3,444 |
4.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,828.20 |
$3,047 |
4.6× |
| MRA head w/o contrast (70544) |
$4,026 |
$6,710 |
15.8× |
| MRA neck w contrast (70548) |
$4,281 |
$7,135 |
11.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,212.40 |
$10,354 |
16.7× |
| MRA neck w/o contrast (70547) |
$4,044 |
$6,740 |
15.9× |
| MRI abdomen w contrast (74182) |
$5,017.20 |
$8,362 |
13.5× |
| MRI abdomen w/o contrast (74181) |
$3,151.80 |
$5,253 |
12.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,384.40 |
$8,974 |
6.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,507.60 |
$10,846 |
17.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,237 |
$5,395 |
12.7× |
| MRI cervical spine w/o cont (72141) |
$2,692.20 |
$4,487 |
10.6× |
| MRI chest w/o contrast (71550) |
$6,133.20 |
$10,222 |
24.1× |
| MRI chest wo w contrast (71552) |
$8,365.80 |
$13,943 |
22.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,358.60 |
$8,931 |
14.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,591.60 |
$5,986 |
14.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,774.20 |
$7,957 |
12.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,651 |
$6,085 |
14.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,338.80 |
$8,898 |
14.3× |
| MRI pelvis w/o & w contrast (72197) |
$5,325 |
$8,875 |
14.3× |
| MRI pelvis w/o contrast (72195) |
$3,636.60 |
$6,061 |
14.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,699.40 |
$4,499 |
10.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,377.80 |
$8,963 |
21.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$7,026 |
$11,710 |
18.9× |
| MRI, abdomen, combo (74183) |
$5,331.60 |
$8,886 |
14.3× |
| MRI, dorsal spine combo (72157) |
$4,793.40 |
$7,989 |
12.9× |
| MRI, joint upper extrem (73221) |
$3,040.80 |
$5,068 |
11.9× |
| MRI, joint upper extrem combo (73223) |
$6,520.80 |
$10,868 |
17.5× |
| MRI, lumbar spine combo (72158) |
$4,761 |
$7,935 |
12.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,834.20 |
$8,057 |
3.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$11,050.20 |
$18,417 |
7.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$12,499.20 |
$20,832 |
5.3× |
| Neck soft tissue (70360) |
$366.60 |
$611 |
3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,760 |
$14,600 |
5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,073 |
$3,455 |
4.9× |
| Pelvis 1 or 2 views (72170) |
$409.20 |
$682 |
3.7× |
| Pet Image W/Ct Lmtd (78814) |
$5,981.40 |
$9,969 |
3.9× |
| PET image w/CT, full body (78816) |
$7,927.20 |
$13,212 |
5.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,927.20 |
$13,212 |
5.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$511.80 |
$853 |
4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$545.40 |
$909 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$415.20 |
$692 |
4.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$319.20 |
$532 |
3.4× |
| Radex elbow complete minimum 3 views (73080) |
$355.20 |
$592 |
3.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$511.80 |
$853 |
4.6× |
| Radex fingr minimum 2 views (73140) |
$450.60 |
$751 |
4.8× |
| Radex foot complete minimum 3 views (73630) |
$384.60 |
$641 |
4.1× |
| Radex Hand Minimum 3 Views (73130) |
$415.20 |
$692 |
4.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$432.60 |
$721 |
4.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$391.20 |
$652 |
4.2× |
| Radex shoulder complete minimum 2 views (73030) |
$348.60 |
$581 |
3.8× |
| Radex Spine 1 View Specify Level (72020) |
$258.60 |
$431 |
2.8× |
| Radex Sternum Minimum 2 Views (71120) |
$355.20 |
$592 |
3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$625.80 |
$1,043 |
6.7× |
| Radex Toe Minimum 2 Views (73660) |
$372.60 |
$621 |
4.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$469.20 |
$782 |
5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,590 |
$2,650 |
14.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,406 |
$29,010 |
2.2× |
| Radiation treatment delivery level 1 (77402) |
$1,098 |
$1,830 |
10.1× |
| Radiation treatment delivery level 3 (77412) |
$1,632.60 |
$2,721 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$463.80 |
$773 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$445.20 |
$742 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$2,140.80 |
$3,568 |
11.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,240.80 |
$2,068 |
6.6× |
| Radiologic exam knee complete 4/more views (73564) |
$511.80 |
$853 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,509 |
$2,515 |
8.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,720.20 |
$2,867 |
9.2× |
| Radiologic examination femur minimum 2 views (73552) |
$409.20 |
$682 |
4.4× |
| Radiologic examination knee 1/2 views (73560) |
$403.20 |
$672 |
4.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$361.80 |
$603 |
3.9× |
| Ribs bilateral 3 views (71110) |
$445.20 |
$742 |
4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,845 |
$3,075 |
3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$170.40 |
$284 |
7.3× |
| Skull less than 4 views (70250) |
$427.20 |
$712 |
3.8× |
| Special Physics Consult (77370) |
$1,269.60 |
$2,116 |
8.8× |
| Special teletherapy port plan (77321) |
$1,308 |
$2,180 |
3.3× |
| Special treatment procedure (77470) |
$2,103.60 |
$3,506 |
3.6× |
| Stereotactic Body Radiation Delivery (77373) |
$8,625.60 |
$14,376 |
4.5× |
| Sternoclavicular joints (71130) |
$445.20 |
$742 |
4.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,407 |
$2,345 |
3.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$778.80 |
$1,298 |
1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,458.80 |
$4,098 |
6.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,425 |
$2,375 |
9.9× |
| Thoracic spine 2 views (72070) |
$384.60 |
$641 |
3.4× |
| Thoracic spine 3 views (72072) |
$427.20 |
$712 |
3.8× |
| Thoracolumbar 2 views (72080) |
$379.20 |
$632 |
4.1× |
| Thyroid Uptake Measurement (78012) |
$1,388.40 |
$2,314 |
3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,506.60 |
$2,511 |
3.5× |
| Tx Devices Design & Construction Complex (77334) |
$1,389 |
$2,315 |
3.5× |
| Tx devices design & construction intermediate (77333) |
$714.60 |
$1,191 |
5.0× |
| Tx devices design & construction simple (77332) |
$293.40 |
$489 |
2.0× |
| Ultrasound Breast Limited (76642) |
$424.20 |
$707 |
4.6× |
| Ultrasound Exam Aaa Screen (76706) |
$714.60 |
$1,191 |
6.4× |
| Ultrasound, abdomen limited (76705) |
$551.40 |
$919 |
4.9× |
| Umbilical-artery Doppler (OB) (76820) |
$136.20 |
$227 |
1.2× |
| Upper gi w/o kub (74240) |
$1,479 |
$2,465 |
7.9× |
| Urethrocystogram voiding (74455) |
$1,204.20 |
$2,007 |
4.7× |
| Us chest (76604) |
$555 |
$925 |
5.0× |
| Us complete joint (76881) |
$475.80 |
$793 |
4.3× |
| Us exam, pelvic, limited (76857) |
$581.40 |
$969 |
5.2× |
| Us head (76506) |
$692.40 |
$1,154 |
6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$523.20 |
$872 |
4.7× |
| Us ob detailed single fetus (76811) |
$929.40 |
$1,549 |
3.6× |
| Us ob limited 1 or more fetuses (76815) |
$427.80 |
$713 |
3.8× |
| Us ob transvaginal (76817) |
$486.60 |
$811 |
4.4× |
| Us pelvic non ob complete (76856) |
$622.20 |
$1,037 |
5.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$601.20 |
$1,002 |
5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$585.60 |
$976 |
5.2× |
| Us retroperitoneal complete (76770) |
$627.60 |
$1,046 |
5.6× |
| Us scrotum and contents (76870) |
$607.20 |
$1,012 |
5.4× |
| Us spinal canal and contents (76800) |
$696 |
$1,160 |
6.2× |
| Us thyroid (76536) |
$690.60 |
$1,151 |
6.2× |
| Venography extremity unilateral rs&i (75820) |
$1,367.40 |
$2,279 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$450.60 |
$751 |
4.8× |
| X-Ray Bend Only L-S Spine (72120) |
$535.80 |
$893 |
4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$319.20 |
$532 |
3.4× |
| X-Ray Exam Breast Specimen (76098) |
$138.60 |
$231 |
0.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$823.80 |
$1,373 |
7.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$535.80 |
$893 |
5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$589.20 |
$982 |
5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$715.20 |
$1,192 |
6.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$703.80 |
$1,173 |
6.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$427.20 |
$712 |
4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$703.80 |
$1,173 |
6.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$432.60 |
$721 |
3.9× |
| X-ray eye for foreign body (70030) |
$355.20 |
$592 |
3.8× |
| X-ray humerus (73060) |
$366.60 |
$611 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$481.20 |
$802 |
5.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$427.20 |
$712 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$547.80 |
$913 |
4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$427.20 |
$712 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$366.60 |
$611 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$445.20 |
$742 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$505.80 |
$843 |
4.5× |
| X-ray thoracic spine 4 vw (72074) |
$487.20 |
$812 |
4.4× |
| X-Rays Bone Length Studies (77073) |
$391.20 |
$652 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$1,101 |
$1,835 |
9.9× |
| Xr c-spine 4 or 5 views (72050) |
$583.20 |
$972 |
5.2× |
| Xr facial bones less than 3 views (70140) |
$343.80 |
$573 |
3.7× |
| Xr orbits complete 4 views (70200) |
$505.80 |
$843 |
4.5× |