Radiology CPT codes 2024 are standardized to identify specific radiology procedures and services. CPT full form, is Current Procedural Terminology, a medical code maintained and published by the American Medical Association (AMA). These CPT codes serve as a universal language between healthcare providers, Hospitals, and insurance companies to accurately communicate and bill for radiology services.
The list of 2024 Radiology CPT code is updated as below at the latest information and also add new updates as well. Please review the below mention list
List of Radiology CPT Codes
| Procedure Code | Radiology CPT Code Description | Allowd Modifier | Allowd Amt | Eff Date |
| CPT 70010 | MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 70010 | MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $64.13 | 7-1-2019 |
| CPT 70010 | MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $147.81 | 7-1-2019 |
| CPT 70015 | CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 70015 | CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $64.13 | 7-1-2019 |
| CPT 70015 | CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $46.34 | 7-1-2019 |
| CPT 70030 | RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY | $49.20 | 7-1-2019 | |
| CPT 70030 | RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY | 26 | $9.30 | 7-1-2019 |
| CPT 70030 | RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY | 50 | $49.20 | 7-1-2019 |
| CPT 70030 | RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY | TC | $14.44 | 7-1-2019 |
| CPT 70100 | RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS | $49.20 | 7-1-2019 | |
| CPT 70100 | RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS | 26 | $9.83 | 7-1-2019 |
| CPT 70100 | RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 70110 | RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS | $49.20 | 7-1-2019 | |
| CPT 70110 | RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS | 26 | $13.37 | 7-1-2019 |
| CPT 70110 | RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS | TC | $21.38 | 7-1-2019 |
| CPT 70120 | RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE | $49.20 | 7-1-2019 | |
| CPT 70120 | RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE | 26 | $9.83 | 7-1-2019 |
| CPT 70120 | RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE | TC | $21.38 | 7-1-2019 |
| CPT 70130 | RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE | $49.20 | 7-1-2019 | |
| CPT 70130 | RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE | 26 | $17.92 | 7-1-2019 |
| CPT 70130 | RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE | TC | $26.97 | 7-1-2019 |
| CPT 70134 | RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE | $83.74 | 7-1-2019 | |
| CPT 70134 | RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE | 26 | $17.92 | 7-1-2019 |
| CPT 70134 | RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE | TC | $25.30 | 7-1-2019 |
| CPT 70140 | RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 70140 | RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS | 26 | $10.14 | 7-1-2019 |
| CPT 70140 | RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS | TC | $21.38 | 7-1-2019 |
| CPT 70150 | RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 70150 | RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $14.00 | 7-1-2019 |
| CPT 70150 | RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 70150 | RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 70150 | RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | TC | $26.97 | 7-1-2019 |
| CPT 70160 | RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 70160 | RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | 26 | $9.15 | 7-1-2019 |
| CPT 70160 | RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 70160 | RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 70160 | RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 70170 | DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 70170 | DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $15.31 | 7-1-2019 |
| CPT 70170 | DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $32.24 | 7-1-2019 |
| CPT 70190 | RADIOLOGIC EXAMINATION; OPTIC FORAMINA | $49.20 | 7-1-2019 | |
| CPT 70190 | RADIOLOGIC EXAMINATION; OPTIC FORAMINA | 26 | $11.44 | 7-1-2019 |
| CPT 70190 | RADIOLOGIC EXAMINATION; OPTIC FORAMINA | TC | $21.38 | 7-1-2019 |
| CPT 70200 | RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS | $49.20 | 7-1-2019 | |
| CPT 70200 | RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS | 26 | $14.98 | 7-1-2019 |
| CPT 70200 | RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS | TC | $26.97 | 7-1-2019 |
| CPT 70210 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 70210 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS | 26 | $9.15 | 7-1-2019 |
| CPT 70210 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS | TC | $21.38 | 7-1-2019 |
| CPT 70220 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 70220 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS | 26 | $13.38 | 7-1-2019 |
| CPT 70220 | RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS | TC | $26.97 | 7-1-2019 |
| CPT 70240 | RADIOLOGIC EXAMINATION, SELLA TURCICA | $49.20 | 7-1-2019 | |
| CPT 70240 | RADIOLOGIC EXAMINATION, SELLA TURCICA | 26 | $10.39 | 7-1-2019 |
| CPT 70240 | RADIOLOGIC EXAMINATION, SELLA TURCICA | TC | $14.44 | 7-1-2019 |
| CPT 70250 | RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO | $49.20 | 7-1-2019 | |
| CPT 70250 | RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO | 26 | $13.01 | 7-1-2019 |
| CPT 70250 | RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO | TC | $21.38 | 7-1-2019 |
| CPT 70260 | RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO | $83.74 | 7-1-2019 | |
| CPT 70260 | RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO | 26 | $17.92 | 7-1-2019 |
| CPT 70260 | RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO | TC | $30.56 | 7-1-2019 |
| CPT 70300 | RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW | $54.08 | 7-1-2019 | |
| CPT 70300 | RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW | 26 | $5.37 | 7-1-2019 |
| CPT 70300 | RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW | TC | $8.85 | 7-1-2019 |
| CPT 70310 | RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH | $54.08 | 7-1-2019 | |
| CPT 70310 | RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH | 26 | $8.33 | 7-1-2019 |
| CPT 70310 | RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH | TC | $14.44 | 7-1-2019 |
| CPT 70320 | RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH | $54.08 | 7-1-2019 | |
| CPT 70320 | RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH | 26 | $11.94 | 7-1-2019 |
| CPT 70320 | RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH | TC | $26.97 | 7-1-2019 |
| CPT 70328 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL | $49.20 | 7-1-2019 | |
| CPT 70328 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL | 26 | $9.83 | 7-1-2019 |
| CPT 70328 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL | TC | $17.12 | 7-1-2019 |
| CPT 70330 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL | $49.20 | 7-1-2019 | |
| CPT 70330 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL | 26 | $13.01 | 7-1-2019 |
| CPT 70330 | RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL | TC | $28.64 | 7-1-2019 |
| CPT 70332 | TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 70332 | TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 70332 | TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $71.73 | 7-1-2019 |
| CPT 70336 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT | $343.96 | 7-1-2019 | |
| CPT 70336 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT | 26 | $48.97 | 7-1-2019 |
| CPT 70336 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT | TC | $382.71 | 7-1-2019 |
| CPT 70350 | CEPHALOGRAM, ORTHODONTIC | $49.20 | 7-1-2019 | |
| CPT 70350 | CEPHALOGRAM, ORTHODONTIC | 26 | $8.87 | 7-1-2019 |
| CPT 70350 | CEPHALOGRAM, ORTHODONTIC | TC | $12.53 | 7-1-2019 |
| CPT 70355 | ORTHOPANTOGRAM | $49.20 | 7-1-2019 | |
| CPT 70355 | ORTHOPANTOGRAM | 26 | $10.69 | 7-1-2019 |
| CPT 70355 | ORTHOPANTOGRAM | TC | $19.70 | 7-1-2019 |
| CPT 70360 | RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE | $49.20 | 7-1-2019 | |
| CPT 70360 | RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE | 26 | $9.07 | 7-1-2019 |
| CPT 70360 | RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE | TC | $14.44 | 7-1-2019 |
| CPT 70370 | RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQUE | $89.64 | 7-1-2019 | |
| CPT 70370 | RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQUE | 26 | $17.11 | 7-1-2019 |
| CPT 70370 | RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQUE | TC | $44.42 | 7-1-2019 |
| CPT 70371 | COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING | $89.64 | 7-1-2019 | |
| CPT 70371 | COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING | 26 | $45.45 | 7-1-2019 |
| CPT 70371 | COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING | TC | $71.73 | 7-1-2019 |
| CPT 70373 | LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 70373 | LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $22.63 | 7-1-2019 |
| CPT 70373 | LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $60.88 | 7-1-2019 |
| CPT 70380 | RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS | $49.20 | 7-1-2019 | |
| CPT 70380 | RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS | 26 | $9.15 | 7-1-2019 |
| CPT 70380 | RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS | TC | $23.05 | 7-1-2019 |
| CPT 70390 | SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 70390 | SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $19.26 | 7-1-2019 |
| CPT 70390 | SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $60.88 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | 26 | $46.13 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | 59 | $213.19 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | 76 | $213.19 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | ET | $213.19 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | GA | $213.19 | 7-1-2019 |
| CPT 70450 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | TC | $161.25 | 7-1-2019 |
| CPT 70460 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 70460 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S) | 26 | $60.94 | 7-1-2019 |
| CPT 70460 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S) | TC | $193.15 | 7-1-2019 |
| CPT 70470 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | $344.34 | 7-1-2019 | |
| CPT 70470 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | 26 | $68.81 | 7-1-2019 |
| CPT 70470 | COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | TC | $241.50 | 7-1-2019 |
| CPT 70480 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | $213.19 | 7-1-2019 | |
| CPT 70480 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | 26 | $69.41 | 7-1-2019 |
| CPT 70480 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | 59 | $212.87 | 7-1-2019 |
| CPT 70480 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | TC | $161.25 | 7-1-2019 |
| CPT 70481 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST | $289.49 | 7-1-2019 | |
| CPT 70481 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST | 26 | $74.73 | 7-1-2019 |
| CPT 70481 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST | TC | $193.15 | 7-1-2019 |
| CPT 70482 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | $344.34 | 7-1-2019 | |
| CPT 70482 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | 26 | $78.51 | 7-1-2019 |
| CPT 70482 | COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA | TC | $241.50 | 7-1-2019 |
| CPT 70486 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 70486 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | 26 | $61.48 | 7-1-2019 |
| CPT 70486 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | TC | $161.25 | 7-1-2019 |
| CPT 70487 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 70487 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S) | 26 | $70.18 | 7-1-2019 |
| CPT 70487 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S) | TC | $193.15 | 7-1-2019 |
| CPT 70488 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) | $344.34 | 7-1-2019 | |
| CPT 70488 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) | 26 | $77.14 | 7-1-2019 |
| CPT 70488 | COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) | TC | $241.50 | 7-1-2019 |
| CPT 70490 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 70490 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | 26 | $69.41 | 7-1-2019 |
| CPT 70490 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | TC | $161.25 | 7-1-2019 |
| CPT 70491 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 70491 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S) | 26 | $74.73 | 7-1-2019 |
| CPT 70491 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S) | TC | $193.15 | 7-1-2019 |
| CPT 70492 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN | $344.34 | 7-1-2019 | |
| CPT 70492 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN | 26 | $78.51 | 7-1-2019 |
| CPT 70492 | COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN | TC | $241.50 | 7-1-2019 |
| CPT 70496 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND | $336.85 | 7-1-2019 | |
| CPT 70498 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FUR | $336.85 | 7-1-2019 | |
| CPT 70540 | MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK | $395.76 | 7-1-2019 | |
| CPT 70540 | MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK | 26 | $80.09 | 7-1-2019 |
| CPT 70540 | MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK | TC | $382.71 | 7-1-2019 |
| CPT 70542 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 70543 | MAGNETIC RESONANCE INAMGING, ORBIT, FACE AND NECK WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) | $573.77 | 7-1-2019 | |
| CPT 70544 | MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S) | $395.76 | 7-1-2019 | |
| CPT 70545 | MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 70546 | MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH | $573.77 | 7-1-2019 | |
| CPT 70546 | MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH | XS | $573.77 | 7-1-2019 |
| CPT 70547 | MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S) | $395.76 | 7-1-2019 | |
| CPT 70548 | MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 70549 | MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH | $573.77 | 7-1-2019 | |
| CPT 70551 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL | $395.76 | 7-1-2019 | |
| CPT 70551 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL | 26 | $80.09 | 7-1-2019 |
| CPT 70551 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL | TC | $382.71 | 7-1-2019 |
| CPT 70552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 70552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST MATERIAL(S) | 26 | $91.88 | 7-1-2019 |
| CPT 70552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST MATERIAL(S) | TC | $459.03 | 7-1-2019 |
| CPT 70553 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY | $573.77 | 7-1-2019 | |
| CPT 70553 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY | 26 | $122.18 | 7-1-2019 |
| CPT 70553 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY | 52 | $573.77 | 7-1-2019 |
| CPT 70553 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY | TC | $850.02 | 7-1-2019 |
| CPT 70554 | MAGNETIC RESONANCE IMAGING, BRAIN FUNCATIONAL MRI; INCLUDING TEST SELECTION AND ADMINISTRATION OF REPETITIVE | $382.73 | 7-1-2019 | |
| CPT 70555 | MAGNETIC RESONANCE IMAGING, BRAIN FUNCATIONAL MRI; REQUIRING PHYSICIAN OR PSYCHOLOGIST ADMINISTRATION OF ENTIR | $382.73 | 7-1-2019 | |
| CPT 70557 | MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE; WITHOUT CONTRAST MATERIAL | $395.76 | 7-1-2019 | |
| CPT 70558 | MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE; WITH CONTRAST MATERIAL | $420.48 | 7-1-2019 | |
| CPT 70559 | MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE; WITHOUT CONTRAST MATERIAL FOLLOWED | $573.77 | 7-1-2019 | |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | $49.20 | 7-1-2019 | |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | 26 | $9.61 | 7-1-2019 |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | 59 | $49.20 | 7-1-2019 |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | 76 | $49.20 | 7-1-2019 |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | RT | $49.20 | 7-1-2019 |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | TC | $16.46 | 7-1-2019 |
| CPT 71010 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL | XU | $49.20 | 7-1-2019 |
| CPT 71015 | RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL | $49.20 | 7-1-2019 | |
| CPT 71015 | RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL | 26 | $11.19 | 7-1-2019 |
| CPT 71015 | RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL | TC | $18.13 | 7-1-2019 |
| CPT 71020 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; | $49.20 | 7-1-2019 | |
| CPT 71020 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; | 26 | $11.74 | 7-1-2019 |
| CPT 71020 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; | 59 | $49.20 | 7-1-2019 |
| CPT 71020 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; | GA | $49.20 | 7-1-2019 |
| CPT 71020 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; | TC | $21.38 | 7-1-2019 |
| CPT 71021 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH APICAL LORDOTIC PROCEDURE | $49.20 | 7-1-2019 | |
| CPT 71021 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH APICAL LORDOTIC PROCEDURE | 26 | $14.21 | 7-1-2019 |
| CPT 71021 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH APICAL LORDOTIC PROCEDURE | TC | $25.30 | 7-1-2019 |
| CPT 71022 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH OBLIQUE PROJECTIONS | $49.20 | 7-1-2019 | |
| CPT 71022 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH OBLIQUE PROJECTIONS | 26 | $16.50 | 7-1-2019 |
| CPT 71022 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH OBLIQUE PROJECTIONS | TC | $25.30 | 7-1-2019 |
| CPT 71023 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH FLUOROSCOPY | $89.64 | 7-1-2019 | |
| CPT 71023 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH FLUOROSCOPY | 26 | $20.31 | 7-1-2019 |
| CPT 71023 | RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH FLUOROSCOPY | TC | $26.97 | 7-1-2019 |
| CPT 71030 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; | $49.20 | 7-1-2019 | |
| CPT 71030 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; | 26 | $16.50 | 7-1-2019 |
| CPT 71030 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; | TC | $26.97 | 7-1-2019 |
| CPT 71034 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; WITH FLUOROSCOPY | $89.64 | 7-1-2019 | |
| CPT 71034 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; WITH FLUOROSCOPY | 26 | $25.12 | 7-1-2019 |
| CPT 71034 | RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; WITH FLUOROSCOPY | TC | $49.35 | 7-1-2019 |
| CPT 71035 | RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL DECUBITUS, BUCKY STUDIES) | $49.20 | 7-1-2019 | |
| CPT 71035 | RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL DECUBITUS, BUCKY STUDIES) | 26 | $9.61 | 7-1-2019 |
| CPT 71035 | RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL DECUBITUS, BUCKY STUDIES) | TC | $18.13 | 7-1-2019 |
| CPT 71036 | NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS; FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL | $82.21 | 7-1-2019 | |
| CPT 71036 | NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS; FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL | 26 | $29.87 | 7-1-2019 |
| CPT 71036 | NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS; FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL | TC | $53.94 | 7-1-2019 |
| CPT 71038 | FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING | $85.80 | 7-1-2019 | |
| CPT 71038 | FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING | 26 | $29.87 | 7-1-2019 |
| CPT 71038 | FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING | TC | $57.53 | 7-1-2019 |
| CPT 71040 | BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 71040 | BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $30.29 | 7-1-2019 |
| CPT 71040 | BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $50.02 | 7-1-2019 |
| CPT 71045 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW | $53.28 | 7-1-2019 | |
| CPT 71045 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW | 26 | $5.76 | 7-1-2019 |
| CPT 71045 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW | FY | $53.28 | 7-1-2019 |
| CPT 71045 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW | TC | $6.64 | 7-1-2019 |
| CPT 71045 | RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW | UD | $53.28 | 7-1-2019 |
| CPT 71046 | RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS | $53.28 | 7-1-2019 | |
| CPT 71046 | RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS | 26 | $6.86 | 7-1-2019 |
| CPT 71046 | RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS | FY | $53.28 | 7-1-2019 |
| CPT 71046 | RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS | PO | $53.28 | 7-1-2019 |
| CPT 71046 | RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS | TC | $12.17 | 7-1-2019 |
| CPT 71047 | RADIOLOGIC EXAMINATION, CHEST; 3 VIEWS | $53.28 | 7-1-2019 | |
| CPT 71047 | RADIOLOGIC EXAMINATION, CHEST; 3 VIEWS | 26 | $8.85 | 7-1-2019 |
| CPT 71047 | RADIOLOGIC EXAMINATION, CHEST; 3 VIEWS | TC | $15.49 | 7-1-2019 |
| CPT 71048 | RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWS | $98.17 | 7-1-2019 | |
| CPT 71048 | RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWS | 26 | $10.17 | 7-1-2019 |
| CPT 71048 | RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWS | TC | $15.93 | 7-1-2019 |
| CPT 71060 | BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 71060 | BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $38.28 | 7-1-2019 |
| CPT 71060 | BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $75.32 | 7-1-2019 |
| CPT 71090 | INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $89.64 | 7-1-2019 | |
| CPT 71090 | INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 71090 | INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $57.53 | 7-1-2019 |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | 26 | $11.94 | 7-1-2019 |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 71100 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | 26 | $14.45 | 7-1-2019 |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 71101 | RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | TC | $23.05 | 7-1-2019 |
| CPT 71110 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 71110 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS | 26 | $14.45 | 7-1-2019 |
| CPT 71110 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS | TC | $26.97 | 7-1-2019 |
| CPT 71111 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS | $83.74 | 7-1-2019 | |
| CPT 71111 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS | 26 | $16.87 | 7-1-2019 |
| CPT 71111 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS | 59 | $83.74 | 7-1-2019 |
| CPT 71111 | RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS | TC | $30.56 | 7-1-2019 |
| CPT 71120 | RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 71120 | RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS | 26 | $10.69 | 7-1-2019 |
| CPT 71120 | RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS | TC | $22.38 | 7-1-2019 |
| CPT 71130 | RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 71130 | RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS | 26 | $11.74 | 7-1-2019 |
| CPT 71130 | RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS | TC | $24.06 | 7-1-2019 |
| CPT 71250 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 71250 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL | 26 | $62.77 | 7-1-2019 |
| CPT 71250 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL | 59 | $213.19 | 7-1-2019 |
| CPT 71250 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL | TC | $201.42 | 7-1-2019 |
| CPT 71260 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 71260 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S) | 26 | $67.24 | 7-1-2019 |
| CPT 71260 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S) | 59 | $289.49 | 7-1-2019 |
| CPT 71260 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S) | TC | $241.50 | 7-1-2019 |
| CPT 71270 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | $344.34 | 7-1-2019 | |
| CPT 71270 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | 26 | $74.73 | 7-1-2019 |
| CPT 71270 | COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | TC | $301.80 | 7-1-2019 |
| CPT 71275 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S), FOLLO | $336.85 | 7-1-2019 | |
| CPT 71550 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY) | $395.76 | 7-1-2019 | |
| CPT 71550 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY) | 26 | $86.81 | 7-1-2019 |
| CPT 71550 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY) | TC | $382.71 | 7-1-2019 |
| CPT 71551 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPH WITH CONTRAS | $420.48 | 7-1-2019 | |
| CPT 71552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG,FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPH WITHOUT | $573.77 | 7-1-2019 | |
| CPT 71555 | MAGNETIC RESONANCE IMAGING, CHEST | $501.76 | 7-1-2019 | |
| CPT 72010 | RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, ANTEROPOSTERIOR AND LATERAL | $49.20 | 7-1-2019 | |
| CPT 72010 | RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, ANTEROPOSTERIOR AND LATERAL | 26 | $23.97 | 7-1-2019 |
| CPT 72010 | RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, ANTEROPOSTERIOR AND LATERAL | TC | $34.90 | 7-1-2019 |
| CPT 72020 | RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL | $49.20 | 7-1-2019 | |
| CPT 72020 | RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL | 26 | $7.95 | 7-1-2019 |
| CPT 72020 | RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL | 59 | $49.20 | 7-1-2019 |
| CPT 72020 | RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL | 76 | $49.20 | 7-1-2019 |
| CPT 72020 | RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL | TC | $14.44 | 7-1-2019 |
| CPT 72040 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL | $49.20 | 7-1-2019 | |
| CPT 72040 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL | 26 | $11.74 | 7-1-2019 |
| CPT 72040 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL | TC | $20.71 | 7-1-2019 |
| CPT 72050 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS | $83.74 | 7-1-2019 | |
| CPT 72050 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS | 26 | $16.50 | 7-1-2019 |
| CPT 72050 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS | PO | $83.74 | 7-1-2019 |
| CPT 72050 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS | TC | $30.56 | 7-1-2019 |
| CPT 72052 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES | $83.74 | 7-1-2019 | |
| CPT 72052 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES | 26 | $18.99 | 7-1-2019 |
| CPT 72052 | RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES | TC | $38.50 | 7-1-2019 |
| CPT 72069 | RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS) | $49.20 | 7-1-2019 | |
| CPT 72069 | RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS) | 26 | $11.02 | 7-1-2019 |
| CPT 72069 | RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS) | TC | $17.12 | 7-1-2019 |
| CPT 72070 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL | $49.20 | 7-1-2019 | |
| CPT 72070 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL | 26 | $11.75 | 7-1-2019 |
| CPT 72070 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL | TC | $22.38 | 7-1-2019 |
| CPT 72072 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT | $49.20 | 7-1-2019 | |
| CPT 72072 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT | 26 | $11.74 | 7-1-2019 |
| CPT 72072 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT | TC | $25.30 | 7-1-2019 |
| CPT 72074 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING OBLIQUES, MINIMUM OF FOUR VIEWS | $49.20 | 7-1-2019 | |
| CPT 72074 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING OBLIQUES, MINIMUM OF FOUR VIEWS | 26 | $11.74 | 7-1-2019 |
| CPT 72074 | RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING OBLIQUES, MINIMUM OF FOUR VIEWS | TC | $31.23 | 7-1-2019 |
| CPT 72080 | RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR AND LATERAL | $49.20 | 7-1-2019 | |
| CPT 72080 | RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR AND LATERAL | 26 | $11.74 | 7-1-2019 |
| CPT 72080 | RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR AND LATERAL | TC | $23.05 | 7-1-2019 |
| CPT 72081 | X-RAY OF SPINE, 1 VIEW | $55.63 | 7-1-2019 | |
| CPT 72082 | X-RAY OF SPINE, 2 OR 3 VIEWS | $92.12 | 7-1-2019 | |
| CPT 72083 | X-RAY OF SPINE, 4 OR 5 VIEWS | $175.63 | 7-1-2019 | |
| CPT 72084 | X-RAY OF SPINE, MINIMUM OF 6 VIEWS | $175.63 | 7-1-2019 | |
| CPT 72084 | X-RAY OF SPINE, MINIMUM OF 6 VIEWS | $163.83 | 1-1-2060 | |
| CPT 72090 | RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE AND ERECT STUDIES | $83.74 | 7-1-2019 | |
| CPT 72090 | RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE AND ERECT STUDIES | 26 | $14.74 | 7-1-2019 |
| CPT 72090 | RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE AND ERECT STUDIES | TC | $23.05 | 7-1-2019 |
| CPT 72100 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | $49.20 | 7-1-2019 | |
| CPT 72100 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | 26 | $11.75 | 7-1-2019 |
| CPT 72100 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | 59 | $49.20 | 7-1-2019 |
| CPT 72100 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | FY | $49.20 | 7-1-2019 |
| CPT 72100 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | TC | $23.05 | 7-1-2019 |
| CPT 72110 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS | $83.74 | 7-1-2019 | |
| CPT 72110 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS | 26 | $16.50 | 7-1-2019 |
| CPT 72110 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS | TC | $31.23 | 7-1-2019 |
| CPT 72114 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS | $83.74 | 7-1-2019 | |
| CPT 72114 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS | 26 | $18.99 | 7-1-2019 |
| CPT 72114 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS | TC | $40.17 | 7-1-2019 |
| CPT 72120 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS | $83.74 | 7-1-2019 | |
| CPT 72120 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS | 26 | $11.74 | 7-1-2019 |
| CPT 72120 | RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS | TC | $30.56 | 7-1-2019 |
| CPT 72125 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 72125 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | 26 | $62.77 | 7-1-2019 |
| CPT 72125 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | 59 | $213.19 | 7-1-2019 |
| CPT 72125 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | TC | $201.42 | 7-1-2019 |
| CPT 72126 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL | $289.49 | 7-1-2019 | |
| CPT 72126 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL | 26 | $65.87 | 7-1-2019 |
| CPT 72126 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL | TC | $241.50 | 7-1-2019 |
| CPT 72127 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | $344.34 | 7-1-2019 | |
| CPT 72127 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | 26 | $68.81 | 7-1-2019 |
| CPT 72127 | COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | TC | $301.80 | 7-1-2019 |
| CPT 72128 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 72128 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | 26 | $62.77 | 7-1-2019 |
| CPT 72128 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | TC | $201.42 | 7-1-2019 |
| CPT 72129 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL | $289.49 | 7-1-2019 | |
| CPT 72129 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL | 26 | $65.87 | 7-1-2019 |
| CPT 72129 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL | TC | $241.50 | 7-1-2019 |
| CPT 72130 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | $344.34 | 7-1-2019 | |
| CPT 72130 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | 26 | $68.81 | 7-1-2019 |
| CPT 72130 | COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND | TC | $301.80 | 7-1-2019 |
| CPT 72131 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 72131 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | 26 | $62.77 | 7-1-2019 |
| CPT 72131 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | TC | $201.42 | 7-1-2019 |
| CPT 72132 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL | $289.49 | 7-1-2019 | |
| CPT 72132 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL | 26 | $65.87 | 7-1-2019 |
| CPT 72132 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL | TC | $241.50 | 7-1-2019 |
| CPT 72133 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F | $344.34 | 7-1-2019 | |
| CPT 72133 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F | 26 | $68.81 | 7-1-2019 |
| CPT 72133 | COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F | TC | $301.80 | 7-1-2019 |
| CPT 72141 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | $395.76 | 7-1-2019 | |
| CPT 72141 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | 26 | $86.81 | 7-1-2019 |
| CPT 72141 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | TC | $382.71 | 7-1-2019 |
| CPT 72142 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 72142 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S) | 26 | $99.20 | 7-1-2019 |
| CPT 72142 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S) | TC | $459.03 | 7-1-2019 |
| CPT 72146 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | $395.76 | 7-1-2019 | |
| CPT 72146 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | 26 | $86.81 | 7-1-2019 |
| CPT 72146 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | TC | $424.89 | 7-1-2019 |
| CPT 72147 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 72147 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S) | 26 | $99.20 | 7-1-2019 |
| CPT 72147 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S) | TC | $459.03 | 7-1-2019 |
| CPT 72148 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | $395.76 | 7-1-2019 | |
| CPT 72148 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | 26 | $76.57 | 7-1-2019 |
| CPT 72148 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | TC | $424.89 | 7-1-2019 |
| CPT 72149 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 72149 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S) | 26 | $91.88 | 7-1-2019 |
| CPT 72149 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S) | TC | $459.03 | 7-1-2019 |
| CPT 72156 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | $573.77 | 7-1-2019 | |
| CPT 72156 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | 26 | $132.52 | 7-1-2019 |
| CPT 72156 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | TC | $850.02 | 7-1-2019 |
| CPT 72157 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | $573.77 | 7-1-2019 | |
| CPT 72157 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | 26 | $132.52 | 7-1-2019 |
| CPT 72157 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | TC | $850.02 | 7-1-2019 |
| CPT 72158 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | $573.77 | 7-1-2019 | |
| CPT 72158 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | 26 | $122.18 | 7-1-2019 |
| CPT 72158 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON | TC | $850.02 | 7-1-2019 |
| CPT 72159 | MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, WITH OR WITHOUT CONTRAST MATERIAL(S) | $573.77 | 7-1-2019 | |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | $49.20 | 7-1-2019 | |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | 26 | $12.04 | 7-1-2019 |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | 59 | $49.20 | 7-1-2019 |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | FY | $49.20 | 7-1-2019 |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | LT | $49.20 | 7-1-2019 |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | RT | $49.20 | 7-1-2019 |
| CPT 72170 | RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | TC | $18.13 | 7-1-2019 |
| CPT 72190 | RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 72190 | RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $10.69 | 7-1-2019 |
| CPT 72190 | RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS | TC | $23.05 | 7-1-2019 |
| CPT 72191 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND | $336.85 | 7-1-2019 | |
| CPT 72192 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 72192 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | 26 | $55.96 | 7-1-2019 |
| CPT 72192 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | TC | $201.42 | 7-1-2019 |
| CPT 72193 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 72193 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | 26 | $59.90 | 7-1-2019 |
| CPT 72193 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | 59 | $289.49 | 7-1-2019 |
| CPT 72193 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | GZ | $289.49 | 7-1-2019 |
| CPT 72193 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | TC | $233.65 | 7-1-2019 |
| CPT 72194 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | $344.34 | 7-1-2019 | |
| CPT 72194 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | 26 | $62.60 | 7-1-2019 |
| CPT 72194 | COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER | TC | $289.93 | 7-1-2019 |
| CPT 72195 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S) | $395.76 | 7-1-2019 | |
| CPT 72196 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS | $420.48 | 7-1-2019 | |
| CPT 72196 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS | 26 | $82.88 | 7-1-2019 |
| CPT 72196 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS | TC | $382.71 | 7-1-2019 |
| CPT 72197 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, PELVIS; WITHOUTCONTRAST MATERIAL(S) AND FURTHER SEQUENCES | $573.77 | 7-1-2019 | |
| CPT 72198 | MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUT CONTRAST MATERIAL(S) | $498.14 | 7-1-2019 | |
| CPT 72200 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 72200 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS | 26 | $8.66 | 7-1-2019 |
| CPT 72200 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 72202 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS | $49.20 | 7-1-2019 | |
| CPT 72202 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS | 26 | $9.68 | 7-1-2019 |
| CPT 72202 | RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS | TC | $21.38 | 7-1-2019 |
| CPT 72220 | RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 72220 | RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 72220 | RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 72240 | MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 72240 | MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $49.16 | 7-1-2019 |
| CPT 72240 | MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $161.93 | 7-1-2019 |
| CPT 72255 | MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 72255 | MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $49.16 | 7-1-2019 |
| CPT 72255 | MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $147.81 | 7-1-2019 |
| CPT 72265 | MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 72265 | MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $44.69 | 7-1-2019 |
| CPT 72265 | MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $138.87 | 7-1-2019 |
| CPT 72270 | MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 72270 | MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $71.83 | 7-1-2019 |
| CPT 72270 | MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $208.02 | 7-1-2019 |
| CPT 72275 | EPIDUROGRAPHY, RADIOLOGICAL SUPERVISON AND INTERPRETATION | $196.68 | 7-1-2019 | |
| CPT 72285 | DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $820.92 | 7-1-2019 | |
| CPT 72285 | DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $42.91 | 7-1-2019 |
| CPT 72285 | DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $286.59 | 7-1-2019 |
| CPT 72291 | RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING | $172.27 | 7-1-2019 | |
| CPT 72291 | RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING | 76 | $172.27 | 7-1-2019 |
| CPT 72292 | RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING | $172.27 | 7-1-2019 | |
| CPT 72295 | DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $820.92 | 7-1-2019 | |
| CPT 72295 | DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $42.91 | 7-1-2019 |
| CPT 72295 | DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $820.92 | 7-1-2019 |
| CPT 72295 | DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $268.23 | 7-1-2019 |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | $49.20 | 7-1-2019 | |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | 26 | $8.25 | 7-1-2019 |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | 50 | $49.20 | 7-1-2019 |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | LT | $49.20 | 7-1-2019 |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | RT | $49.20 | 7-1-2019 |
| CPT 73000 | RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | TC | $18.13 | 7-1-2019 |
| CPT 73010 | RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE | $49.20 | 7-1-2019 | |
| CPT 73010 | RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE | 26 | $9.07 | 7-1-2019 |
| CPT 73010 | RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE | LT | $49.20 | 7-1-2019 |
| CPT 73010 | RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE | RT | $49.20 | 7-1-2019 |
| CPT 73010 | RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE | TC | $18.13 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | $49.20 | 7-1-2019 | |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | 26 | $7.85 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | 51 | $49.20 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | 59 | $49.20 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | 76 | $49.20 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | LT | $49.20 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | RT | $49.20 | 7-1-2019 |
| CPT 73020 | RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW | TC | $16.46 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | 26 | $9.54 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73030 | RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73040 | RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73040 | RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73040 | RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $235.57 | 7-1-2019 |
| CPT 73040 | RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $235.57 | 7-1-2019 |
| CPT 73040 | RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $71.73 | 7-1-2019 |
| CPT 73050 | RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION | $49.20 | 7-1-2019 | |
| CPT 73050 | RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION | 26 | $10.53 | 7-1-2019 |
| CPT 73050 | RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION | 50 | $49.20 | 7-1-2019 |
| CPT 73050 | RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION | RT | $49.20 | 7-1-2019 |
| CPT 73050 | RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACTION | TC | $23.05 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | 26 | $8.79 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73060 | RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $7.95 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73070 | RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 73080 | RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73080 | RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 73080 | RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73080 | RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73080 | RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73085 | RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73085 | RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73085 | RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $71.73 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.43 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 73090 | RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | XU | $49.20 | 7-1-2019 |
| CPT 73092 | RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73092 | RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73092 | RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | PO | $49.20 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73100 | RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73110 | RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | TC | $18.46 | 7-1-2019 |
| CPT 73115 | RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73115 | RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73115 | RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $235.57 | 7-1-2019 |
| CPT 73115 | RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $53.94 | 7-1-2019 |
| CPT 73120 | RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73120 | RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73120 | RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73120 | RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73120 | RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73130 | RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | TC | $18.46 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | 26 | $6.73 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F1 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F3 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F4 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F5 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F6 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F7 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | F8 | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73140 | RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | TC | $14.44 | 7-1-2019 |
| CPT 73200 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 73200 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | 26 | $58.48 | 7-1-2019 |
| CPT 73200 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | LT | $213.19 | 7-1-2019 |
| CPT 73200 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | RT | $213.19 | 7-1-2019 |
| CPT 73200 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | TC | $169.18 | 7-1-2019 |
| CPT 73201 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 73201 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S) | 26 | $62.77 | 7-1-2019 |
| CPT 73201 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S) | TC | $201.42 | 7-1-2019 |
| CPT 73202 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | $344.34 | 7-1-2019 | |
| CPT 73202 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | 26 | $65.87 | 7-1-2019 |
| CPT 73202 | COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | TC | $253.69 | 7-1-2019 |
| CPT 73206 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, UPPER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL | $336.85 | 7-1-2019 | |
| CPT 73218 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | $395.76 | 7-1-2019 | |
| CPT 73218 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | LT | $395.76 | 7-1-2019 |
| CPT 73218 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | RT | $395.76 | 7-1-2019 |
| CPT 73219 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY0THER THAN JOINT; WITH CONTRAST MATERIEL(S) | $420.48 | 7-1-2019 | |
| CPT 73220 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT | $573.77 | 7-1-2019 | |
| CPT 73220 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT | 26 | $80.09 | 7-1-2019 |
| CPT 73220 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT | LT | $573.77 | 7-1-2019 |
| CPT 73220 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT | RT | $573.77 | 7-1-2019 |
| CPT 73220 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT | TC | $382.71 | 7-1-2019 |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | $395.76 | 7-1-2019 | |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | 26 | $48.97 | 7-1-2019 |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | 50 | $395.76 | 7-1-2019 |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | LT | $395.76 | 7-1-2019 |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | RT | $395.76 | 7-1-2019 |
| CPT 73221 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | TC | $382.71 | 7-1-2019 |
| CPT 73222 | MAGNETIC RESONANCE (EG, PROTON)IMAGING, ANY JOINT OF UPPER EXTREMITY WITH; CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 73223 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED | $573.77 | 7-1-2019 | |
| CPT 73223 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED | LT | $573.77 | 7-1-2019 |
| CPT 73223 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED | RT | $573.77 | 7-1-2019 |
| CPT 73225 | MAGNETIC RSONANCE ANGIOGRAPHY, UPPER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S) | $408.12 | 7-1-2019 | |
| CPT 73500 | RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW | $49.20 | 7-1-2019 | |
| CPT 73500 | RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW | 26 | $8.87 | 7-1-2019 |
| CPT 73500 | RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW | LT | $49.20 | 7-1-2019 |
| CPT 73500 | RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW | RT | $49.20 | 7-1-2019 |
| CPT 73500 | RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW | TC | $16.46 | 7-1-2019 |
| CPT 73501 | X-RAY OF HIP WITH PELVIS, 1 VIEW | $55.63 | 7-1-2019 | |
| CPT 73501 | X-RAY OF HIP WITH PELVIS, 1 VIEW | LT | $55.63 | 7-1-2019 |
| CPT 73501 | X-RAY OF HIP WITH PELVIS, 1 VIEW | RT | $55.63 | 7-1-2019 |
| CPT 73502 | X-RAY OF HIP WITH PELVIS, 2-3 VIEWS | $55.63 | 7-1-2019 | |
| CPT 73502 | X-RAY OF HIP WITH PELVIS, 2-3 VIEWS | LT | $55.63 | 7-1-2019 |
| CPT 73502 | X-RAY OF HIP WITH PELVIS, 2-3 VIEWS | RT | $55.63 | 7-1-2019 |
| CPT 73503 | X-RAY OF HIP WITH PELVIS, MINIMUM OF 4 VIEWS | $92.12 | 7-1-2019 | |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | 26 | $11.19 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73510 | RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73520 | RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P | $83.74 | 7-1-2019 | |
| CPT 73520 | RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P | 26 | $13.95 | 7-1-2019 |
| CPT 73520 | RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P | TC | $23.05 | 7-1-2019 |
| CPT 73521 | X-RAY OF BOTH HIPS WITH PELVIS, 2 VIEWS | $92.12 | 7-1-2019 | |
| CPT 73522 | X-RAY OF BOTH HIPS WITH PELVIS, 3-4 VIEWS | $92.12 | 7-1-2019 | |
| CPT 73523 | X-RAY OF BOTH HIPS WITH PELVIS, MINIMUM OF 5 VIEWS | $175.63 | 7-1-2019 | |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $235.57 | 7-1-2019 |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $235.57 | 7-1-2019 |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $235.57 | 7-1-2019 |
| CPT 73525 | RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $71.73 | 7-1-2019 |
| CPT 73530 | RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE | $83.74 | 7-1-2019 | |
| CPT 73530 | RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE | 26 | $15.44 | 7-1-2019 |
| CPT 73530 | RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE | RT | $83.74 | 7-1-2019 |
| CPT 73530 | RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE | TC | $18.13 | 7-1-2019 |
| CPT 73540 | RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73540 | RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF TWO VIEWS | 26 | $10.89 | 7-1-2019 |
| CPT 73540 | RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF TWO VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73542 | RADIOLOGICAL JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $9.15 | 7-1-2019 |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73550 | RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73551 | X-RAY OF FEMUR, 1 VIEW | $55.63 | 7-1-2019 | |
| CPT 73551 | X-RAY OF FEMUR, 1 VIEW | LT | $55.63 | 7-1-2019 |
| CPT 73551 | X-RAY OF FEMUR, 1 VIEW | RT | $55.63 | 7-1-2019 |
| CPT 73552 | X-RAY OF FEMUR, MINIMUM 2 VIEWS | $55.63 | 7-1-2019 | |
| CPT 73552 | X-RAY OF FEMUR, MINIMUM 2 VIEWS | LT | $55.63 | 7-1-2019 |
| CPT 73552 | X-RAY OF FEMUR, MINIMUM 2 VIEWS | RT | $55.63 | 7-1-2019 |
| 73560 cpt code description | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.55 | 7-1-2019 |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | 59 | $83.74 | 7-1-2019 |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73560 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | 26 | $9.83 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73562 | RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | $49.20 | 7-1-2019 | |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | 26 | $11.94 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | 50 | $49.20 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | 76 | $49.20 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | LT | $49.20 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | RT | $49.20 | 7-1-2019 |
| CPT 73564 | RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW | TC | $21.38 | 7-1-2019 |
| CPT 73565 | RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR | $49.20 | 7-1-2019 | |
| CPT 73565 | RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR | 26 | $11.43 | 7-1-2019 |
| CPT 73565 | RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR | 59 | $49.20 | 7-1-2019 |
| CPT 73565 | RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR | TC | $17.12 | 7-1-2019 |
| CPT 73580 | RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73580 | RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73580 | RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $89.77 | 7-1-2019 |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.55 | 7-1-2019 |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73590 | RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $18.13 | 7-1-2019 |
| CPT 73592 | RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73592 | RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73592 | RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73600 | RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73600 | RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.12 | 7-1-2019 |
| CPT 73600 | RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73600 | RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73600 | RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | TC | $18.46 | 7-1-2019 |
| CPT 73615 | RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $235.57 | 7-1-2019 | |
| CPT 73615 | RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 73615 | RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $71.73 | 7-1-2019 |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | $49.20 | 7-1-2019 | |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73620 | RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | TC | $17.12 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | $49.20 | 7-1-2019 | |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | 26 | $9.30 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | TC | $18.46 | 7-1-2019 |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | 26 | $8.10 | 7-1-2019 |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73650 | RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | TC | $16.46 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | $49.20 | 7-1-2019 | |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | 26 | $6.73 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | 50 | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | 76 | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | LT | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | RT | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | T5 | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | T6 | $49.20 | 7-1-2019 |
| CPT 73660 | RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | TC | $14.44 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | 26 | $58.48 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | 50 | $213.19 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | 59 | $213.19 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | LT | $49.20 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | RT | $49.20 | 7-1-2019 |
| CPT 73700 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | TC | $169.18 | 7-1-2019 |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | 26 | $62.77 | 7-1-2019 |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | 59 | $289.49 | 7-1-2019 |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | LT | $289.49 | 7-1-2019 |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | RT | $289.49 | 7-1-2019 |
| CPT 73701 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | TC | $201.42 | 7-1-2019 |
| CPT 73702 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | $344.34 | 7-1-2019 | |
| CPT 73702 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | 26 | $65.87 | 7-1-2019 |
| CPT 73702 | COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN | TC | $253.69 | 7-1-2019 |
| CPT 73706 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL | $336.85 | 7-1-2019 | |
| CPT 73706 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL | 59 | $336.85 | 7-1-2019 |
| CPT 73706 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL | LT | $336.85 | 7-1-2019 |
| CPT 73718 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | $395.76 | 7-1-2019 | |
| CPT 73718 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | LT | $395.76 | 7-1-2019 |
| CPT 73718 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) | RT | $395.76 | 7-1-2019 |
| CPT 73719 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 73720 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT | $573.77 | 7-1-2019 | |
| CPT 73720 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT | 26 | $80.09 | 7-1-2019 |
| CPT 73720 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT | LT | $573.77 | 7-1-2019 |
| CPT 73720 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT | RT | $573.77 | 7-1-2019 |
| CPT 73720 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT | TC | $382.71 | 7-1-2019 |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | $395.76 | 7-1-2019 | |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | 26 | $146.63 | 7-1-2019 |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | 50 | $395.76 | 7-1-2019 |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | LT | $395.76 | 7-1-2019 |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | RT | $395.76 | 7-1-2019 |
| CPT 73721 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY | TC | $382.71 | 7-1-2019 |
| CPT 73722 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 73723 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S) | $573.77 | 7-1-2019 | |
| CPT 73723 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S) | LT | $573.77 | 7-1-2019 |
| CPT 73725 | MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S) | $498.94 | 7-1-2019 | |
| CPT 74000 | RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW | $49.20 | 7-1-2019 | |
| CPT 74000 | RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW | 26 | $12.50 | 7-1-2019 |
| CPT 74000 | RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW | 59 | $49.20 | 7-1-2019 |
| CPT 74000 | RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW | 76 | $49.20 | 7-1-2019 |
| CPT 74000 | RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW | TC | $18.13 | 7-1-2019 |
| CPT 74010 | RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND CONE VIEWS | $49.20 | 7-1-2019 | |
| CPT 74010 | RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND CONE VIEWS | 26 | $12.23 | 7-1-2019 |
| CPT 74010 | RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND CONE VIEWS | TC | $19.70 | 7-1-2019 |
| CPT 74018 | RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW | $53.28 | 7-1-2019 | |
| CPT 74018 | RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW | 26 | $5.76 | 7-1-2019 |
| CPT 74018 | RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW | TC | $11.29 | 7-1-2019 |
| CPT 74019 | RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS | $98.17 | 7-1-2019 | |
| CPT 74019 | RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS | 26 | $7.30 | 7-1-2019 |
| CPT 74019 | RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS | TC | $13.50 | 7-1-2019 |
| CPT 74020 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS | $49.20 | 7-1-2019 | |
| CPT 74020 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS | 26 | $14.45 | 7-1-2019 |
| CPT 74020 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS | 59 | $49.20 | 7-1-2019 |
| CPT 74020 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS | TC | $21.38 | 7-1-2019 |
| CPT 74021 | RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWS | $98.17 | 7-1-2019 | |
| CPT 74021 | RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWS | 26 | $8.63 | 7-1-2019 |
| CPT 74021 | RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWS | TC | $15.70 | 7-1-2019 |
| CPT 74022 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE | $83.74 | 7-1-2019 | |
| CPT 74022 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE | 26 | $16.87 | 7-1-2019 |
| CPT 74022 | RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE | TC | $25.30 | 7-1-2019 |
| CPT 74150 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | $213.19 | 7-1-2019 | |
| CPT 74150 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | 26 | $64.13 | 7-1-2019 |
| CPT 74150 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | TC | $193.15 | 7-1-2019 |
| CPT 74160 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | $289.49 | 7-1-2019 | |
| CPT 74160 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | 26 | $68.81 | 7-1-2019 |
| CPT 74160 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | 59 | $289.49 | 7-1-2019 |
| CPT 74160 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | GZ | $289.49 | 7-1-2019 |
| CPT 74160 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | TC | $233.65 | 7-1-2019 |
| CPT 74170 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE | $344.34 | 7-1-2019 | |
| CPT 74170 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE | 26 | $75.84 | 7-1-2019 |
| CPT 74170 | COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE | TC | $289.93 | 7-1-2019 |
| CPT 74174 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES | $365.52 | 7-1-2019 | |
| CPT 74175 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, WITHOUT CONTRAST MATERIAL(S),FOLLOWED BY CONTRAST MATERIAL(S) AND | $336.85 | 7-1-2019 | |
| CPT 74176 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL | $189.83 | 7-1-2019 | |
| CPT 74177 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL | $293.59 | 7-1-2019 | |
| CPT 74177 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL | PO | $293.59 | 7-1-2019 |
| CPT 74177 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL | TC | $136.74 | 7-1-2019 |
| CPT 74177 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL | XP | $293.59 | 7-1-2019 |
| CPT 74178 | COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY | $327.30 | 7-1-2019 | |
| CPT 74181 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN | $395.76 | 7-1-2019 | |
| CPT 74181 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN | 26 | $86.81 | 7-1-2019 |
| CPT 74181 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN | 59 | $395.76 | 7-1-2019 |
| CPT 74181 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN | TC | $382.71 | 7-1-2019 |
| CPT 74182 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITH CONTRAST MATERIAL(S) | $420.48 | 7-1-2019 | |
| CPT 74183 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATE | $573.77 | 7-1-2019 | |
| CPT 74183 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATE | 59 | $573.77 | 7-1-2019 |
| CPT 74185 | MAGNETIC RESONANCE ANGIOGRAPHY, ABDOMEN, WITH OR WITHOUT CONTRAST MATERIAL(S) | $498.54 | 7-1-2019 | |
| CPT 74190 | PERITONEOGRAM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 74210 | RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS | $99.10 | 7-1-2019 | |
| CPT 74210 | RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS | 26 | $18.77 | 7-1-2019 |
| CPT 74210 | RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS | TC | $40.17 | 7-1-2019 |
| CPT 74220 | RADIOLOGIC EXAMINATION; ESOPHAGUS | $96.42 | 7-1-2019 | |
| CPT 74220 | RADIOLOGIC EXAMINATION; ESOPHAGUS | 26 | $25.34 | 7-1-2019 |
| CPT 74220 | RADIOLOGIC EXAMINATION; ESOPHAGUS | TC | $40.17 | 7-1-2019 |
| CPT 74230 | SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO | $96.42 | 7-1-2019 | |
| CPT 74230 | SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO | 26 | $29.33 | 7-1-2019 |
| CPT 74230 | SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO | TC | $44.42 | 7-1-2019 |
| CPT 74235 | REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT | $153.00 | 7-1-2019 | |
| CPT 74235 | REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT | 26 | $64.13 | 7-1-2019 |
| CPT 74235 | REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT | TC | $89.77 | 7-1-2019 |
| CPT 74240 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB | $99.10 | 7-1-2019 | |
| CPT 74240 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB | 26 | $37.41 | 7-1-2019 |
| CPT 74240 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB | TC | $50.02 | 7-1-2019 |
| CPT 74241 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB | $99.10 | 7-1-2019 | |
| CPT 74241 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB | 26 | $37.41 | 7-1-2019 |
| CPT 74241 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB | TC | $51.03 | 7-1-2019 |
| CPT 74245 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | $154.80 | 7-1-2019 | |
| CPT 74245 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | 26 | $49.32 | 7-1-2019 |
| CPT 74245 | RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | TC | $81.59 | 7-1-2019 |
| CPT 74246 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | $99.10 | 7-1-2019 | |
| CPT 74246 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | 26 | $37.41 | 7-1-2019 |
| CPT 74246 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | TC | $56.28 | 7-1-2019 |
| CPT 74247 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | $99.10 | 7-1-2019 | |
| CPT 74247 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | 26 | $37.41 | 7-1-2019 |
| CPT 74247 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | TC | $57.53 | 7-1-2019 |
| CPT 74249 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | $154.80 | 7-1-2019 | |
| CPT 74249 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | 26 | $49.32 | 7-1-2019 |
| CPT 74249 | RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE | TC | $87.85 | 7-1-2019 |
| CPT 74250 | RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | $99.10 | 7-1-2019 | |
| CPT 74250 | RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | 26 | $25.49 | 7-1-2019 |
| CPT 74250 | RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS | TC | $44.42 | 7-1-2019 |
| CPT 74251 | RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS; VIA ENTEROCLYSIS TUBE | $154.80 | 7-1-2019 | |
| CPT 74260 | DUODENOGRAPHY, HYPOTONIC | $154.80 | 7-1-2019 | |
| CPT 74260 | DUODENOGRAPHY, HYPOTONIC | 26 | $27.46 | 7-1-2019 |
| CPT 74260 | DUODENOGRAPHY, HYPOTONIC | TC | $51.03 | 7-1-2019 |
| CPT 74261 | COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING IMAGE POSTPROCESSING; WITHOUT CONTRAST MATERIAL | $189.83 | 7-1-2019 | |
| CPT 74270 | RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA | $99.10 | 7-1-2019 | |
| CPT 74270 | RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA | 26 | $37.41 | 7-1-2019 |
| CPT 74270 | RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA | TC | $58.20 | 7-1-2019 |
| CPT 74280 | RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT GLUCAGON | $154.80 | 7-1-2019 | |
| CPT 74280 | RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT GLUCAGON | 26 | $53.46 | 7-1-2019 |
| CPT 74280 | RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT GLUCAGON | TC | $76.33 | 7-1-2019 |
| CPT 74283 | THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION | $99.10 | 7-1-2019 | |
| CPT 74283 | THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION | 26 | $104.17 | 7-1-2019 |
| CPT 74283 | THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION | TC | $87.52 | 7-1-2019 |
| CPT 74290 | CHOLECYSTOGRAPHY, ORAL CONTRAST; | $99.10 | 7-1-2019 | |
| CPT 74290 | CHOLECYSTOGRAPHY, ORAL CONTRAST; | 26 | $16.87 | 7-1-2019 |
| CPT 74290 | CHOLECYSTOGRAPHY, ORAL CONTRAST; | TC | $25.30 | 7-1-2019 |
| CPT 74291 | CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT EXAMINATION OR MULTIPLE DAY EXAMINATION | $99.10 | 7-1-2019 | |
| CPT 74291 | CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT EXAMINATION OR MULTIPLE DAY EXAMINATION | 26 | $10.69 | 7-1-2019 |
| CPT 74291 | CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT EXAMINATION OR MULTIPLE DAY EXAMINATION | TC | $14.44 | 7-1-2019 |
| CPT 74300 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; DURING SURGERY | $114.52 | 7-1-2019 | |
| CPT 74300 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; DURING SURGERY | 26 | $19.24 | 7-1-2019 |
| CPT 74301 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET DURING SURGERY | $114.52 | 7-1-2019 | |
| CPT 74301 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET DURING SURGERY | 26 | $11.19 | 7-1-2019 |
| CPT 74305 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE | $114.52 | 7-1-2019 | |
| CPT 74305 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE | 26 | $22.67 | 7-1-2019 |
| CPT 74305 | CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE | TC | $26.97 | 7-1-2019 |
| CPT 74320 | CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 74320 | CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 74320 | CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74327 | POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T- TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ | $153.00 | 7-1-2019 | |
| CPT 74327 | POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T- TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ | 26 | $37.97 | 7-1-2019 |
| CPT 74327 | POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T- TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ | TC | $60.20 | 7-1-2019 |
| CPT 74328 | ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $143.57 | 7-1-2019 | |
| CPT 74328 | ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $37.97 | 7-1-2019 |
| CPT 74328 | ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74329 | ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $143.57 | 7-1-2019 | |
| CPT 74329 | ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $37.97 | 7-1-2019 |
| CPT 74329 | ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74330 | COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND | $143.57 | 7-1-2019 | |
| CPT 74330 | COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND | 26 | $37.97 | 7-1-2019 |
| CPT 74330 | COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND | TC | $107.31 | 7-1-2019 |
| CPT 74340 | INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT), WITH MULTIPLE FLUOROSCOPIES AND FILMS | $89.64 | 7-1-2019 | |
| CPT 74340 | INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT), WITH MULTIPLE FLUOROSCOPIES AND FILMS | 26 | $29.87 | 7-1-2019 |
| CPT 74340 | INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT), WITH MULTIPLE FLUOROSCOPIES AND FILMS | TC | $89.77 | 7-1-2019 |
| CPT 74350 | PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 74350 | PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $41.15 | 7-1-2019 |
| CPT 74350 | PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74355 | PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 74355 | PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $41.15 | 7-1-2019 |
| CPT 74355 | PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $89.77 | 7-1-2019 |
| CPT 74360 | INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE | $153.00 | 7-1-2019 | |
| CPT 74360 | INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE | 26 | $29.87 | 7-1-2019 |
| CPT 74360 | INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE | TC | $107.31 | 7-1-2019 |
| CPT 74363 | PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE WITH OR WITHOUT PLACEMENT OF STENT, RADIOLOGICA | $343.82 | 7-1-2019 | |
| CPT 74363 | PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE WITH OR WITHOUT PLACEMENT OF STENT, RADIOLOGICA | 26 | $45.60 | 7-1-2019 |
| CPT 74400 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; | $172.39 | 7-1-2019 | |
| CPT 74400 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; | 26 | $26.64 | 7-1-2019 |
| CPT 74400 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; | TC | $57.53 | 7-1-2019 |
| CPT 74405 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI | $93.38 | 7-1-2019 | |
| CPT 74405 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI | 26 | $26.64 | 7-1-2019 |
| CPT 74405 | UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI | TC | $68.05 | 7-1-2019 |
| CPT 74410 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; | $172.39 | 7-1-2019 | |
| CPT 74410 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; | 26 | $26.64 | 7-1-2019 |
| CPT 74410 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; | TC | $66.47 | 7-1-2019 |
| CPT 74415 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY | $172.39 | 7-1-2019 | |
| CPT 74415 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY | 26 | $26.64 | 7-1-2019 |
| CPT 74415 | UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY | TC | $72.40 | 7-1-2019 |
| CPT 74420 | UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB | $172.39 | 7-1-2019 | |
| CPT 74420 | UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB | 26 | $18.77 | 7-1-2019 |
| CPT 74420 | UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB | 76 | $172.39 | 7-1-2019 |
| CPT 74420 | UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB | TC | $89.77 | 7-1-2019 |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $18.01 | 7-1-2019 |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $172.39 | 7-1-2019 |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $172.39 | 7-1-2019 |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $172.39 | 7-1-2019 |
| CPT 74425 | UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $44.42 | 7-1-2019 |
| CPT 74430 | CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74430 | CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $16.33 | 7-1-2019 |
| CPT 74430 | CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $35.83 | 7-1-2019 |
| CPT 74440 | VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74440 | VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $19.26 | 7-1-2019 |
| CPT 74440 | VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $38.50 | 7-1-2019 |
| CPT 74445 | CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74445 | CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $58.90 | 7-1-2019 |
| CPT 74445 | CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $38.50 | 7-1-2019 |
| CPT 74450 | URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74450 | URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $16.66 | 7-1-2019 |
| CPT 74450 | URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $50.02 | 7-1-2019 |
| CPT 74455 | URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $172.39 | 7-1-2019 | |
| CPT 74455 | URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $16.66 | 7-1-2019 |
| CPT 74455 | URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $53.94 | 7-1-2019 |
| CPT 74470 | RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN | $114.52 | 7-1-2019 | |
| CPT 74470 | RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN | 26 | $28.27 | 7-1-2019 |
| CPT 74470 | RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN | TC | $42.75 | 7-1-2019 |
| CPT 74475 | INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO | $343.82 | 7-1-2019 | |
| CPT 74475 | INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO | 26 | $29.87 | 7-1-2019 |
| CPT 74475 | INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO | LT | $343.82 | 7-1-2019 |
| CPT 74475 | INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO | RT | $343.82 | 7-1-2019 |
| CPT 74475 | INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO | TC | $138.87 | 7-1-2019 |
| CPT 74480 | INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER | $153.00 | 7-1-2019 | |
| CPT 74480 | INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER | 26 | $29.87 | 7-1-2019 |
| CPT 74480 | INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER | TC | $138.87 | 7-1-2019 |
| CPT 74485 | DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $153.00 | 7-1-2019 | |
| CPT 74485 | DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 74485 | DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $153.00 | 7-1-2019 |
| CPT 74485 | DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $153.00 | 7-1-2019 |
| CPT 74485 | DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74710 | PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION | $83.74 | 7-1-2019 | |
| CPT 74710 | PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION | 26 | $18.17 | 7-1-2019 |
| CPT 74710 | PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION | TC | $35.83 | 7-1-2019 |
| CPT 74712 | MAGNETIC RESONANCE IMAGING OF FETUS, SINGLE OR FIRST PREGNANCY | $250.25 | 7-1-2019 | |
| CPT 74740 | HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 74740 | HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $20.05 | 7-1-2019 |
| CPT 74740 | HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $44.42 | 7-1-2019 |
| CPT 74742 | TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 74742 | TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $30.64 | 7-1-2019 |
| CPT 74742 | TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $107.31 | 7-1-2019 |
| CPT 74775 | PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES) | $172.39 | 7-1-2019 | |
| CPT 74775 | PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES) | 26 | $33.89 | 7-1-2019 |
| CPT 74775 | PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES) | TC | $50.02 | 7-1-2019 |
| CPT 75500 | ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $453.13 | 7-1-2019 | |
| CPT 75500 | ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75500 | ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $394.24 | 7-1-2019 |
| CPT 75505 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $453.13 | 7-1-2019 | |
| CPT 75505 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75505 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $394.24 | 7-1-2019 |
| CPT 75507 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $461.80 | 7-1-2019 | |
| CPT 75507 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75507 | ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $394.24 | 7-1-2019 |
| CPT 75519 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | $437.82 | 7-1-2019 | |
| CPT 75519 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | 26 | $45.45 | 7-1-2019 |
| CPT 75519 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | TC | $394.24 | 7-1-2019 |
| CPT 75523 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $437.82 | 7-1-2019 | |
| CPT 75523 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $45.45 | 7-1-2019 |
| CPT 75523 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $394.24 | 7-1-2019 |
| CPT 75527 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE | $471.82 | 7-1-2019 | |
| CPT 75527 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE | 26 | $81.00 | 7-1-2019 |
| CPT 75527 | CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE | TC | $394.24 | 7-1-2019 |
| CPT 75552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUM | $395.76 | 7-1-2019 | |
| CPT 75552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUM | 26 | $86.81 | 7-1-2019 |
| CPT 75552 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUM | TC | $382.71 | 7-1-2019 |
| CPT 75553 | CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITHOUT CONTRAST MATERIAL | $420.48 | 7-1-2019 | |
| CPT 75554 | CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY; COMPLETE STUDY | $395.76 | 7-1-2019 | |
| CPT 75555 | CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY; LIMITED STUDY | $395.76 | 7-1-2019 | |
| CPT 75556 | CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING | $395.76 | 7-1-2019 | |
| CPT 75557 | CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL; | $320.14 | 7-1-2019 | |
| CPT 75561 | CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTR | $582.37 | 7-1-2019 | |
| CPT 75600 | AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75600 | AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $26.64 | 7-1-2019 |
| CPT 75600 | AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75605 | AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75605 | AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75605 | AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75625 | AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75625 | AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75625 | AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $1,377.18 | 7-1-2019 |
| CPT 75625 | AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75630 | AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU | $1,377.18 | 7-1-2019 | |
| CPT 75630 | AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU | 26 | $70.93 | 7-1-2019 |
| CPT 75630 | AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU | 59 | $1,377.18 | 7-1-2019 |
| CPT 75630 | AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU | TC | $448.51 | 7-1-2019 |
| CPT 75635 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA AND BILATERAL ILIOFEMORAL LOWER EXTREMITY RUNOFF, RADIOLOGIC | $336.85 | 7-1-2019 | |
| CPT 75650 | ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75650 | ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $80.40 | 7-1-2019 |
| CPT 75650 | ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75658 | ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75658 | ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75658 | ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75660 | ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75660 | ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75660 | ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75662 | ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75662 | ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $89.70 | 7-1-2019 |
| CPT 75662 | ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75665 | ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75665 | ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75665 | ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $1,377.18 | 7-1-2019 |
| CPT 75665 | ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75671 | ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75671 | ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $89.70 | 7-1-2019 |
| CPT 75671 | ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75676 | ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75676 | ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75676 | ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75680 | ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75680 | ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $89.70 | 7-1-2019 |
| CPT 75680 | ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75685 | ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75685 | ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75685 | ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75705 | ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75705 | ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $117.76 | 7-1-2019 |
| CPT 75705 | ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75710 | ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75710 | ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75710 | ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $1,377.18 | 7-1-2019 |
| CPT 75710 | ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $1,377.18 | 7-1-2019 |
| CPT 75710 | ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75716 | ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75716 | ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75716 | ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $1,377.18 | 7-1-2019 |
| CPT 75716 | ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75722 | ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA | $1,377.18 | 7-1-2019 | |
| CPT 75722 | ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA | 26 | $61.70 | 7-1-2019 |
| CPT 75722 | ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA | TC | $430.15 | 7-1-2019 |
| CPT 75724 | ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), | $1,377.18 | 7-1-2019 | |
| CPT 75724 | ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), | 26 | $80.40 | 7-1-2019 |
| CPT 75724 | ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), | TC | $430.15 | 7-1-2019 |
| CPT 75726 | ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION | $1,377.18 | 7-1-2019 | |
| CPT 75726 | ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION | 26 | $61.70 | 7-1-2019 |
| CPT 75726 | ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION | 59 | $1,377.18 | 7-1-2019 |
| CPT 75726 | ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION | TC | $430.15 | 7-1-2019 |
| CPT 75731 | ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75731 | ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75731 | ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75733 | ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75733 | ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75733 | ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75736 | ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75736 | ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75736 | ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75741 | ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75741 | ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75741 | ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75743 | ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75743 | ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $89.70 | 7-1-2019 |
| CPT 75743 | ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75746 | ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | $586.71 | 7-1-2019 | |
| CPT 75746 | ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | 26 | $61.70 | 7-1-2019 |
| CPT 75746 | ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | TC | $430.15 | 7-1-2019 |
| CPT 75750 | ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $489.05 | 7-1-2019 | |
| CPT 75750 | ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75750 | ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75752 | ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM | $489.05 | 7-1-2019 | |
| CPT 75752 | ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM | 26 | $61.70 | 7-1-2019 |
| CPT 75752 | ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM | TC | $430.15 | 7-1-2019 |
| CPT 75754 | ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A | $498.05 | 7-1-2019 | |
| CPT 75754 | ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A | 26 | $71.25 | 7-1-2019 |
| CPT 75754 | ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A | TC | $430.15 | 7-1-2019 |
| CPT 75756 | ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75756 | ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75756 | ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75762 | ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $489.05 | 7-1-2019 | |
| CPT 75762 | ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75762 | ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75766 | ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $497.71 | 7-1-2019 | |
| CPT 75766 | ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75766 | ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75774 | ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION, RADIOLOGICAL SUPERVISION AND I | $586.71 | 7-1-2019 | |
| CPT 75774 | ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION, RADIOLOGICAL SUPERVISION AND I | 26 | $18.01 | 7-1-2019 |
| CPT 75774 | ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION, RADIOLOGICAL SUPERVISION AND I | TC | $430.15 | 7-1-2019 |
| CPT 75790 | ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75790 | ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $99.33 | 7-1-2019 |
| CPT 75790 | ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $586.71 | 7-1-2019 |
| CPT 75790 | ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $586.71 | 7-1-2019 |
| CPT 75790 | ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $46.34 | 7-1-2019 |
| CPT 75801 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 75801 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $43.75 | 7-1-2019 |
| CPT 75801 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $184.97 | 7-1-2019 |
| CPT 75803 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 75803 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $62.99 | 7-1-2019 |
| CPT 75803 | LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $184.97 | 7-1-2019 |
| CPT 75805 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 75805 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $43.75 | 7-1-2019 |
| CPT 75805 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $208.02 | 7-1-2019 |
| CPT 75807 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 75807 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $62.99 | 7-1-2019 |
| CPT 75807 | LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $208.02 | 7-1-2019 |
| CPT 75809 | SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE | $114.52 | 7-1-2019 | |
| CPT 75809 | SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE | 26 | $23.65 | 7-1-2019 |
| CPT 75809 | SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE | TC | $26.97 | 7-1-2019 |
| CPT 75810 | SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75810 | SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75810 | SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $37.97 | 7-1-2019 |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $425.62 | 7-1-2019 |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $425.62 | 7-1-2019 |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $425.62 | 7-1-2019 |
| CPT 75820 | VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $32.24 | 7-1-2019 |
| CPT 75822 | VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75822 | VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $56.96 | 7-1-2019 |
| CPT 75822 | VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $50.68 | 7-1-2019 |
| CPT 75825 | VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75825 | VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75825 | VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $586.71 | 7-1-2019 |
| CPT 75825 | VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75827 | VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75827 | VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75827 | VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $586.71 | 7-1-2019 |
| CPT 75827 | VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75831 | VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75831 | VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75831 | VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75833 | VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75833 | VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $80.40 | 7-1-2019 |
| CPT 75833 | VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75840 | VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75840 | VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75840 | VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75842 | VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75842 | VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $80.40 | 7-1-2019 |
| CPT 75842 | VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75860 | VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75860 | VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75860 | VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $425.62 | 7-1-2019 |
| CPT 75860 | VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75870 | VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75870 | VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75870 | VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75872 | VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75872 | VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75872 | VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75880 | VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75880 | VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $37.97 | 7-1-2019 |
| CPT 75880 | VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $32.24 | 7-1-2019 |
| CPT 75885 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75885 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $77.97 | 7-1-2019 |
| CPT 75885 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75887 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | $586.71 | 7-1-2019 | |
| CPT 75887 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | 26 | $77.97 | 7-1-2019 |
| CPT 75887 | PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT | TC | $430.15 | 7-1-2019 |
| CPT 75889 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $1,377.18 | 7-1-2019 | |
| CPT 75889 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $61.70 | 7-1-2019 |
| CPT 75889 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75891 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | $586.71 | 7-1-2019 | |
| CPT 75891 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | 26 | $61.70 | 7-1-2019 |
| CPT 75891 | HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | TC | $430.15 | 7-1-2019 |
| CPT 75893 | VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC | $458.42 | 7-1-2019 | |
| CPT 75893 | VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC | 26 | $29.87 | 7-1-2019 |
| CPT 75893 | VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC | 59 | $458.42 | 7-1-2019 |
| CPT 75893 | VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC | TC | $430.15 | 7-1-2019 |
| CPT 75894 | TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $343.82 | 7-1-2019 | |
| CPT 75894 | TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $70.93 | 7-1-2019 |
| CPT 75894 | TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $824.38 | 7-1-2019 |
| CPT 75896 | TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A | $343.82 | 7-1-2019 | |
| CPT 75896 | TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A | 26 | $70.93 | 7-1-2019 |
| CPT 75896 | TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A | TC | $716.49 | 7-1-2019 |
| CPT 75898 | ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION | $114.52 | 7-1-2019 | |
| CPT 75898 | ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION | 26 | $89.40 | 7-1-2019 |
| CPT 75898 | ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION | TC | $35.83 | 7-1-2019 |
| CPT 75901 | MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS DEVICE VIA SEPERATE VENOUS ACCESS | $114.52 | 7-1-2019 | |
| CPT 75902 | MECHANICAL REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN, RADIO | $114.52 | 7-1-2019 | |
| CPT 75940 | PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $343.82 | 7-1-2019 | |
| CPT 75940 | PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 75940 | PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $430.15 | 7-1-2019 |
| CPT 75945 | INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL SUPERVISION AND INTERPRETATION; INTIAL VESSEL | $172.28 | 7-1-2019 | |
| CPT 75946 | INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL SUPERVISION AND INTERPRETATION; EACH ADDITIONAL | $107.12 | 7-1-2019 | |
| CPT 75960 | TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON- CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO | $425.62 | 7-1-2019 | |
| CPT 75960 | TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON- CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO | 26 | $42.24 | 7-1-2019 |
| CPT 75960 | TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON- CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO | TC | $508.57 | 7-1-2019 |
| CPT 75961 | TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE | $425.62 | 7-1-2019 | |
| CPT 75961 | TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE | 26 | $230.07 | 7-1-2019 |
| CPT 75961 | TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE | TC | $358.41 | 7-1-2019 |
| CPT 75962 | TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75962 | TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 75962 | TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $537.46 | 7-1-2019 |
| CPT 75964 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI | $425.62 | 7-1-2019 | |
| CPT 75964 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI | 26 | $18.01 | 7-1-2019 |
| CPT 75964 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI | TC | $286.93 | 7-1-2019 |
| CPT 75966 | TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75966 | TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $67.57 | 7-1-2019 |
| CPT 75966 | TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $537.46 | 7-1-2019 |
| CPT 75968 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75968 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $18.01 | 7-1-2019 |
| CPT 75968 | TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $286.93 | 7-1-2019 |
| CPT 75970 | TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $425.62 | 7-1-2019 | |
| CPT 75970 | TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $44.69 | 7-1-2019 |
| CPT 75970 | TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $394.24 | 7-1-2019 |
| CPT 75978 | TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO | $425.62 | 7-1-2019 | |
| CPT 75978 | TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO | 26 | $36.63 | 7-1-2019 |
| CPT 75978 | TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO | 59 | $425.62 | 7-1-2019 |
| CPT 75978 | TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO | LT | $425.62 | 7-1-2019 |
| CPT 75978 | TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO | RT | $425.62 | 7-1-2019 |
| CPT 75980 | PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI | $343.82 | 7-1-2019 | |
| CPT 75980 | PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI | 26 | $77.97 | 7-1-2019 |
| CPT 75980 | PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI | TC | $184.97 | 7-1-2019 |
| CPT 75982 | PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA | $343.82 | 7-1-2019 | |
| CPT 75982 | PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA | 26 | $77.97 | 7-1-2019 |
| CPT 75982 | PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA | 52 | $343.82 | 7-1-2019 |
| CPT 75982 | PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA | TC | $208.02 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | $114.52 | 7-1-2019 | |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | 26 | $37.27 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | 50 | $114.52 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | 59 | $114.52 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | LT | $114.52 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | RT | $114.52 | 7-1-2019 |
| CPT 75984 | CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG | TC | $66.47 | 7-1-2019 |
| CPT 75989 | RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN | $126.26 | 7-1-2019 | |
| CPT 75989 | RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN | 26 | $52.49 | 7-1-2019 |
| CPT 75989 | RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN | TC | $107.31 | 7-1-2019 |
| CPT 75992 | TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75992 | TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 75992 | TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $537.46 | 7-1-2019 |
| CPT 75993 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75993 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $18.01 | 7-1-2019 |
| CPT 75993 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $286.93 | 7-1-2019 |
| CPT 75994 | TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75994 | TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $67.57 | 7-1-2019 |
| CPT 75994 | TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $537.46 | 7-1-2019 |
| CPT 75995 | TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $586.71 | 7-1-2019 | |
| CPT 75995 | TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $67.57 | 7-1-2019 |
| CPT 75995 | TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $537.46 | 7-1-2019 |
| CPT 75996 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | $586.71 | 7-1-2019 | |
| CPT 75996 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | 26 | $18.01 | 7-1-2019 |
| CPT 75996 | TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO | TC | $286.93 | 7-1-2019 |
| CPT 76000 | FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 | $89.64 | 7-1-2019 | |
| CPT 76000 | FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 | 26 | $8.55 | 7-1-2019 |
| CPT 76000 | FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 | 59 | $89.64 | 7-1-2019 |
| CPT 76000 | FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 | TC | $44.42 | 7-1-2019 |
| CPT 76000 | FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 | XU | $89.64 | 7-1-2019 |
| CPT 76001 | FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON- RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY, | $124.68 | 7-1-2019 | |
| CPT 76001 | FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON- RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY, | 26 | $36.60 | 7-1-2019 |
| CPT 76001 | FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON- RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY, | 59 | $124.68 | 7-1-2019 |
| CPT 76001 | FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON- RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY, | 76 | $124.68 | 7-1-2019 |
| CPT 76001 | FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON- RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY, | TC | $89.77 | 7-1-2019 |
| CPT 76003 | FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE ASPIRATION | $72.69 | 7-1-2019 | |
| CPT 76003 | FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE ASPIRATION | 26 | $29.87 | 7-1-2019 |
| CPT 76003 | FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE ASPIRATION | TC | $44.42 | 7-1-2019 |
| CPT 76006 | MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN FOR JOINT RADIOLOGY, INCLUDING CONTRALATERAL JOINT IF IND | $49.20 | 7-1-2019 | |
| CPT 76010 | RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM, CHILD | $49.20 | 7-1-2019 | |
| CPT 76010 | RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM, CHILD | 26 | $9.61 | 7-1-2019 |
| CPT 76010 | RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM, CHILD | TC | $18.13 | 7-1-2019 |
| CPT 76012 | RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, PER VERTEBRAL BODY; UNDER FLUOROSCOP | $196.68 | 7-1-2019 | |
| CPT 76013 | RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY; UNDER CT GUIDANCE | $196.68 | 7-1-2019 | |
| CPT 76020 | BONE AGE STUDIES | $49.20 | 7-1-2019 | |
| CPT 76020 | BONE AGE STUDIES | 26 | $10.39 | 7-1-2019 |
| CPT 76020 | BONE AGE STUDIES | TC | $18.13 | 7-1-2019 |
| CPT 76040 | BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM) | $83.74 | 7-1-2019 | |
| CPT 76040 | BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM) | 26 | $14.45 | 7-1-2019 |
| CPT 76040 | BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM) | TC | $26.97 | 7-1-2019 |
| CPT 76061 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES) | $83.74 | 7-1-2019 | |
| CPT 76061 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES) | 26 | $24.29 | 7-1-2019 |
| CPT 76061 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES) | TC | $33.91 | 7-1-2019 |
| CPT 76062 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) | $83.74 | 7-1-2019 | |
| CPT 76062 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) | 26 | $29.87 | 7-1-2019 |
| CPT 76062 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) | TC | $49.35 | 7-1-2019 |
| CPT 76065 | RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANT | $83.74 | 7-1-2019 | |
| CPT 76065 | RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANT | 26 | $14.74 | 7-1-2019 |
| CPT 76065 | RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANT | TC | $25.30 | 7-1-2019 |
| CPT 76066 | JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY) | $49.20 | 7-1-2019 | |
| CPT 76066 | JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY) | 26 | $16.50 | 7-1-2019 |
| CPT 76066 | JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY) | TC | $37.83 | 7-1-2019 |
| CPT 76070 | COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR MORE SITES | $82.39 | 7-1-2019 | |
| CPT 76070 | COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR MORE SITES | 26 | $13.37 | 7-1-2019 |
| CPT 76070 | COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR MORE SITES | TC | $100.71 | 7-1-2019 |
| CPT 76071 | COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, ONE OR MORE SITES;APPENDICULAR SKELETON | $107.47 | 7-1-2019 | |
| CPT 76075 | DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; AXIAL SKELETON (EG, HIPS, PEL | $82.39 | 7-1-2019 | |
| CPT 76076 | DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON | $43.04 | 7-1-2019 | |
| CPT 76077 | DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, ONE OR MORE SITES; VERTEBRAL FRACTURE ASSESSMENT | $49.20 | 7-1-2019 | |
| CPT 76078 | RADIOGRAPHIC ABSORPTIOMETRY (PHOTODENSITOMETRY), ONE OR MORE SITES | $49.20 | 7-1-2019 | |
| CPT 76080 | RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 76080 | RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $28.27 | 7-1-2019 |
| CPT 76080 | RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $114.52 | 7-1-2019 |
| CPT 76080 | RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $35.83 | 7-1-2019 |
| CPT 76082 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION | $17.25 | 7-1-2019 | |
| CPT 76082 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION | LT | $17.25 | 7-1-2019 |
| CPT 76082 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION | RT | $17.25 | 7-1-2019 |
| CPT 76083 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION | $17.25 | 7-1-2019 | |
| CPT 76086 | MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 76086 | MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $18.34 | 7-1-2019 |
| CPT 76086 | MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $89.77 | 7-1-2019 |
| CPT 76088 | MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 76088 | MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $22.97 | 7-1-2019 |
| CPT 76088 | MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $125.09 | 7-1-2019 |
| CPT 76090 | MAMMOGRAPHY; UNILATERAL | $44.40 | 7-1-2019 | |
| CPT 76090 | MAMMOGRAPHY; UNILATERAL | 26 | $13.37 | 7-1-2019 |
| CPT 76090 | MAMMOGRAPHY; UNILATERAL | LT | $44.40 | 7-1-2019 |
| CPT 76090 | MAMMOGRAPHY; UNILATERAL | RT | $44.40 | 7-1-2019 |
| CPT 76090 | MAMMOGRAPHY; UNILATERAL | TC | $35.83 | 7-1-2019 |
| CPT 76091 | MAMMOGRAPHY; BILATERAL | $55.22 | 7-1-2019 | |
| CPT 76091 | MAMMOGRAPHY; BILATERAL | 26 | $21.93 | 7-1-2019 |
| CPT 76091 | MAMMOGRAPHY; BILATERAL | TC | $44.42 | 7-1-2019 |
| CPT 76092 | SCREENING MAMMOGRAPHY, BILATERAL (TWO VIEW FILM STUDY OF EACH BREAST) | $52.00 | 7-1-2019 | |
| CPT 76095 | STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $232.98 | 7-1-2019 | |
| CPT 76095 | STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $232.98 | 7-1-2019 |
| CPT 76095 | STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $232.98 | 7-1-2019 |
| CPT 76096 | PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.52 | 7-1-2019 | |
| CPT 76096 | PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $29.28 | 7-1-2019 |
| CPT 76096 | PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $114.52 | 7-1-2019 |
| CPT 76096 | PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $114.52 | 7-1-2019 |
| CPT 76096 | PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $44.42 | 7-1-2019 |
| CPT 76098 | RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN | $49.20 | 7-1-2019 | |
| CPT 76098 | RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN | 26 | $8.10 | 7-1-2019 |
| CPT 76098 | RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN | LT | $49.20 | 7-1-2019 |
| CPT 76098 | RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN | RT | $49.20 | 7-1-2019 |
| CPT 76098 | RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN | TC | $14.44 | 7-1-2019 |
| CPT 76100 | RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY | $83.74 | 7-1-2019 | |
| CPT 76100 | RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY | 26 | $32.00 | 7-1-2019 |
| CPT 76100 | RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY | TC | $42.75 | 7-1-2019 |
| CPT 76101 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | $114.52 | 7-1-2019 | |
| CPT 76101 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | 26 | $32.00 | 7-1-2019 |
| CPT 76101 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | TC | $48.35 | 7-1-2019 |
| CPT 76102 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | $232.98 | 7-1-2019 | |
| CPT 76102 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | 26 | $32.00 | 7-1-2019 |
| CPT 76102 | RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T | TC | $59.21 | 7-1-2019 |
| CPT 76120 | CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED | $89.64 | 7-1-2019 | |
| CPT 76120 | CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED | 26 | $20.31 | 7-1-2019 |
| CPT 76120 | CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED | TC | $35.83 | 7-1-2019 |
| CPT 76125 | CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION | $49.20 | 7-1-2019 | |
| CPT 76125 | CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION | 26 | $14.21 | 7-1-2019 |
| CPT 76125 | CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION | TC | $26.97 | 7-1-2019 |
| CPT 76150 | XERORADIOGRAPHY | $49.20 | 7-1-2019 | |
| CPT 76355 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION | $289.49 | 7-1-2019 | |
| CPT 76355 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION | 26 | $65.56 | 7-1-2019 |
| CPT 76355 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION | TC | $282.00 | 7-1-2019 |
| CPT 76360 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $289.49 | 7-1-2019 | |
| CPT 76360 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $59.57 | 7-1-2019 |
| CPT 76360 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $282.00 | 7-1-2019 |
| CPT 76362 | COMPUTERIZED AXIAL TOMOGRAPHIC GUIDANCE FOR, AND MONITORING OF, TISSUE ABLATION | $344.34 | 7-1-2019 | |
| CPT 76365 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $341.57 | 7-1-2019 | |
| CPT 76365 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $59.57 | 7-1-2019 |
| CPT 76365 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $282.00 | 7-1-2019 |
| CPT 76370 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS | $107.47 | 7-1-2019 | |
| CPT 76370 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS | 26 | $46.13 | 7-1-2019 |
| CPT 76370 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS | TC | $100.71 | 7-1-2019 |
| CPT 76375 | CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO | $128.50 | 7-1-2019 | |
| CPT 76375 | CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO | 26 | $8.10 | 7-1-2019 |
| CPT 76375 | CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO | TC | $120.50 | 7-1-2019 |
| CPT 76376 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | $41.39 | 7-1-2019 | |
| CPT 76376 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | 59 | $41.39 | 7-1-2019 |
| CPT 76376 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | LT | $41.39 | 7-1-2019 |
| CPT 76376 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | RT | $41.39 | 7-1-2019 |
| CPT 76377 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | $107.47 | 7-1-2019 | |
| CPT 76377 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | 59 | $107.47 | 7-1-2019 |
| CPT 76377 | 3D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, | ET | $107.47 | 7-1-2019 |
| CPT 76380 | COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY | $107.47 | 7-1-2019 | |
| CPT 76380 | COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY | 26 | $50.57 | 7-1-2019 |
| CPT 76380 | COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY | 59 | $107.47 | 7-1-2019 |
| CPT 76380 | COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY | TC | $119.50 | 7-1-2019 |
| CPT 76393 | MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT (EG, FOR BIOPSY)RADIOLOGICAL SUPERVISION AND INTERPRETATION | $343.96 | 7-1-2019 | |
| CPT 76394 | MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF, TISSUE ABLATION | $343.96 | 7-1-2019 | |
| CPT 76400 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY | $343.96 | 7-1-2019 | |
| CPT 76400 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY | 26 | $82.88 | 7-1-2019 |
| CPT 76400 | MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY | TC | $382.71 | 7-1-2019 |
| CPT 76496 | UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL) | $89.64 | 7-1-2019 | |
| CPT 76497 | UNLISTED COMPUTED TOMOGRAPHY PROCEDURE (EG, DIAGNOSTIC INTERVENTIONAL) | $107.47 | 7-1-2019 | |
| CPT 76498 | UNLISTED MAGNETIC RESONANCE PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL) | $343.96 | 7-1-2019 | |
| CPT 76499 | UNLISTED DIAGNOSTIC RADIOLOGIC PROCEDURE | $49.20 | 7-1-2019 | |
| CPT 76506 | ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR | $66.98 | 7-1-2019 | |
| CPT 76506 | ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR | 26 | $34.43 | 7-1-2019 |
| CPT 76506 | ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR | TC | $48.35 | 7-1-2019 |
| CPT 76510 | OPHTHALMIC ULTRASOUND, DIAGNOSTIC; B-SCAN AND QUANTITATIVE A-SCAN PERFORMED DURING THE SAME PATIENT ENCOUNTER | $107.12 | 7-1-2019 | |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | $107.12 | 7-1-2019 | |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | 26 | $33.25 | 7-1-2019 |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | 50 | $107.12 | 7-1-2019 |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | LT | $107.12 | 7-1-2019 |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | RT | $107.12 | 7-1-2019 |
| CPT 76511 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION | TC | $42.75 | 7-1-2019 |
| CPT 76512 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) | $107.12 | 7-1-2019 | |
| CPT 76512 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) | 26 | $36.00 | 7-1-2019 |
| CPT 76512 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) | LT | $107.12 | 7-1-2019 |
| CPT 76512 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) | RT | $107.12 | 7-1-2019 |
| CPT 76512 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) | TC | $52.27 | 7-1-2019 |
| CPT 76513 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR SEGMENT ULTRASOUND, | $107.12 | 7-1-2019 | |
| CPT 76513 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR SEGMENT ULTRASOUND, | 26 | $36.00 | 7-1-2019 |
| CPT 76513 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR SEGMENT ULTRASOUND, | TC | $52.27 | 7-1-2019 |
| CPT 76514 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL | $41.39 | 7-1-2019 | |
| CPT 76514 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL | 50 | $41.39 | 7-1-2019 |
| CPT 76514 | OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL | PO | $0.01 | 7-1-2019 |
| CPT 76516 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; | $66.98 | 7-1-2019 | |
| CPT 76516 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; | 26 | $29.63 | 7-1-2019 |
| CPT 76516 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; | TC | $42.75 | 7-1-2019 |
| CPT 76519 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATION | $107.12 | 7-1-2019 | |
| CPT 76519 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATION | 26 | $29.63 | 7-1-2019 |
| CPT 76519 | OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATION | TC | $42.75 | 7-1-2019 |
| CPT 76529 | OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION | $66.98 | 7-1-2019 | |
| CPT 76529 | OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION | 26 | $31.40 | 7-1-2019 |
| CPT 76529 | OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION | TC | $46.67 | 7-1-2019 |
| CPT 76536 | ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM | $107.12 | 7-1-2019 | |
| CPT 76536 | ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM | 26 | $30.69 | 7-1-2019 |
| CPT 76536 | ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM | 59 | $107.12 | 7-1-2019 |
| CPT 76536 | ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM | TC | $48.35 | 7-1-2019 |
| CPT 76604 | ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION | $107.12 | 7-1-2019 | |
| CPT 76604 | ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION | 26 | $30.40 | 7-1-2019 |
| CPT 76604 | ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION | TC | $44.42 | 7-1-2019 |
| CPT 76641 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE | $95.46 | 7-1-2019 | |
| CPT 76641 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE | 26 | $22.57 | 7-1-2019 |
| CPT 76641 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE | 50 | $95.46 | 7-1-2019 |
| CPT 76641 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE | TC | $44.25 | 7-1-2019 |
| CPT 76642 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED | $83.38 | 7-1-2019 | |
| CPT 76642 | ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED | XS | $83.38 | 7-1-2019 |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | $66.98 | 7-1-2019 | |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | 26 | $29.63 | 7-1-2019 |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | 50 | $66.98 | 7-1-2019 |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | LT | $66.98 | 7-1-2019 |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | RT | $66.98 | 7-1-2019 |
| CPT 76645 | ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE DOCUMENTATION | TC | $35.83 | 7-1-2019 |
| CPT 76700 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $107.12 | 7-1-2019 | |
| CPT 76700 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | 26 | $43.59 | 7-1-2019 |
| CPT 76700 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | 59 | $107.12 | 7-1-2019 |
| CPT 76700 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | TC | $67.14 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | $107.12 | 7-1-2019 | |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | 26 | $32.29 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | 59 | $107.12 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | GA | $107.12 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | TC | $48.35 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | XS | $107.12 | 7-1-2019 |
| CPT 76705 | ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, | XU | $107.12 | 7-1-2019 |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | $107.12 | 7-1-2019 | |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | 26 | $40.09 | 7-1-2019 |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | 59 | $107.12 | 7-1-2019 |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | GA | $107.12 | 7-1-2019 |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | TC | $67.14 | 7-1-2019 |
| CPT 76770 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL | XU | $107.12 | 7-1-2019 |
| CPT 76775 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT | $107.12 | 7-1-2019 | |
| CPT 76775 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT | 26 | $32.00 | 7-1-2019 |
| CPT 76775 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT | 59 | $107.12 | 7-1-2019 |
| CPT 76775 | ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT | TC | $48.35 | 7-1-2019 |
| CPT 76776 | ULTRASOUND, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER WITH IMAGE DOCUMENTATION | $105.26 | 7-1-2019 | |
| CPT 76778 | ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO | $107.12 | 7-1-2019 | |
| CPT 76778 | ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO | 26 | $38.28 | 7-1-2019 |
| CPT 76778 | ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO | TC | $67.14 | 7-1-2019 |
| CPT 76800 | ECHOGRAPHY, SPINAL CANAL AND CONTENTS | $107.12 | 7-1-2019 | |
| CPT 76800 | ECHOGRAPHY, SPINAL CANAL AND CONTENTS | 26 | $58.56 | 7-1-2019 |
| CPT 76800 | ECHOGRAPHY, SPINAL CANAL AND CONTENTS | TC | $48.35 | 7-1-2019 |
| CPT 76801 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, FIR | $107.12 | 7-1-2019 | |
| CPT 76802 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, EACH ADDITIONA | $66.98 | 7-1-2019 | |
| CPT 76805 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | $107.12 | 7-1-2019 | |
| CPT 76805 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | 26 | $53.46 | 7-1-2019 |
| CPT 76805 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | TC | $71.73 | 7-1-2019 |
| CPT 76810 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | $107.12 | 7-1-2019 | |
| CPT 76810 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | 26 | $101.56 | 7-1-2019 |
| CPT 76810 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA | TC | $142.89 | 7-1-2019 |
| CPT 76811 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, SINGLE OR FIRS | $172.28 | 7-1-2019 | |
| CPT 76811 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, SINGLE OR FIRS | TC | $172.28 | 7-1-2019 |
| CPT 76812 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, EACH ADDITIONA | $107.12 | 7-1-2019 | |
| CPT 76813 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY | $105.26 | 7-1-2019 | |
| CPT 76813 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY | 55 | $105.26 | 7-1-2019 |
| CPT 76813 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY | PO | $105.26 | 7-1-2019 |
| CPT 76814 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY | $105.26 | 7-1-2019 | |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | $66.98 | 7-1-2019 | |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | 22 | $66.98 | 7-1-2019 |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | 25 | $66.98 | 7-1-2019 |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | 26 | $35.26 | 7-1-2019 |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | 52 | $66.98 | 7-1-2019 |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | 59 | $66.98 | 7-1-2019 |
| CPT 76815 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART | TC | $48.35 | 7-1-2019 |
| CPT 76816 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT | $66.98 | 7-1-2019 | |
| CPT 76816 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT | 26 | $31.40 | 7-1-2019 |
| CPT 76816 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT | PO | $66.98 | 7-1-2019 |
| CPT 76816 | ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT | TC | $37.83 | 7-1-2019 |
| CPT 76817 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL | $107.12 | 7-1-2019 | |
| CPT 76817 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL | 25 | $107.12 | 7-1-2019 |
| CPT 76818 | FETAL BIOPHYSICAL PROFILE | $107.12 | 7-1-2019 | |
| CPT 76818 | FETAL BIOPHYSICAL PROFILE | 26 | $41.45 | 7-1-2019 |
| CPT 76818 | FETAL BIOPHYSICAL PROFILE | 59 | $107.12 | 7-1-2019 |
| CPT 76818 | FETAL BIOPHYSICAL PROFILE | TC | $55.28 | 7-1-2019 |
| CPT 76819 | FETAL BIOPHYSICAL PROFILE; WITHOUT STRESS OR NON-STRESS TESTING | $107.12 | 7-1-2019 | |
| CPT 76820 | DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY | $108.05 | 7-1-2019 | |
| CPT 76820 | DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY | 51 | $108.05 | 7-1-2019 |
| CPT 76820 | DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY | 59 | $108.05 | 7-1-2019 |
| CPT 76821 | DOPPLER VELOCIMETRY, FETAL; MIDDLE CEREBRAL ARTERY | $108.05 | 7-1-2019 | |
| CPT 76825 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | $113.06 | 7-1-2019 | |
| CPT 76825 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | 26 | $41.15 | 7-1-2019 |
| CPT 76825 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | TC | $67.14 | 7-1-2019 |
| CPT 76826 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | $101.99 | 7-1-2019 | |
| CPT 76826 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | 26 | $53.10 | 7-1-2019 |
| CPT 76826 | ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE | TC | $24.30 | 7-1-2019 |
| CPT 76827 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | $113.06 | 7-1-2019 | |
| CPT 76827 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | 26 | $38.51 | 7-1-2019 |
| CPT 76827 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | TC | $59.37 | 7-1-2019 |
| CPT 76828 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | $101.99 | 7-1-2019 | |
| CPT 76828 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | 26 | $26.41 | 7-1-2019 |
| CPT 76828 | DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL | TC | $5.60 | 7-1-2019 |
| CPT 76830 | ECHOGRAPHY, TRANSVAGINAL | $107.12 | 7-1-2019 | |
| CPT 76830 | ECHOGRAPHY, TRANSVAGINAL | 25 | $107.12 | 7-1-2019 |
| CPT 76830 | ECHOGRAPHY, TRANSVAGINAL | 26 | $37.66 | 7-1-2019 |
| CPT 76830 | ECHOGRAPHY, TRANSVAGINAL | 59 | $107.12 | 7-1-2019 |
| CPT 76830 | ECHOGRAPHY, TRANSVAGINAL | TC | $52.27 | 7-1-2019 |
| CPT 76831 | HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER | $172.28 | 7-1-2019 | |
| CPT 76856 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $107.12 | 7-1-2019 | |
| CPT 76856 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | 26 | $37.66 | 7-1-2019 |
| CPT 76856 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | 59 | $107.12 | 7-1-2019 |
| CPT 76856 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | TC | $52.27 | 7-1-2019 |
| CPT 76856 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | XU | $107.12 | 7-1-2019 |
| CPT 76857 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, | $66.98 | 7-1-2019 | |
| CPT 76857 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, | 26 | $20.05 | 7-1-2019 |
| CPT 76857 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, | LT | $66.98 | 7-1-2019 |
| CPT 76857 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, | RT | $66.98 | 7-1-2019 |
| CPT 76857 | ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, | TC | $35.83 | 7-1-2019 |
| CPT 76870 | ECHOGRAPHY, SCROTUM AND CONTENTS | $107.12 | 7-1-2019 | |
| CPT 76870 | ECHOGRAPHY, SCROTUM AND CONTENTS | 26 | $34.64 | 7-1-2019 |
| CPT 76870 | ECHOGRAPHY, SCROTUM AND CONTENTS | 59 | $107.12 | 7-1-2019 |
| CPT 76870 | ECHOGRAPHY, SCROTUM AND CONTENTS | TC | $52.27 | 7-1-2019 |
| CPT 76872 | ECHOGRAPHY, TRANSRECTAL | $107.12 | 7-1-2019 | |
| CPT 76872 | ECHOGRAPHY, TRANSRECTAL | 26 | $37.66 | 7-1-2019 |
| CPT 76872 | ECHOGRAPHY, TRANSRECTAL | TC | $52.27 | 7-1-2019 |
| CPT 76873 | ECHOGRAPHY, TRANSRECTAL; PROSTATE VOLUME STUDY FOR BRACHYTHERAPY TREATMENT PLANNING | $107.12 | 7-1-2019 | |
| CPT 76880 | ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | $107.12 | 7-1-2019 | |
| CPT 76880 | ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | 26 | $32.29 | 7-1-2019 |
| CPT 76880 | ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | LT | $107.12 | 7-1-2019 |
| CPT 76880 | ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | RT | $107.12 | 7-1-2019 |
| CPT 76880 | ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | TC | $48.35 | 7-1-2019 |
| CPT 76881 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; COMPLETE | $94.28 | 7-1-2019 | |
| CPT 76881 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; COMPLETE | LT | $94.28 | 7-1-2019 |
| CPT 76881 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; COMPLETE | RT | $94.28 | 7-1-2019 |
| CPT 76882 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC | $60.95 | 7-1-2019 | |
| CPT 76882 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC | LT | $60.95 | 7-1-2019 |
| CPT 76882 | ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC | RT | $60.95 | 7-1-2019 |
| CPT 76885 | ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC (EG, REQUIRING MANIPULATION) | $66.98 | 7-1-2019 | |
| CPT 76886 | ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; LIMITED, STATIC (EG, NOT REQUIRING MANIPULATO | $107.12 | 7-1-2019 | |
| CPT 76930 | ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76930 | ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $34.92 | 7-1-2019 |
| CPT 76930 | ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76932 | ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76932 | ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $34.92 | 7-1-2019 |
| CPT 76932 | ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76934 | ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $87.19 | 7-1-2019 | |
| CPT 76934 | ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $34.92 | 7-1-2019 |
| CPT 76934 | ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76936 | ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDO- ANEURYSM OR ARTERIOVENOUS FISTULAE (INCLUDES DIAGNOSTI | $70.55 | 7-1-2019 | |
| CPT 76937 | ULTRASOUND GUIDANCE FOR VASCULAR ACCESS REQUIRING ULTRASOUND EVALUATION OF POTENTIAL ACCESS SITES, | $20.14 | 7-1-2019 | |
| CPT 76938 | ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE | $87.19 | 7-1-2019 | |
| CPT 76938 | ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE | 26 | $34.92 | 7-1-2019 |
| CPT 76938 | ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE | TC | $52.27 | 7-1-2019 |
| CPT 76940 | ULTRASOUND GUIDANCE FOR, AND MONITORING OF VISCERAL TISSUE ABLATION | $70.55 | 7-1-2019 | |
| CPT 76941 | ULTRSONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION OR CORDOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRET | $70.55 | 7-1-2019 | |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $34.92 | 7-1-2019 |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $70.55 | 7-1-2019 |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $70.55 | 7-1-2019 |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $70.55 | 7-1-2019 |
| CPT 76942 | ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76945 | ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76946 | ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76946 | ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $19.26 | 7-1-2019 |
| CPT 76946 | ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76948 | ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $70.55 | 7-1-2019 | |
| CPT 76948 | ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 26 | $20.05 | 7-1-2019 |
| CPT 76948 | ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL SUPERVISION AND INTERPRETATION | TC | $52.27 | 7-1-2019 |
| CPT 76950 | ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN | $70.55 | 7-1-2019 | |
| CPT 76950 | ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN | 26 | $32.00 | 7-1-2019 |
| CPT 76950 | ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN | TC | $44.42 | 7-1-2019 |
| CPT 76960 | ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS, EXCEPT FOR B-SCAN ECHOGRAPHY | $74.72 | 7-1-2019 | |
| CPT 76960 | ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS, EXCEPT FOR B-SCAN ECHOGRAPHY | 26 | $32.00 | 7-1-2019 |
| CPT 76960 | ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS, EXCEPT FOR B-SCAN ECHOGRAPHY | TC | $44.42 | 7-1-2019 |
| CPT 76965 | ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION | $70.55 | 7-1-2019 | |
| CPT 76970 | ULTRASOUND STUDY FOLLOW-UP (SPECIFY) | $66.98 | 7-1-2019 | |
| CPT 76970 | ULTRASOUND STUDY FOLLOW-UP (SPECIFY) | 26 | $20.61 | 7-1-2019 |
| CPT 76970 | ULTRASOUND STUDY FOLLOW-UP (SPECIFY) | TC | $35.83 | 7-1-2019 |
| CPT 76975 | GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $107.12 | 7-1-2019 | |
| CPT 76977 | ULTRASOUND BONE DENSITY MEASUREMENT AND INTERPRETATION,PERIPHERAL SITE(S), ANY METHOD | $41.39 | 7-1-2019 | |
| CPT 76978 | ULTRASOUND USING TARGETED MICROBUBBLE CONTRAST OF FIRST LESION | $171.18 | 7-1-2019 | |
| CPT 76978 | ULTRASOUND USING TARGETED MICROBUBBLE CONTRAST OF FIRST LESION | XS | $171.18 | 7-1-2019 |
| CPT 76986 | ECHOGRAPHY, INTRAOPERATIVE | $107.12 | 7-1-2019 | |
| CPT 76986 | ECHOGRAPHY, INTRAOPERATIVE | 26 | $65.27 | 7-1-2019 |
| CPT 76986 | ECHOGRAPHY, INTRAOPERATIVE | TC | $89.77 | 7-1-2019 |
| CPT 76998 | ULTRASONIC GUIDANCE, INTRAOPERATIVE | $105.26 | 7-1-2019 | |
| CPT 76999 | UNLISTED ULTRASOUND PROCEDURE | $66.98 | 7-1-2019 | |
| CPT 77001 | FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT, REPLACEMENT, OR REMOVAL | $68.05 | 7-1-2019 | |
| CPT 77001 | FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT, REPLACEMENT, OR REMOVAL | 59 | $68.05 | 7-1-2019 |
| CPT 77002 | FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENT | $52.46 | 7-1-2019 | |
| CPT 77002 | FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENT | 59 | $52.46 | 7-1-2019 |
| CPT 77002 | FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENT | LT | $52.46 | 7-1-2019 |
| CPT 77003 | FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT | $48.04 | 7-1-2019 | |
| CPT 77003 | FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT | 50 | $48.04 | 7-1-2019 |
| CPT 77003 | FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT | 59 | $48.04 | 7-1-2019 |
| CPT 77011 | COMPUTED TOMOGRAPHY GUIDANCE FOR STEROTACTIC | $275.35 | 7-1-2019 | |
| CPT 77012 | COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $275.36 | 7-1-2019 | |
| CPT 77012 | COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $275.36 | 7-1-2019 |
| CPT 77013 | COMPUTERIZED TOMOGRAPHY GUIDANCE FOR, AND MONITORING OF PARENCHYMAL TISSUE ABLATION | $326.48 | 7-1-2019 | |
| CPT 77014 | COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS | $103.73 | 7-1-2019 | |
| CPT 77014 | COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS | 59 | $103.73 | 7-1-2019 |
| CPT 77021 | MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT RADIOLOGICAL SUPERVISION AND INTERPRETATION | $307.04 | 7-1-2019 | |
| CPT 77022 | MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF PARENCHYMAL TISSUE ABLATION | $307.04 | 7-1-2019 | |
| CPT 77031 | STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON | $199.55 | 7-1-2019 | |
| CPT 77031 | STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON | 50 | $199.55 | 7-1-2019 |
| CPT 77031 | STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON | 59 | $199.55 | 7-1-2019 |
| CPT 77031 | STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON | LT | $199.55 | 7-1-2019 |
| CPT 77031 | STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON | RT | $199.55 | 7-1-2019 |
| CPT 77032 | MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.36 | 7-1-2019 | |
| CPT 77032 | MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | 59 | $114.36 | 7-1-2019 |
| CPT 77032 | MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | LT | $114.36 | 7-1-2019 |
| CPT 77032 | MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION | RT | $114.36 | 7-1-2019 |
| CPT 77051 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY | $14.86 | 7-1-2019 | |
| CPT 77051 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY | LT | $14.86 | 7-1-2019 |
| CPT 77051 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY | RT | $14.86 | 7-1-2019 |
| CPT 77052 | COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR INTERPRETATION; SCREENING MAMMOGRAPHY | $14.86 | 7-1-2019 | |
| CPT 77053 | MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION | $114.36 | 7-1-2019 | |
| CPT 77054 | MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISON AND INTERPRETATION | $114.36 | 7-1-2019 | |
| CPT 77055 | MAMMOGRAPHY, UNILATERAL | $36.69 | 7-1-2019 | |
| CPT 77055 | MAMMOGRAPHY, UNILATERAL | 59 | $36.69 | 7-1-2019 |
| CPT 77055 | MAMMOGRAPHY, UNILATERAL | LT | $36.69 | 7-1-2019 |
| CPT 77055 | MAMMOGRAPHY, UNILATERAL | RT | $36.69 | 7-1-2019 |
| CPT 77056 | MAMMOGRAPHY; BILATERAL | $59.31 | 7-1-2019 | |
| CPT 77057 | SCREENING MAMMOGRAPHY, BILATERAL, 2 VIEW FILM STUDY OF EACH BREAST | $51.26 | 7-1-2019 | |
| CPT 77058 | MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIALS, UNILATERAL | $768.21 | 7-1-2019 | |
| CPT 77059 | MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIALS, BILATERAL | $969.07 | 7-1-2019 | |
| CPT 77065 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; UNILATERAL | $108.18 | 7-1-2019 | |
| CPT 77065 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; UNILATERAL | 26 | $1.20 | 7-1-2019 |
| CPT 77065 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; UNILATERAL | LT | $108.18 | 7-1-2019 |
| CPT 77065 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; UNILATERAL | RT | $108.18 | 7-1-2019 |
| CPT 77065 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; UNILATERAL | TC | $2.86 | 7-1-2019 |
| CPT 77066 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; BILATERAL | $138.16 | 7-1-2019 | |
| CPT 77066 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; BILATERAL | 26 | $1.49 | 7-1-2019 |
| CPT 77066 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; BILATERAL | LT | $138.16 | 7-1-2019 |
| CPT 77066 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; BILATERAL | RT | $138.16 | 7-1-2019 |
| CPT 77066 | DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PREFORMED; BILATERAL | TC | $3.66 | 7-1-2019 |
| CPT 77067 | SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED | $114.25 | 7-1-2019 | |
| CPT 77067 | SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED | 26 | $1.14 | 7-1-2019 |
| CPT 77067 | SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED | LT | $114.25 | 7-1-2019 |
| CPT 77067 | SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED | RT | $114.25 | 7-1-2019 |
| CPT 77067 | SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED | TC | $3.02 | 7-1-2019 |
| CPT 77071 | MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN FOR JOINT RADIOLOGY, INCLUDING CONTRALATERAL JOINT IF | $47.84 | 7-1-2019 | |
| CPT 77072 | BONE AGE STUDIES | $47.84 | 7-1-2019 | |
| CPT 77073 | BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM) | $47.84 | 7-1-2019 | |
| CPT 77074 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED | $82.45 | 7-1-2019 | |
| CPT 77075 | RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) | $82.45 | 7-1-2019 | |
| CPT 77076 | RADIOLOGIC EXAMINATION , OSSEOUS SURVEY, INFANT | $47.84 | 7-1-2019 | |
| CPT 77077 | JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS (SPECIFY) | $47.84 | 7-1-2019 | |
| CPT 77078 | COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE) | $79.29 | 7-1-2019 | |
| CPT 77079 | COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON | $103.73 | 7-1-2019 | |
| CPT 77080 | DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON | $79.29 | 7-1-2019 | |
| CPT 77080 | DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON | 59 | $79.29 | 7-1-2019 |
| CPT 77080 | DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON | GA | $79.29 | 7-1-2019 |
| CPT 77081 | DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE SITE; APPENDICULAR SKELETON | $37.08 | 7-1-2019 | |
| CPT 77081 | DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE SITE; APPENDICULAR SKELETON | 59 | $37.08 | 7-1-2019 |
| CPT 77082 | DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE SITE; VERTEBRAL FRACTURE ASSESSMENT | $47.84 | 7-1-2019 | |
| CPT 77083 | RADIOGRAPHIC ABSORPTIOMETRY, 1 OR MORE SITES | $82.45 | 7-1-2019 | |
| CPT 77084 | MAGNETIC RESONANCE IMAGING, BONE MARROW BLOOD SUPPLY | $307.04 | 7-1-2019 | |
| CPT 77261 | THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE | $75.50 | 7-1-2019 | |
| CPT 77262 | THERAPEUTIC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE | $113.77 | 7-1-2019 | |
| CPT 77263 | THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX | $169.52 | 7-1-2019 | |
| CPT 77280 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE | $275.53 | 7-1-2019 | |
| CPT 77280 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE | 26 | $37.81 | 7-1-2019 |
| CPT 77280 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE | TC | $118.50 | 7-1-2019 |
| CPT 77285 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE | $265.30 | 7-1-2019 | |
| CPT 77285 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE | 26 | $56.34 | 7-1-2019 |
| CPT 77285 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE | TC | $190.23 | 7-1-2019 |
| CPT 77290 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX | $275.53 | 7-1-2019 | |
| CPT 77290 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX | 26 | $84.54 | 7-1-2019 |
| CPT 77290 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX | TC | $222.13 | 7-1-2019 |
| CPT 77295 | THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; BY THREE DIMENSIONAL RECONSTRUCTION OF TUMOR VOLUME | $936.28 | 7-1-2019 | |
| CPT 77299 | UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY CLINICAL TREATMENT PLANNING | $116.84 | 7-1-2019 | |
| CPT 77300 | BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI | $116.84 | 7-1-2019 | |
| CPT 77300 | BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI | 26 | $33.74 | 7-1-2019 |
| CPT 77300 | BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI | TC | $45.76 | 7-1-2019 |
| CPT 77301 | INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE- VOLUME HISTOGRAMS FOR TARGET AND CRITICAL STRUCTURE PAR | $936.28 | 7-1-2019 | |
| CPT 77301 | INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE- VOLUME HISTOGRAMS FOR TARGET AND CRITICAL STRUCTURE PAR | 59 | $936.28 | 7-1-2019 |
| CPT 77305 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE | $116.84 | 7-1-2019 | |
| CPT 77305 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE | 26 | $37.81 | 7-1-2019 |
| CPT 77305 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE | TC | $63.46 | 7-1-2019 |
| CPT 77310 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D | $265.30 | 7-1-2019 | |
| CPT 77310 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D | 26 | $56.34 | 7-1-2019 |
| CPT 77310 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D | 59 | $265.30 | 7-1-2019 |
| CPT 77310 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D | TC | $79.57 | 7-1-2019 |
| CPT 77315 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR | $265.30 | 7-1-2019 | |
| CPT 77315 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR | 26 | $84.54 | 7-1-2019 |
| CPT 77315 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR | 59 | $265.30 | 7-1-2019 |
| CPT 77315 | TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR | TC | $90.77 | 7-1-2019 |
| CPT 77321 | SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY | $265.30 | 7-1-2019 | |
| CPT 77321 | SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY | 26 | $51.28 | 7-1-2019 |
| CPT 77321 | SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY | TC | $137.62 | 7-1-2019 |
| CPT 77326 | BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP | $116.84 | 7-1-2019 | |
| CPT 77326 | BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP | 26 | $50.15 | 7-1-2019 |
| CPT 77326 | BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP | TC | $80.91 | 7-1-2019 |
| CPT 77327 | BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO | $265.30 | 7-1-2019 | |
| CPT 77327 | BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO | 26 | $75.50 | 7-1-2019 |
| CPT 77327 | BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO | TC | $118.50 | 7-1-2019 |
| CPT 77328 | BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU | $265.30 | 7-1-2019 | |
| CPT 77328 | BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU | 26 | $112.69 | 7-1-2019 |
| CPT 77328 | BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU | TC | $169.18 | 7-1-2019 |
| CPT 77331 | SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYSICIAN | $116.84 | 7-1-2019 | |
| CPT 77331 | SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYSICIAN | 26 | $47.28 | 7-1-2019 |
| CPT 77331 | SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYSICIAN | TC | $17.45 | 7-1-2019 |
| CPT 77332 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS) | $190.47 | 7-1-2019 | |
| CPT 77332 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS) | 26 | $29.78 | 7-1-2019 |
| CPT 77332 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS) | 59 | $190.47 | 7-1-2019 |
| CPT 77332 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS) | TC | $45.76 | 7-1-2019 |
| CPT 77333 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS) | $190.47 | 7-1-2019 | |
| CPT 77333 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS) | 26 | $45.15 | 7-1-2019 |
| CPT 77333 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS) | 59 | $190.47 | 7-1-2019 |
| CPT 77333 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS) | TC | $64.80 | 7-1-2019 |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | $190.47 | 7-1-2019 | |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | 26 | $66.94 | 7-1-2019 |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | 59 | $190.47 | 7-1-2019 |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | LT | $190.47 | 7-1-2019 |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | RT | $190.47 | 7-1-2019 |
| CPT 77334 | TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES, | TC | $110.65 | 7-1-2019 |
| CPT 77336 | CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q | $116.84 | 7-1-2019 | |
| CPT 77336 | CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q | 59 | $116.84 | 7-1-2019 |
| CPT 77336 | CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q | LT | $116.84 | 7-1-2019 |
| CPT 77336 | CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q | RT | $116.84 | 7-1-2019 |
| CPT 77338 | MULTI-LEAF COLLIMATOR (MLC) DEVICE(S) FOR INTENSITY MODULATED RADIATION THERAPY (IMRT), DESIGN AND | $286.03 | 7-1-2019 | |
| CPT 77370 | SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION | $116.84 | 7-1-2019 | |
| CPT 77371 | RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF TREATMENT OF CEREBRAL LESION | $9,337.95 | 7-1-2019 | |
| CPT 77385 | INTENSITY MODULATED RADIATION TREATMENT DELIVERY, INCLUDES GUIDANCE AND TRACKING, WHEN PERFORMED; SIMPLE | $524.48 | 7-1-2019 | |
| CPT 77386 | INTENSITY MODULATED RADIATION TREATMENT DELIVERY, INCLUDES GUIDANCE AND TRACKING, WHEN PERFORMED; COMPLEX | $461.71 | 7-1-2019 | |
| CPT 77399 | UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY AND TREATMENT DEVICES | $116.84 | 7-1-2019 | |
| CPT 77401 | RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHO VOLTAGE | $98.88 | 7-1-2019 | |
| CPT 77402 | RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N | $98.88 | 7-1-2019 | |
| CPT 77403 | RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N | $98.88 | 7-1-2019 | |
| CPT 77404 | RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N | $98.88 | 7-1-2019 | |
| CPT 77406 | RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N | $98.88 | 7-1-2019 | |
| CPT 77407 | RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US | $98.88 | 7-1-2019 | |
| CPT 77408 | RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US | $98.88 | 7-1-2019 | |
| CPT 77409 | RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US | $98.88 | 7-1-2019 | |
| CPT 77411 | RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US | $148.76 | 7-1-2019 | |
| CPT 77412 | RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE | $148.76 | 7-1-2019 | |
| CPT 77413 | RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE | $148.76 | 7-1-2019 | |
| CPT 77413 | RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE | 76 | $148.76 | 7-1-2019 |
| CPT 77414 | RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE | $148.76 | 7-1-2019 | |
| CPT 77416 | RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE | $148.76 | 7-1-2019 | |
| CPT 77417 | THERAPEUTIC RADIOLOGY PORT FILM(S) | $49.20 | 7-1-2019 | |
| CPT 77418 | INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS, VIA NARROW SPATIALLY AND TEPORALLY MOD | $361.34 | 7-1-2019 | |
| CPT 77420 | WEEKLY RADIOLOGY THERAPY MANAGEMENT; SIMPLE | $87.04 | 7-1-2019 | |
| CPT 77421 | STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR THE DELIVERY OF RADIATION THERAPY | $85.00 | 7-1-2019 | |
| CPT 77422 | HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY; SINGLE TREATMENT AREA USING A SINGLE PORT OR PARALLEL | $148.76 | 7-1-2019 | |
| CPT 77423 | HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY; 1 OR MORE ISOCENTER(S) WITH COPLANAR OR NON-COPLANAR GEOMETR | $148.76 | 7-1-2019 | |
| CPT 77425 | INTRAOPERATIVE RADIATION TREATMENT DELIVERY, ELECTRONS, SINGLE TREATMENT SESSION | $131.95 | 7-1-2019 | |
| CPT 77430 | WEEKLY RADIOLOGY THERAPY MANAGEMENT; COMPLEX | $194.76 | 7-1-2019 | |
| CPT 77431 | RADIATION THERAPY MANAGEMENT WITH COMPLETE COURSE OF THERAPY CONSISTING OF ONE OR TWO FRACTIONS ONLY | $93.23 | 7-1-2019 | |
| CPT 77470 | SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT | $389.02 | 7-1-2019 | |
| CPT 77470 | SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT | 26 | $107.53 | 7-1-2019 |
| CPT 77470 | SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT | TC | $380.46 | 7-1-2019 |
| CPT 77520 | PROTON BEAM DELIVERY TO A SINGLE TREATMENT AREA, SINGLEPORT, CUSTOM BLOCK, W/ OR W/OUT COMPENSATIN, W/TREATMEN | $1,074.34 | 7-1-2019 | |
| CPT 77522 | PROTON TREATMENT DELIVERY; SIMPLE, WITH COMPENSATION | $1,074.34 | 7-1-2019 | |
| CPT 77523 | PROTON BEAM DELIVERY TO ONE OR TWO TREATMENT AREAS, TWO OR MORE PORTS, TWO OR MORE CUSTOM BLOCKS AND TWO OR MO | $1,285.31 | 7-1-2019 | |
| CPT 77525 | PROTON TREATMENT DELIVERY; COMPLEX | $1,285.31 | 7-1-2019 | |
| CPT 77600 | HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS) | $376.63 | 7-1-2019 | |
| CPT 77600 | HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS) | 26 | $84.54 | 7-1-2019 |
| CPT 77600 | HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS) | TC | $103.72 | 7-1-2019 |
| CPT 77605 | HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM) | $376.63 | 7-1-2019 | |
| CPT 77605 | HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM) | 26 | $112.69 | 7-1-2019 |
| CPT 77605 | HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM) | TC | $138.53 | 7-1-2019 |
| CPT 77610 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS | $376.63 | 7-1-2019 | |
| CPT 77610 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS | 26 | $84.54 | 7-1-2019 |
| CPT 77610 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS | TC | $103.72 | 7-1-2019 |
| CPT 77615 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS | $376.63 | 7-1-2019 | |
| CPT 77615 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS | 26 | $112.69 | 7-1-2019 |
| CPT 77615 | HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS | TC | $138.53 | 7-1-2019 |
| CPT 77620 | HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S) | $376.63 | 7-1-2019 | |
| CPT 77620 | HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S) | 26 | $84.54 | 7-1-2019 |
| CPT 77620 | HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S) | TC | $103.72 | 7-1-2019 |
| CPT 77750 | INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION | $148.76 | 7-1-2019 | |
| CPT 77750 | INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION | 26 | $236.44 | 7-1-2019 |
| CPT 77750 | INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION | TC | $45.43 | 7-1-2019 |
| CPT 77761 | INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE | $375.50 | 7-1-2019 | |
| CPT 77761 | INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE | 26 | $183.52 | 7-1-2019 |
| CPT 77761 | INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE | TC | $85.85 | 7-1-2019 |
| CPT 77762 | INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE | $375.50 | 7-1-2019 | |
| CPT 77762 | INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE | 26 | $289.39 | 7-1-2019 |
| CPT 77762 | INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE | TC | $123.42 | 7-1-2019 |
| CPT 77763 | INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX | $375.50 | 7-1-2019 | |
| CPT 77763 | INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX | 26 | $412.98 | 7-1-2019 |
| CPT 77763 | INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX | TC | $153.40 | 7-1-2019 |
| CPT 77767 | HIGH DOSE BRACHYTHERAPY THROUGH SKIN SURFACE, 1 CHANNEL OR UP TO 2.0 CM | $177.80 | 7-1-2019 | |
| CPT 77768 | HIGH DOSE BRACHYTHERAPY THROUGH SKIN SURFACE, 2 CHANNELS OR MORE THAN 2.0 CM | $177.80 | 7-1-2019 | |
| CPT 77770 | HIGH DOSE BRACHYTHERAPY, 1 CHANNEL | $636.92 | 7-1-2019 | |
| CPT 77771 | HIGH DOSE BRACHYTHERAPY, 2-12 CHANNELS | $636.92 | 7-1-2019 | |
| CPT 77772 | HIGH DOSE BRACHYTHERAPY, MORE THAN 12 CHANNELS | $636.92 | 7-1-2019 | |
| CPT 77776 | INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE | $375.50 | 7-1-2019 | |
| CPT 77776 | INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE | 26 | $240.40 | 7-1-2019 |
| CPT 77776 | INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE | TC | $74.32 | 7-1-2019 |
| CPT 77777 | INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE | $375.50 | 7-1-2019 | |
| CPT 77777 | INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE | 26 | $360.30 | 7-1-2019 |
| CPT 77777 | INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE | TC | $144.46 | 7-1-2019 |
| CPT 77778 | INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX | $755.05 | 7-1-2019 | |
| CPT 77778 | INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX | 26 | $539.78 | 7-1-2019 |
| CPT 77778 | INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX | TC | $174.78 | 7-1-2019 |
| CPT 77781 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE POSITIONS OR CATHETERS | $878.17 | 7-1-2019 | |
| CPT 77781 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE POSITIONS OR CATHETERS | 26 | $80.19 | 7-1-2019 |
| CPT 77781 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE POSITIONS OR CATHETERS | TC | $693.44 | 7-1-2019 |
| CPT 77782 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS | $878.17 | 7-1-2019 | |
| CPT 77782 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS | 26 | $120.49 | 7-1-2019 |
| CPT 77782 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS | 76 | $878.17 | 7-1-2019 |
| CPT 77782 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS | TC | $693.44 | 7-1-2019 |
| CPT 77783 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE POSITIONS OR CATHETERS | $878.17 | 7-1-2019 | |
| CPT 77783 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE POSITIONS OR CATHETERS | 26 | $179.82 | 7-1-2019 |
| CPT 77783 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE POSITIONS OR CATHETERS | TC | $693.44 | 7-1-2019 |
| CPT 77784 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12 SOURCE POSITIONS OR CATHETERS | $878.17 | 7-1-2019 | |
| CPT 77784 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12 SOURCE POSITIONS OR CATHETERS | 26 | $270.35 | 7-1-2019 |
| CPT 77784 | REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12 SOURCE POSITIONS OR CATHETERS | TC | $693.44 | 7-1-2019 |
| CPT 77785 | REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY; 1 CHANNEL | $748.66 | 7-1-2019 | |
| CPT 77786 | REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY; 2-12 CHANNELS | $748.66 | 7-1-2019 | |
| CPT 77787 | REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY; OVER 12 CHANNELS | $748.66 | 7-1-2019 | |
| CPT 77789 | SURFACE APPLICATION OF RADIOELEMENT | $98.88 | 7-1-2019 | |
| CPT 77789 | SURFACE APPLICATION OF RADIOELEMENT | 26 | $53.93 | 7-1-2019 |
| CPT 77789 | SURFACE APPLICATION OF RADIOELEMENT | TC | $15.45 | 7-1-2019 |
| CPT 77790 | SUPERVISION, HANDLING, LOADING OF RADIOELEMENT | $71.38 | 7-1-2019 | |
| CPT 77790 | SUPERVISION, HANDLING, LOADING OF RADIOELEMENT | 26 | $53.93 | 7-1-2019 |
| CPT 77790 | SUPERVISION, HANDLING, LOADING OF RADIOELEMENT | TC | $17.45 | 7-1-2019 |
| CPT 77799 | UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY | $878.17 | 7-1-2019 | |
| CPT 78000 | THYROID UPTAKE; SINGLE DETERMINATION | $96.29 | 7-1-2019 | |
| CPT 78000 | THYROID UPTAKE; SINGLE DETERMINATION | 26 | $12.21 | 7-1-2019 |
| CPT 78000 | THYROID UPTAKE; SINGLE DETERMINATION | TC | $32.90 | 7-1-2019 |
| CPT 78001 | THYROID UPTAKE; MULTIPLE DETERMINATIONS | $96.29 | 7-1-2019 | |
| CPT 78001 | THYROID UPTAKE; MULTIPLE DETERMINATIONS | 26 | $13.61 | 7-1-2019 |
| CPT 78001 | THYROID UPTAKE; MULTIPLE DETERMINATIONS | TC | $44.42 | 7-1-2019 |
| CPT 78003 | THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT INCLUDING INITIAL UPTAKE STUDIES) | $237.62 | 7-1-2019 | |
| CPT 78003 | THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT INCLUDING INITIAL UPTAKE STUDIES) | 26 | $16.66 | 7-1-2019 |
| CPT 78003 | THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT INCLUDING INITIAL UPTAKE STUDIES) | TC | $32.90 | 7-1-2019 |
| CPT 78006 | THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION | $166.34 | 7-1-2019 | |
| CPT 78006 | THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION | 26 | $30.39 | 7-1-2019 |
| CPT 78006 | THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION | TC | $81.59 | 7-1-2019 |
| CPT 78007 | THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS | $187.52 | 7-1-2019 | |
| CPT 78007 | THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS | 26 | $26.01 | 7-1-2019 |
| CPT 78007 | THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS | TC | $87.85 | 7-1-2019 |
| CPT 78010 | THYROID IMAGING; ONLY | $166.34 | 7-1-2019 | |
| CPT 78010 | THYROID IMAGING; ONLY | 26 | $25.26 | 7-1-2019 |
| CPT 78010 | THYROID IMAGING; ONLY | TC | $61.88 | 7-1-2019 |
| CPT 78011 | THYROID IMAGING; WITH VASCULAR FLOW | $166.34 | 7-1-2019 | |
| CPT 78011 | THYROID IMAGING; WITH VASCULAR FLOW | 26 | $30.19 | 7-1-2019 |
| CPT 78011 | THYROID IMAGING; WITH VASCULAR FLOW | TC | $82.25 | 7-1-2019 |
| CPT 78012 | THYROID UPTAKE, SINGLE OR MULTIPLE, QUANTITATIVE MEASUREMENT(S) (INCLUDING STIMULATION, SUPRESSION, OR | $130.29 | 7-1-2019 | |
| CPT 78014 | THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED); WITH SINGLE OR MULTIPLE UPTAKE(S) | $220.31 | 7-1-2019 | |
| CPT 78015 | THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY) | $279.21 | 7-1-2019 | |
| CPT 78015 | THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY) | 26 | $34.92 | 7-1-2019 |
| CPT 78015 | THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY) | TC | $87.85 | 7-1-2019 |
| CPT 78016 | THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY) | $279.21 | 7-1-2019 | |
| CPT 78016 | THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY) | 26 | $42.57 | 7-1-2019 |
| CPT 78016 | THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY) | TC | $118.83 | 7-1-2019 |
| CPT 78017 | THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS | $194.04 | 7-1-2019 | |
| CPT 78017 | THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS | 26 | $44.93 | 7-1-2019 |
| CPT 78017 | THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS | TC | $127.10 | 7-1-2019 |
| CPT 78018 | THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY | $279.21 | 7-1-2019 | |
| CPT 78018 | THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY | 26 | $49.40 | 7-1-2019 |
| CPT 78018 | THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY | TC | $185.31 | 7-1-2019 |
| CPT 78070 | PARATHYROID IMAGING | $187.52 | 7-1-2019 | |
| CPT 78070 | PARATHYROID IMAGING | 26 | $26.59 | 7-1-2019 |
| CPT 78070 | PARATHYROID IMAGING | TC | $61.88 | 7-1-2019 |
| CPT 78071 | PARATHYROID PLANAR IMAGING; WITH TOMOGRAPHIC (SPECT) | $304.59 | 7-1-2019 | |
| CPT 78072 | PARATHYROID PLANAR IMAGING; WITH TOMOGRAPHIC (SPECT), AND CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY | $304.59 | 7-1-2019 | |
| CPT 78075 | ADRENAL IMAGING, CORTEX AND/OR MEDULLA | $187.52 | 7-1-2019 | |
| CPT 78075 | ADRENAL IMAGING, CORTEX AND/OR MEDULLA | 26 | $40.07 | 7-1-2019 |
| CPT 78075 | ADRENAL IMAGING, CORTEX AND/OR MEDULLA | TC | $185.31 | 7-1-2019 |
| CPT 78099 | UNLISTED ENDOCRINE PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $166.34 | 7-1-2019 | |
| CPT 78102 | BONE MARROW IMAGING; LIMITED AREA | $264.12 | 7-1-2019 | |
| CPT 78102 | BONE MARROW IMAGING; LIMITED AREA | 26 | $31.02 | 7-1-2019 |
| CPT 78102 | BONE MARROW IMAGING; LIMITED AREA | TC | $69.72 | 7-1-2019 |
| CPT 78103 | BONE MARROW IMAGING; MULTIPLE AREAS | $264.12 | 7-1-2019 | |
| CPT 78103 | BONE MARROW IMAGING; MULTIPLE AREAS | 26 | $50.03 | 7-1-2019 |
| CPT 78103 | BONE MARROW IMAGING; MULTIPLE AREAS | TC | $107.97 | 7-1-2019 |
| CPT 78104 | BONE MARROW IMAGING; WHOLE BODY | $264.12 | 7-1-2019 | |
| CPT 78104 | BONE MARROW IMAGING; WHOLE BODY | 26 | $51.26 | 7-1-2019 |
| CPT 78104 | BONE MARROW IMAGING; WHOLE BODY | TC | $138.87 | 7-1-2019 |
| CPT 78110 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE SAMPLING | $232.47 | 7-1-2019 | |
| CPT 78110 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE SAMPLING | 26 | $10.71 | 7-1-2019 |
| CPT 78110 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE SAMPLING | TC | $32.24 | 7-1-2019 |
| CPT 78111 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | $232.47 | 7-1-2019 | |
| CPT 78111 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | 26 | $14.48 | 7-1-2019 |
| CPT 78111 | PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | TC | $87.85 | 7-1-2019 |
| CPT 78120 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING | $232.47 | 7-1-2019 | |
| CPT 78120 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING | 26 | $17.42 | 7-1-2019 |
| CPT 78120 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING | TC | $59.21 | 7-1-2019 |
| CPT 78121 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | $232.47 | 7-1-2019 | |
| CPT 78121 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | 26 | $19.53 | 7-1-2019 |
| CPT 78121 | RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS | TC | $99.13 | 7-1-2019 |
| CPT 78122 | WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU | $232.47 | 7-1-2019 | |
| CPT 78122 | WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU | 26 | $30.18 | 7-1-2019 |
| CPT 78122 | WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU | TC | $157.33 | 7-1-2019 |
| CPT 78130 | RED CELL SURVIVAL STUDY; | $232.47 | 7-1-2019 | |
| CPT 78130 | RED CELL SURVIVAL STUDY; | 26 | $33.20 | 7-1-2019 |
| CPT 78130 | RED CELL SURVIVAL STUDY; | TC | $97.46 | 7-1-2019 |
| CPT 78135 | RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG, SPLENIC AND/OR HEPATIC SEQUESTRATION) | $232.47 | 7-1-2019 | |
| CPT 78135 | RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG, SPLENIC AND/OR HEPATIC SEQUESTRATION) | 26 | $33.79 | 7-1-2019 |
| CPT 78135 | RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG, SPLENIC AND/OR HEPATIC SEQUESTRATION) | TC | $166.18 | 7-1-2019 |
| CPT 78140 | LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC) | $232.47 | 7-1-2019 | |
| CPT 78140 | LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC) | 26 | $33.20 | 7-1-2019 |
| CPT 78140 | LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC) | TC | $134.28 | 7-1-2019 |
| CPT 78160 | PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE | $154.90 | 7-1-2019 | |
| CPT 78160 | PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE | 26 | $21.84 | 7-1-2019 |
| CPT 78160 | PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE | TC | $125.09 | 7-1-2019 |
| CPT 78162 | RADIOIRON ORAL ABSORPTION | $146.18 | 7-1-2019 | |
| CPT 78162 | RADIOIRON ORAL ABSORPTION | 26 | $30.18 | 7-1-2019 |
| CPT 78162 | RADIOIRON ORAL ABSORPTION | TC | $108.98 | 7-1-2019 |
| CPT 78170 | RADIOIRON RED CELL UTILIZATION | $154.60 | 7-1-2019 | |
| CPT 78170 | RADIOIRON RED CELL UTILIZATION | 26 | $23.58 | 7-1-2019 |
| CPT 78170 | RADIOIRON RED CELL UTILIZATION | TC | $181.38 | 7-1-2019 |
| CPT 78172 | CHELATABLE IRON FOR ESTIMATION OF TOTAL BODY IRON | 26 | $36.81 | 7-1-2019 |
| CPT 78185 | SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW | $264.12 | 7-1-2019 | |
| CPT 78185 | SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW | 26 | $27.88 | 7-1-2019 |
| CPT 78185 | SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW | TC | $80.58 | 7-1-2019 |
| CPT 78190 | KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL ORGAN/TISSUE LOCALIZATION | $237.62 | 7-1-2019 | |
| CPT 78190 | KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL ORGAN/TISSUE LOCALIZATION | 26 | $55.96 | 7-1-2019 |
| CPT 78190 | KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL ORGAN/TISSUE LOCALIZATION | TC | $195.16 | 7-1-2019 |
| CPT 78191 | PLATELET SURVIVAL STUDY | $237.62 | 7-1-2019 | |
| CPT 78191 | PLATELET SURVIVAL STUDY | 26 | $41.88 | 7-1-2019 |
| CPT 78191 | PLATELET SURVIVAL STUDY | TC | $250.44 | 7-1-2019 |
| CPT 78192 | WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNING | $177.50 | 7-1-2019 | |
| CPT 78192 | WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNING | 26 | $53.93 | 7-1-2019 |
| CPT 78192 | WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNING | TC | $115.92 | 7-1-2019 |
| CPT 78193 | WHITE BLOOD CELL LOCALIZATION; WHOLE BODY | $413.40 | 7-1-2019 | |
| CPT 78193 | WHITE BLOOD CELL LOCALIZATION; WHOLE BODY | 26 | $59.60 | 7-1-2019 |
| CPT 78193 | WHITE BLOOD CELL LOCALIZATION; WHOLE BODY | TC | $332.78 | 7-1-2019 |
| CPT 78195 | LYMPHATICS AND LYMPH GLANDS IMAGING | $264.12 | 7-1-2019 | |
| CPT 78195 | LYMPHATICS AND LYMPH GLANDS IMAGING | 26 | $63.16 | 7-1-2019 |
| CPT 78195 | LYMPHATICS AND LYMPH GLANDS IMAGING | LT | $264.12 | 7-1-2019 |
| CPT 78195 | LYMPHATICS AND LYMPH GLANDS IMAGING | RT | $264.12 | 7-1-2019 |
| CPT 78195 | LYMPHATICS AND LYMPH GLANDS IMAGING | TC | $138.87 | 7-1-2019 |
| CPT 78199 | UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $264.12 | 7-1-2019 | |
| CPT 78201 | LIVER IMAGING; STATIC ONLY | $290.75 | 7-1-2019 | |
| CPT 78201 | LIVER IMAGING; STATIC ONLY | 26 | $28.78 | 7-1-2019 |
| CPT 78201 | LIVER IMAGING; STATIC ONLY | TC | $80.58 | 7-1-2019 |
| CPT 78202 | LIVER IMAGING; WITH VASCULAR FLOW | $290.75 | 7-1-2019 | |
| CPT 78202 | LIVER IMAGING; WITH VASCULAR FLOW | 26 | $53.30 | 7-1-2019 |
| CPT 78202 | LIVER IMAGING; WITH VASCULAR FLOW | TC | $98.46 | 7-1-2019 |
| CPT 78205 | LIVER IMAGING (SPECT) | $290.75 | 7-1-2019 | |
| CPT 78205 | LIVER IMAGING (SPECT) | 26 | $48.59 | 7-1-2019 |
| CPT 78205 | LIVER IMAGING (SPECT) | TC | $201.42 | 7-1-2019 |
| CPT 78206 | LIVER IMAGING (SPECT); WITH VASCULAR FLOW | $295.24 | 7-1-2019 | |
| CPT 78215 | LIVER AND SPLEEN IMAGING; STATIC ONLY | $290.75 | 7-1-2019 | |
| CPT 78215 | LIVER AND SPLEEN IMAGING; STATIC ONLY | 26 | $32.21 | 7-1-2019 |
| CPT 78215 | LIVER AND SPLEEN IMAGING; STATIC ONLY | TC | $100.12 | 7-1-2019 |
| CPT 78216 | LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW | $290.75 | 7-1-2019 | |
| CPT 78216 | LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW | 26 | $33.80 | 7-1-2019 |
| CPT 78216 | LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW | TC | $118.83 | 7-1-2019 |
| CPT 78220 | LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES | $290.75 | 7-1-2019 | |
| CPT 78220 | LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES | 26 | $36.56 | 7-1-2019 |
| CPT 78220 | LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES | TC | $127.10 | 7-1-2019 |
| CPT 78223 | HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O | $290.75 | 7-1-2019 | |
| CPT 78223 | HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O | 26 | $39.33 | 7-1-2019 |
| CPT 78223 | HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O | TC | $125.09 | 7-1-2019 |
| CPT 78226 | HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT | $339.22 | 7-1-2019 | |
| CPT 78227 | HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; WITH PHARMACOLOGIC INTERVENTION, INCLUDING | $297.35 | 7-1-2019 | |
| CPT 78230 | SALIVARY GLAND IMAGING; | $254.25 | 7-1-2019 | |
| CPT 78230 | SALIVARY GLAND IMAGING; | 26 | $46.40 | 7-1-2019 |
| CPT 78230 | SALIVARY GLAND IMAGING; | TC | $74.32 | 7-1-2019 |
| CPT 78231 | SALIVARY GLAND IMAGING; WITH SERIAL IMAGES | $254.25 | 7-1-2019 | |
| CPT 78231 | SALIVARY GLAND IMAGING; WITH SERIAL IMAGES | 26 | $59.10 | 7-1-2019 |
| CPT 78231 | SALIVARY GLAND IMAGING; WITH SERIAL IMAGES | TC | $107.97 | 7-1-2019 |
| CPT 78232 | SALIVARY GLAND FUNCTION STUDY | $254.25 | 7-1-2019 | |
| CPT 78232 | SALIVARY GLAND FUNCTION STUDY | 26 | $32.88 | 7-1-2019 |
| CPT 78232 | SALIVARY GLAND FUNCTION STUDY | TC | $120.50 | 7-1-2019 |
| CPT 78258 | ESOPHAGEAL MOTILITY | $254.25 | 7-1-2019 | |
| CPT 78258 | ESOPHAGEAL MOTILITY | 26 | $50.30 | 7-1-2019 |
| CPT 78258 | ESOPHAGEAL MOTILITY | TC | $98.46 | 7-1-2019 |
| CPT 78261 | GASTRIC MUCOSA IMAGING | $254.25 | 7-1-2019 | |
| CPT 78261 | GASTRIC MUCOSA IMAGING | 26 | $46.94 | 7-1-2019 |
| CPT 78261 | GASTRIC MUCOSA IMAGING | TC | $139.87 | 7-1-2019 |
| CPT 78262 | GASTROESOPHAGEAL REFLUX STUDY | $254.25 | 7-1-2019 | |
| CPT 78262 | GASTROESOPHAGEAL REFLUX STUDY | 26 | $46.30 | 7-1-2019 |
| CPT 78262 | GASTROESOPHAGEAL REFLUX STUDY | TC | $144.81 | 7-1-2019 |
| CPT 78264 | GASTRIC EMPTYING STUDY | $254.25 | 7-1-2019 | |
| CPT 78264 | GASTRIC EMPTYING STUDY | 26 | $40.65 | 7-1-2019 |
| CPT 78264 | GASTRIC EMPTYING STUDY | TC | $140.54 | 7-1-2019 |
| CPT 78265 | STOMACH EMPTYING AND SMALL BOWEL TRANSIT STUDY | $304.32 | 7-1-2019 | |
| CPT 78266 | STOMACH EMPTYING AND SMALL BOWEL WITH COLON TRANSIT STUDY | $403.78 | 7-1-2019 | |
| CPT 78267 | UREA BREATH TEST, C-14; ACQUISITION FOR ANALYSIS | $11.77 | 7-1-2019 | |
| CPT 78268 | UREA BREATH TEST, C-14; ANALYSIS | $100.89 | 7-1-2019 | |
| CPT 78270 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC FACTOR | $237.62 | 7-1-2019 | |
| CPT 78270 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC FACTOR | 26 | $14.86 | 7-1-2019 |
| CPT 78270 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC FACTOR | TC | $52.95 | 7-1-2019 |
| CPT 78271 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC FACTOR | $237.62 | 7-1-2019 | |
| CPT 78271 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC FACTOR | 26 | $14.86 | 7-1-2019 |
| CPT 78271 | VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC FACTOR | TC | $56.28 | 7-1-2019 |
| CPT 78272 | VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT INTRINSIC FACTOR | $237.62 | 7-1-2019 | |
| CPT 78272 | VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT INTRINSIC FACTOR | 26 | $16.49 | 7-1-2019 |
| CPT 78272 | VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT INTRINSIC FACTOR | TC | $79.24 | 7-1-2019 |
| CPT 78276 | GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATION | $111.98 | 7-1-2019 | |
| CPT 78276 | GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATION | 26 | $33.67 | 7-1-2019 |
| CPT 78276 | GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATION | TC | $108.98 | 7-1-2019 |
| CPT 78278 | ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING | $254.25 | 7-1-2019 | |
| CPT 78278 | ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING | 26 | $42.68 | 7-1-2019 |
| CPT 78278 | ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING | TC | $166.18 | 7-1-2019 |
| CPT 78280 | GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING) | $101.57 | 7-1-2019 | |
| CPT 78280 | GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING) | 26 | $19.61 | 7-1-2019 |
| CPT 78280 | GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING) | TC | $110.65 | 7-1-2019 |
| CPT 78282 | GASTROINTESTINAL PROTEIN LOSS | $254.25 | 7-1-2019 | |
| CPT 78282 | GASTROINTESTINAL PROTEIN LOSS | 26 | $25.47 | 7-1-2019 |
| CPT 78290 | BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION, VOLVULUS) | $254.25 | 7-1-2019 | |
| CPT 78290 | BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION, VOLVULUS) | 26 | $52.28 | 7-1-2019 |
| CPT 78290 | BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION, VOLVULUS) | TC | $103.72 | 7-1-2019 |
| CPT 78291 | PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT) | $254.25 | 7-1-2019 | |
| CPT 78291 | PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT) | 26 | $59.60 | 7-1-2019 |
| CPT 78291 | PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT) | TC | $104.39 | 7-1-2019 |
| CPT 78299 | UNLISTED GASTROINTESTINAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $254.25 | 7-1-2019 | |
| CPT 78300 | BONE AND/OR JOINT IMAGING; LIMITED AREA | $269.25 | 7-1-2019 | |
| CPT 78300 | BONE AND/OR JOINT IMAGING; LIMITED AREA | 26 | $36.41 | 7-1-2019 |
| CPT 78300 | BONE AND/OR JOINT IMAGING; LIMITED AREA | TC | $85.17 | 7-1-2019 |
| CPT 78305 | BONE AND/OR JOINT IMAGING; MULTIPLE AREAS | $269.25 | 7-1-2019 | |
| CPT 78305 | BONE AND/OR JOINT IMAGING; MULTIPLE AREAS | 26 | $55.87 | 7-1-2019 |
| CPT 78305 | BONE AND/OR JOINT IMAGING; MULTIPLE AREAS | TC | $125.09 | 7-1-2019 |
| CPT 78306 | BONE AND/OR JOINT IMAGING; WHOLE BODY | $269.25 | 7-1-2019 | |
| CPT 78306 | BONE AND/OR JOINT IMAGING; WHOLE BODY | 26 | $56.14 | 7-1-2019 |
| CPT 78306 | BONE AND/OR JOINT IMAGING; WHOLE BODY | TC | $145.80 | 7-1-2019 |
| CPT 78310 | BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLY | $118.50 | 7-1-2019 | |
| CPT 78310 | BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLY | 26 | $48.41 | 7-1-2019 |
| CPT 78310 | BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLY | TC | $40.17 | 7-1-2019 |
| CPT 78315 | BONE AND/OR JOINT IMAGING; THREE PHASE STUDY | $269.25 | 7-1-2019 | |
| CPT 78315 | BONE AND/OR JOINT IMAGING; THREE PHASE STUDY | 26 | $61.56 | 7-1-2019 |
| CPT 78315 | BONE AND/OR JOINT IMAGING; THREE PHASE STUDY | 59 | $269.25 | 7-1-2019 |
| CPT 78315 | BONE AND/OR JOINT IMAGING; THREE PHASE STUDY | TC | $162.92 | 7-1-2019 |
| CPT 78320 | BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT) | $269.25 | 7-1-2019 | |
| CPT 78320 | BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT) | 26 | $70.41 | 7-1-2019 |
| CPT 78320 | BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT) | TC | $201.42 | 7-1-2019 |
| CPT 78350 | BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES; SINGLE PHOTON ABSORPTIOMETRY | $49.20 | 7-1-2019 | |
| CPT 78350 | BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES; SINGLE PHOTON ABSORPTIOMETRY | 26 | $15.00 | 7-1-2019 |
| CPT 78350 | BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES; SINGLE PHOTON ABSORPTIOMETRY | TC | $25.96 | 7-1-2019 |
| CPT 78399 | UNLISTED MUSCULOSKELETAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $269.25 | 7-1-2019 | |
| CPT 78414 | DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR W | $283.53 | 7-1-2019 | |
| CPT 78414 | DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR W | 26 | $42.64 | 7-1-2019 |
| CPT 78428 | CARDIAC SHUNT DETECTION | $283.53 | 7-1-2019 | |
| CPT 78428 | CARDIAC SHUNT DETECTION | 26 | $30.71 | 7-1-2019 |
| CPT 78428 | CARDIAC SHUNT DETECTION | TC | $76.99 | 7-1-2019 |
| CPT 78445 | NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY) | $140.49 | 7-1-2019 | |
| CPT 78445 | NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY) | 26 | $41.75 | 7-1-2019 |
| CPT 78445 | NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY) | TC | $64.47 | 7-1-2019 |
| CPT 78451 | MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); SINGLE STUDY, AT REST OR STRESS | $744.13 | 7-1-2019 | |
| CPT 78452 | MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MULTIPLE STUDIES, AT REST OR STRESS AND/OR REDISTRUBUTION | $744.13 | 7-1-2019 | |
| CPT 78454 | MYOCARDIAL PERFUSION IMAGING, PLANAR; MULITPLE STUDIES, AT REST AND/OR STRESS AND/OR REDISTRIBUTION AND/OR | $775.57 | 7-1-2019 | |
| CPT 78455 | VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN) | $194.13 | 7-1-2019 | |
| CPT 78455 | VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN) | 26 | $43.69 | 7-1-2019 |
| CPT 78455 | VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN) | TC | $135.95 | 7-1-2019 |
| CPT 78456 | ACUTE VENOUS THROMBOSIS IMAGING, PEPTIDE | $140.49 | 7-1-2019 | |
| CPT 78457 | VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL | $140.49 | 7-1-2019 | |
| CPT 78457 | VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL | 26 | $44.60 | 7-1-2019 |
| CPT 78457 | VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL | TC | $90.77 | 7-1-2019 |
| CPT 78458 | VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL | $140.49 | 7-1-2019 | |
| CPT 78458 | VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL | 26 | $47.76 | 7-1-2019 |
| CPT 78458 | VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL | TC | $136.96 | 7-1-2019 |
| CPT 78459 | MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION | $907.31 | 7-1-2019 | |
| CPT 78460 | MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH | $283.53 | 7-1-2019 | |
| CPT 78460 | MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH | 26 | $58.64 | 7-1-2019 |
| CPT 78460 | MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH | TC | $80.58 | 7-1-2019 |
| CPT 78461 | MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) | $450.07 | 7-1-2019 | |
| CPT 78461 | MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) | 26 | $69.45 | 7-1-2019 |
| CPT 78461 | MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) | TC | $161.25 | 7-1-2019 |
| CPT 78464 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG | $283.53 | 7-1-2019 | |
| CPT 78464 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG | 26 | $73.69 | 7-1-2019 |
| CPT 78464 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG | TC | $241.83 | 7-1-2019 |
| CPT 78465 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE AND | $450.07 | 7-1-2019 | |
| CPT 78465 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE AND | 26 | $98.96 | 7-1-2019 |
| CPT 78465 | MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE AND | TC | $402.50 | 7-1-2019 |
| CPT 78466 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE | $283.53 | 7-1-2019 | |
| CPT 78466 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE | 26 | $47.26 | 7-1-2019 |
| CPT 78466 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE | TC | $89.77 | 7-1-2019 |
| CPT 78468 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE | $283.53 | 7-1-2019 | |
| CPT 78468 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE | 26 | $53.93 | 7-1-2019 |
| CPT 78468 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE | TC | $125.09 | 7-1-2019 |
| CPT 78469 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTIFICATION | $283.53 | 7-1-2019 | |
| CPT 78469 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTIFICATION | 26 | $79.38 | 7-1-2019 |
| CPT 78469 | MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTIFICATION | TC | $178.70 | 7-1-2019 |
| CPT 78472 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT REST, WALL MOTION STUDY PLUS EJECTION FRACTION, | $283.53 | 7-1-2019 | |
| CPT 78472 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT REST, WALL MOTION STUDY PLUS EJECTION FRACTION, | 26 | $74.49 | 7-1-2019 |
| CPT 78472 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT REST, WALL MOTION STUDY PLUS EJECTION FRACTION, | TC | $188.22 | 7-1-2019 |
| CPT 78473 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, RES | $339.36 | 7-1-2019 | |
| CPT 78473 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, RES | 26 | $75.90 | 7-1-2019 |
| CPT 78473 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, RES | TC | $282.00 | 7-1-2019 |
| CPT 78478 | MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO | $101.43 | 7-1-2019 | |
| CPT 78478 | MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO | 26 | $31.98 | 7-1-2019 |
| CPT 78478 | MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO | TC | $53.28 | 7-1-2019 |
| CPT 78480 | MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | $101.43 | 7-1-2019 | |
| CPT 78480 | MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | 26 | $31.98 | 7-1-2019 |
| CPT 78480 | MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | TC | $53.28 | 7-1-2019 |
| CPT 78481 | CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR WITH STRESS | $283.53 | 7-1-2019 | |
| CPT 78481 | CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR WITH STRESS | 26 | $66.62 | 7-1-2019 |
| CPT 78481 | CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR WITH STRESS | TC | $178.70 | 7-1-2019 |
| CPT 78483 | CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE; MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE | $339.36 | 7-1-2019 | |
| CPT 78483 | CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE; MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE | 26 | $75.90 | 7-1-2019 |
| CPT 78483 | CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE; MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE | TC | $268.80 | 7-1-2019 |
| CPT 78491 | MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION; SINGLE STUDY AT REST OR STRESS | $907.31 | 7-1-2019 | |
| CPT 78492 | MYCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION; MULTIPLE STUDIES AT REST AND/OR STRESS | $2,816.24 | 7-1-2019 | |
| CPT 78494 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, AT REST, WALL MOTION STUDY PLUS EJECTION FRACTION, WITH | $278.32 | 7-1-2019 | |
| CPT 78496 | CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SINGLE STUDY, AT REST, WITH RIGHT VENTRICULAR EJECTION FRACTION | $101.43 | 7-1-2019 | |
| CPT 78499 | UNLISTED CARDIOVASCULAR PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $283.53 | 7-1-2019 | |
| CPT 78580 | PULMONARY PERFUSION IMAGING; PARTICULATE | $223.69 | 7-1-2019 | |
| CPT 78580 | PULMONARY PERFUSION IMAGING; PARTICULATE | 26 | $48.34 | 7-1-2019 |
| CPT 78580 | PULMONARY PERFUSION IMAGING; PARTICULATE | TC | $117.16 | 7-1-2019 |
| CPT 78581 | PULMONARY PERFUSION IMAGING; GASEOUS | $95.78 | 7-1-2019 | |
| CPT 78581 | PULMONARY PERFUSION IMAGING; GASEOUS | 26 | $33.22 | 7-1-2019 |
| CPT 78581 | PULMONARY PERFUSION IMAGING; GASEOUS | TC | $81.59 | 7-1-2019 |
| CPT 78582 | PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGING | $175.64 | 7-1-2019 | |
| CPT 78582 | PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGING | 26 | $49.76 | 7-1-2019 |
| CPT 78582 | PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGING | TC | $128.68 | 7-1-2019 |
| CPT 78584 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE BREATH | $364.64 | 7-1-2019 | |
| CPT 78584 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE BREATH | 26 | $51.24 | 7-1-2019 |
| CPT 78584 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE BREATH | TC | $108.98 | 7-1-2019 |
| CPT 78585 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR | $364.64 | 7-1-2019 | |
| CPT 78585 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR | 26 | $55.96 | 7-1-2019 |
| CPT 78585 | PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR | TC | $192.23 | 7-1-2019 |
| CPT 78586 | PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION | $223.69 | 7-1-2019 | |
| CPT 78586 | PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION | 26 | $31.00 | 7-1-2019 |
| CPT 78586 | PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION | TC | $88.52 | 7-1-2019 |
| CPT 78587 | PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL VIEWS) | $223.69 | 7-1-2019 | |
| CPT 78587 | PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL VIEWS) | 26 | $33.44 | 7-1-2019 |
| CPT 78587 | PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL VIEWS) | TC | $95.78 | 7-1-2019 |
| CPT 78588 | PULMONY PERFUSION IMAGING PARTICULATE WITH VENTILATION IMAGING | $364.64 | 7-1-2019 | |
| CPT 78591 | PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE PROJECTION | $223.69 | 7-1-2019 | |
| CPT 78591 | PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE PROJECTION | 26 | $31.00 | 7-1-2019 |
| CPT 78591 | PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE PROJECTION | TC | $97.46 | 7-1-2019 |
| CPT 78593 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO | $223.69 | 7-1-2019 | |
| CPT 78593 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO | 26 | $33.34 | 7-1-2019 |
| CPT 78593 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO | TC | $117.83 | 7-1-2019 |
| CPT 78594 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P | $223.69 | 7-1-2019 | |
| CPT 78594 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P | 26 | $57.21 | 7-1-2019 |
| CPT 78594 | PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P | TC | $169.86 | 7-1-2019 |
| CPT 78596 | PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION (VENTILATION/PERFUSION) STUDY | $364.64 | 7-1-2019 | |
| CPT 78596 | PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION (VENTILATION/PERFUSION) STUDY | 26 | $65.54 | 7-1-2019 |
| CPT 78596 | PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION (VENTILATION/PERFUSION) STUDY | TC | $241.83 | 7-1-2019 |
| CPT 78597 | QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING WHEN PERFORMED | $287.24 | 7-1-2019 | |
| CPT 78599 | UNLISTED RESPIRATORY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $223.69 | 7-1-2019 | |
| CPT 78600 | BRAIN IMAGING, LIMITED PROCEDURE; STATIC | $348.76 | 7-1-2019 | |
| CPT 78600 | BRAIN IMAGING, LIMITED PROCEDURE; STATIC | 26 | $41.08 | 7-1-2019 |
| CPT 78600 | BRAIN IMAGING, LIMITED PROCEDURE; STATIC | TC | $98.46 | 7-1-2019 |
| CPT 78601 | BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW | $348.76 | 7-1-2019 | |
| CPT 78601 | BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW | 26 | $43.09 | 7-1-2019 |
| CPT 78601 | BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW | TC | $115.92 | 7-1-2019 |
| CPT 78605 | BRAIN IMAGING, COMPLETE STUDY; STATIC | $348.76 | 7-1-2019 | |
| CPT 78605 | BRAIN IMAGING, COMPLETE STUDY; STATIC | 26 | $43.57 | 7-1-2019 |
| CPT 78605 | BRAIN IMAGING, COMPLETE STUDY; STATIC | TC | $115.92 | 7-1-2019 |
| CPT 78606 | BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW | $348.76 | 7-1-2019 | |
| CPT 78606 | BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW | 26 | $45.95 | 7-1-2019 |
| CPT 78606 | BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW | TC | $132.03 | 7-1-2019 |
| CPT 78607 | BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT) | $348.76 | 7-1-2019 | |
| CPT 78607 | BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT) | 26 | $83.65 | 7-1-2019 |
| CPT 78607 | BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT) | TC | $223.80 | 7-1-2019 |
| CPT 78608 | BRAIN IMAGING POSITRON EMISSION TOMOGRAPHY (PET); METABOLIC EVALUATION | $1,303.36 | 7-1-2019 | |
| CPT 78610 | BRAIN IMAGING, VASCULAR FLOW ONLY | $348.76 | 7-1-2019 | |
| CPT 78610 | BRAIN IMAGING, VASCULAR FLOW ONLY | 26 | $45.47 | 7-1-2019 |
| CPT 78610 | BRAIN IMAGING, VASCULAR FLOW ONLY | TC | $53.94 | 7-1-2019 |
| CPT 78615 | CEREBRAL BLOOD FLOW | $348.76 | 7-1-2019 | |
| CPT 78615 | CEREBRAL BLOOD FLOW | 26 | $37.41 | 7-1-2019 |
| CPT 78615 | CEREBRAL BLOOD FLOW | 52 | $66.98 | 7-1-2019 |
| CPT 78615 | CEREBRAL BLOOD FLOW | TC | $131.36 | 7-1-2019 |
| CPT 78630 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY | $236.16 | 7-1-2019 | |
| CPT 78630 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY | 26 | $70.82 | 7-1-2019 |
| CPT 78630 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY | TC | $171.78 | 7-1-2019 |
| CPT 78635 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY | $236.16 | 7-1-2019 | |
| CPT 78635 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY | 26 | $41.88 | 7-1-2019 |
| CPT 78635 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY | TC | $86.84 | 7-1-2019 |
| CPT 78645 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION | $236.16 | 7-1-2019 | |
| CPT 78645 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION | 26 | $39.43 | 7-1-2019 |
| CPT 78645 | CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION | TC | $117.16 | 7-1-2019 |
| CPT 78647 | CEREBROSPINAL FLUID FLOW, IMAGING; TOMOGRAPHIC (SPECT) | $236.16 | 7-1-2019 | |
| CPT 78650 | CSF LEAKAGE DETECTION AND LOCALIZATION | $236.16 | 7-1-2019 | |
| CPT 78650 | CSF LEAKAGE DETECTION AND LOCALIZATION | 26 | $43.15 | 7-1-2019 |
| CPT 78650 | CSF LEAKAGE DETECTION AND LOCALIZATION | TC | $158.33 | 7-1-2019 |
| CPT 78652 | CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT) | $275.28 | 7-1-2019 | |
| CPT 78652 | CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT) | 26 | $61.31 | 7-1-2019 |
| CPT 78652 | CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT) | TC | $201.42 | 7-1-2019 |
| CPT 78655 | RADIONUCLIDE IDENTIFICATION OF EYE TUMOR | $219.19 | 7-1-2019 | |
| CPT 78655 | RADIONUCLIDE IDENTIFICATION OF EYE TUMOR | 26 | $28.43 | 7-1-2019 |
| CPT 78655 | RADIONUCLIDE IDENTIFICATION OF EYE TUMOR | TC | $169.86 | 7-1-2019 |
| CPT 78660 | RADIONUCLIDE DACRYOCYSTOGRAPHY | $236.16 | 7-1-2019 | |
| CPT 78660 | RADIONUCLIDE DACRYOCYSTOGRAPHY | 26 | $42.77 | 7-1-2019 |
| CPT 78660 | RADIONUCLIDE DACRYOCYSTOGRAPHY | TC | $72.40 | 7-1-2019 |
| CPT 78699 | UNLISTED NERVOUS SYSTEM PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $348.76 | 7-1-2019 | |
| CPT 78700 | KIDNEY IMAGING; STATIC ONLY | $246.57 | 7-1-2019 | |
| CPT 78700 | KIDNEY IMAGING; STATIC ONLY | 26 | $37.92 | 7-1-2019 |
| CPT 78700 | KIDNEY IMAGING; STATIC ONLY | TC | $103.72 | 7-1-2019 |
| CPT 78701 | KIDNEY IMAGING; WITH VASCULAR FLOW | $246.57 | 7-1-2019 | |
| CPT 78701 | KIDNEY IMAGING; WITH VASCULAR FLOW | 26 | $39.61 | 7-1-2019 |
| CPT 78701 | KIDNEY IMAGING; WITH VASCULAR FLOW | TC | $121.51 | 7-1-2019 |
| CPT 78704 | KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM) | $246.57 | 7-1-2019 | |
| CPT 78704 | KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM) | 26 | $39.15 | 7-1-2019 |
| CPT 78704 | KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM) | TC | $134.94 | 7-1-2019 |
| CPT 78707 | KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY WITHOUT PHARMACOLOGICAL INTERVENTION | $246.57 | 7-1-2019 | |
| CPT 78707 | KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY WITHOUT PHARMACOLOGICAL INTERVENTION | 26 | $48.30 | 7-1-2019 |
| CPT 78707 | KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY WITHOUT PHARMACOLOGICAL INTERVENTION | TC | $152.74 | 7-1-2019 |
| CPT 78708 | KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY, WITH PHARMACOLOGICAL INTERVENTION (EG, ANGIOTEN | $279.86 | 7-1-2019 | |
| CPT 78709 | KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; MULTIPLE STUDIES, WITH AND WITHOUT PHARMACOLOGICAL | $279.86 | 7-1-2019 | |
| CPT 78710 | KIDNEY IMAGING, TOMOGRAPHIC (SPECT) | $246.57 | 7-1-2019 | |
| CPT 78710 | KIDNEY IMAGING, TOMOGRAPHIC (SPECT) | 26 | $45.17 | 7-1-2019 |
| CPT 78710 | KIDNEY IMAGING, TOMOGRAPHIC (SPECT) | TC | $201.42 | 7-1-2019 |
| CPT 78715 | KIDNEY VASCULAR FLOW ONLY | $246.57 | 7-1-2019 | |
| CPT 78715 | KIDNEY VASCULAR FLOW ONLY | 26 | $17.11 | 7-1-2019 |
| CPT 78715 | KIDNEY VASCULAR FLOW ONLY | TC | $53.94 | 7-1-2019 |
| CPT 78725 | KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION | $96.29 | 7-1-2019 | |
| CPT 78725 | KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION | 26 | $26.81 | 7-1-2019 |
| CPT 78725 | KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION | TC | $60.88 | 7-1-2019 |
| CPT 78726 | KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTION | $166.72 | 7-1-2019 | |
| CPT 78726 | KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTION | 26 | $59.23 | 7-1-2019 |
| CPT 78726 | KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTION | TC | $101.05 | 7-1-2019 |
| CPT 78727 | KIDNEY TRANSPLANT EVALUATION | $211.58 | 7-1-2019 | |
| CPT 78727 | KIDNEY TRANSPLANT EVALUATION | 26 | $67.08 | 7-1-2019 |
| CPT 78727 | KIDNEY TRANSPLANT EVALUATION | TC | $135.95 | 7-1-2019 |
| CPT 78730 | URINARY BLADDER RESIDUAL STUDY | $41.39 | 7-1-2019 | |
| CPT 78730 | URINARY BLADDER RESIDUAL STUDY | 26 | $23.55 | 7-1-2019 |
| CPT 78730 | URINARY BLADDER RESIDUAL STUDY | TC | $50.02 | 7-1-2019 |
| CPT 78740 | URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM) | $246.57 | 7-1-2019 | |
| CPT 78740 | URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM) | 26 | $39.37 | 7-1-2019 |
| CPT 78740 | URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM) | TC | $72.40 | 7-1-2019 |
| CPT 78760 | TESTICULAR IMAGING; | $246.57 | 7-1-2019 | |
| CPT 78760 | TESTICULAR IMAGING; | 26 | $33.99 | 7-1-2019 |
| CPT 78760 | TESTICULAR IMAGING; | TC | $91.44 | 7-1-2019 |
| CPT 78761 | TESTICULAR IMAGING; WITH VASCULAR FLOW | $246.57 | 7-1-2019 | |
| CPT 78761 | TESTICULAR IMAGING; WITH VASCULAR FLOW | 26 | $36.27 | 7-1-2019 |
| CPT 78761 | TESTICULAR IMAGING; WITH VASCULAR FLOW | TC | $108.98 | 7-1-2019 |
| CPT 78799 | UNLISTED GENITOURINARY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $246.57 | 7-1-2019 | |
| CPT 78800 | RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA | $279.21 | 7-1-2019 | |
| CPT 78800 | RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA | 26 | $35.30 | 7-1-2019 |
| CPT 78800 | RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA | TC | $115.92 | 7-1-2019 |
| CPT 78801 | RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS | $279.21 | 7-1-2019 | |
| CPT 78801 | RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS | 26 | $58.88 | 7-1-2019 |
| CPT 78801 | RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS | TC | $144.13 | 7-1-2019 |
| CPT 78802 | RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY | $279.21 | 7-1-2019 | |
| CPT 78802 | RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY | 26 | $60.75 | 7-1-2019 |
| CPT 78802 | RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY | TC | $188.90 | 7-1-2019 |
| CPT 78803 | TUMOR LOCALIZATION (SPECT) | $279.21 | 7-1-2019 | |
| CPT 78803 | TUMOR LOCALIZATION (SPECT) | 26 | $73.69 | 7-1-2019 |
| CPT 78803 | TUMOR LOCALIZATION (SPECT) | TC | $223.80 | 7-1-2019 |
| CPT 78804 | RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRUBUTION OF RADIOPHARMACEUTICAL AGENT, WHOLE BODY | $736.68 | 7-1-2019 | |
| CPT 78805 | RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREA | $279.21 | 7-1-2019 | |
| CPT 78805 | RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREA | 26 | $38.23 | 7-1-2019 |
| CPT 78805 | RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREA | TC | $115.92 | 7-1-2019 |
| CPT 78806 | RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODY | $279.21 | 7-1-2019 | |
| CPT 78806 | RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODY | 26 | $43.92 | 7-1-2019 |
| CPT 78806 | RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODY | TC | $188.90 | 7-1-2019 |
| CPT 78807 | RADIONUCLIDE LOCALIZATION OF ABSCESS, SPECT | $279.21 | 7-1-2019 | |
| CPT 78811 | TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); LIMITED AREA, ( EG, CHEST, HEAD/NECK ) | $1,303.36 | 7-1-2019 | |
| CPT 78812 | TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); SKULL BASE TO MID THIGH | $1,303.36 | 7-1-2019 | |
| CPT 78813 | TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) ; WHOLE BODY | $1,303.36 | 7-1-2019 | |
| CPT 78814 | TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI | $1,416.69 | 7-1-2019 | |
| CPT 78814 | TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI | PI | $1,416.69 | 7-1-2019 |
| CPT 78814 | TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI | PS | $1,416.69 | 7-1-2019 |
| CPT 78815 | TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL | $1,416.69 | 7-1-2019 | |
| CPT 78815 | TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL | PI | $1,416.69 | 7-1-2019 |
| CPT 78815 | TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL | PS | $1,416.69 | 7-1-2019 |
| CPT 78815 | TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL | QR | $1,416.69 | 7-1-2019 |
| CPT 78815 | TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL | TC | $1,416.69 | 7-1-2019 |
| CPT 78816 | TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO | $1,416.69 | 7-1-2019 | |
| CPT 78816 | TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO | PI | $1,416.69 | 7-1-2019 |
| CPT 78816 | TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO | PS | $1,416.69 | 7-1-2019 |
| CPT 78816 | TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO | QR | $1,416.69 | 7-1-2019 |
| CPT 78890 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | $50.81 | 7-1-2019 | |
| CPT 78890 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | 26 | $3.36 | 7-1-2019 |
| CPT 78890 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | TC | $44.42 | 7-1-2019 |
| CPT 78891 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | $101.90 | 7-1-2019 | |
| CPT 78891 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | 26 | $6.72 | 7-1-2019 |
| CPT 78891 | GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA | TC | $89.77 | 7-1-2019 |
| CPT 78999 | UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE | $96.29 | 7-1-2019 | |
| CPT 79000 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING EVALUATION OF PATIENT | $210.04 | 7-1-2019 | |
| CPT 79000 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING EVALUATION OF PATIENT | 26 | $95.70 | 7-1-2019 |
| CPT 79000 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING EVALUATION OF PATIENT | TC | $89.77 | 7-1-2019 |
| CPT 79001 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY | $173.65 | 7-1-2019 | |
| CPT 79001 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY | 26 | $76.64 | 7-1-2019 |
| CPT 79001 | RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY | TC | $44.42 | 7-1-2019 |
| CPT 79005 | RADIOPHARMACEUTICAL THERAPY, BY ORAL ADMINISTRATION | $261.41 | 7-1-2019 | |
| CPT 79020 | RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC DISEASE), INCLUDING EVALUATION OF PATIENT | $217.53 | 7-1-2019 | |
| CPT 79020 | RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC DISEASE), INCLUDING EVALUATION OF PATIENT | 26 | $93.23 | 7-1-2019 |
| CPT 79020 | RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC DISEASE), INCLUDING EVALUATION OF PATIENT | TC | $89.77 | 7-1-2019 |
| CPT 79030 | RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMA | $292.87 | 7-1-2019 | |
| CPT 79030 | RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMA | 26 | $133.23 | 7-1-2019 |
| CPT 79030 | RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMA | TC | $89.77 | 7-1-2019 |
| CPT 79035 | RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMA | $323.10 | 7-1-2019 | |
| CPT 79035 | RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMA | 26 | $106.45 | 7-1-2019 |
| CPT 79035 | RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMA | TC | $89.77 | 7-1-2019 |
| CPT 79100 | RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH TREATMENT | $184.60 | 7-1-2019 | |
| CPT 79100 | RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH TREATMENT | 26 | $78.03 | 7-1-2019 |
| CPT 79100 | RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH TREATMENT | TC | $89.77 | 7-1-2019 |
| CPT 79101 | RADIOPHARMACEUTICAL THERAPY, BY INTRAVENOUS ADMINISTRATION | $261.41 | 7-1-2019 | |
| CPT 79200 | INTRACAVITARY RADIOACTIVE COLLOID THERAPY | $261.41 | 7-1-2019 | |
| CPT 79200 | INTRACAVITARY RADIOACTIVE COLLOID THERAPY | 26 | $135.01 | 7-1-2019 |
| CPT 79200 | INTRACAVITARY RADIOACTIVE COLLOID THERAPY | TC | $89.77 | 7-1-2019 |
| CPT 79300 | INTERSTITIAL RADIOACTIVE COLLOID THERAPY | $261.41 | 7-1-2019 | |
| CPT 79300 | INTERSTITIAL RADIOACTIVE COLLOID THERAPY | 26 | $108.57 | 7-1-2019 |
| CPT 79400 | RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGIC | $193.13 | 7-1-2019 | |
| CPT 79400 | RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGIC | 26 | $96.35 | 7-1-2019 |
| CPT 79400 | RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGIC | TC | $89.77 | 7-1-2019 |
| CPT 79403 | RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONAL ANTIBODY BY INTRAVENOUS INFUSION | $623.35 | 7-1-2019 | |
| CPT 79420 | INTRAVASCULAR RADIONUCLIDE THERAPY, PARTICULATE | 26 | $102.20 | 7-1-2019 |
| CPT 79440 | INTRA-ARTICULAR RADIONUCLIDE THERAPY | $261.41 | 7-1-2019 | |
| CPT 79440 | INTRA-ARTICULAR RADIONUCLIDE THERAPY | 26 | $130.76 | 7-1-2019 |
| CPT 79440 | INTRA-ARTICULAR RADIONUCLIDE THERAPY | TC | $89.77 | 7-1-2019 |
| CPT 79445 | RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL PARTICULATE ADMINISTRATION | $261.41 | 7-1-2019 | |
| CPT 79999 | UNLISTED RADIONUCLIDE THERAPEUTIC PROCEDURE | $261.41 | 7-1-2019 |
Radiology CPT Codes 2023 Pdf :
Please find the 2023 Radiology CPT codes Pdf from attachment.
The list of Radiology CPT codes 2023 along with the CPT code for chest X-ray is updated as per the latest info available on authorized resources like CMS, and other government portals. if any discrepancy is found please let us know via the contact us page.
Note- CPT is registered trademark of American Medical Association. The content shared in this website is for education and training purpose only.
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