2024 CPT Code Quick Reference Guide

The following is provided as a quick reference guide only and not inclusive of all diagnostic imaging
codes. The AMA CPT Code book or online resource should be used to confirm all codes.

Issued: January 2024 Page 1 of 25

 Breast Imaging & Biopsy Procedures
Exam/Procedure CPT Code
US GUIDED BIOPSY
US BREAST BIOPSY 19083
+ EACH ADDITIONAL LESION (USE WITH 19083) 19084
US BREAST CYST ASPIRATION 76942, 19000
+ EACH ADDITIONAL CYST (USE WITH 19000) 19001
US PLACEMENT OF LOCALIZATION DEVICE
US PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS 19285
+ EACH ADDITIONAL LESION (USE WITH 19285) 19286
US THYROID FNA; FIRST LESION 10005
US + EACH ADD'L LESION 10006
US THYROID CORE 76942, 60100
US THYROID CYST ASPIRATION 76942, 60300
STEREOTACTIC GUIDED BIOPSY
BX BREAST BIOPSY 19081
+ EACH ADDITIONAL LESION (USE WITH 19081) 19082
BX BREAST CYST ASPIRATION 77031, 19000
+ EACH ADDITIONAL CYST (USE WITH 19000) 19001
STEREOTACTIC PLACEMENT OF LOCALIZATION WIRE
BX PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS 19283
+ EACH ADDITIONAL LESION (USE WITH 19283) 19284
MR GUIDED BIOPSY
MR BREAST BIOPSY 19085
+ EACH ADDITIONAL LESION (USE WITH 19085) 19086
MR BREAST CYST ASPIRATION 77021, 19000
+ EACH ADDITIONAL CYST (USE WITH 19000) 19001
MR PLACEMENT OF LOCALIZATION DEVICE
MR PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS 19287
+ EACH ADDITIONAL LESION (USE WITH 19287) 19288
CT GUIDED BIOPSY
CT BREAST BIOPSY PER LESION 77012, 19499
CT BREAST CYST ASPIRATION 77012, 19000
+ EACH ADDITIONAL CYST (USE WITH 19000) 19001
MAMMOGRAPHIC GUIDED BIOPSY
XRM BREAST CYST ASPIRATION 77032, 19000, 19001
MAMMOGRAPHIC PLACEMENT OF LOCALIZATION WIRE
XRM PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS 19281
+ EACH ADDITIONAL LESION (USE WITH 19281) 19282
POST BIOPSY MAMMOGRAM
XRM BILATERAL 77066
XRM UNILATERAL 77065

Page 2 of 25
 MAMMOGRAPHY
XRM DIGITAL DIAGNOSTIC BILATERAL 77066
XRM DIGITAL DIAGNOSTIC BILATERAL WITH TOMO 77066, G0279, 76641-x2 for Bilateral
XRM DIGITAL DIAGNOSTIC UNILATERAL 77065
XRM DIGITAL DIAGNOSTIC UNILATERAL WITH TOMO 77065, G0279, 76641-x2 for Bilateral
XRM DIGITAL SCREENING BILATERAL 77067
XRM DIGITAL SCREENING BILATERAL WITH TOMO 77067, 77063, G0279
XRM DIGITAL SCREENING UNILATERAL 77067
XRM DIGITAL SCREENING UNILATERAL WITH TOMO 77067, 77063, G0279
XRM DUCTOGRAM MULTI DUCT 19030, 77054
XRM DUCTOGRAM SINGLE DUCT 19030, 77053
XRM SURGICAL SPECIMEN 76098
ULTRASOUND
US BREAST - COMPLETE UNILATERAL, INCLUDING AXILLA IF PERFORMED 76641
US BREAST - LTD UNILATERAL 76642
MRI
MRI MRI BREAST, UNILATERAL, WITHOUT CONTRAST 77046
MRI MRI BREAST, BILATERAL, WITHOUT CONTRAST 77047
MRI MRI BREAST, UNILATERAL, W-W/OUT CONTRAST, WITH CAD 77048
MRI MRI BREAST, BILATERAL, W-W/OUT CONTRAST, WITH CAD 77049

Page 3 of 25
 CT / CTA
Exam/Procedure CPT Code
CT - COMPUTED TOMOGRAPHY
CT 3D RECONSTRUCITON W/O POSTPROCESSING 76376
CT 3D RECONSTRUCTION WITH POSTPROCESSING 76377
CT ABDOMEN AND PELVIS WITHOUT CONTRAST 74176
CT ABDOMEN AND PELVIS WITH CONTRAST 74177
CT ABDOMEN AND PELVIS W-W/OUT CONTRAST 74178
CT ABDOMEN WITHOUT CONTRAST 74150
CT ABDOMEN WITH CONTRAST 74160
CT ABDOMEN W-W/OUT CONTRAST 74170
CT BRAIN/HEAD WITHOUT CONTRAST 70450
CT BRAIN/HEAD WITH CONTRAST 70460
CT BRAIN/HEAD W-W/O CONTRAST 70470
CT HEART - CARDIAC SCORING WITHOUT CONTRAST 75571
CT HEART - CARDIAC STRUCTURE AND MORPHOLOGY WITH CONTRAST 75572
HEART - CARDIAC STRUCTURE AND MORPHOLOGY IN THE SETTING OF CONGENITAL HEART
CT 75573
DISEASE WITH CONTRAST
CT CERVICAL SPINE WITHOUT CONTRAST 72125
CT CERVICAL SPINE WITH CONTRAST 72126
CT CERVICAL SPINE W-W/O CONTRAST 72127
CT CHEST WITHOUT CONTRAST / CT LOW DOSE 71250
CT CHEST WITH CONTRAST 71260
CT CHEST W-W/OUT CONTRAST 71270
CT COCCYX WITHOUT CONTRAST 72192
CT COCCYX WITH CONTRAST 72193
CT COCCYX W-W/OUT CONTRAST 72194
CT DENTAL IMPLANTS WO CONT 70486
CT ELBOW WITHOUT CONTRAST 73200
CT ELBOW WITH CONTRAST 73201
CT ELBOW W-W/OUT CONTRAST 73202
CT ENTEROGRAPHY (ABDOMEN AND PELVIS WITH CONTRAST) 74177, 76376 or 76377
CT FACIAL BONES WITHOUT CONTRAST 70486
CT FACIAL BONES WITH CONTRAST 70487
CT FACIAL BONES W-W/O CONTRAST 70488
CT FOLLOW-UP STUDY LIMITED OR LOCALIZED 76380
CT FOOT AND/OR ANKLE WITHOUT CONTRAST 73700
CT FOOT AND/OR ANKLE WITH CONTRAST 73701
CT FOOT AND/OR ANKLE W-W/OUT CONTRAST 73702
CT FOREARM WITHOUT CONTRAST 73200
CT FOREARM WITH CONTRAST 73201
CT FOREARM W-W/OUT CONTRAST 73202
CT HAND WITHOUT CONTRAST 73200
CT HAND WITH CONTRAST 73201
CT HAND W-W/OUT CONTRAST 73202
CT HIP WITHOUT CONTRAST 73700
CT HIP WITH CONTRAST 73701
CT HIP W-W/OUT CONTRAST 73702
CT HUMERUS (UPPER ARM) WITHOUT CONTRAST 73200
CT HUMERUS (UPPER ARM) WITH CONTRAST 73201
CT HUMERUS (UPPER ARM) W-W/OUT CONTRAST 73202
CT IACS, ORBIT, SELLA OR POSTERIOR FOSSA WITHOUT CONTRAST 70480
CT IACS, ORBIT, SELLA OR POSTERIOR FOSSA WITH CONTRAST 70481

Page 4 of 25
CT IACS, ORBIT, SELLA OR POSTERIOR FOSSA W-W/O CONTRAST 70482
CT KNEE WITHOUT CONTRAST 73700
CT KNEE WITH CONTRAST 73701
CT KNEE W-W/OUT CONTRAST 73702
CT KUB (ABDOMEN AND PELVIS) WITHOUT CONTRAST 74176
CT LARYNX WITHOUT CONTRAST 70490
CT LARYNX WITH CONTRAST 70491
CT LARYNX W-W/O CONTRAST 70492
CT LUMBAR SPINE WITHOUT CONTRAST 72131
CT LUMBAR SPINE WITH CONTRAST 72132
CT LUMBAR SPINE W-W/O CONTRAST 72133
CT LOW DOSE LUNG CANCER SCREENING 71271
CT MAXILLOFACIAL WITHOUT CONTRAST 70486
CT MAXILLOFACIAL WITH CONTRAST 70487
CT MAXILLOFACIAL W-W/O CONTRAST 70488
CT NECK SOFT TISSUE WITHOUT CONTRAST 70490
CT NECK SOFT TISSUE WITH CONTRAST 70491
CT NECK SOFT TISSUE W-W/OUT CONTRAST 70492
CT PARATHYROID WITHOUT CONTRAST 70490
CT PARATHYROID WITH CONTRAST 70491
CT PARATHYROID W-W/OUT CONTRAST 70492
CT ORBITS WITHOUT CONTRAST 70480
CT ORBITS WITH CONTRAST 70481
CT ORBITS W-W/OUT CONTRAST 70482
CT PELVIS WITHOUT CONTRAST 72192
CT PELVIS WITH CONTRAST 72193
CT PELVIS W-W/OUT CONTRAST 72194
CT PITUITARY-SELLA WITHOUT CONTRAST 70480
CT PITUITARY-SELLA WITH CONTRAST 70481
CT PITUITARY-SELLA W-W/O CONTRAST 70482
CT POSTERIOR FOSSA WITHOUT CONTRAST 70480
CT POSTERIOR FOSSA WITH CONTRAST 70481
CT POSTERIOR FOSSA W-W/O CONTRAST 70482
CT SACRUM WITHOUT CONTRAST 72192
CT SACRUM WITH CONTRAST 72193
CT SACRUM W-W/OUT CONTRAST 72194
CT SCANOGRAM 73700
CT SHOULDER WITHOUT CONTRAST 73200
CT SHOULDER WITH CONTRAST 73201
CT SHOULDER W-W/OUT CONTRAST 73202
CT SINUS LTD WITHOUT CONTRAST 70486
CT SINUS WITHOUT CONTRAST 70486
CT SINUS WITH CONTRAST 70487
CT SINUS W-W/O CONTRAST 70488
CT TEMPORAL BONES WITHOUT CONTRAST 70480
CT TEMPORAL BONES WITH CONTRAST 70481
CT TEMPORAL BONES W-W/O CONTRAST 70482
CT THIGH (FEMUR) WITHOUT CONTRAST 73700
CT THIGH (FEMUR) WITH CONTRAST 73701
CT THIGH (FEMUR) W-W/OUT CONTRAST 73702
CT THORACIC SPINE WITHOUT CONTRAST 72128
CT THORACIC SPINE WITH CONTRAST 72129
CT THORACIC SPINE W-W/O CONTRAST 72130

Page 5 of 25
CT TIB-FIB (LOWER LEG) WITHOUT CONTRAST 73700
CT TIB-FIB (LOWER LEG) WITH CONTRAST 73701
CT TIB-FIB (LOWER LEG) W-W/OUT CONTRAST 73702
CT TMJS WITHOUT CONTRAST 70486
CT TMJS WITH CONTRAST 70487
CT TMJS W-W/O CONTRAST 70488
CT UROGRAM (ABDOMEN AND PELVIS W-W/OUT CONTRAST) 74178
CT DIAGNOSTIC VIRTUAL COLONOSCOPY WITHOUT CONTRAST 74261
CT DIAGNOSTIC VIRTUAL COLONOSCOPY WITH OR W-W/OUT CONTRAST 74262
CT SCREENING VIRTUAL COLONOSCOPY WITHOUT CONTRAST 74263
CT WRIST WITHOUT CONTRAST 73200
CT WRIST WITH CONTRAST 73201
CT WRIST W-W/OUT CONTRAST 73202
CT RADIATION THERAPY PLANNING 77014
CTA - COMPUTED TOMOGRAPHY ANGIOGRAPHY
CTA ABDOMEN 74175
CTA ABDOMEN AND PELVIS 74174
CTA RUN-OFF STUDY (ABDOMINAL AORTA AND BILATERAL LOWER EXTREMITIES) 75635
CTA CHEST (NONCORONARY) 71275
CTA HEART - CORONARY ARTERIES 75574
CTA HEAD 70496
CTA NECK (CAROTID) 70498
CTA PELVIS 72191
MYELOGRAM **REQUIRES FLUORO EXAM WITH CT MYELO**
CT CERVICAL SPINE 62284, 62302, 72240, 72126, 77003
CT CERVICAL C-1-C2 61055, 62302, 72240, 72126, 77003
CT THORACIC SPINE 62284, 62303, 72255, 72129, 77003
CT LUMBAR 62284, 62304, 72265, 72132, 77003
62284, 62305, 72270, 77003 and APPROPRIATE 2 CT
CT 2 OR MORE REGIONS (EG, LUMBAR/THORACIC, THORACIC/CERVICAL, LUMBAR/CERVICAL)
CODES, BASED ON REGIONS
CT POSTERIOR FOSSA 70460, 61055 or 62284, 70010, 77003
CT CISTERNOGRAPHY 70460, 61055 or 62284, 70015, 77003
ARTHROGRAM - CONVENTIONAL (RAD) WITH CT **REQUIRES FLUORO EXAM WITH CT ARTHRO**
CT ELBOW 73201, 24220, 73085
CT HIP 73701, 27093, 73525
CT SHOULDER 73201, 23350, 73040
CT KNEE 73701, 27369, 73580
CT WRIST 73201, 25246, 73115
CT WRIST 3 JOINT 73201, 25246x3, 73115
CT ANKLE 73701, 27648, 73615
CT SACROILIAC (SI) JOINT 27096, 72193
CT TMJ 70487, 21116, 70332
ARTHROGRAM - NON-CONVENTIONAL WITH CT **REQUIRES FLUORO EXAM WITH CT ARTHRO**
CT ELBOW 73201, 24220, 77002
CT HIP 73701, 27093, 77002
CT SHOULDER 73201, 23350, 77002
CT KNEE 73701, 27369, 77002
CT WRIST 73201, 25246, 77002
CT WRIST 3 JOINT 73201, 25246x3, 77002x3
CT ANKLE 73701, 27648, 77002
CT SACROILIAC (SI) JOINT 27096, 72193
CT TMJ 21116, 70487, 77002

Page 6 of 25
 NEEDLE GUIDED BIOPSY
CT LIVER 47000, 77012
CT LYMPH NODES 38505, 77012
CT THIGH 20206, 77012
CT KIDNEY - RENAL MASS 50200, 77012
CT SOFT TISSUE MASS 20206, 77012
CT OTHER
CT UNLISTED CT PROCEDURE 76497
BONE MINERAL DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON
CT 77078
(EG, HIPS, SPINE, PELVIS)
ARTHROCENTESIS
CT GUIDED ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG,
CT 20600, 77012
TOES/FINGERS)
CT GUIDED ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT (EG,
CT 20605, 77012
TMJ, AC JOINTS, ELBOW, WRIST, ANKLE)
CT GUIDED ARTHROCENTESIS, ASPRIATION AND/OR INJECTIONS, MAJOR JOINT (EG,
CT 20610, 77012
SHOULDER, KNEE, HIP)

PET/CT
Exam/Procedure CPT Code
PET CT PET CT AXUMIN SKULL TO THIGH 78815, A9588
PET CT PET CT BONE WHOLE BODY 78816, A9580
PET CT PET CT BRAIN METABOLIC EVAL 78608, A9552
PET CT PET CT DETECTNET SKULL TO THIGH 78815, A9592
PET CT PET CT FDG SKULL THIGH 78815, A9552
PET CT PET CT FDG WHOLE BODY 78816, A9552
PET CT PET CT ILLUCCIX SKULL TO THIGH 78815, A9596
PET CT PET CT MYOCARDIAL METABOLIC FOR SARCOIDOSIS 78429, A9552
PET CT PET CT NETSPOT SKULL TO THIGH 78815, A9587

Page 7 of 25
 MRI / MRA
Exam/Procedure CPT Code
MRI - MAGNETIC RESONANCE IMAGING
MRI ABDOMEN WITHOUT CONTRAST 74181
MRI ABDOMEN WITH CONTRAST 74182
MRI ABDOMEN W-W/OUT CONTRAST 74183
MRI BRACHIAL PLEXUS WITHOUT CONTRAST - TO IDENTIFY APICAL LUNG CANCERS 71550
MRI BRACHIAL PLEXUS WITH CONTRAST - TO IDENTIFY APICAL LUNG CANCERS 71551
MRI BRACHIAL PLEXUS W-W/O CONTRAST - TO IDENTIFY APICAL LUNG CANCERS 71552
MRI BRACHIAL PLEXUS WITHOUT CONTRAST - EVALUATION OF TUMOR IN AXILLA 73218
MRI BRACHIAL PLEXUS WITH CONTRAST - EVALUATION OF TUMOR IN AXILLA 73219
MRI BRACHIAL PLEXUS W-W/OUT CONTRAST - EVALUATION OF TUMOR IN AXILLA 73220

MRI BRACHIAL PLEXUS WITHOUT CONTRAST - EVALUATION OF TUMOR IN SHOULDER GIRDLE 73221

MRI BRACHIAL PLEXUS WITH CONTRAST - EVALUATION OF TUMOR IN SHOULDER GIRDLE 73222

MRI BRACHIAL PLEXUS W-W/OUTCONTRAST - EVALUATION OF TUMOR IN SHOULDER GIRDLE 73223

BRACHIAL PLEXUS WITHOUT CONTRAST - EVALUATION TO IDENTIFY HEAD/NECK CA TO

MRI 70540
LEVEL OF THYROID
BRACHIAL PLEXUS WITH CONTRAST - EVALUATION TO IDENTIFY HEAD/NECK CA TO LEVEL OF
MRI 70542
THYROID
BRACHIAL PLEXUS W-W/O CONTRAST - EVALUATION TO IDENTIFY HEAD/NECK CA TO LEVEL
MRI 70543
OF THYROID
MRI BRAIN WITHOUT CONTRAST 70551
MRI BRAIN WITH CONTRAST 70552
MRI BRAIN W-W/O CONTRAST 70553
MRI MRI BREAST, UNILATERAL, WITHOUT CONTRAST 77046
MRI MRI BREAST, BILATERAL, WITHOUT CONTRAST 77047
MRI MRI BREAST, UNILATERAL, W-W/OUT CONTRAST, WITH CAD 77048
MRI MRI BREAST, BILATERAL, W-W/OUT CONTRAST, WITH CAD 77049
MRI CARDIAC FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST 75557
CARDIAC FOR MORPHOLOGY AND FUNCTION, WITH STRESS IMAGING,
MRI 75559
WITHOUT CONTRAST
MRI CARDIAC FOR MORPHOLOGY AND FUNCTION W-W/OUT CONTRAST 75561
CARDIAC FOR MORPHOLOGY AND FUNCTION, WITH STRESS IMAGING,
MRI 75563
W-W/OUT CONTRAST
MRI + VELOCITY FLOW MAPPING (USE WITH CPT: 75557, 75559, 75561, 75563) 75565
MRI CERVICAL SPINE WITHOUT CONTRAST 72141
MRI CERVICAL SPINE WITH CONTRAST 72142
MRI CERVICAL SPINE W-W/O CONTRAST 72156
MRI CHEST WITHOUT CONTRAST 71550
MRI CHEST WITH CONTRAST 71551
MRI CHEST W-W/O CONTRAST 71552
MRI ELASTOGRAPHY 76391
MRI ENTEROGRAPHY WITHOUT CONTRAST 74181
MRI ENTEROGRAPHY WITH CONTRAST 74182
MRI ENTEROGRAPHY W-W/OUT CONTRAST 74183
FETAL, INCLUDING PLACENTAL AND MATERNAL PELVIC IMAGING WHEN PERFORMED; SINGLE
MRI 74712
OR FIRST GESTATION
MRI + EACH ADDITIONAL GESTATION (USE WITH CPT 74712) 74713
MRI IACS WITHOUT CONTRAST 70551
MRI IACS WITH CONTRAST 70552

Page 8 of 25
MRI IACS WITH-W/O CONTRAST 70553
MRI LUMBAR SPINE WITHOUT CONTRAST 72148
MRI LUMBAR SPINE WITH CONTRAST 72149
MRI LUMBAR SPINE W-W/O CONTRAST 72158
MRI MRCP 74183
MRI ORBIT, FACE AND/OR NECK WITHOUT CONTRAST 70540
MRI ORBIT, FACE AND/OR NECK WITH CONTRAST 70542
MRI ORBIT, FACE AND OR/NECK W-W/O CONTRAST 70543
MRI PELVIS WITHOUT CONTRAST 72195
MRI PELVIS WITH CONTRAST 72196
MRI PELVIS W-W/OUT CONTRAST 72197
MRI PELVIS W-W/O PROTOCOL STUDY 72197
MRI PITUITARY WITHOUT CONTRAST 70551
MRI PITUITARY WITH CONTRAST 70552
MRI PITUITARY W-W/O CONTRAST 70553
MRI PROSTATE WITHOUT CONTRAST 72195
MRI PROSTATE WITH CONTRAST 72196
MRI PROSTATE W-W/OUT CONTRAST - OUR PROTOCOL 72197
MRI SACRUM WITHOUT CONTRAST 72195
MRI SACRUM WITH CONTRAST 72196
MRI SACRUM W-W/OUT CONTRAST 72197
MRI SINUS WITHOUT CONTRAST 70540
MRI SINUS WITH CONTRAST 70542
MRI SINUS W-W/O CONTRAST 70543
MRI TEMPORAL/MASTOID (BRAIN) WITHOUT CONTRAST 70551
MRI TEMPORAL/MASTOID (BRAIN) WITH CONTRAST 70552
MRI TEMPORAL/MASTOID (BRAIN) W/WO CONTRAST 70553
MRI THORACIC SPINE WITHOUT CONTRAST 72146
MRI THORACIC SPINE WITH CONTRAST 72147
MRI THORACIC SPINE W-W/O CONTRAST 72157
MRI TEMPOROMANDIBULAR JOINT (TMJ) WITHOUT CONTRAST 70336
UPPER EXTREMITY (NON-JOINT)
MRI FOREARM WITHOUT CONTRAST 73218
MRI FOREARM WITH CONTRAST 73219
MRI FOREARM W-W/OUT CONTRAST 73220
MRI HAND WITHOUT CONTRAST 73218
MRI HAND WITH CONTRAST 73219
MRI HAND W-W/OUT CONTRAST 73220
MRI HUMERUS (UPPER ARM) WITHOUT CONTRAST 73218
MRI HUMERUS (UPPER ARM) WITH CONTRAST 73219
MRI HUMERUS (UPPER ARM) W-W/OUT CONTRAST 73220
MRI SCAPULA (SHOULDER BLADE) WITHOUT CONTRAST 73218
MRI SCAPULA (SHOULDER BLADE) WITH CONTRAST 73219
MRI SCAPULA (SHOULDER BLADE) W-W/OUT CONTRAST 73220
MRI UPPER EXTREMITY NON-JOINT WITHOUT CONTRAST 73218
MRI UPPER EXTREMITY NON-JOINT WITH CONTRAST 73219
MRI UPPER EXTREMITY NON-JOINT W-W/OUT CONTRAST 73220

Page 9 of 25
 UPPER EXTREMITY (JOINT)
MRI ELBOW WITHOUT CONTRAST 73221
MRI ELBOW WITH CONTRAST 73222
MRI ELBOW W-W/OUT CONTRAST 73223
MRI FINGER WITHOUT CONTRAST 73221
MRI FINGER WITH CONTRAST 73222
MRI FINGER W-W/OUT CONTRAST 73223
MRI SHOULDER WITHOUT CONTRAST 73221
MRI SHOULDER WITH CONTRAST 73222
MRI SHOULDER W-W/OUT CONTRAST 73223
MRI WRIST WITHOUT CONTRAST 73221
MRI WRIST WITH CONTRAST 73222
MRI WRIST W-W/OUT CONTRAST 73223
MRI WRIST W-W/OUT PFIZER PROTOCOL 73223
LOWER EXTREMITY (NON-JOINT)
MRI FOOT WITHOUT CONTRAST 73718
MRI FOOT WITH CONTRAST 73719
MRI FOOT W-W/OUT CONTRAST 73720
MRI LOWER EXTREMITY WITHOUT CONTRAST 73718
MRI LOWER EXTREMITY WITH CONTRAST 73719
MRI LOWER EXTREMITY W-W/OUT CONTRAST 73720
MRI FEMUR (THIGH) WITHOUT CONTRAST 73718
MRI FEMUR (THIGH) WITH CONTRAST 73719
MRI FEMUR (THIGH) W-W/OUT CONTRAST 73720
MRI TIB FIB (LOWER LEG) WITHOUT CONTRAST 73718
MRI TIB FIB (LOWER LEG) WITH CONTRAST 73719
MRI TIB FIB (LOWER LEG) W-W/OUT CONTRAST 73720
LOWER EXTREMITY (JOINT)
MRI ANKLE POST ARTHROGRAM 73722
MRI ANKLE WITHOUT CONTRAST 73721
MRI ANKLE WITH CONTRAST 73722
MRI ANKLE W-W/OUT CONTRAST 73723
MRI HIP WITHOUT CONTRAST 73721
MRI HIP WITH CONTRAST 73722
MRI HIP W-W/OUT CONTRAST 73723
MRI KNEE WITHOUT CONTRAST 73721
MRI KNEE WITH CONTRAST 73722
MRI KNEE W-W/OUT CONTRAST 73723
MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST 73721
MRI LOWER EXTREMITY JOINT WITH CONTRAST 73722
MRI LOWER EXTREMITY JOINT W-W/OUT CONTRAST 73723

Page 10 of 25
 MRA - Magnetic Resonance Angiography
MRA ABDOMEN 74185
MRA CHEST 71555
MRA HEAD WITHOUT CONTRAST 70544
MRA HEAD WITH CONTRAST 70545
MRA HEAD W-W/O CONTRAST 70546
MRA NECK WITHOUT CONTRAST 70547
MRA NECK WITH CONTRAST 70548
MRA NECK W-W/O CONTRAST 70549
MRA PELVIS 72198
MRA RUN-OFF STUDY (ABDOMINAL AORTA & BILATERAL LOWER EXTREMITIES) 74185, 73725 x 2
MRA SPINAL CANAL AND CONTENTS 72159
MRV - Magnetic Resonance Venography
MRV MRV HEAD WITHOUT CONTRAST 70544
MRV MRV HEAD WITH CONTRAST 70545
MRV MRV HEAD WITH W/O CONTRAST 70546
ARTHROGRAM - CONVENTIONAL (RAD) W/ MRI **REQUIRES FLUORO EXAM WITH MR ARTHRO**
MRI ANKLE 73722, 27648, 73615
MRI ELBOW 73222, 24220, 73085
MRI HIP 73722, 27093, 73525
MRI KNEE 73722, 27369, 73580
MRI SHOULDER 73222, 23350, 73040
MRI WRIST 73222, 25246, 73115
MRI WRIST 3 JOINT 73222, 25246x3, 73115
MRI SACROILIAC (SI) JOINT 27096, 72196
MRI TMJ 70336, 21116, 70332
ARTHROGRAM - NON-CONVENTIONAL W/ MRI **REQUIRES FLUORO EXAM WITH MR ARTHRO**
MRI ANKLE 73722, 27648, 77002
MRI ELBOW 73222, 24220, 77002
MRI HIP 73722, 27093, 77002
MRI KNEE 73722, 27369, 77002
MRI SHOULDER 73222, 23350, 77002
MRI WRIST 73222, 25246, 73115
MRI WRIST 3 JOINT 73222, 25246x3, 77002
MRI SACROILIAC (SI) JOINT 27096, 72196
MRI TMJ 70336, 21116, 77002
MUSCLE INJ **EXAM MUST BE VERIFIED W/ MSK RAD**
US SINGLE OR MULTIPLE - 1 OR 2 MUSCLE(S) 20552, 77021
US SINGLE OR MULTIPLE - 3 OR MORE MUSCLE(S) 20553, 77021
TENDON INJECTION
US SINGLE TENDON SHEATH, OR LIGAMENT 20550, 77021
US SINGLE TENDON ORIGIN/INSERTION 20551, 77021
OTHER
MRS SPECTROSCOPY (ANY AREA OF THE BODY) 76390
MRI BONE MARROW BLOOD SUPPLY 77084

Page 11 of 25
 Ultrasound
Exam/Procedure CPT Code
DIAGNOSTIC
US ABDOMEN COMPLETE 76700
US ABDOMEN WITH DOPPLER COMPLETE 76700, 93975
US ABDOMEN LTD 76705
US LOWER BACK 76705
US AORTA ABDOMINAL (AORTA BACKWALL) 76775
US AAA SCREENING 76706
US BONE DENSITY MEASUREMENT AND INTERPRETATION, PERIPHERAL 76977
US BREAST - COMPLETE UNILATERAL, INCLUDING AXILLA IF PERFORMED 76641
US BREAST - LTD UNILATERAL 76642
US AXILLA 76882
US CHEST/MEDIASTINUM 76604
US CONTRAST ENHANCED ULTRASOUND; INITIAL LESION 76978
US + EACH ADD'L LESION 76979
US ELASTOGRAPHY; PARENCHYMA (EG., ORGAN) 76981
US ELASTOGRAPHY; FIRST TARGET LESION 76982
US + EACH ADD'L TARGET LESION 76983
US UPPER BACK 76604
US EXTREMITY NON VASCULAR JOINT COMPLETE 76881
US EXTREMITY NON VASCULAR JOINT OR OTHER NON-VASCULAR STRUCTURES LTD 76882
US GROIN 76882
US GALLBLADDER 76705
INFANT HIPS; DYNAMIC (REQUIRING PHYSICIAN OR OTHER QUALIFIED PROFESSIONAL
76885
US MANIPULATION)
US INFANT HIPS LIMITED (NOT REQUIRING MANIPULATION) 76886
US HYSTEROSONOGRAPHY (SONOHYSTERGRAPHY) 76831, 58340
US KIDNEY DOPPLER 93975
US LIVER 76705
US NECK/HEAD SOFT TISSUE 76536
US NEONATAL BRAIN 76506
US PELVIS LTD - NON OB 76857
US BUTTOCK 76857
US PENIS 76857
US PERINEUM 76857
US PELVIS COMPLETE - NON OB 76856
US PELVIS - T-VAG AND T-ABDOMINAL COMPLETE 76856, 76830
US PROSTATE VOLUME STUDY 76873
US RENAL COMPLETE 76770
US RENAL WITH DOPPLER 76770, 93975
US RENAL LTD 76775
US RENAL TRANSPLANT WITH DOPPLER 76776
US RENAL TRANSPLANT WITHOUT DOPPLER 76775
US RETROPERITONEAL (RENAL, AORTA, NODES) COMPLETE 76770
US RETROPERITONEAL (RENAL, AORTA, NODES) LTD 76775
US SPINAL CANAL AND CONTENTS 76800
US SPINAL CANAL AND CONTENTS - INFANTS 76800
US TRANSVAGINAL APPROACH - NON OB 76830
US TESTICULAR/SCROTUM 76870
US THYROID 76536
US URINARY BLADDER 76775

Page 12 of 25
 OBSTETRICAL
US OB BIOPHYSICAL PROFILE WITH NON-STRESS TESTING 76818
US OB BIOPHYSICAL PROFILE WITHOUT NON-STRESS TESTING 76819
US OB FOLLOW UP EXAM, PER FETUS 76816
US OB GREATER THAN 14 WEEKS - SINGLE FETUS 76805
US + EACH ADDITIONAL FETUS 76810
US OB LESS THAN 14 WEEKS - SINGLE FETUS 76801
US + EACH ADDITIONAL FETUS 76802
OB FETAL AND MATERNAL EVALUATION PLUS DETAILED FETAL ANATOMIC EXAM,
76811
US TRANSABDOMINAL
US + EACH ADDITIONAL FETUS 76812
US OB LTD 76815
US OB TRANSVAGINAL APPROACH 76817
US FETAL ECHOCARDIOGRAPHY 76825
US FETAL ECHOCARDIOGRAPHY - FOLLOW UP OR REPEAT STUDY 76826
US FETAL DOPPLER 76827
US FETAL DOPPLER - FOLLOW UP OR REPEAT STUDY 76828
VASCULAR
US ABI SINGLE LEVEL - BILATERAL/UNILATERAL 93922
US ABI 2 LEVELS - BILATERAL/UNILATERAL 93922
US ABI 3 LEVELS - UNILATERAL 93922
US ABI COMPLETE - 3 LEVELS, BILATERAL 93923
US ABI COMPLETE AND BILATERAL ARTERIAL 93923, 93925
US AORTA AND/OR IVC DUPLEX LIMITED 93979
US AORTA IVC DUPLEX COMPLETE 93978
US ART BILAT LOWER EXTREMITY 93925
US ART BILAT UPPER EXTREMITY 93930
US ART HEMODIALYSIS ACCESS ** AV FISTULA 93990
US ART REST STRESS LOWER EXTREMITY 93924
US ART UNILAT LOWER EXTREMITY 93926
US ART UNILAT UPPER EXTREMITY 93931
US CAROTID DUPLEX - COMPLETE 93880
US CAROTID DUPLEX - LIMITED 93882
DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR RETROPERITONEAL ORGANS -
93975
US COMPLETE

93976
US DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR RETROPERITONEAL ORGANS - LTD
US PENILE DOPPLER 93980
US PENILE DOPPLER FOLLOW UP OR LIMITED 93981
US TRANSCRANIAL DOPPLER - COMPLETE 93886
US TRANSCRANIAL DOPPLER - LIMITED 93888
US VENOUS DOPPLER EXT BILATERAL 93970
US VENOUS INSUFFICIENCY 93970
US VENOUS DOPPLER EXT UNILATERAL 93971
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW FOR PREOPERATIVE VESSEL
93985
US ASSESSMENT PRIOR TO CREATION OF HEMODIALYSIS ACCESS; COMPLETE BILATERAL STUDY

DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW FOR PREOPERATIVE VESSEL 93986
US ASSESSMENT PRIOR TO CREATION OF HEMODIALYSIS ACCESS; COMPLETE UNILATERAL STUDY
ARTHROCENTISIS (US GUIDED ONLY)
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS,
20604
US TOES); WITH ULTRASOUND GUIDANCE
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG,
TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW OR ANKLE, OLECRANON BURSA); 20606
US WITH ULTRASOUND GUIDANCE
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER,
20611
US HIP, KNEE, SUBACROMIAL BURSA); WITH ULTRASOUND GUIDANCE

Page 13 of 25
 THORACENTESIS/PARACENTESIS
US CHEST TUBE EXTENDED USE 32550, 75989
US PARACENTESIS 49083
US THORACENTESIS 32555
US THORACENTESIS WITH TUBE 32557
OTHER
US FOLLOW UP STUDY (SPECIFY) 76970
US UNLISTED PROCEDURE 76999

51798
US MEASUREMENT OF POST-VOIDING RESIDUAL URINE AND/OR URINARY BLADDER (NON-IMAGING)
US VESSEL MAPPING FOR HEMODIALYSIS ACCESS -UNILATERAL 93986
US VESSEL MAPPING FOR HEMODIALYSIS ACCESS - BILATERAL 93985
US DUPLEX SCAN OF HEMODIALYSIS ACCESS 93990
MUSCLE INJ **EXAM MUST BE VERIFIED W/ MSK RAD**
US SINGLE OR MULTIPLE - 1 OR 2 MUSCLE(S) 20552, 76942
US SINGLE OR MULTIPLE - 3 OR MORE MUSCLE(S) 20553, 76942
TENDON INJECTION
US SINGLE TENDON SHEATH, OR LIGAMENT 20550, 76942
US SINGLE TENDON ORIGIN/INSERTION 20551, 76942

Page 14 of 25
 Fluoroscopy
Exam/Procedure CPT Code
FLOUROSCOPIC GUIDED INJECTION/ASPIRATION
FL FISTULA SINUS TRACT STUDY 76080, 20501
FL INJECTION OF SINUS TRACT, THERAPEUTIC (NON-VASCULAR SCLEROTHERAPY) 20500, 76080
FL FLUORO GUID LOC NEEDLE, SPINE 77003
FL FLUORO GUIDE BX, INJ, ASP 77002
FL SINGLE TENDON, SHEATH OR LIGAMENT 20550, 77002
FL SINGLE TENDON ORIGIN/INSERTION 20551, 77002
FL SINGLE OR MULTIPLE TRIGGER POINT(S), 1 OR 2 MUSCLE(S) 20552, 77002
FL SINGLE OR MULTIPLE TRIGGER POINT(S), 3 OR MORE MUSCLES 20553, 77002
ARTHROCENTESIS
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS,
20600, 77002
FL TOES); WITH FLOURO GUIDANCE
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG,
TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW OR ANKLE, OLECRANON 20605, 77002
FL BURSA); WITH FLOURO GUIDANCE
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER,
20610, 77002
FL HIP, KNEE, SUBACROMIAL BURSA); WITH FLOURO GUIDANCE
INDEPENDENT STUDY
FL SNIFF TEST 76000
FL FLOURO, UP TO ONE HOUR 76000
FL FLUORO EVAL OF EXISTING CENTRAL VEOUS ACCESS DEVICE 36598, 75820, 75825 or 75827
FL NOSE TO RECTUM - FOR DETECTION OF FOREIGN BODY - CHILD 76010
FL BLOOD PATCH 62273, 77003
FL UNLISTED FLOUROSCOPIC PROCEDURE 76496
FL TOMOGRAPHY TO COMPLETE EXAM 76100
FL COMPLEX TOMOGRAPHY TO COMPLETE EXAM - UNILATERAL 76101
FL COMPLEX TOMOGRAPHY TO COMPLETE EXAM - BILATERAL 76102
FL GANGLION CYST ASPIRATION INJECTION 20612, 77002
FL INJ SINGLE TENDON SHEATH, LIGAMENT 20550, 77002
FL INJ SINUS TRACT - SINOGRAM 76080, 20501
FL INJECTION VENOGRAM 36005 (x 2 if bilateral) , 75820, 75822
FL SIALOGRAM 70390, 42550
FL PERITONEOGRAM 74190, 49400
MYELOGRAM - CONVENTIONAL (RAD)
FL POSTERIOR FOSSA - WITH C1-C2 INJECTION 70010, 61055
POSTERIOR FOSSA - OTHER THAN C1-C2 INJECTION 70010, 62284
FL CISTERNOGRAPHY - WITH C1-C2 INJECTION 70015, 61055
CISTERNOGRAPHY - OTHER THAN C1-C2 INJECTION 70015, 62284
FL CERVICAL MYELOGRAM 62302
FL THORACIC MYELOGRAM 62303
FL LUMBAR MYELOGRAM 62304
FL MYELOGRAM 2 OR MORE REGIONS 62305

Page 15 of 25
 ARTHROGRAM - CONVENTIONAL (RAD)
FL ANKLE 73615, 27648
FL ELBOW 73085, 24220
FL HIP 73525, 27093
FL KNEE 73580, 27369
FL TEMPOROMANDIBULAR JOINT (TMJ) ARTHROGRAM 70332, 21116
FL WRIST ARTHROGRAM 73115, 25246
FL WRIST ARTHROGRAM 3 JOINT 73115, 25246 x3
FL SACROILIAC (SI) JOINT 27096
FL SHOULDER 73040, 23350
GASTROINTESTINAL TRACT
FL BE (BARIUM ENEMA) WITH OR WITHOUT KUB 74270
FL BE AC (BARIUM ENEMA) DOUBLE CONTRAST (AIR/BARIUM) 74280
FL THERAPEUTIC ENEMA 74283
FL CHOLANGIOGRAM THROUGH EXISTING T-TUBE 47531
FL PHARYNX AND/OR CERVICAL ESOPHAGUS 74210
FL BARIUM SWALLOW - ESOPHAGUS 74220
FL BARIUM SWALLOW - ESOPHAGUS, DOUBLE CONTRAST 74221
FL ESO UGI 74240
FL MODIFIED BARIUM SWALLOW - ESOPHAGUS - MODIFIED WITH VIDEO 74230
FL FOREIGN BODY REMOVAL - ESOPHAGEAL 74235, 43499
FL GB - CHOLECYSTOGRAPHY, ORAL CONTRAST 74290
FL UGI (UPPER GASTROINTESTINAL TRACT), SINGLE CONTRAST 74240
+ WITH SMALL INTESTINE FOLLOW-THROUGH (USE IN ADDITION TO 74240) 74248
FL UGI (UPPER GASTROINTESTINAL TRACT), DOUBLE CONTRAST 74246
+ WITH SMALL INTESTINE FOLLOW-THROUGH (USE IN ADDITION TO 74240) 74248
FL SMALL BOWEL STUDY 74250
FL SMALL BOWEL STUDY VIA ENTEROCLYSIS TUBE 74251, 44500, 74340
FL ENTEROCLYSIS TUBE PLACEMENT, PERCUTANEOUS 74355
FL GI (GASTROINTESTINAL) TUBE PLACEMENT (EG, MILLER-ABBOT) 44500, 74340
CONTRAST INJECTION AND EVALUATION OF OF GASTROSTOMY, DUEDENOSTOMY,
49465
FL JEJUNOSTOMY, GASTRO-JEJUNOSTOMY, CECOSTOMY (OTHER THAN COLONIC) TUBE
GYNECOLOGICAL AND OBSTETRICAL
FL HYSTERSALPINGOGRAM (AKA HSG) 74740, 58340
FL VAGINOGRAM (PERINEOGRAM) 74775
URINARY TRACT
IVP - UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR
74400
FL WITHOUT TOMO
FL IVP ROUTINE - UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE 74410
IVP ROUTINE - UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE WITH
74415
FL TOMO (18 YEARS OF AGE+)
FL RETROGRADE PYELOGRAM (UROGRAPHY) 74420
FL ANTEGRADE PYELOGRAM (UROGRAPHY, LOOPOGRAM) 74425, 50690
FL ANTEGRADE PYELOGRAM (UROGRAPHY, LOOPOGRAM) THROUGH EXISTING CATHETER 50431
FL CYSTOGRAPHY 74430, 51600 or 51605
FL URETHROCYSTOGRAPHY - RETROGRADE 74450, 51610
FL URETHROCYSTOGRAPHY - VOIDING (VCUG) 74455, 51600
URETHROCYSTOGRAPHY - VOIDING (AKA VCUG) - MALE 74455, 51600

Page 16 of 25
 X-Ray
Exam/Procedure CPT Code
DEXA
DXA SCAN BODY FAT ASSESSMENT 76499
DXA BONE DENSITY; AXIAL SKELETON (HIPS, SPINE, PELVIS) 77080
DXA BONE DENSITY; APPENDICULAR SKELETON (RADIUS, WRIST, HEEL) 77081
BONE DENSITY; AXIAL SKELETON (HIPS, SPINE, PELVIS) WITH VERTEBRAL FRACTURE
DXA 77085
ASSESSMENT
DXA VERTEBRAL FRACTURE ASSESSMENT ONLY 77086
DXA TRABECULAR BONE SCORE (TBS) 77089
DIAGNOSTIC X-RAY
XR ABDOMEN; 1 VIEW 74018
XR ABDOMEN; 2 VIEWS 74019
XR ABDOMEN; 3 OR MORE VIEWS 74021
ABDOMEN - COMPLETE ACUTE SERIES, INCLUDING SUPINE, ERECT, AND/OR DECUBITUS VIEWS
XR 74022
+ 1 VIEW CHEST
XR ACROMIOCLAVICULAR (AC) JOINTS - WITH OR WITHOUT WEIGHTED DISTRACTION 73050
XR ANKLE COMPLETE - MIN 3 VIEWS 73610
XR ANKLE LTD - 2 VIEWS 73600
XR BONE AGE 77072
XR BONE LENGTH (SCANOGRAM / ORTHOROENTGENOGRAM) 77073
XR CALCANEUS (HEEL) 73650
XR CERVICAL SPINE - 2 OR 3 VIEWS 72040
XR CERVICAL SPINE - 4 OR 5 VIEWS 72050
XR CERVICAL SPINE - 6 OR MORE VIEWS 72052
XR CHEST - 1 VIEW 71045
XR CHEST - 2 VIEWS 71046
XR CHEST - 3 VIEWS 71047
XR CHEST - 4 VIEWS 71048
XR CLAVICLE 73000
XR ELBOW COMPLETE - MIN 3 VIEWS 73080
XR ELBOW LTD - 2 VIEWS 73070
XR EYE - FOR DETECTION OF FOREIGN BODY 70030
XR FACIAL BONES COMPLETE - MIN 3 VIEWS 70150
XR FACIAL BONES LTD - LESS THAN 3 VIEWS 70140
XR FEMUR (THIGH); 1 VIEW 73551
XR FEMUR (THIGH); 2 VIEWS 73552
XR FINGER 73140
XR FOOT COMPLETE - MIN 3 VIEWS 73630
XR FOOT LTD - 2 VIEWS 73620
XR FOREARM 73090
XR HAND COMPLETE - MIN 3 VIEWS 73130
XR HAND LTD - 2 VIEWS 73120
XR HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 1 VIEW 73501
XR HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 2 - 3 VIEWS 73502
XR HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; MINIMUM 4 VIEWS 73503
XR HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED; 2 VIEWS 73521
XR HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED; 3 - 4 VIEWS 73522
XR HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED; MINIMUM 5 VIEWS 73523
XR HUMERUS (UPPER ARM) 73060

Page 17 of 25
XR INFANT LOWER EXTREMITY 73592
XR INFANT UPPER EXTREMITY 73092
XR INTERNAL AUDITORY MEATI COMPLETE 70134
XR JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS 77077
XR KNEE - 1 OR 2 VIEWS 73560
XR KNEE - 3 VIEWS 73562
XR KNEE AP STANDING - BILATERAL 73565
XR KNEE COMPLETE - 4 OR MORE VIEWS 73564
XR KUB 74018
XR LUMBAR SPINE - 2 OR 3 VIEWS 72100
XR LUMBAR SPINE - 4 OR MORE VIEWS 72110
XR LUMBAR SPINE COMPLETE INCLUDING FLEXION/EXTENSION - MIN 6 VIEWS 72114
XR LUMBAR SPINE FLEX EXT ONLY - 2 OR 3 VIEWS 72120
XR MANDIBLE COMPLETE - MIN 4 VIEWS 70110
XR MANDIBLE LIMITED - LESS THAN 4 VIEWS 70100
XR MASTOIDS COMPLETE - MIN 3 VIEWS PER SIDE 70130
XR MASTOIDS LIMITED - LESS THAN 3 VIEWS PER SIDE 70120
XR NASAL BONES COMPLETE - MIN 3 VIEWS 70160
XR NECK SOFT TISSUE 70360
XR OPTIC FORAMINA 70190
XR ORBITS COMPLETE - MIN 4 VIEWS 70200
XR ORTHOPANTOGRAM AKA "PANORAMIC X-RAY" 70355
XR OSSEOUS (BONE / SKELETAL) SURVEY COMPLETE 77075
XR OSSEOUS (BONE / SKELETAL) SURVEY INFANT 77076
XR OSSEOUS (BONE / SKELETAL) SURVEY LTD 77074
XR PELVIS COMPLETE - MIN 3 VIEWS 72190
XR PELVIS LTD - 1 OR 2 VIEWS 72170
PHARYNX OR LARYNX INCLUDING FLOURO AND/OR MAGNIFICATION TECHNIQUE AKA
XR 70370
"NASOPHARYNGOGRAM"
XR RIBS BILATERAL - 3 VIEWS 71110
XR RIBS BILATERAL W/PA CHEST - 4 VIEWS 71111
XR RIBS UNILATERAL - 2 VIEWS 71100
XR RIBS UNILATERAL W/PA CHEST - MIN 3 VIEWS 71101
XR SACROILIAC (SI) JOINTS COMPLETE - MIN 3 VIEWS 72202
XR SACROILIAC (SI) JOINTS LTD - LESS THAN 3 VIEWS 72200
XR SACRUM & COCCYX - MIN 2 VIEWS 72220
XR SALIVARY GLAND FOR CALCULUS 70380
XR SCAPULA 73010
XR SELLA TURCICA AKA "TURKISH SADDLE" 70240
XR SHOULDER COMPLETE - MIN 2 VIEWS 73030
XR SHOULDER LTD - 1 VIEW 73020
XR SINUS/PARANASAL COMPLETE - MIN 3 VIEWS 70220
XR SINUS/PARANASAL LTD - LESS THAN 3 VIEWS 70210
XR SITZMARKS STUDY 74018 PER DAY
XR SKULL COMPLETE - MIN 4 VIEWS 70260
XR SKULL LTD - LESS THAN 4 VIEWS 70250

Page 18 of 25
XR SPINE - 1 VIEW (SPECIFY LEVEL) 72020
SPINE, ENTIRE THORACIC AND LUMBAR, INCLUDING SKULL, CERVICAL AND SACRAL SPINE IF
XR 72081
PERFORMED (EG, SCOLIOSIS EVALUATION; 1 VIEW
SPINE, ENTIRE THORACIC AND LUMBAR, INCLUDING SKULL, CERVICAL AND SACRAL SPINE IF
XR 72082
PERFORMED (EG, SCOLIOSIS EVALUATION; 2 OR 3 VIEWS
SPINE, ENTIRE THORACIC AND LUMBAR, INCLUDING SKULL, CERVICAL AND SACRAL SPINE IF
XR 72083
PERFORMED (EG, SCOLIOSIS EVALUATION; 4 OR 5 VIEWS
SPINE, ENTIRE THORACIC AND LUMBAR, INCLUDING SKULL, CERVICAL AND SACRAL SPINE IF
XR 72084
PERFORMED (EG, SCOLIOSIS EVALUATION; MINIMUM OF 6 VIEWS
XR STERNOCLAVICULAR JOINT OR JOINTS - MIN 3 VIEWS 71130
XR STERNUM - MIN 2 VIEWS 71120
XR TEETH COMPLETE - FULL MOUTH 70320
XR TEETH PARTIAL EXAMINATION - LESS THAN FULL MOUTH 70310
XR TEETH SINGLE VIEW 70300
XR TEMPOROMANDIBULAR JOINT (TMJ) - BILATERAL 70330
XR TEMPOROMANDIBULAR JOINT (TMJ) - UNILATERAL 70328
XR THORACIC SPINE - 2VIEWS - AP/LAT 72070
XR THORACIC SPINE - 3 VIEWS 72072
XR THORACIC SPINE - MIN 4 VIEWS 72074
XR THORACOLUMBAR JUNCTION - 2 VIEWS 72080
XR TIBIA FIBULA (LOWER LEG) 73590
XR TOE(S) 73660
XR WRIST COMPLETE - MIN 3 VIEWS 73110
XR WRIST LTD - 2 VIEWS 73100
OTHER
XR UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE 76499
XR CONSULTATION ON X-RAY EXAMINATION MADE ELSEWHERE, WRITTEN REPORT 76140

Page 19 of 25
 Nuclear Medicine
Exam/Procedure CPT Code
NUCLEAR MEDICINE
NM ABSCESS LOCALIZATION LIMITED, SINGLE DAY (WHITE BLOOD CELL) **HIGH VALUE** 78800 A9569 (WBC), A9556 *
NM ABSCESS LOCALIZATION, 2 OR MORE AREAS, 2 OR MORE DAYS 78801 A9569 (WBC), A9556 *
NM ABSCESS LOCALIZATION, WHOLE BODY, SINGLE DAY 78802, A9569 (WBC), A9556 *
NM ABSCESS LOCALIZATION SPECT 78803 A9560, A9572, A9569 (WBC), A9500, A9556 *
NM ABSCESS LOCALIZATION WHOLE BODY, 2 OR MORE DAYS 78804, A9569 (WBC), A9556 *
NM ADRENAL IMAGING, CORTEX AND/OR MEDULLA 78075, A9508, A9582 or A9548 *
NM BONE MARROW IMAGING LTD AREA 78102, A9541
NM BONE MARROW IMAGING MULTIPLE AREAS 78103, A9541
NM BONE MARROW IMAGING WHOLE BODY 78104, A9541
NM BONE SCAN 3 PHASE 78315, A9561 or A9503 *
NM BONE OR JOINT IMAGING; LIMITED AREA 78300, A9561 or A9503 *
NM BONE OR JOINT IMAGING; MULTIPLE AREAS 78305, A9561 or A9503 *
NM BONE OR JOINT IMAGING; WHOLE BODY 78306, A9561 or A9503 *
NM BONE OR JOINT IMAGING; WHOLE BODY WITH SPECT 78306, 78803, A9561 or A9503 *
NM BRAIN IMAGING LESS THAN 4 STATIC VIEWS 78600, A9569
NM BRAIN IMAGING LESS THAN 4 STATIC VIEWS WITH VASCULAR FLOW 78601, A9569
NM BRAIN IMAGING MINIMUM 4 STATIC VIEWS 78605, A9569
NM BRAIN IMAGING MINIMUM 4 STATIC VIEWS WITH VASCULAR FLOW 78606, A9569
NM BRAIN IMAGING VASCULAR FLOW ONLY 78610, A9569
NM CARDIAC SHUNT IMAGING/DETECTION 78428, A9540
NM CARDIAC AMYLOIDOSIS 78803, A9538
NM CEA SPECT SCAN 78803, A9560, A9572, A9569, A9500, A9556 *
NM CEA WHOLE BODY SCAN MULTI DAY 78804, A9560, A9572, A9569, A9500, A9556 *
NM CEA WHOLE BODY SCAN SINGLE DAY 78802, A9560, A9572, A9569, A9500, A9556 *
NM CEA WHOLE BODY MULTI DAY SPECT 78803, 78804, A9560, A9572, A9569, A9500, A9556 *
NM CISTERNOGRAM **HIGH VALUE** 78630, 62321, 62323, A9548
NM CSF LEAKAGE DETECTION AND LOCALIZATION 78650
NM DATSCAN **HIGH VALUE** 78803, A9584
NM GALLIUM SCAN LTD AREA - TUMOR LOCALIZATION 78800, A9560, A9572, A9569, A9500, A9556 *
NM GALLIUM SCAN WHOLE BODY MULTI DAY - TUMOR LOCALIZATION 78804, A9560, A9572, A9569, A9500, A9556 *
NM GALLIUM SCAN WHOLE BODY SINGLE DAY - TUMOR LOCALIZATION 78802, 78803, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATION, SINGLE AREA, SINGLE DAY 78800, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATION, 2 OR MORE AREAS, 2 OR MORE DAYS 78801, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATION, WHOLE BODY, SINGLE DAY 78802, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATION SPECT 78803, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATOIN, WHOLE BODY, 2 OR MORE DAYS 78804, A9560, A9572, A9569, A9500, A9556 *
NM TUMOR LOCALIZATION - WHOLE BODY SPECT, 2 OR MORE DAYS 78803, 78804, A9560, A9572, A9569, A9500, A9556 *
NM GASTRIC EMPTYING SCAN 78264, A9541
NM GASTRIC EMPTYING SCAN WITH SMALL BOWEL TRANSIT 78265, A9541
NM GASTRIC EMPTYING SCAN WITH SMALL BOWEL AND COLON TRANSIT, MULIPLE DAYS 78266, A9541
NM ACUTE GI BLOOD LOSS IMAGING 78278, A9560 or A9541 *
NM HIDA SCAN (HEPATOBILIARY SYSTEM IMAGING) 78226, A9537
78227, A9537, J2805 (kinevac/CCK ) or J2275
NM HIDA SCAN WITH PHARMACOLOGIC INTERVENTION (CCK)
(morphine )
NM I 131 BODY SCAN 78018, A9528
NM LIVER SCAN STATIC ONLY 78201, A9541
NM LIVER SCAN WITH VASCULAR FLOW 78202, A9541

Page 20 of 25
NM LIVER & SPLEEN IMAGING STATIC ONLY 78215, A9541
NM LIVER & SPLEEN IMAGING WITH VASCULAR FLOW 78216, A9541
NM LYMPHATICS AND LYMPH NODE IMAGING 78195, A9541
NM MECKELS SCAN 78290, A9512
NM MIBG SPECT SCAN I 123 78803, 78804, A9582
NM MIBG SPECT SCAN 1 131 **HIGH VALUE** 78803, 78804, A9508
TOMOGRAPHIC (SPECT) WITH CONCURRENTLY ACQUIRED CT FOR ANATOMICAL REVIEW,
NM LOCALIZATION AND DETERMINATION/DETECTION OF PATHOLOGY, SINGLE AREA (EG, HEAD, 78830
NECK, CHEST, PELVIS), SINGLE DAY IMAGING
TOMOGRAPHIC (SPECT), MINIMUM 2 AREAS (EG, PELVIS AND KNEES, ABDOMEN AND PELVIS),
NM 78831
SINGLE DAY OR SINGLE AREA IMAGING OVER 2 OR MORE DAYS
TOMOGRAPHIC (SPECT) WITH CONCURRENTLY ACQUIRED CT FOR ANATOMICAL REVIEW,
NM LOCALIZATION AND DETERMINATION/DETECTION OF PATHOLOGY, MINIMUM 2 AREAS, 78832
SINGLE DAY OR SINGLE AREA IMAGING OVER 2 OR MORE DAYS
+ RADIOPHARMACEUTICAL QUANTIFICATION MEASUREMENT(S), SINGLE AREA
NM 78835
(USE WITH 78830, 78832)
NM MUGA; PLANAR, SINGLE STUDY AT REST OR STRESS 78472, A9560, A9512, A9538 *
NM + RIGHT VENTRICULAR EJECTION FRACTION (USE WITH 78472) 78496
MUGA; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION,
NM 78473, A9560, A9512, A9538 *
AT REST AND STRESS
NM MUGA SPECT 78494, A9560, A9512, A9538
NM OCTREOSCAN SPECT 78803, A9572
NM OCTREOSCAN WHOLE BODY MULTI DAY 78804, A9572
NM OCTRESCAN WHOLE BODY MULTI DAY W/SPECT **HIGH VALUE** 78803, 78804, A9572
NM OCTREOSCAN WHOLE BODY SINGLE DAY 78802, A9572
NM PARATHYROID IMAGING 78070, A9500
NM PARATHYROID IMAGING WITH SPECT **HIGH VALUE** 78070, 78071, A9500
NM PARATHYROID IMAGING WITH SPECT AND CT FOR ANATOMICAL LOCALIZATION 78072, A9500
NM PROSTASCINT MULTI DAY SPECT NEEDS ABD/PEL W/WO TOO 78803, 78804, A9507
NM PROSTASCINT WHOLE BODY SINGLE 78802, A9507
NM PROSTASCINT WHOLE BODY MULTI W OUT SPECT **HIGH VALUE** 78804, A9507
NM PULMONARY VENTILATION IMAGING (EG, AEROSOL OR GAS) 78579, A9540, A9567
NM PULMONARY PERFUSION PARTICULATE ONLY **HIGH VALUE** 78580, A9540
NM PULMONARY VENTILATION AND PERFUSION SCAN (AKA VQ SCAN) 78582, A9540, A9567
NM PULMONARY PERFUSION AND VENTILATION WITH QUANTITATIVE DIFFERENTIAL 78598, A9540, A9567
QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION,
NM 78597
INCLUDING IMAGING WHEN PERFORMED
NM RA I 131 THYROID ABLATION THERAPY (#1) 79005, A9517
NM RENAL FUNCTION STUDY 78725, A9539
NM RENAL SCAN W/CAPTOPRIL MULTIPLE STUDIES 78709, A9562, J1940
NM RENAL SCAN W/CAPTOPRIL SINGLE STUDY 78708, A9562, J1940
NM RENAL SCAN W/LASIX MULTIPLE STUDIES 78709, A9562, J1940
NM RENAL SCAN W/LASIX SINGLE STUDY 78708, A9562, J1940
NM RENAL SCAN MORPHOLOGY 78700
NM RENAL SCAN WITH VASCULAR FLOW 78701, A9562, A9551, A9539 *
RENAL SCAN WITH VASCULAR FLOW AND FUNCTION, SINGLE STUDY W/OUT PHARM
NM 78707
INTERVENTION
NM SALIVARY GLAND FUNTION STUDY 78232, A9512
NM SALIVARY GLAND IMAGING 78230, A9512
NM SALIVARY GLAND WITH SERIAL IMAGES 78231, A9512
NM SESTAMIBI SCAN 78803, A9500
NM SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW 78185

Page 21 of 25
NM TESTICULAR IMAGING WITH VASCULAR FLOW 78761, A9512
NM THYROID UPTAKE - SINGLE OR MULTIPLE 78012, A9516

NM THYROID IMAGING, INCLUDING VASCULAR FLOW, IF PERFORMED 78013, A9516

NM THYROID UPTAKE AND SCAN - SINGLE OR MULTIPLE 78014, A9516
NM THYROID CARCINOMA METASTASES LTD 78015, A9528
NM THYROID CARCINOMA METASTASES WITH ADDITIONAL STUDIES 78016, A9528
NM THYROID CARCINOMA METASTASES WHOLE BODY SCAN 78018, A9528
NM + THYROID CARCINOMA METASTASES UPTAKE (USE WITH 78018) 78020
NM URETAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING CYSTOGRAM) 78740
NM + URINARY BLADDER RESIDUAL STUDY (USE WITH 78740) 78730
NM PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN DENVER SHUNT) 78291, 49427
NM NM LEXISCAN CARDIAC STRESS TEST SINGLE STUDY 78451, A9500, J2785
NM NM LEXISCAN CARDIAC STRESS TEST DOUBLE STUDY – INCLUDES TREADMILL 78452, A9500, J2785
93015, 93016, 93017 or 93018 -
NM NON-NUCLEAR TREADMILL STRESS TEST
MUST BE SPECIFIED IN REFERRAL
NM TREADMILL STRESS TEST SINGLE STUDY W/ CARDIOLITE 78451, A9500
NM NM STRESS TEST MULTIPLE STUDY W/ CARDIOLITE 78452, A9500
NM MYOCARDIAL PERFUSION IMAGING, PLANAR, SINGLE STUDY AT REST OR STRESS 78453, A9505
MULTIPLE STUDIES AT REST AND/OR STRESS AND/OR
NM 78454, A9505
REDISTRIBUTION AND/OR REST REINJECTIONS
OTHER
NM BONE DENSITY STUDY 78350
NM BONE DENSITY DUAL PHOTON ABSORPTIOMETRY, 1 OR MORE SITES 78351
NM UNLISTED ENDOCRINE PROCEDURE 78099
NM UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE 78199
NM UNLISTED GASTROINTESTINAL PROCEDURE 78299
NM UNLISTED MUSCOSKELETAL PROCEDURE 78399
NM UNLISTED CARDIOVASCULAR PROCEDURE 78499
NM UNLISTED RESPIRATORY PROCEDURE 78599
NM UNLISTED NERVOUS SYSTEM PROCEDURE 78699
NM UNLISTED GENITOURINARY PROCEDURE 78799
NM UNLISTED MISCELLANEOUS PROCEDURE 78999
NM UNLISTED RADIOPHARMACEUTICAL THERAPY PROCEDURE 79999
INJECTION PROCEDURE FOR RADIOPHARMACEUTICAL LOCALIZATION BY
NM 78808
NON-IMAGING PROBE STUDY, INTRAVENOUS

Page 22 of 25
Biopsy, Drainage and Aspiration
Exam/Procedure CPT Code
BIOPSY
20206 with either 76942 (US ), 77012 (CT ),
MUSCLE/SOFT TISSUE
77002 (FL ) or 77021 (MR )
20220 with either 76942 (US ), 77012 (CT ),
BONE, SUPERFICIAL (EG, STERNUM, ILIUM, RIB)
77002 (FL ) or 77021 (MR )
20225 with either 76942 (US ), 77012 (CT ),
BONE, DEEP (EG, FEMUR, VERTEBRAL BODY)
77002 (FL ) or 77021 (MR )
32400 with either 76942 (US ), 77012 (CT),
PLEURA
77002 (FL ) or 77021 (MR )
LUNG OR MEDIASTINUM 32408
38220 with either 76942 (US ), 77012 (CT ),
BONE MARROW - ASPIRATION ONLY
77002 (FL ) or 77021 (MR )
38221 with either 76942 (US ), 77012 (CT ),
BONE MARROW
77002 (FL ) or 77021 (MR )
38222 with either 76942 (US ), 77012 (CT ),
BONE MARROW - BIOPSY AND ASPIRATION
77002 (FL ) or 77021 (MR )
38505 with either 76942 (US ), 77012 (CT ),
LYMPH NODES; SUPERFICIAL
77002 (FL ) or 77021 (MR )
47000 with either 76942 (US ), 77012 (CT ),
LIVER
77002 (FL ) or 77021 (MR )
48102 with either 76942 (US ), 77012 (CT ),
PANCREAS
77002 (FL ) or 77021 (MR )
49180 with either 76942 (US ), 77012 (CT ),
ABDOMINAL OR RETROPERITONEAL MASS
77002 (FL ) or 77021 (MR )
50200 with either 76942 (US ), 77012 (CT ),
KIDNEY
77002 (FL ) or 77021 (MR )
55700 with either 76942 (US ), 77012 (CT ),
PROSTATE
77002 (FL ) or 77021 (MR )
60100 with either 76942 (US ), 77012 (CT ),
THYROID; CORE
77002 (FL ) or 77021 (MR )
THYROID; US GUIDED FNA (FINE NEEDLE ASPIRATION) 10005
+ EACH ADD'L LESION 10006
FNA; US GUIDED 10005
+ EACH ADD'L LESION 10006
FNA; FL GUIDED 10007
+ EACH ADD'L LESION 10008
FNA; CT GUIDED 10009
+ EACH ADD'L LESION 10010
FNA; MR GUIDED 10011
+ EACH ADD'L LESION 10012
PARACENTESIS 49083
THORACENTESIS 32555

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ASPIRATION AND/OR DRAINAGE
10160 with either 76942 (US ), 77012 (CT ), 77002 (FL ) or 77021
PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, CYST OR BULLA
(MR )
50390 with either 76942 (US ), 77012 (CT ), 77002 (FL ) or 77021
ASPIRATION AND/OR INJECTION OF RENAL CYST OR PELVIS
(MR )
60300 with either 76942 (US ), 77012 (CT ), 77002 (FL ) or 77021
ASPIRATION AND/OR INJECTION OF THRYROID CYST
(MR )
10140 with either 76942 (US ), 77012 (CT ), 77002 (FL ) or 77021
INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION
(MR )

FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE (EG, ABSCESS, SEROMA,

10030
LYMPHOCELE, CYST), SOFT TISSUE (EG, ABDOMINAL WALL, EXTREMITY, NECK),

FLUID COLLECTION DRAINAGE (EG, ABSCESS, HEMATOMA, CYST, LYMPHOCELE,

49405
SEROMA), WITH IMAGING GUIDANCE, VISCERAL (EG, LIVER, KIDNEY, SPLEEN, LUNG)

FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, PERITONEAL OR

49406
RETROERITONEAL THROUH ABDOMINAL WALL OR FLANK
FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, PERITONEAL OR
49407
RETROERITONEAL, T-VAG OR T-RECTAL APPROACH
INTERVERTEBRAL DISC ASPIRATION 62267, 77003
CHEST TUBE PLACEMENT AND DRAINAGE 32557
LUMBAR PUNCTURE, DIAGNOSTIC, WITH FL OR CT GUIDANCE 62328
SPINAL PUNCTURE, THERAPEUTIC, WITH FL OR CT GUIDANCE 62329
IVC FILTER
IVC FILTER INSERTION 37191
IVC FILTER REPOSITIONING 37192
IVC FILTER REMOVAL 37193
SCLEROTHERAPY
SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTIONS, SPIDER VEIN(S );
36468
TRUNK OR LIMB
INJECTION OF SCLEROSING SOLUTION; SINGLE VEIN 36470
MULTIPLE VEINS ON THE SAME LEG 36471
SCLEROTHERAPY OF A FLUID COLLECTION (EG, LYMPHOCELE, SEROMA OR CYST) 49185
ABLATIONS AND CRYOTHERAPY
RADIOFREQUENCY ABLATION, 1 OR MORE RENAL TUMOR(S), PERCUTANEOUS,
50592, 76940 (US) 77013 (CT) or 77022 (MR)
UNILATERAL
CYROTHERAPY ABLATION, RENAL TUMOR(S), PERCUTANEOUS, UNILATERAL 50593, 76940 (US) 77013 (CT) or 77022 (MR)
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE
OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; 36475
FIRST VEIN
SECOND AND SUBSEQUENT VEINTS TREATED IN A SINGLE EXTREMITY (USE IN
36476
ADDITION TO 36478)

ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE

36478
OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, LASER; FIRST VEIN

SECOND AND SUBSEQUENT VEINTS TREATED IN A SINGLE EXTREMITY (USE IN

36479
ADDITION TO 36478)
DESTRUCTION OF NEUROLYTIC AGENT, GENICULAR NERVE BRANCHES, INCLUDING
64624
IMAGING GUIDANCE
RADIOFREQUENCY ABLATION, NERVES INNERVATING THE SACROILIAC JOINT, WITH
64625
IMAGING GUIDANCE

Page 24 of 25
ANGIOGRAPHY
NON-SELECTIVE ARCH ARTERIOGRAM 36221
36222, 36223, 36224, 36225, 36226, 36227, 36228
CAROTID ARTERIOGRAM
(USE ALL x 2 IF BILATERAL)
UNLIATERAL UPPER EXTREMITY 36215, 36216, 36217, 75710, 75774
BILATERAL UPPER EXTREMITY 36215, 36216, 36217, 75716, 75774
BRACHIAL, RETROGRADE 36215, 36216, 36217, 75658, 75774
ABDOMINAL AORTOGRAM 36200, 75625
ABDOMINAL AORTOGRAM WITH BILATERAL LOWER EXTREMITY RUN-OFF 36200, 75625, 75630, 75716
UNILATERAL RENAL 36251, 36253, 75774
BILATERAL RENAL 36252, 36254, 75774
UNILATERAL LOWER EXTREMITY 36245, 36246, 36247, 75710
BILATERAL LOWER EXTREMITY 36245, 36246, 36247, 75716
VENOGRAPHY
UNILATERAL UPPER OR LOWER EXTREMITY 36005, 75820
BILATERAL UPPER OR LOWER EXTREMITY 36005, 36005, 75822
UNILATERAL RENAL 36011, 75831
BILATERAL RENAL 36011, 36011, 75833
URINARY TRACT
DILATION OF EXISTING TRACT, INCLUDING TUBE PLACEMENT WHEN PERFORMED 50436
DILATION OF EXISTING TRACT, INCLUDING TUBE PLACEMENT WHEN PERFORMED,
50437
INCLUDING NEW ACCESS TO RENAL COLLECTING SYSTEM
NEPHROSTOGRAM; NEW ACCESS 50430
NEPHROSTOGRAM; EXISTING ACCESS 50431
NEPHROSTOMY CATHETER PLACEMENT 50432
NEPHROSTOMY CATHETER EXCHANGE 50435
REMOVAL OF NEPHROSTOMY TUBE 50389
NEPHROURETERAL CATHETER PLACEMENT 50433
CONVERSION OF NEPHROSTOMY TO NEPHROURETERAL CATHETER 50434
REMOVAL AND REPLACEMENT OF NEPHROURETERAL CATHETER 50387
PLACEMENT OF URETERAL STENT; EXISTING NEPHROSTOMY TRACT 50693
PLACEMENT OF URETERAL STENT; NEW ACCESS, WITHOUT SEPARATE
50694
NEPHROSTOMY CATHETER
PLACEMENT OF URETERAL STENT; NEW ACCESS, WITH SEPARATE NEPHROSTOMY
50695
CATHETER
REMOVAL AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT,
50382
PERCUTANEOUS APPROACH
REMOVAL AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT,
50385
TRANSURETHRAL APPROACH

REMOVAL OF INTERNALLY DWELLING URETERAL STENT, PERCUTANEOUS APPROACH 50384

REMOVAL OF INTERNALLY DWELLING URETERAL STENT, TRANSURETHRAL APPROACH 50386

Page 25 of 25