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|---|---|---|---|---|---|---|---|---|---|---|---|
579210000 | 57921-00-00 | Radiography of nose | Radiography of nose (maxilla) | 20 | Imaging services | 1,967 | Radiography of head or neck | Radiography of nose (maxilla), excluding that of cervical spine. | null | That of Cervical Spine (58100-00-00 [1968]) | null |
579270001 | 57927-00-01 | Radiography temporomandibular joint uni | Radiography of temporomandibular joint, unilateral | 20 | Imaging services | 1,967 | Radiography of head or neck | Except that of cervical spine. | null | That of Cervical Spine (58100-00-00 [1968])
Arthrography (59751-00-00 [1985]) | null |
579270002 | 57927-00-02 | Radiography tmj bil | Radiography of temporomandibular joint, bilateral | 20 | Imaging services | 1,967 | Radiography of head or neck | Radiography of temporomandibular joint (both sides), excluding that of cervical spine and arthrography. | null | That of Cervical Spine (58100-00-00 [1968])
Arthrography (59751-00-00 [1985]) | null |
579300000 | 57930-00-00 | Radiography of teeth | Radiography of teeth | 20 | Imaging services | 1,967 | Radiography of head or neck | Dental radiography, orthodontic: cephalography and cephalometry, except that of cervical spine. | Dental Radiography
orthodontic:
• Cephalography
• Cephalometry | That of Cervical Spine (58100-00-00 [1968])
That of Full Mouth (57933-00-00 [1967]) | null |
579390000 | 57939-00-00 | Palatopharyngeal stud w fluorosc screen | Palatopharyngeal study with fluoroscopic screening | 20 | Imaging services | 1,967 | Radiography of head or neck | Except that of cervical spine. | null | That of Cervical Spine (58100-00-00 [1968]) | null |
579450000 | 57945-00-00 | Radiography of larynx | Radiography of larynx | 20 | Imaging services | 1,967 | Radiography of head or neck | Except that of cervical spine. | Soft Tissue of Neck | That of Cervical Spine (58100-00-00 [1968]) | null |
579600000 | 57960-00-00 | Orthopantomography | Orthopantomography | 20 | Imaging services | 1,967 | Radiography of head or neck | Except that of cervical spine. | null | That of Cervical Spine (58100-00-00 [1968]) | null |
597030000 | 59703-00-00 | Dacryocystography | Dacryocystography | 20 | Imaging services | 1,967 | Radiography of head or neck | Except that of cervical spine. | Contrast | That of Cervical Spine (58100-00-00 [1968]) | null |
597330000 | 59733-00-00 | Radiography salivary gland with contrast | Sialography with contrast | 20 | Imaging services | 1,967 | Radiography of head or neck | Sialography with contrast | null | That of Cervical Spine (58100-00-00 [1968]) | null |
909000000 | 90900-00-00 | Encephalography | Encephalography | 20 | Imaging services | 1,967 | Radiography of head or neck | Pneumocisternography, Pneumoencephalography, except that of cervical spine. | Pneumocisternography
Pneumoencephalography | That of Cervical Spine (58100-00-00 [1968]) | null |
581000000 | 58100-00-00 | Radiography of cervical spine | Radiography of cervical spine | 20 | Imaging services | 1,968 | Radiography of spine | Except radiography of spine: 2,3 and 4 regions. | Functional Views | Radiography of Spine:
• 2 Regions (58112-00-00 [1969])
• 3 Regions (58115-00-00 [1969])
• 4 Regions (58108-00-00 [1969])
| null |
581030000 | 58103-00-00 | Radiography of thoracic spine | Radiography of thoracic spine | 20 | Imaging services | 1,968 | Radiography of spine | Except radiography of spine: 2,3 and 4 regions. | Functional Views | Radiography of Spine:
• 2 Regions (58112-00-00 [1969])
• 3 Regions (58115-00-00 [1969])
• 4 Regions (58108-00-00 [1969])
| null |
581060000 | 58106-00-00 | Radiography of lumbosacral spine | Radiography of lumbosacral spine | 20 | Imaging services | 1,968 | Radiography of spine | Except radiography of spine: 2,3 and 4 regions. | Functional Views | Radiography of Spine:
• 2 Regions (58112-00-00 [1969])
• 3 Regions (58115-00-00 [1969])
• 4 Regions (58108-00-00 [1969])
| null |
581090000 | 58109-00-00 | Radiography of sacrococcygeal spine | Radiography of sacrococcygeal spine | 20 | Imaging services | 1,968 | Radiography of spine | Except radiography of spine: 2,3 and 4 regions. | Functional Views | Radiography of Spine:
• 2 Regions (58112-00-00 [1969])
• 3 Regions (58115-00-00 [1969])
• 4 Regions (58108-00-00 [1969])
| null |
597000000 | 59700-00-00 | Discography | Discography | 20 | Imaging services | 1,968 | Radiography of spine | null | Functional Views | null | null |
597240000 | 59724-00-00 | Myelography | Myelography | 20 | Imaging services | 1,968 | Radiography of spine | null | Functional Views | null | null |
581120000 | 58112-00-00 | Radiography of spine 2 regions | Radiography of spine, 2 regions | 20 | Imaging services | 1,969 | Radiography of spine, 2 regions | null | Functional Views
That of 2, 3 or 4 of the Following Spinal Regions:
• Cervical
• Lumbosacral
• Sacrococcygeal
• Thoracic | null | null |
581150000 | 58115-00-00 | Radiography of spine 3 regions | Radiography of spine, 3 regions | 20 | Imaging services | 1,969 | Radiography of spine, 2 regions | null | Functional Views
That of 2, 3 or 4 of the Following Spinal Regions:
• Cervical
• Lumbosacral
• Sacrococcygeal
• Thoracic | null | null |
581080000 | 58108-00-00 | Radiography of spine 4 regions | Radiography of spine, 4 regions | 20 | Imaging services | 1,969 | Radiography of spine, 2 regions | null | Functional Views
That of 2, 3 or 4 of the Following Spinal Regions:
• Cervical
• Lumbosacral
• Sacrococcygeal
• Thoracic | null | null |
575060121 | 57506-01-21 | Radiography elbow >=3 views uni | Radiography of elbow, 3 or more views, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of elbow, 3 or more view (one side), excluding hand, wrist, shoulder or scapula. | null | null | null |
575060122 | 57506-01-22 | Radiography elbow >=3 views bil | Radiography of elbow, 3 or more views, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of elbow, 3 or more view (both sides), excluding hand, wrist, shoulder or scapula. | null | null | null |
575060321 | 57506-03-21 | Radiography wrist >=3 views uni | Radiography of wrist, 3 or more views, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of wrist, 3 or more view (one side), excluding hand, elbow, shoulder or scapula. | null | null | null |
575060322 | 57506-03-22 | Radiography wrist >=3 views bil | Radiography of wrist, 3 or more views, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of wrist, 3 or more view (both sides), excluding hand, elbow, shoulder or scapula. | null | null | null |
575060421 | 57506-04-21 | Radiography hand >=3 views uni | Radiography of hand, 3 or more views, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of hand, 3 or more view (one side), excluding wrist, elbow, shoulder or scapula. | null | null | null |
575060422 | 57506-04-22 | Radiography hand >=3 views bil | Radiography of hand, 3 or more views, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of hand, 3 or more view (both sides), excluding wrist, elbow, shoulder or scapula. | null | null | null |
577000011 | 57700-00-11 | Radiography shoulder/scapula 1 vw uni | Radiography of shoulder or scapula, 1 view, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of shoulder or scapula, 1 view (one side). | null | null | null |
577000012 | 57700-00-12 | Radiography shoulder /scapula 1 vw bil | Radiography of shoulder or scapula, 1 view, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of shoulder or scapula, 1 view (both sides). | null | null | null |
577000021 | 57700-00-21 | Radiography shoulder/scapula 2 /more views uni | Radiography of shoulder or scapula, 2 or more views, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of shoulder or scapula, 2 or more views (one side). | null | null | null |
577000022 | 57700-00-22 | Radiography shoulder/scapula 2/more views bil | Radiography of shoulder or scapula, 2 or more views, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of shoulder or scapula, 2 or more views (both sides). | null | null | null |
577060001 | 57706-00-01 | Radiography clavicle uni | Radiography of clavicle, unilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of clavicle (one side). | null | null | null |
577060002 | 57706-00-02 | Radiography clavicle bil | Radiography of clavicle, bilateral | 20 | Imaging services | 1,970 | Radiography of shoulder region | Radiography of clavicle (both sides). | null | null | null |
575060001 | 57506-00-01 | Radiography humerus uni | Radiography of humerus, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of humerus (one side). | null | null | null |
575060002 | 57506-00-02 | Radiography humerus bil | Radiography of humerus, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of humerus (both sides). | null | null | null |
575060111 | 57506-01-11 | Radiography elbow 1 or 2 views uni | Radiography of elbow, 1 or 2 views, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow, 1 or 2 views (one side). | null | null | null |
575060112 | 57506-01-12 | Radiography elbow 1 or 2 views bil | Radiography of elbow, 1 or 2 views, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow, 1 or 2 views (both sides). | null | null | null |
575060201 | 57506-02-01 | Radiography forearm uni | Radiography of forearm, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of forearm (one side). | null | null | null |
575060202 | 57506-02-02 | Radiography forearm bil | Radiography of forearm, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of forearm (both sides). | null | null | null |
575060311 | 57506-03-11 | Radiography wrist 1 or 2 views uni | Radiography of wrist, 1 or 2 views, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Except bone age study of wrist and knee. | null | Bone Age Study of Wrist and Knee (58300-00-00 [1984]) | null |
575060312 | 57506-03-12 | Radiography wrist 1 or 2 views bil | Radiography of wrist, 1 or 2 views, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Except bone age study of wrist and knee. | null | Bone Age Study of Wrist and Knee (58300-00-00 [1984]) | null |
575060411 | 57506-04-11 | Radiography hand 1 or 2 views uni | Radiography of hand, 1 or 2 views, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand, 1 or 2 views (one side). | null | null | null |
575060412 | 57506-04-12 | Radiography hand 1 or 2 views bil | Radiography of hand, 1 or 2 views, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand, 1 or 2 views (both sides). | null | null | null |
575120001 | 57512-00-01 | Radiography elbow & humerus uni | Radiography of elbow and humerus, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow and humerus (one side), excluding forearm. | null | null | null |
575120002 | 57512-00-02 | Radiography elbow & humerus bil | Radiography of elbow and humerus, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow and humerus (both sides), excluding forearm. | null | null | null |
575120101 | 57512-01-01 | Radiography elbow & forearm uni | Radiography of elbow and forearm, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow and forearm (one side). | null | null | null |
575120102 | 57512-01-02 | Radiography elbow & forearm bil | Radiography of elbow and forearm, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of elbow and forearm (both sides). | null | null | null |
575120201 | 57512-02-01 | Radiography hand wrist & forearm uni | Radiography of hand, wrist and forearm, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand, wrist and forearm (one side). | null | null | null |
575120202 | 57512-02-02 | Radiography hand wrist & forearm bil | Radiography of hand, wrist and forearm, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand, wrist and forearm (both sides). | null | null | null |
575120301 | 57512-03-01 | Radiography hand & wrist uni | Radiography of hand and wrist, unilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand and wrist (one side) without the forearm. | null | null | null |
575120302 | 57512-03-02 | Radiography hand & wrist bil | Radiography of hand and wrist, bilateral | 20 | Imaging services | 1,971 | Radiography of upper limb | Radiography of hand and wrist (both sides) without the forearm. | null | null | null |
585210000 | 58521-00-00 | Radiography of sternum | Radiography of sternum | 20 | Imaging services | 1,972 | Radiography of sternum or ribs | Radiography of sternum. | null | null | null |
585210100 | 58521-01-00 | Radiography of ribs unilateral | Radiography of ribs, unilateral | 20 | Imaging services | 1,972 | Radiography of sternum or ribs | Radiography of ribs (one side). | null | null | null |
585240000 | 58524-00-00 | Radiography of ribs bilateral | Radiography of ribs, bilateral | 20 | Imaging services | 1,972 | Radiography of sternum or ribs | Radiography of ribs (both sides). | null | null | null |
585240100 | 58524-01-00 | Radiography of sternum & ribs unilateral | Radiography of sternum and ribs, unilateral | 20 | Imaging services | 1,972 | Radiography of sternum or ribs | Radiography of sternum and ribs (one side). | null | null | null |
585270000 | 58527-00-00 | Radiography of sternum & ribs bilateral | Radiography of sternum and ribs, bilateral | 20 | Imaging services | 1,972 | Radiography of sternum or ribs | Radiography of sternum and ribs (both sides). | null | null | null |
593000000 | 59300-00-00 | Radiography of breast bilateral | Radiography of breast, bilateral | 20 | Imaging services | 1,973 | Radiography of breast | Mammography, except mammary ductography . | null | Mammary Ductography (59309-00-00 [1973]) | null |
593000100 | 59300-01-00 | Radiography breast w thermography bil | Radiography of breast with thermography, bilateral | 20 | Imaging services | 1,973 | Radiography of breast | Mammography | Mammography | null | null |
593030000 | 59303-00-00 | Radiography of breast unilateral | Radiography of breast, unilateral | 20 | Imaging services | 1,973 | Radiography of breast | Mammography, except mammary ductography . | null | Mammary Ductography (59306-00-00 [1973]) | null |
593030100 | 59303-01-00 | Radiography breast w thermography uni | Radiography of breast with thermography, unilateral | 20 | Imaging services | 1,973 | Radiography of breast | Mammography | Mammography | null | null |
593060000 | 59306-00-00 | Mammary ductography of breast unilateral | Mammary ductography of breast, unilateral | 20 | Imaging services | 1,973 | Radiography of breast | Galactography of breasts, unilateral, and mammography. | Galactography of Breast, Unilateral
Mammography | null | null |
593090000 | 59309-00-00 | Mammary ductography of breast bilateral | Mammary ductography of breast, bilateral | 20 | Imaging services | 1,973 | Radiography of breast | Galactography of breasts, bilateral, and mammography. | Galactography of Breasts, Bilateral
Mammography | null | null |
585000010 | 58500-00-10 | Radiography chest 1 view | Radiography of chest, 1 view | 20 | Imaging services | 1,974 | Other radiography of chest | Except that of: ribs, sternum, thoracic inlet and trachea. | Bronchus
Diaphragm
Heart
Lung
Mediastinum | That of:
• Ribs (58521-01-00, 58524-00-00 [1972])
• Sternum (58521-00-00 [1972])
• Thoracic Inlet (58509-00-00 [1974])
• Trachea (58509-00-00 [1974]) | null |
585000020 | 58500-00-20 | Radiography chest 2 views | Radiography of chest, 2 views | 20 | Imaging services | 1,974 | Other radiography of chest | Except that of: ribs, sternum, thoracic inlet and trachea. | Bronchus
Diaphragm
Heart
Lung
Mediastinum | That of:
• Ribs (58521-01-00, 58524-00-00 [1972])
• Sternum (58521-00-00 [1972])
• Thoracic Inlet (58509-00-00 [1974])
• Trachea (58509-00-00 [1974]) | null |
585000030 | 58500-00-30 | Radiography chest 3 views | Radiography of chest, 3 views | 20 | Imaging services | 1,974 | Other radiography of chest | Except that of: ribs, sternum, thoracic inlet and trachea. | Bronchus
Diaphragm
Heart
Lung
Mediastinum | That of:
• Ribs (58521-01-00, 58524-00-00 [1972])
• Sternum (58521-00-00 [1972])
• Thoracic Inlet (58509-00-00 [1974])
• Trachea (58509-00-00 [1974]) | null |
585000040 | 58500-00-40 | Radiography chest 4/ more views | Radiography of chest, 4 or more views | 20 | Imaging services | 1,974 | Other radiography of chest | Except that of: ribs, sternum, thoracic inlet and trachea. | Bronchus
Diaphragm
Heart
Lung
Mediastinum | That of:
• Ribs (58521-01-00, 58524-00-00 [1972])
• Sternum (58521-00-00 [1972])
• Thoracic Inlet (58509-00-00 [1974])
• Trachea (58509-00-00 [1974]) | null |
585060000 | 58506-00-00 | Radiography chest w/ fluoroscopic screen | Radiography of chest with fluoroscopic screening | 20 | Imaging services | 1,974 | Other radiography of chest | null | Bronchus
Diaphragm
Heart
Lung
Mediastinum
| null | null |
585060010 | 58506-00-10 | Fluoroscopy radiography chest | Fluoroscopy for radiography of the chest | 20 | Imaging services | 1,974 | Other radiography of chest | null | Bronchus
Diaphragm
Heart
Lung
Mediastinum
| null | null |
585090000 | 58509-00-00 | Radiography of thoracic inlet or trachea | Radiography of thoracic inlet or trachea | 20 | Imaging services | 1,974 | Other radiography of chest | Radiography of thoracic inlet or trachea. | null | null | null |
597150000 | 59715-00-00 | Bronchography | Bronchography | 20 | Imaging services | 1,974 | Other radiography of chest | Endotracheal bronchography
| Endotracheal Bronchography | null | null |
589210000 | 58921-00-00 | Other opaque enema | Other opaque enema | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Except noncontrast radiography of abdomen. | Air Contrast Study
Preliminary Plain Film
| Noncontrast Radiography of Abdomen (58900 [1977]) | null |
589210010 | 58921-00-10 | Opaque meal large intestine | Opaque meal of large intestine | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Opaque meal of large intestine. | null | null | null |
589090000 | 58909-00-00 | Opaque meal phrynx/oesoph/stomch/duodnm | Opaque meal of pharynx, oesophagus, stomach or duodenum | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Barium meal of pharynx, oesophagus, stomach or duodenum, except noncontrast radiography of abdomen. | Preliminary Plain Film | Noncontrast Radiography of Abdomen (58900 [1977])
Opaque Meal of Oesophagus, Stomach and Duodenum with Follow Through to Colon (58912-00-00 [1975]) | null |
589090100 | 58909-01-00 | Opaque meal to stomch/duodnm w radiogr | Opaque meal of pharynx, oesophagus, stomach or duodenum with screening radiography of chest | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Barium meal of pharynx, oesophagus, stomach or duodenum with screening radiography of chest, except noncontrast radiography of abdomen. | Preliminary Plain Film | Noncontrast Radiography of Abdomen (58900 [1977])
Opaque Meal of Oesophagus, Stomach and Duodenum with Follow Through to Colon (58912-00-00 [1975]) | null |
589120000 | 58912-00-00 | Opaque meal pharynx through to colon | Opaque meal of oesophagus, stomach and duodenum and follow through to colon | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Barium meal of pharynx, oesophagus, stomach and duodenum and follow through to colon, except noncontrast radiography of abdomen. | null | Noncontrast Radiography of Abdomen (58900 [1977]) | null |
589120100 | 58912-01-00 | Opaq meal & thru to colon w radiogr chst | Opaque meal of oesophagus, stomach and duodenum and follow through to colon with screening radiography of chest | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Barium meal of oesophagus, stomach and duodenum and follow through to colon with screening radiography of chest, except noncontrast radiography of abdomen.
| null | Noncontrast Radiography of Abdomen (58900 [1977]) | null |
589150000 | 58915-00-00 | Opaque meal of small intestine | Opaque meal of small intestine | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Small bowel series, except noncontrast radiography of abdomen. | Preliminary Plain Film | Noncontrast Radiography of Abdomen (58900 [1977])
That of Duodenum (58909 [1975]) | null |
589160000 | 58916-00-00 | Opaque enema of small intestine | Opaque enema of small intestine | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Barium enema of small intestine, except noncontrast radiography of abdomen. | Duodenal Intubation
Preliminary Plain Film
| Noncontrast Radiography of Abdomen (58900 [1977])
That for Reduction of Intussusception (14212-00-00 [1898]) | null |
589390000 | 58939-00-00 | Defaecography | Defaecography | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Except noncontrast radiography of abdomen. | null | Noncontrast Radiography of Abdomen (58900 [1977]) | null |
909060000 | 90906-00-00 | Ileal conduitography | Ileal conduitography | 20 | Imaging services | 1,975 | Radiography of gastrointestinal tract | Except noncontrast radiography of abdomen. | null | Noncontrast Radiography of Abdomen (58900 [1977]) | null |
589240000 | 58924-00-00 | Cholecystography | Cholecystography | 20 | Imaging services | 1,976 | Radiography of biliary tract | Graham's test, except intraoperative cholangiography, noncontrast radiography of abdomen.
| Preliminary Plain Film
tomography
| Intraoperative Cholangiography (30439-00-00 [957])
Noncontrast Radiography of Abdomen (58900 [1977])
| null |
589270000 | 58927-00-00 | Direct cholangiography postoperative | Direct cholangiography, postoperative | 20 | Imaging services | 1,976 | Radiography of biliary tract | Cholangiography with dye injected directly into a tube left in biliary tract after surgery
| Cholangiography with Dye Injected Directly Into A Tube Left In Biliary Tract After Surgery | null | null |
589360000 | 58936-00-00 | Drip infusion cholangiography | Drip infusion cholangiography | 20 | Imaging services | 1,976 | Radiography of biliary tract | Cholangiography NOS, Intravenous cholangiography.
| Cholangiography Nos
Intravenous Cholangiography | null | null |
589000010 | 58900-00-10 | Radiography abdo single anteropost view | Radiography of abdomen, single anteroposterior view | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Biliary Tract
Lower Gastrointestinal Region
Retroperitoneum
Stomach | That of Urinary Tract (58700-00-00 [1980]) | null |
589000020 | 58900-00-20 | Radiography abdo anteropost & addtl oblique & cone views | Radiography of abdomen, anteroposterior and additional oblique and cone views | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Biliary Tract
Lower Gastrointestinal Region
Retroperitoneum
Stomach
| That of Urinary Tract (58700-00-00 [1980]) | null |
589000030 | 58900-00-30 | Radiog abd cmplt incl decubit and/or erct veiws | Radiography of abdomen, complete, including decubitus and/or erect views | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Biliary Tract
Lower Gastrointestinal Region
Retroperitoneum
Stomach
| That of Urinary Tract (58700-00-00 [1980]) | null |
589000040 | 58900-00-40 | Radiog abd cmplt incl supn erect/decub vws sngle view chst | Radiography of abdomen, complete, including supine, erect, and/or decubitus views, single view chest | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Biliary Tract
Lower Gastrointestinal Region
Retroperitoneum
Stomach
| That of Urinary Tract (58700-00-00 [1980]) | null |
589000090 | 58900-00-90 | Radiography abdo | Radiography of abdomen | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Biliary Tract
Lower Gastrointestinal Region
Retroperitoneum
Stomach
| That of Urinary Tract (58700-00-00 [1980]) | null |
597600000 | 59760-00-00 | Peritoneography | Peritoneography | 20 | Imaging services | 1,977 | Radiography of abdomen | null | Contrast Medium | Herniography
| null |
587060000 | 58706-00-00 | Intravenous pyelography | Intravenous pyelography | 20 | Imaging services | 1,978 | Intravenous pyelography [IVP] | Infusion pyelogram
| Infusion Pyelogram
Preliminary Plain Film
tomography
| null | null |
587150100 | 58715-01-00 | Retrograde pyelography | Retrograde pyelography | 20 | Imaging services | 1,979 | Retrograde radiography of urinary system | Retrograde pyelography. | null | null | null |
587180000 | 58718-00-00 | Retrograde cystography | Retrograde cystography | 20 | Imaging services | 1,979 | Retrograde radiography of urinary system | Retrograde cystography. | null | null | null |
587180100 | 58718-01-00 | Retrograde urethrography | Retrograde urethrography | 20 | Imaging services | 1,979 | Retrograde radiography of urinary system | Retrograde urethrography. | null | null | null |
587210000 | 58721-00-00 | Retrograde micturating CUG | Retrograde micturating cystourethrography | 20 | Imaging services | 1,979 | Retrograde radiography of urinary system | Retrograde micturating cystourethrography. | null | null | null |
587000000 | 58700-00-00 | Radiography of urinary tract | Radiography of urinary tract | 20 | Imaging services | 1,980 | Other radiography of urinary system | Plain renal x-ray, except contrast: cystography, cystourethrography, pyelography and urethrography. | Bladder
Kidney
Ureter
Urethra
| Contrast:
• Cystography (58718-00 [1979])
• Cystourethrography (58721-00-00 [1979])
• Pyelography (58706-00-00 [1978], 58715 [1979] and [1980])
• Urethrography (58718-01-00 [1979]) | null |
587150000 | 58715-00-00 | Antegrade pyelography | Antegrade pyelography | 20 | Imaging services | 1,980 | Other radiography of urinary system | Nephrostogram, Pyelostogram. | Nephrostogram
Pyelostogram | null | null |
577120011 | 57712-00-11 | Radiography hip joint 1 view uni | Radiography of hip joint, 1 view, unilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
577120012 | 57712-00-12 | Radiography hip joint 1 view bil | Radiography of hip joint, 1 view, bilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
577120021 | 57712-00-21 | Radiography hip joint 2-3 views uni | Radiography of hip joint, 2-3 views, unilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
577120022 | 57712-00-22 | Radiography hip joint 2-3 views bil | Radiography of hip joint, 2-3 views, bilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
577120031 | 57712-00-31 | Radiography hip joint 4/more views uni | Radiography of hip joint, 4 or more views, unilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
577120032 | 57712-00-32 | Radiography hip joint 4/more views bil | Radiography of hip joint, 4 or more views, bilateral | 20 | Imaging services | 1,981 | Radiography of pelvis | Except contrast arthrography and that of neck of femur. | null | Contrast Arthrography (59751-00-00 [1985])
That of Neck of Femur (57518-00-11, 57518-00-12, 57518-00-21, 57518-00-22 [1983])
| null |
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