Legend Pediatric Rate Increases for Recipients (ages 0-20 years) Note • 4% increase for all FSI, Facility, PCI, and TCI rates for all services. Example: (FSI, Facility, PCI, or TCI) X 1.04 = rate with 4% increase. • 24% increase for all FSI, Facility, PCI, and TCI rates for all services with physician specialty types: 02, 03, 04, 05, 08, 10, 14, 15, 17, 21, 22, 23, 29, 30, 31, 36, 37, 38, 39, 43, 46, 51, 53, 55, 57, 58, 60, and 62. Example: (FSI, Facility, PCI, or TCI) X 1.04 X 1.24 = rate with 4% and 24% increases. • Procedure: indicates the service level code reimbursed in the fee-for-service delivery system within the practitioner’s scope of practice. • Modifier (Mod): indicates pricing modifiers that have alerted the code by some circumstance without significantly changing the base definition. • Fee Schedule Increase (FSI): indicates the base Florida Medicaid rate with a 4% increase included for all ages and provider types (independent of increases detailed above). • PCI: indicates the professional component increase for physician work portion of a test. • TCI: indicates the technical component increase for the technical portion (i.e. staff and equipment costs) of a test. • PA: indicates the need for a prior authorization of the service through the Agency’s Quality Improvement Organization vendor. Reimbursement increases noted above do not apply to the following services: Regional Perinatal Intensive Care Center services, injectable medications, immunizations, supplies, devices, portable x-ray, and laboratory/pathology services. RADIOLOGY FEE SCHEDULE Effective January 1, 2018
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Legend
Pediatric Rate Increases for Recipients (ages 0-20 years)
Note
• 4% increase for all FSI, Facility, PCI, and TCI rates for all services. Example: (FSI, Facility, PCI, or TCI) X 1.04 = rate with 4% increase.
• 24% increase for all FSI, Facility, PCI, and TCI rates for all services with physician specialty types: 02, 03, 04, 05, 08, 10, 14, 15, 17, 21, 22, 23, 29, 30, 31, 36, 37, 38, 39, 43, 46, 51, 53, 55, 57, 58, 60, and 62. Example: (FSI, Facility, PCI, or TCI) X 1.04 X 1.24 = rate with 4% and 24% increases.
• Procedure: indicates the service level code reimbursed in the fee-for-service delivery system within the practitioner’s scope of practice.
• Modifier (Mod): indicates pricing modifiers that have alerted the code by some circumstance without significantly changing the base definition.
• Fee Schedule Increase (FSI): indicates the base Florida Medicaid rate with a 4% increase included for all ages and provider types (independent of increases detailed above).
• PCI: indicates the professional component increase for physician work portion of a test.
• TCI: indicates the technical component increase for the technical portion (i.e. staff and equipment costs) of a test.
• PA: indicates the need for a prior authorization of the service through the Agency’s Quality Improvement Organization vendor.
Reimbursement increases noted above do not apply to the following services: Regional Perinatal Intensive Care Center services, injectable medications, immunizations, supplies, devices, portable x-ray, and laboratory/pathology services.
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
Procedure Mod FSI PCI TCI PA70010 60.7970015 91.19 38.49 52.7070030 17.28 5.31 11.9770100 20.60 5.83 14.7770110 23.71 8.03 15.6870120 20.98 5.88 15.1170130 34.11 11.09 23.0270134 27.92 9.75 18.1770140 18.61 6.69 11.9270150 25.92 8.47 17.4470160 20.38 5.55 14.8370170 39.40 7.88 31.5270190 22.15 7.08 15.0870200 26.37 9.06 17.3170210 18.61 5.60 13.0170220 23.49 8.03 15.4670240 17.86 5.80 12.0670250 22.59 7.94 14.6570260 28.58 11.21 17.3770300 8.87 3.62 5.2570310 23.05 5.13 17.9170320 32.30 7.78 24.5170328 19.05 5.82 13.2370330 29.56 7.85 21.7170332 42.15 16.45 25.7070336 197.28 47.22 150.06 Y70350 11.91 6.14 5.7870355 13.07 7.14 5.9270360 17.50 5.31 12.1970370 44.96 10.05 34.9070380 20.32 5.44 14.8970390 56.14 11.61 44.5470450 73.07 27.40 45.67 Y70460 102.86 36.73 66.12 Y70470 120.45 40.91 79.54 Y70480 119.26 43.09 76.17 Y70481 172.35 44.43 127.92 Y70482 188.08 46.46 141.61 Y70486 94.44 29.78 64.66 Y70487 114.78 39.37 75.40 Y70488 139.98 44.61 95.37 Y70490 105.93 41.35 64.58 Y70491 127.86 44.59 83.28 Y70492 153.97 52.22 101.75 Y70496 223.09 68.24 154.85 Y
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
2018 Radiology Fee Schedule 2 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
70498 224.25 68.76 155.50 Y70540 182.51 46.60 135.91 Y70542 220.39 56.96 163.43 Y70543 253.77 68.75 185.02 Y70544 202.05 41.43 160.62 Y70545 223.22 44.68 178.54 Y70546 302.99 47.45 255.54 Y70547 201.55 41.51 160.03 Y70548 211.18 50.39 160.78 Y70549 315.18 57.88 257.31 Y70551 189.80 62.62 127.18 Y70552 207.95 59.26 148.69 Y70553 250.14 77.31 172.82 Y70555 348.00 69.60 278.40 Y70557 402.85 80.57 322.28 Y70558 442.75 88.55 354.20 Y70559 445.65 89.13 356.52 Y71045 12.63 5.88 6.7571046 19.23 6.98 12.2571047 24.50 8.96 15.5571048 26.26 10.28 15.9971100 20.60 7.07 13.5471101 22.81 8.37 14.4471110 23.49 8.77 14.7271111 29.72 10.65 19.0771120 18.39 6.40 11.9971130 21.48 6.80 14.6871250 102.63 37.61 65.03 Y71260 123.53 40.03 83.50 Y71270 147.87 44.59 103.29 Y71275 188.59 58.54 130.05 Y71550 212.43 50.71 161.72 Y71551 286.66 55.68 230.98 Y71552 351.94 72.64 279.30 Y71555 250.66 57.50 193.16 Y72020 13.74 4.84 8.8972040 20.60 7.07 13.5472050 28.36 10.12 18.2472052 35.00 11.68 23.3272070 21.26 7.14 14.1272072 21.48 6.85 14.6372074 24.37 6.94 17.4372080 19.05 6.47 12.5972081 24.37 8.64 15.7272082 38.98 10.38 28.60
2018 Radiology Fee Schedule 3 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
72083 42.32 10.56 31.7672084 50.28 12.71 37.5772100 21.93 7.15 14.7972110 30.57 10.13 20.4472114 38.74 10.65 28.0972120 25.26 7.10 18.1672125 107.10 34.37 72.72 Y72126 143.10 39.37 103.72 Y72127 169.27 40.69 128.58 Y72128 105.12 32.39 72.73 Y72129 143.76 39.37 104.38 Y72130 169.47 40.69 128.77 Y72131 105.12 32.39 72.73 Y72132 143.10 39.37 103.72 Y72133 168.59 40.97 127.62 Y72141 168.52 57.15 111.36 Y72142 209.80 58.92 150.88 Y72146 169.23 57.30 111.92 Y72147 203.76 57.44 146.32 Y72148 167.15 56.69 110.46 Y72149 207.24 59.07 148.17 Y72156 249.21 76.60 172.61 Y72157 239.64 73.52 166.11 Y72158 245.63 75.86 169.76 Y72159 267.99 72.77 195.22 Y72170 19.93 5.60 14.3372190 23.71 6.93 16.7772191 192.26 58.03 134.23 Y72192 91.92 35.03 56.89 Y72193 141.34 37.49 103.85 Y72194 163.11 39.37 123.73 Y72195 196.91 47.00 149.91 Y72196 225.78 57.76 168.02 Y72197 267.78 70.88 196.90 Y72198 251.48 57.22 194.26 Y72200 17.72 5.60 12.1372202 20.60 6.05 14.5572220 17.50 5.53 11.9772240 61.86 29.16 32.7072255 62.23 29.98 32.2672265 58.12 26.52 31.6072270 85.56 45.92 39.6472275 72.22 24.88 47.3472285 68.70 37.26 31.4472295 59.33 26.98 32.36
2018 Radiology Fee Schedule 4 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
73000 17.28 5.31 11.9773010 18.83 5.76 13.0873020 14.40 5.14 9.2673030 18.16 5.96 12.2073040 62.47 17.34 45.1373050 22.15 6.64 15.5173060 18.16 5.38 12.7873070 17.06 5.16 11.9073080 19.49 5.54 13.9573085 58.28 18.01 40.2773090 16.17 5.37 10.8073092 17.25 5.21 12.0373100 18.16 5.17 13.0073110 22.08 5.65 16.4373115 66.46 18.24 48.2273120 16.39 4.97 11.4273130 19.27 5.42 13.8573140 19.71 4.42 15.2973200 105.12 32.39 72.73 Y73201 139.12 37.42 101.69 Y73202 174.10 39.37 134.73 Y73206 205.32 57.48 147.84 Y73218 193.99 43.70 150.28 Y73219 252.86 52.22 200.64 Y73220 312.58 68.97 243.61 Y73221 175.35 51.50 123.85 Y73222 236.37 52.05 184.31 Y73223 293.96 68.87 225.10 Y73225 239.40 63.00 176.40 Y73501 18.61 5.97 12.6473502 25.92 7.16 18.7573503 32.34 9.26 23.0873521 23.62 7.20 16.4273522 30.57 9.69 20.8873523 35.44 10.37 25.0773525 63.58 18.58 45.0073551 17.50 5.38 12.1273552 20.38 5.98 14.4073560 19.27 5.33 13.9573562 22.37 6.05 16.3273564 24.82 7.16 17.6673565 22.37 5.62 16.7673580 71.12 18.15 52.9673590 17.94 5.38 12.5673592 16.59 5.02 11.57
2018 Radiology Fee Schedule 5 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
73600 18.61 5.38 13.2373610 19.71 5.61 14.1173615 62.95 17.48 45.4773620 16.17 4.87 11.3073630 18.16 5.32 12.8473650 16.84 5.09 11.7573660 17.50 4.24 13.2673700 105.12 32.39 72.73 Y73701 141.34 37.49 103.85 Y73702 171.80 39.12 132.67 Y73706 215.73 60.89 154.84 Y73718 192.73 43.70 149.03 Y73719 207.17 52.29 154.88 Y73720 267.19 68.97 198.22 Y73721 179.05 52.58 126.46 Y73722 238.36 52.16 186.20 Y73723 294.18 68.80 225.38 Y73725 251.70 57.88 193.82 Y74018 17.25 5.88 11.3774019 20.99 7.42 13.5774021 24.66 8.89 15.7774022 27.91 10.33 17.5874150 94.50 38.49 56.01 Y74160 144.85 40.91 103.94 Y74170 164.80 45.24 119.56 Y74174 224.90 70.22 154.68 Y74175 192.98 58.10 134.89 Y74176 125.83 55.76 70.07 Y74177 194.72 58.46 136.26 Y74178 219.09 64.41 154.68 Y74181 177.34 47.00 130.34 Y74182 240.48 55.90 184.58 Y74183 268.44 70.88 197.56 Y74185 252.10 57.23 194.87 Y74190 64.75 12.95 51.8074210 46.49 10.97 35.5174220 55.17 14.87 40.3074230 65.30 13.87 51.4274240 70.44 22.25 48.2074241 73.55 22.17 51.3774245 102.10 29.38 72.7274246 79.29 22.18 57.1174247 88.39 22.15 66.2474249 114.75 29.35 85.4074250 64.84 15.21 49.63
2018 Radiology Fee Schedule 6 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
74251 204.16 47.61 156.5574260 168.23 30.82 137.4174270 93.71 22.11 71.6074280 133.36 31.93 101.4474283 122.72 61.35 61.3774290 41.56 9.90 31.6674300 52.36 10.47 41.8974301 29.00 5.80 23.2074328 102.71 20.54 82.1774329 98.60 19.72 78.8874330 130.90 26.18 104.7274340 74.45 14.89 59.5674355 99.35 19.87 79.4874360 80.56 16.11 64.4474363 117.95 23.59 94.3674400 68.80 15.87 52.9374410 66.37 15.11 51.2674415 85.28 15.86 69.4274420 50.35 10.07 40.2874425 50.35 10.07 40.2874430 27.06 11.65 15.4174440 49.83 11.50 38.3374445 146.80 29.36 117.4474450 45.45 9.09 36.3674455 51.17 10.54 40.6374470 72.50 14.50 58.0074485 58.09 16.59 41.5074710 21.44 10.28 11.1574712 235.43 134.44 100.99 Y74713 138.24 55.19 83.05 Y74740 46.74 12.16 34.5874742 79.65 15.93 63.7275557 207.06 74.09 132.97 Y75559 295.97 111.65 184.32 Y75561 272.66 81.78 190.88 Y75563 337.77 97.67 240.10 Y75565 34.24 7.86 26.39 Y75571 58.16 18.98 39.18 Y75572 169.29 52.60 116.69 Y75573 233.10 79.87 153.23 Y75574 230.47 75.79 154.68 Y75600 118.25 15.02 103.2375605 86.39 35.86 50.5375625 85.95 36.43 49.5275630 106.56 56.52 50.04
2018 Radiology Fee Schedule 7 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
75635 231.00 76.32 154.68 Y75705 146.32 69.33 76.9975710 101.46 52.47 48.9975716 116.74 59.26 57.4975726 93.49 35.51 57.9875731 103.37 35.20 68.1775733 114.29 39.91 74.3875736 100.13 35.47 64.6675741 94.66 40.63 54.0375743 106.94 52.25 54.6975746 95.75 35.85 59.9075756 109.97 37.98 72.0075774 54.50 11.25 43.2675801 127.88 25.58 102.3075803 161.45 32.29 129.1675805 105.65 21.13 84.5275807 162.40 32.48 129.9275809 61.81 15.33 46.4875810 157.60 31.52 126.0875820 72.22 22.47 49.7575822 85.73 33.86 51.8875825 84.84 36.52 48.3275827 86.61 36.47 50.1475831 89.03 36.10 52.9375833 98.68 44.88 53.8075840 93.62 36.95 56.6775842 112.34 48.26 64.0875860 85.92 34.33 51.5975870 90.78 35.83 54.9575872 102.91 40.62 62.2975880 79.07 22.62 56.4575885 94.85 42.24 52.6275887 99.06 43.93 55.1375889 89.94 34.96 54.9875891 91.20 35.63 55.5775893 74.45 17.31 57.1475894 195.35 39.07 156.2875898 231.05 46.21 184.8475901 110.76 15.02 95.7375902 45.06 12.23 32.8275956 967.70 193.54 774.1675957 830.40 166.08 664.3275958 551.05 110.21 440.8475959 463.70 92.74 370.9675970 110.20 22.04 88.16
2018 Radiology Fee Schedule 8 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
75984 66.23 22.23 44.0075989 72.31 35.44 36.8876000 34.33 6.62 27.7176010 16.39 5.81 10.5876080 34.56 16.67 17.8976098 10.42 5.00 5.4276100 57.90 20.58 37.3276101 85.77 24.75 61.0276102 105.58 25.35 80.2376120 54.10 10.74 43.3676125 36.70 7.34 29.3676376 23.10 9.84 13.2676377 44.75 25.41 19.3476380 75.51 34.14 41.37 Y76390 241.88 38.28 203.59 Y76496 Y76497 Y76498 Y76499 Y76506 74.39 20.80 53.5976510 87.00 45.62 41.3876511 51.56 26.99 24.5676512 47.48 27.18 20.3176513 59.59 22.39 37.2076514 9.53 6.02 3.5076516 40.24 15.91 24.3376519 46.72 19.73 26.9876529 47.66 19.68 27.9876536 73.33 17.99 55.3376604 55.61 17.14 38.4776641 66.39 22.92 43.4776642 54.67 21.45 33.2276700 77.09 25.77 51.3176705 57.60 18.81 38.7976706 58.93 17.70 41.2376770 71.33 23.56 47.7776775 42.55 21.33 21.2276776 98.80 24.31 74.4976800 89.94 38.20 51.7476801 77.98 31.96 46.0276802 40.77 26.98 13.7876805 89.94 32.55 57.3876810 58.93 32.18 26.7476811 116.08 63.04 53.0476812 130.03 59.66 70.37
2018 Radiology Fee Schedule 9 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
76813 77.31 39.14 38.1776814 51.39 33.11 18.2876815 53.61 21.02 32.6076816 73.33 28.40 44.9376817 61.59 24.43 37.1576818 78.20 35.08 43.1176819 57.16 25.47 31.6976820 28.60 15.44 13.1676821 58.93 23.33 35.6076825 155.38 47.72 107.6676826 93.65 24.01 69.6576827 42.41 16.38 26.0276828 31.45 16.95 14.4976830 77.09 22.34 54.7576831 75.54 23.75 51.7876856 69.56 22.10 47.4776857 37.33 19.39 17.9476870 48.68 23.25 25.4476872 59.81 21.03 38.7876873 107.66 48.92 58.7376881 64.18 20.26 43.9276882 22.59 9.77 12.8376885 75.58 29.12 46.4676886 58.40 20.20 38.2076930 45.12 17.98 27.1476932 93.65 18.73 74.9276936 166.03 61.83 104.2076937 19.71 9.25 10.4676940 284.20 56.84 227.3676941 188.50 37.70 150.8076942 80.01 43.58 36.4376945 100.69 20.14 80.5676946 20.60 12.50 8.1076965 54.23 39.98 14.2576975 116.95 23.39 93.5676977 4.26 1.65 2.6076998 182.26 36.45 145.8076999 Y77001 52.97 12.13 40.8477002 56.01 17.16 38.8677003 46.02 14.87 31.1677011 275.62 78.22 197.40 Y77012 77.76 36.42 41.34 Y77013 537.50 107.50 430.00 Y77014 75.56 28.34 47.21 Y
2018 Radiology Fee Schedule 10 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
77021 240.76 46.48 194.28 Y77022 583.90 116.78 467.12 Y77053 34.88 10.94 23.9477054 45.94 14.10 31.8477058 331.74 52.44 279.30 Y77059 331.74 52.44 279.30 Y77063 34.78 19.17 15.6177065 76.99 23.22 53.7777066 97.83 28.91 68.9377067 80.18 22.29 57.8977071 30.3577072 14.40 6.01 8.3977073 22.37 9.12 13.2677074 40.32 14.65 25.6777075 54.49 17.26 37.2377076 60.38 22.62 37.7677077 23.27 10.30 12.9777078 65.75 11.22 54.54 Y77080 25.70 6.34 19.3577081 17.50 6.82 10.6877084 238.31 61.07 177.24 Y77085 34.28 9.34 24.9477086 19.72 4.86 14.8777261 46.0677262 69.5077263 104.3477280 126.79 16.81 109.9877285 224.25 27.89 196.3577290 324.31 51.17 273.1577293 287.63 64.22 223.4177295 308.36 139.68 168.6877300 41.87 20.33 21.5377301 1,228.14 260.08 968.0677306 88.30 42.93 45.3777307 172.91 89.70 83.2177316 113.25 43.76 69.4877317 148.18 57.03 91.1577318 214.14 90.27 123.8777321 58.49 30.98 27.5077331 40.32 28.34 11.9777332 37.42 15.27 22.1577333 35.09 14.09 21.0077334 82.09 38.40 43.6977336 30.7577338 319.00 139.46 179.54
2018 Radiology Fee Schedule 11 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
77370 76.6577371 593.7277372 549.7877373 856.2077385 130.4277386 151.6577387 45.0377399 Y77401 14.4477402 84.8877407 118.8977412 126.4177417 6.8677423 151.6577427 116.7477431 64.2477432 262.9677435 396.3177470 87.13 67.40 19.7377499 Y77520 712.03 Y77522 731.18 Y77523 699.39 Y77525 669.40 Y77600 260.29 43.36 216.9377605 467.28 66.66 400.6277610 445.52 38.93 406.5977615 589.86 54.73 535.1377620 301.68 58.95 242.7377750 222.67 154.64 68.0477761 244.16 124.54 119.6177762 323.03 185.93 137.0977763 455.60 277.21 178.3977767 134.84 32.55 102.2877768 211.19 43.67 167.5277770 201.59 63.17 138.4277771 375.49 123.74 251.7577772 547.00 167.31 379.6977778 514.92 283.69 231.2377789 74.66 36.90 37.7677790 36.2977799 Y78012 52.06 6.04 46.0378013 117.82 11.11 106.7178014 156.62 15.87 140.75
2018 Radiology Fee Schedule 12 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
78015 136.11 20.04 116.0878016 168.50 19.86 148.6478018 192.90 25.06 167.8378020 51.47 16.70 34.7678070 117.63 15.14 102.5078071 221.19 35.91 185.2878075 255.44 20.86 234.5878099 Y78102 104.64 16.14 88.5078103 129.00 20.65 108.3578104 147.91 22.90 125.0078110 52.74 5.22 47.5378111 50.23 6.06 44.1778120 49.66 6.31 43.3578121 49.17 7.59 41.5878122 58.50 12.72 45.7878130 88.31 16.00 72.3178135 184.84 16.88 167.9678140 72.98 16.00 56.9878185 111.02 10.72 100.3078191 88.31 16.00 72.3178195 230.84 37.75 193.0878199 Y78201 111.08 12.22 98.8678202 109.73 12.76 96.9678205 113.98 17.80 96.1978206 221.75 29.83 191.9278215 125.83 15.59 110.2478216 80.59 17.26 63.3378226 214.43 23.47 190.9778227 290.86 28.71 262.1578230 103.20 13.48 89.7278231 68.14 13.80 54.3478232 61.39 11.77 49.6278258 120.36 19.37 100.9978261 130.59 18.20 112.3978262 134.54 18.19 116.3578264 208.03 23.70 184.3378265 245.22 30.92 214.3078266 292.64 32.65 259.9978267 9.8078268 84.5078270 50.81 5.15 45.6678271 47.47 5.44 42.0378272 52.08 7.42 44.67
2018 Radiology Fee Schedule 13 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
78278 187.18 25.93 161.2578282 49.25 9.85 39.4078290 206.31 20.68 185.6378299 Y78300 117.41 15.83 101.5878305 142.92 20.75 122.1778306 162.82 22.65 140.1778315 224.18 31.96 192.2278320 140.58 30.54 110.0478350 17.98 5.73 12.2578399 Y78414 59.10 11.82 47.2878428 109.70 22.25 87.4678445 102.81 13.57 89.2378451 194.22 37.74 156.4778452 305.26 50.19 255.0778453 168.99 27.04 141.9578454 147.87 22.25 125.6278456 200.93 30.98 169.9478457 121.52 23.43 98.0978458 111.47 24.30 87.1878459 193.35 38.67 154.68 Y78466 112.98 19.82 93.1678468 119.15 23.52 95.6378469 135.30 26.08 109.2278472 147.98 30.74 117.2478473 186.53 45.11 141.4278481 107.40 28.89 78.5178483 147.73 42.78 104.9578491 195.30 39.06 156.24 Y78492 245.55 49.11 196.44 Y78494 138.46 35.12 103.3478496 28.14 15.35 12.7978499 Y78579 115.27 14.51 100.7678580 133.22 20.20 113.0278582 216.88 33.90 182.9778597 112.35 19.34 93.0178598 189.71 25.28 164.4378599 Y78600 109.31 13.06 96.2578601 139.12 16.07 123.0578605 129.14 17.19 111.9678606 198.32 18.62 179.7078607 216.93 36.15 180.78
2018 Radiology Fee Schedule 14 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
78608 1,150.50 39.44 1,111.06 Y78609 1,146.79 40.66 1,106.13 Y78610 105.36 9.06 96.2978630 209.50 20.74 188.7578635 201.87 18.35 183.5278645 172.65 14.61 158.0378647 218.42 27.94 190.4778650 176.49 16.00 160.4978660 112.65 15.99 96.6678699 Y78700 106.34 13.48 92.8678701 130.37 14.31 116.0678707 150.63 29.74 120.8978708 113.64 37.65 75.9978709 236.15 43.45 192.7078710 121.72 17.57 104.1478725 65.98 11.14 54.8478730 43.75 4.50 39.2478740 121.17 14.98 106.1878761 128.89 21.53 107.3678799 Y78800 113.05 19.84 93.2178801 159.67 24.20 135.4778802 200.98 25.45 175.5378803 221.31 32.99 188.3278804 366.85 33.23 333.6278805 118.51 22.98 95.5478806 205.66 25.46 180.2078807 201.08 30.11 170.9778808 24.9478811 1,150.50 42.34 1,108.16 Y78812 1,150.50 51.62 1,098.88 Y78813 1,151.78 50.85 1,100.85 Y78814 1,151.78 59.55 1,092.23 Y78815 1,036.60 58.99 977.62 Y78816 1,151.78 66.12 1,085.66 Y78999 Y79005 86.39 55.63 30.7679101 90.61 60.58 30.0379200 84.58 52.39 32.1979300 208.60 41.72 166.8879403 109.89 62.83 47.0679440 78.27 52.39 25.8879445 316.10 63.22 252.8879999 Y
2018 Radiology Fee Schedule 15 / 16
Procedure Mod FSI PCI TCI PA
RADIOLOGY FEE SCHEDULEEffective January 1, 2018
A4641 YA9500 150.00A9502 143.66A9505 71.37A9552 150.00A9600 879.75 YA9699 YR0070 21.83
2018 Radiology Fee Schedule 16 / 16
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