2010 HCPCS Schedule - DE Medical Assistance Program

77031 STEREOTACT GUIDE FOR BRST BX 3 $173.18
77032 GUIDANCE FOR NEEDLE, BREAST 3 $57.10
77051 COMPUTER DX MAMMOGRAM ADD-ON 3 $11.75
77052 COMP SCREEN MAMMOGRAM ADD-ON 3 $11.75
77053 X-RAY OF MAMMARY DUCT 3 $70.33
77054 X-RAY OF MAMMARY DUCTS 3 $94.66
77055 MAMMOGRAM, ONE BREAST 3 $84.76
77056 MAMMOGRAM, BOTH BREASTS 3 $108.22
77057 MAMMOGRAM, SCREENING 3 $80.61
77058 MRI, ONE BREAST 3 $764.55
77059 MRI, BOTH BREASTS 3 $806.12
77071 X-RAY STRESS VIEW 3 $42.29
77072 X-RAYS FOR BONE AGE 3 $23.30
77073 X-RAYS, BONE LENGTH STUDIES 3 $37.68
77074 X-RAYS, BONE SURVEY, LIMITED 3 $68.20
77075 X-RAYS, BONE SURVEY COMPLETE 3 $99.84
77076 X-RAYS, BONE SURVEY, INFANT 3 $95.34
77077 JOINT SURVEY, SINGLE VIEW 3 $41.79
77078 CT BONE DENSITY, AXIAL 3 $87.11
77079 CT BONE DENSITY, PERIPHERAL 3 $53.88
77080 DXA BONE DENSITY, AXIAL 3 $98.16
77081 DXA BONE DENSITY/PERIPHERAL 3 $28.94
77082 DXA BONE DENSITY, VERT FX 3 $27.53
77083 RADIOGRAPHIC ABSORPTIOMETRY 3 $25.19
77084 MAGNETIC IMAGE, BONE MARROW 3 $440.27
77261 RADIATION THERAPY PLANNING 3 $72.90
77262 RADIATION THERAPY PLANNING 3 $110.13
77263 RADIATION THERAPY PLANNING 3 $163.59
77280 SET RADIATION THERAPY FIELD 3 $186.19
77285 SET RADIATION THERAPY FIELD 3 $323.82
77290 SET RADIATION THERAPY FIELD 3 $511.66
77295 SET RADIATION THERAPY FIELD 3 $613.22
77299 RADIATION THERAPY PLANNING 5 $0.00
77300 RADIATION THERAPY DOSE PLAN 3 $70.63
77301 RADIOTHERAPY DOSE PLAN, IMRT 3 $2,247.48
77305 TELETX ISODOSE PLAN SIMPLE 3 $69.39
77310 TELETX ISODOSE PLAN INTERMED 3 $98.17
77315 TELETX ISODOSE PLAN COMPLEX 3 $146.15
77321 SPECIAL TELETX PORT PLAN 3 $113.55
77326 BRACHYTX ISODOSE CALC SIMP 3 $144.43
77327 BRACHYTX ISODOSE CALC INTERM 3 $204.82
77328 BRACHYTX ISODOSE PLAN COMPL 3 $278.75
77331 SPECIAL RADIATION DOSIMETRY 3 $63.76
77332 RADIATION TREATMENT AID(S) 3 $78.29
77333 RADIATION TREATMENT AID(S) 3 $64.17
77334 RADIATION TREATMENT AID(S) 3 $155.76
77336 RADIATION PHYSICS CONSULT 3 $55.81
77338 DESIGN MLC DEVICE FOR IMRT 3 $493.12
77370 RADIATION PHYSICS CONSULT 3 $116.02