fee schedule 2009 new - DE Medical Assistance Program

73040 3 CONTRAST X-RAY OF SHOULDER 111.94
73041 O RADIOLOGIC EXAMINATION, SHOULDER, A 0.00
73050 3 X-RAY EXAM OF SHOULDERS 37.13
73060 3 X-RAY EXAM OF HUMERUS 30.86
73070 3 X-RAY EXAM OF ELBOW 27.93
73080 3 X-RAY EXAM OF ELBOW 34.40
73085 3 CONTRAST X-RAY OF ELBOW 104.07
73086 O RADIOLOGIC EXAMINATION, ELBOW, ARTH 0.00
73090 3 X-RAY EXAM OF FOREARM 28.31
73092 3 X-RAY EXAM OF ARM, INFANT 28.31
73100 3 X-RAY EXAM OF WRIST 28.70
73110 3 X-RAY EXAM OF WRIST 33.42
73115 3 CONTRAST X-RAY OF WRIST 102.30
73116 O RADIOLOGIC EXAMINATION, WRIST, ARTH 0.00
73120 3 X-RAY EXAM OF HAND 27.92
73130 3 X-RAY EXAM OF HAND 31.45
73140 3 X-RAY EXAM OF FINGER(S) 27.55
73200 3 CT UPPER EXTREMITY W/O DYE 249.15
73201 3 CT UPPER EXTREMITY W/DYE 329.27
73202 3 CT UPPR EXTREMITY W/O&W/DYE 391.69
73206 3 CT ANGIO UPR EXTRM W/O&W/DYE 425.29
73218 3 MRI UPPER EXTREMITY W/O DYE 417.55
73219 3 MRI UPPER EXTREMITY W/DYE 485.82
73220 3 MRI UPPR EXTREMITY W/O&W/DYE 641.94
73221 3 MRI JOINT UPR EXTREM W/O DYE 417.45
73222 3 MRI JOINT UPR EXTREM W/DYE 485.72
73223 3 MRI JOINT UPR EXTR W/O&W/DYE 641.45
73225 3 MR ANGIO UPR EXTR W/O&W/DYE 596.71
73500 3 X-RAY EXAM OF HIP 26.73
73510 3 X-RAY EXAM OF HIP 36.34
73520 3 X-RAY EXAM OF HIPS 40.63
73525 3 CONTRAST X-RAY OF HIP 103.97
73526 O RADIOLOGIC EXAMINATION, HIP, ARTHRO 0.00
73530 3 X-RAY EXAM OF HIP 36.65
73540 3 X-RAY EXAM OF PELVIS & HIPS 36.74
73542 3 X-RAY EXAM, SACROILIAC JOINT 91.35
73550 3 X-RAY EXAM OF THIGH 30.47
73560 3 X-RAY EXAM OF KNEE, 1 OR 2 29.48
73562 3 X-RAY EXAM OF KNEE, 3 34.39
73564 3 X-RAY EXAM, KNEE, 4 OR MORE 39.09
73565 3 X-RAY EXAM OF KNEES 30.27
73580 3 CONTRAST X-RAY OF KNEE JOINT 128.96
73581 O RADIOLOGIC EXAMINATION, KNEE, ARTHR 0.00
73590 3 X-RAY EXAM OF LOWER LEG 28.70
73592 3 X-RAY EXAM OF LEG, INFANT 28.31
73600 3 X-RAY EXAM OF ANKLE 27.92
73610 3 X-RAY EXAM OF ANKLE 31.45
73615 3 CONTRAST X-RAY OF ANKLE 107.12
73616 O RADIOLOGIC EXAMINATION, ANKLE, ARTH 0.00
73620 3 X-RAY EXAM OF FOOT 27.52