| Family |
Imaging Modality/Contiguous Body Area |
| Family 1 Ultrasound (Chest/Abdomen/Pelvis - Non-Obstetrical ) |
| 76604 |
US exam, chest, b-scan |
| 76645 |
US exam, breast(s) |
| 76700 |
US exam, abdom, complete |
| 76705 |
Echo exam of abdomen |
| 76770 |
US exam abdo back wall, comp |
| 76775 |
US exam abdo back wall, lim |
| 76778 |
US exam kidney transplant |
| 76830 |
Transvaginal us, non-ob |
| 76831 |
Echo exam, uterus |
| 76856 |
US exam, pelvic, complete |
| 76857 |
US exam, pelvic, limited |
| Family 2 CT and CTA (Chest/Thorax/Abd/Pelvis) |
| 71250 |
CT thorax w/o dye |
| 71260 |
CT thorax w/ dye |
| 71270 |
CT thorax w/o & w/ dye |
| 72192 |
CT pelvis w/o dye |
| 72193 |
CT pelvis w/ dye |
| 72194 |
CT pelvis w/o & w/ dye |
| 74150 |
CT abdomen w/o dye |
| 74160 |
CT abdomen w/ dye |
| 74170 |
CT abdomen w/o & w/ dye |
| 71275 |
CT angiography, chest |
| 72191 |
CT angiography, pelv w/o & w/ dye |
| 74175 |
CT angiography, abdom w/o & w/ dye |
| 75635 |
CT angio abdominal arteries |
| 0067T |
CT colonography; dx |
| Family 3 CT and CTA (Head/Brain/Orbit/Maxillofacial/Neck) |
| 70450 |
CT head/brain w/o dye |
| 70460 |
CT head/brain w/ dye |
| 70470 |
CT head/brain w/o & w/ dye |
| 70480 |
CT orbit/ear/fossa w/o dye |
| 70481 |
CT orbit/ear/fossa w/ dye |
| 70482 |
CT orbit/ear/fossa w/o & w/ dye |
| 70486 |
CT maxillofacial w/o dye |
| 70487 |
CT maxillofacial w/ dye |
| 70488 |
CT maxillofacial w/o & w/ dye |
| 70490 |
CT soft tissue neck w/o dye |
| 70491 |
CT soft tissue neck w/ dye |
| 70492 |
CT soft tissue neck w/o & w/ dye |
| 70496 |
CT angiography, head |
| 70498 |
CT angiography, neck |
| Family 4 MRI and MRA (Chest/Abd/Pelvis) |
| 71550 |
MRI chest w/o dye |
| 71551 |
MRI chest w/ dye |
| 71552 |
MRI chest w/o & w/ dye |
| 72195 |
MRI pelvis w/o dye |
| 72196 |
MRI pelvis w/dye |
| 72197 |
MRI pelvis w/o &w/ dye |
| 74181 |
MRI abdomen w/o dye |
| 74182 |
MRI abdomen w/ dye |
| 74183 |
MRI abdomen w/o and w/ dye |
| 71555 |
MRI angio chest w/ or w/o dye |
| 72198 |
MRI angio pelvis w/ or w/o dye |
| 74185 |
MRI angio, abdom w/ or w/o dye |
| Family 5 MRI and MRA (Head/Brain/Neck) |
| 70540 |
MRI orbit/face/neck w/o dye |
| 70542 |
MRI orbit/face/neck w/ dye |
| 70543 |
MRI orbit/face/neck w/o & w/dye |
| 70551 |
MRI brain w/o dye |
| 70552 |
MRI brain w/dye |
| 70553 |
MRI brain w/o & w/dye |
| 70544 |
MR angiography head w/o dye |
| 70545 |
MR angiography head w/dye |
| 70546 |
MR angiography head w/o & w/dye |
| 70547 |
MR angiography neck w/o dye |
| 70548 |
MR angiography neck w/dye |
| 70549 |
MR angiography neck w/o & w/dye |
| Family 6 MRI and MRA (Spine) |
| 72141 |
MRI neck spine w/o dye |
| 72142 |
MRI neck spine w/dye |
| 72146 |
MRI chest spine w/o dye |
| 72147 |
MRI chest spine w/dye |
| 72148 |
MRI lumbar spine w/o dye |
| 72149 |
MRI lumbar spine w/dye |
| 72156 |
MRI neck spine w/o & w/dye |
| 72157 |
MRI chest spine w/o & w/dye |
| 72158 |
MRI lumbar spine w/o & w/dye |
| Family 7 (CT Spine) |
| 72125 |
CT neck spine w/o dye |
| 72126 |
CT neck spine w/dye |
| 72127 |
CT neck spine w/o & w/dye |
| 72128 |
CT chest spine w/o dye |
| 72129 |
CT chest spine w/dye |
| 72130 |
CT chest spine w/o & w/dye |
| 72131 |
CT lumbar spine w/o dye |
| 72132 |
CT lumbar spine w/dye |
| 72133 |
CT lumbar spine w/o & w/dye |
| Family 8 MRI and MRA (Lower Extremities) |
| 73718 |
MRI lower extremity w/o dye |
| 73719 |
MRI lower extremity w/dye |
| 73720 |
MRI lower ext w/ & w/o dye |
| 73721 |
MRI joint of lwr extre w/o dye |
| 73722 |
MRI joint of lwr extr w/dye |
| 73723 |
MRI joint of lwr extr w/o & w/dye |
| 73725 |
MRA lower ext w or w/o dye |
| Family 9 CT and CTA (Lower Extremities) |
| 73700 |
CT lower extremity w/o dye |
| 73701 |
CT lower extremity w/dye |
| 73702 |
CT lower extremity w/o & w/dye |
| 73706 |
CT angio lower ext w/o & w/dye |
| Family 10 MR and MRI (Upper Extremities & Joints) |
| 73218 |
MRI upper extr w/o dye |
| 73219 |
MRI upper extr w/dye |
| 73220 |
MRI upper extremity w/o & w/dye |
| 73221 |
MRI joint upper extr w/o dye |
| 73222 |
MRI joint upper extr w/dye |
| 73223 |
MRI joint upper extr w/o & w/dye |
| Family 11 CT and CTA (Upper Extremities) |
| 73200 |
CT upper extremity w/o dye |
| 73201 |
CT upper extremity w/dye |
| 73202 |
CT upper extremity w/o & w/dye |
| 73206 |
CT angio upper extr w/o & w/dye |
