Radiology Benefits
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Radiology Applicable Codes
Arms and Shoulders
| Tariff Code | Description |
| 61100 | X-Ray Of The Left Clavicle |
| 61105 | X-Ray Of The Right Clavicle |
| 61110 | X-Ray Of The Left Scapula |
| 61115 | X-Ray Of The Right Scapula |
| 61120 | X-Ray Of The Left Acromio-Clavicular Joint |
| 61125 | X-Ray Of The Right Acromio-Clavicular Joint |
| 61130 | X-Ray Of The Left Shoulder |
| 61135 | X-Ray Of The Right Shoulder |
| 62100 | X-Ray Of The Left Humerus |
| 62105 | X-Ray Of The Right Humerus |
| 63100 | X-Ray Of The Left Elbow |
| 63105 | X-Ray Of The Right Elbow |
| 64100 | X-Ray Of The Left Forearm |
| 64105 | X-Ray Of The Right Forearm |
Hand and Wrist
| Tariff Code | Description |
| 65100 | X-Ray Of The Left Hand |
| 61105 | X-Ray Of The Right Hand |
| 65120 | X-Ray Of A Finger |
| 65130 | X-Ray Of The Left Wrist |
| 65135 | X-Ray Of The Right Wrist |
| 65140 | X-Ray Of The Left Scaphoid |
| 65145 | X-Ray Of The Right Scaphoid |
Legs and Knees
| Tariff Code | Description |
| 71100 | X-Ray Of The Left Femur |
| 71105 | X-Ray Of The Right Femur |
| 72100 | X-Ray Of The Left Knee One Or Two Views |
| 72105 | X-Ray Of The Right Knee One Or Two Views |
| 73100 | X-Ray Of The Left Lower Leg |
| 73105 | X-Ray Of The Right Lower Leg |
| 72150 | X-Ray Both Knees Standing – Single View |
Foot and Ankle
| Tariff Code | Description |
| 74145 | X-Ray Of A Toe |
| 74100 | X-Ray Of The Left Ankle |
| 74105 | X-Ray Of The Right Ankle |
| 74120 | X-Ray Of The Left Foot |
| 74125 | X-Ray Of The Right Foot |
| 74130 | X-Ray Of The Left Calcaneus |
| 74135 | X-Ray Of The Right Calcaneus |
Chest
| Tariff Code | Description |
| 30100 | X-Ray Of The Chest, Single View |
| 30110 | X-Ray Of The Chest Two Views, PA & Lateral |
| 30150 | X-Ray Of The Ribs |
| 30155 | X-Ray Of The Chest And Ribs |
Pregnancy: 2 Per Pregnancy
| Tariff Code | Description |
| 43250 | Ultrasound Of The Pregnant Uterus, First Trimester |
Spine
| Tariff Code | Description |
| 51110 | X-Ray Of The Cervical Spine, 1 Or 2 Views |
| 52100 | X-Ray Of The Thoracic Spine,1 Or 2 Views |
| 53110 | X-Ray Of The Lumbar Spine, 1 Or 2 Views |
Abdomen
| Tariff Code | Description |
| 40100 | X-Ray Of The Abdomen |
| 40105 | X-Ray Of The Abdomen Supine & Erect, Or Decubitus |
Pelvis and Hip
| Tariff Code | Description |
| 55100 | X-Ray Of The Pelvis |
| 56100 | X-Ray Of The Left Hip |
| 56110 | X-Ray Of The Right Hip |
| 56120 | X-Ray Pelvis And Hips |
To download a copy of the Pathology benefit information click on the download button below.
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