| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $24 | $28 | $31 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $20 | $22 | $25 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $20 | $20 | $20 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $22 | $22 | $22 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $28 | $28 | $28 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $24 | $24 | $24 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $20 | $21 | $22 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $9 | $10 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $13 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $316 | $316 | $316 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $230 | $230 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $99 | $99 | $99 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $19 | $19 |
| MMR vaccine CPT 90707 • Preventive Care | $91 | $91 | $91 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $40 | $40 | $40 |
| Varicella vaccine CPT 90716 • Preventive Care | $184 | $184 | $184 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $176 | $197 | $219 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $87 | $94 | $101 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $113 | $113 | $113 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $94 | $103 | $113 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $107 | $119 | $127 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $119 | $133 | $152 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $132 | $139 | $147 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $55 | $77 | $100 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $89 | $89 | $89 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $102 | $102 | $102 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $97 | $97 | $97 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $99 | $99 | $99 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $98 | $98 | $98 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $107 | $112 | $116 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $119 | $198 | $241 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $195 | $195 | $195 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $126 | $126 | $126 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $130 | $130 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $88 | $95 | $103 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $45 | $45 | $45 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $45 | $45 | $45 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $45 | $45 | $45 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $139 | $139 | $139 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $73 | $73 | $73 |
| Spirometry CPT 94010 • Pulmonology | $19 | $36 | $45 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $32 | $39 | $45 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $45 | $45 | $45 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $45 | $45 | $45 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $6 | $6 | $6 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $17 | $17 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $11 | $31 | $42 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $34 | $34 | $34 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $46 | $46 | $46 |