| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $287 | $287 | $287 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $232 | $232 | $232 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $59 | $59 | $59 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $285 | $285 | $285 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $524 | $524 | $524 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $262 | $262 | $262 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $253 | $253 | $253 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $253 | $253 | $253 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $197 | $197 | $197 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $606 | $606 | $606 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $680 | $680 | $680 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $327 | $327 | $327 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $868 | $868 | $868 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $924 | $924 | $924 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $3,182 | $3,182 | $3,182 |
| Laparoscopic partial nephrectomy CPT 50543 • Urology | $3,617 | $3,617 | $3,617 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $3,241 | $3,241 | $3,241 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $1,808 | $1,808 | $1,808 |
| Complex uroflowmetry CPT 51741 • Urology | $21 | $21 | $21 |
| Post-void residual urine measurement CPT 51798 • Urology | $25 | $25 | $25 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $592 | $592 | $592 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $594 | $594 | $594 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $695 | $695 | $695 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $509 | $509 | $509 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $992 | $992 | $992 |
| Cystourethroscopy with lithotripsy CPT 52353 • Urology | $946 | $946 | $946 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $1,770 | $1,770 | $1,770 |
| Laser vaporization of prostate CPT 52648 • Urology | $3,985 | $3,985 | $3,985 |
| Circumcision CPT 54150 • Urology | $30 | $30 | $30 |
| Orchiectomy simple CPT 54520 • Urology | $797 | $797 | $797 |
| Orchiectomy radical inguinal CPT 54530 • Urology | $1,235 | $1,235 | $1,235 |
| Vasectomy CPT 55250 • Urology | $553 | $553 | $553 |
| Radical prostatectomy retropubic CPT 55840 • Urology | $2,839 | $2,839 | $2,839 |
| Laparoscopic radical prostatectomy CPT 55866 • Urology | $3,498 | $3,498 | $3,498 |