| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $75 | $78 | $81 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $75 | $78 | $81 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $28 | $45 | $55 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $29 | $34 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $26 | $27 | $30 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $25 | $26 | $29 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $28 | $30 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $30 | $37 | $43 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $33 | $34 | $37 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $12 | $17 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $8 | $13 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $1 | $10 | $16 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $312 | $321 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $235 | $245 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $42 | $70 | $99 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $2 | $16 | $21 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $59 | $94 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $33 | $47 |
| Varicella vaccine CPT 90716 • Preventive Care | $20 | $109 | $184 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $25 | $54 | $111 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $205 | $217 | $239 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $44 | $44 | $44 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $5 | $69 | $109 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $8 | $66 | $112 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $60 | $89 | $118 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $98 | $121 | $133 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $69 | $92 | $110 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $125 | $137 | $149 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $78 | $108 | $137 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $51 | $83 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $5 | $66 | $103 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $5 | $68 | $103 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $13 | $74 | $113 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $6 | $64 | $99 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $115 | $117 | $123 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $10 | $83 | $133 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $4 | $25 | $36 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $151 | $161 | $171 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $28 | $166 | $323 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $41 | $182 | $323 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $136 | $144 | $160 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $135 | $145 | $164 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $111 | $121 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $108 | $207 | $276 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $30 | $198 | $300 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $133 | $163 | $211 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $17 | $244 | $379 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $143 | $250 | $357 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $654 | $1,011 | $1,308 |