| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $71 | $79 | $87 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $87 | $87 | $87 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $49 | $54 | $60 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $30 | $31 | $31 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $23 | $26 | $28 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $22 | $24 | $27 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $23 | $26 | $29 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $40 | $40 | $41 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $29 | $31 | $36 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $22 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $8 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $15 | $19 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $14 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $371 | $371 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $251 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $10 | $77 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $23 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $75 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $48 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $195 | $203 | $217 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $20 | $95 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $120 | $183 | $244 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $63 | $63 | $63 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $106 | $116 | $135 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $111 | $121 | $141 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $103 | $111 | $116 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $131 | $148 | $165 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $126 | $143 | $160 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $115 | $149 | $185 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $159 | $180 | $200 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $121 | $121 | $121 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $73 | $82 | $91 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $102 | $116 | $129 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $103 | $107 | $112 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $144 | $144 | $144 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $121 | $132 | $153 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $99 | $132 | $165 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $4 | $25 | $39 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $185 | $205 | $225 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $338 | $376 | $414 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $414 | $414 | $414 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $168 | $181 | $206 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $179 | $206 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $140 | $161 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $294 | $298 | $304 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $326 | $330 | $335 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $32 | $172 | $312 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $413 | $417 | $425 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $105 | $160 | $214 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,477 | $1,483 | $1,496 |