| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $76 | $81 | $84 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $76 | $79 | $83 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $52 | $56 | $58 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $32 | $35 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $27 | $29 | $30 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $26 | $27 | $30 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $30 | $32 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $30 | $36 | $40 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $34 | $35 | $37 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $15 | $24 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $9 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $20 | $34 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $12 | $15 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $316 | $322 | $329 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $257 | $258 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $92 | $96 | $102 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $14 | $68 | $97 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $34 | $40 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $24 | $141 | $192 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $13 | $65 | $117 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $187 | $212 | $225 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $46 | $46 | $46 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $92 | $110 | $134 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $90 | $113 | $140 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $115 | $124 | $146 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $112 | $135 | $164 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $109 | $126 | $142 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $144 | $151 | $164 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $137 | $166 | $202 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $91 | $118 | $142 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $10 | $85 | $128 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $102 | $112 | $129 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $83 | $113 | $141 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $92 | $121 | $143 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $115 | $129 | $154 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $99 | $124 | $166 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $27 | $36 | $45 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $184 | $209 | $234 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $169 | $279 | $413 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $234 | $234 | $234 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $163 | $176 | $201 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $177 | $206 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $121 | $125 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $129 | $327 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $30 | $197 | $364 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $30 | $187 | $341 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $30 | $139 | $356 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $26 | $370 | $590 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,278 | $1,341 | $1,468 |