| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $101 | $109 | $117 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $70 | $75 | $80 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $31 | $42 | $54 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $41 | $44 | $47 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $39 | $39 | $39 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $41 | $45 | $48 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $59 | $59 | $59 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $50 | $50 | $50 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $17 | $23 | $29 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $12 | $17 |
| Immunization admin injection single CPT 90471 • Preventive Care | $19 | $23 | $27 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $11 | $16 | $20 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $336 | $344 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $231 | $244 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $105 | $111 | $117 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $100 | $106 | $111 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $42 | $50 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $196 | $205 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $129 | $140 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $218 | $221 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $55 | $55 | $55 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $99 | $125 | $137 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $115 | $134 | $158 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $71 | $138 | $210 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $101 | $142 | $183 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $147 | $163 | $180 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $132 | $175 | $205 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $143 | $212 | $290 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $111 | $124 | $136 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $67 | $110 | $145 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $84 | $119 | $142 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $96 | $133 | $159 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $89 | $127 | $160 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $85 | $138 | $173 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $126 | $161 | $183 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $47 | $48 | $49 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $208 | $208 | $208 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $121 | $284 | $465 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $223 | $238 | $258 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $180 | $180 | $180 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $185 | $185 | $185 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $125 | $139 | $153 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $167 | $174 | $180 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $447 | $447 | $447 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $204 | $255 | $326 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $215 | $325 | $435 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $123 | $291 | $459 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $304 | $852 | $1,399 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $102 | $102 | $102 |