| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $70 | $72 | $74 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $70 | $70 | $70 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $48 | $50 | $52 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $29 | $30 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $24 | $27 | $30 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $24 | $27 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $25 | $27 | $29 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $33 | $35 | $36 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $29 | $30 | $31 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $21 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $8 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $16 | $21 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $10 | $11 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $332 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $244 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $102 | $103 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $100 | $103 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $44 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $193 | $195 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $125 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $218 | $220 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $39 | $39 | $39 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $92 | $100 | $104 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $97 | $102 | $108 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $74 | $93 | $112 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $87 | $116 | $135 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $111 | $116 | $122 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $128 | $163 | $199 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $139 | $146 | $153 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $60 | $61 | $62 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $89 | $89 | $89 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $69 | $79 | $89 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $97 | $97 | $97 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $76 | $87 | $99 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $106 | $112 | $117 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $19 | $77 | $126 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $23 | $28 | $33 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $33 | $43 | $54 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $110 | $147 | $184 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $324 | $324 | $324 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $99 | $102 | $107 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $98 | $120 | $142 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $77 | $86 | $95 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $260 | $266 | $269 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $275 | $286 | $297 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $259 | $259 | $259 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $279 | $329 | $379 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $165 | $165 | $165 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $752 | $1,068 | $1,383 |