| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $125 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $207 | $211 | $216 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $43 | $43 | $43 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $101 | $102 | $103 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $106 | $107 | $108 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $81 | $91 | $101 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $95 | $110 | $126 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $92 | $94 | $96 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $112 | $130 | $149 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $120 | $120 | $120 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $65 | $78 | $91 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $72 | $77 | $82 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $72 | $88 | $104 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $81 | $93 | $106 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $83 | $83 | $83 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $105 | $111 | $117 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $102 | $114 | $126 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $26 | $29 | $32 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $134 | $134 | $134 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $378 | $378 | $378 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $209 | $209 | $209 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $120 | $120 | $120 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $159 | $159 | $159 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $113 | $121 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $300 | $300 | $300 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $142 | $142 | $142 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $300 | $300 | $300 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $165 | $165 | $165 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $371 | $371 | $371 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $820 | $820 | $820 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $89 | $89 | $89 |
| Spirometry CPT 94010 • Pulmonology | $25 | $26 | $26 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $12 | $25 | $37 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $28 | $28 | $28 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $21 | $28 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $89 | $89 | $89 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $6 | $11 | $16 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $15 | $15 | $16 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $38 | $46 | $54 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $28 | $32 | $37 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $42 | $44 | $46 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $3 | $3 | $3 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $14 | $14 | $14 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $53 | $61 | $69 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $103 | $103 | $103 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $127 | $140 | $152 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $28 | $31 | $33 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $63 | $245 | $426 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $255 | $255 | $255 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $25 | $44 | $64 |