| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $70 | $73 | $75 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $48 | $50 | $52 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $31 | $32 | $32 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $25 | $26 | $28 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $27 | $27 | $27 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $22 | $25 | $29 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $30 | $35 | $40 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $34 | $34 | $34 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $12 | $19 | $23 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $10 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $12 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $263 | $268 | $274 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $206 | $241 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $82 | $91 | $99 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $18 | $19 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $77 | $89 | $94 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $38 | $39 | $40 |
| Varicella vaccine CPT 90716 • Preventive Care | $153 | $166 | $184 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $94 | $114 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $172 | $182 | $192 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $37 | $37 | $37 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $63 | $95 | $109 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $95 | $105 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $72 | $103 | $118 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $85 | $106 | $124 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $102 | $109 | $116 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $98 | $128 | $148 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $136 | $149 | $161 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $54 | $73 | $83 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $63 | $81 | $102 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $87 | $91 | $102 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $72 | $88 | $114 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $86 | $98 | $111 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $80 | $104 | $123 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $91 | $112 | $132 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $23 | $30 | $36 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $144 | $144 | $144 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $235 | $253 | $272 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $155 | $175 | $195 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $135 | $135 | $135 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $134 | $138 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $94 | $117 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $199 | $265 | $330 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $110 | $236 | $361 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $155 | $181 | $207 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $130 | $244 | $359 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $139 | $288 | $426 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $184 | $184 | $184 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $76 | $76 | $76 |