| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $91 | $101 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $94 | $118 | $145 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $107 | $134 | $164 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $119 | $139 | $159 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $120 | $153 | $185 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $159 | $159 | $159 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $67 | $67 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $11 | $11 | $11 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $83 | $92 | $101 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $91 | $91 | $91 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $99 | $111 | $122 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $20 | $20 | $20 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $27 | $33 | $38 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $126 | $155 | $183 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $36 | $36 | $36 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $90 | $90 | $90 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $126 | $145 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $147 | $163 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $88 | $108 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $118 | $207 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $30 | $30 | $30 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $163 | $163 | $163 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $30 | $30 | $30 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $157 | $264 | $371 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $700 | $989 | $1,278 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $91 | $91 |
| Spirometry CPT 94010 • Pulmonology | $30 | $30 | $30 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $30 | $34 | $37 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $59 | $59 | $59 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $30 | $30 | $30 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $45 | $98 | $150 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $30 | $30 | $30 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $42 | $47 | $52 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $30 | $32 | $34 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $47 | $47 | $47 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $2 | $2 | $2 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $6 | $12 | $19 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $69 | $69 | $69 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $105 | $105 | $105 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $111 | $137 | $164 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $36 | $146 | $257 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $457 | $457 | $457 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $30 | $36 | $42 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $1,774 | $1,774 | $1,774 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $24 | $24 | $24 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $51 | $64 | $77 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $734 | $896 | $1,058 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $718 | $841 | $964 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $172 | $172 | $172 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $30 | $30 | $30 |