| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $51 | $96 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $75 | $89 | $102 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $75 | $88 | $101 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $5 | $58 | $111 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $5 | $60 | $114 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $95 | $108 | $122 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $68 | $131 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $35 | $36 | $38 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $165 | $174 | $183 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $301 | $320 | $338 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $302 | $320 | $338 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $148 | $155 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $148 | $155 | $163 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $116 | $122 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $243 | $258 | $272 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $273 | $287 | $301 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $252 | $266 | $280 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $348 | $365 | $383 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $371 | $390 | $409 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $242 | $760 | $1,278 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $92 | $93 |
| Spirometry CPT 94010 • Pulmonology | $25 | $26 | $27 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $24 | $37 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $32 | $33 | $33 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $22 | $23 | $24 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $69 | $75 | $82 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $9 | $9 | $10 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $16 | $16 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $52 | $53 | $54 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $30 | $31 | $31 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $55 | $56 | $56 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $2 | $2 | $2 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $25 | $25 | $25 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $69 | $71 | $72 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $105 | $108 | $110 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $164 | $168 | $172 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $229 | $243 | $257 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $366 | $402 | $439 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $231 | $344 | $457 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $34 | $48 | $62 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $1,398 | $1,573 | $1,747 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $62 | $90 | $119 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $77 | $81 | $85 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $1,058 | $1,077 | $1,097 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $5 | $485 | $964 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $5 | $89 | $172 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $5 | $117 | $228 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $186 | $190 | $195 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $104 | $107 | $109 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $5 | $418 | $831 |