| Preventive visit established patient infant CPT 99391 • Preventive Care | $85 | $111 | $137 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $94 | $124 | $159 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $91 | $105 | $120 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $5 | $73 | $114 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $5 | $95 | $191 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $5 | $96 | $189 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $53 | $101 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $23 | $29 | $35 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $104 | $135 | $165 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $236 | $269 | $301 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $236 | $269 | $302 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $100 | $124 | $148 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $103 | $125 | $148 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $70 | $93 | $116 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $150 | $234 | $318 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $151 | $248 | $345 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $95 | $192 | $326 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $178 | $296 | $413 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $427 | $430 | $433 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $252 | $504 | $947 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $80 | $93 | $106 |
| Spirometry CPT 94010 • Pulmonology | $21 | $31 | $41 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $16 | $34 | $54 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $52 | $61 | $70 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $34 | $39 | $44 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $79 | $111 | $143 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $12 | $16 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $15 | $17 | $19 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $14 | $53 | $98 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $36 | $36 | $37 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $10 | $24 | $48 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $3 | $4 | $5 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $22 | $25 | $29 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $82 | $88 | $94 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $126 | $133 | $141 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $197 | $202 | $207 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $44 | $199 | $353 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $418 | $542 | $666 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $550 | $587 | $625 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $38 | $61 | $84 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $492 | $1,507 | $2,523 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $144 | $169 | $194 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $5 | $55 | $105 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $5 | $788 | $1,571 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $5 | $893 | $1,781 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $200 | $229 | $258 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $5 | $183 | $361 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $223 | $227 | $232 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $125 | $126 | $127 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $5 | $981 | $1,956 |