| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $97 | $128 | $159 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $66 | $96 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $56 | $88 | $107 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $5 | $60 | $101 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $85 | $104 | $116 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $5 | $68 | $114 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $5 | $85 | $129 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $105 | $127 | $144 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $38 | $41 | $45 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $65 | $119 | $183 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $227 | $334 | $437 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $338 | $380 | $422 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $119 | $141 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $187 | $212 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $134 | $141 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $243 | $319 | $366 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $273 | $352 | $403 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $171 | $259 | $354 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $348 | $375 | $399 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $222 | $349 | $453 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $306 | $874 | $1,278 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $83 | $87 | $91 |
| Spirometry CPT 94010 • Pulmonology | $8 | $11 | $17 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $21 | $37 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $28 | $38 | $59 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $23 | $36 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $69 | $103 | $150 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $12 | $15 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $15 | $16 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $48 | $53 | $58 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $32 | $36 | $42 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $50 | $54 | $58 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $2 | $4 | $5 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $5 | $17 | $25 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $69 | $73 | $78 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $105 | $110 | $119 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $157 | $166 | $176 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $167 | $199 | $257 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $86 | $303 | $439 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $457 | $766 | $1,084 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $48 | $54 | $62 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $391 | $1,309 | $1,789 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $68 | $101 | $119 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $77 | $88 | $96 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $1,058 | $1,148 | $1,274 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $5 | $924 | $1,804 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $5 | $116 | $172 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $5 | $143 | $228 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $179 | $190 | $205 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $93 | $101 | $106 |