| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $70 | $72 | $74 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $70 | $72 | $74 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $47 | $49 | $50 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $24 | $24 | $25 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $25 | $25 | $25 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $23 | $23 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $24 | $24 | $24 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $21 | $24 | $26 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $21 | $22 | $24 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $22 | $23 | $24 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $11 | $12 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $14 | $16 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $12 | $14 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $369 | $382 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $254 | $263 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $115 | $119 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $5 | $14 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $107 | $112 | $117 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $55 | $57 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $215 | $223 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $131 | $136 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $241 | $262 | $282 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $31 | $31 | $31 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $48 | $79 | $109 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $78 | $81 | $83 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $78 | $80 | $82 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $5 | $47 | $89 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $5 | $34 | $62 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $5 | $55 | $104 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $83 | $122 | $160 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $23 | $42 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $69 | $81 | $93 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $68 | $68 | $68 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $56 | $79 | $102 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $75 | $89 | $103 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $5 | $44 | $83 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $37 | $70 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $30 | $30 | $30 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $49 | $49 | $49 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $170 | $170 | $170 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $170 | $170 | $170 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $84 | $84 | $84 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $155 | $155 | $155 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $104 | $104 | $104 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $177 | $219 | $260 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $286 | $346 | $406 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $180 | $223 | $266 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $210 | $247 | $284 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $340 | $407 | $474 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $294 | $558 | $822 |