| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $81 | $82 | $83 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $81 | $82 | $83 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $81 | $82 | $83 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $55 | $56 | $57 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $20 | $25 | $31 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $26 | $31 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $19 | $23 | $28 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $20 | $25 | $29 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $23 | $28 | $33 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $20 | $25 | $29 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $12 | $25 | $31 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $14 | $16 |
| Immunization admin injection single CPT 90471 • Preventive Care | $12 | $19 | $26 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $12 | $13 | $14 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $314 | $346 | $378 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $114 | $213 | $307 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $70 | $93 | $117 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $25 | $27 |
| MMR vaccine CPT 90707 • Preventive Care | $10 | $63 | $111 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $46 | $57 |
| Varicella vaccine CPT 90716 • Preventive Care | $17 | $119 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $53 | $104 | $159 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $220 | $230 | $248 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $49 | $49 | $49 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $69 | $113 | $127 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $113 | $128 | $132 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $79 | $123 | $137 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $104 | $136 | $156 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $123 | $140 | $151 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $110 | $143 | $176 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $120 | $169 | $189 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $79 | $92 | $101 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $81 | $100 | $122 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $81 | $106 | $121 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $92 | $117 | $133 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $100 | $114 | $124 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $110 | $129 | $146 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $116 | $135 | $157 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $0 | $30 | $45 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $66 | $71 | $75 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $263 | $355 | $402 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $215 | $239 | $263 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $154 | $214 | $294 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $194 | $224 | $293 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $131 | $161 | $230 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $368 | $404 | $441 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $96 | $139 | $181 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $300 | $374 | $450 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $113 | $247 | $415 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $205 | $319 | $476 |