| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $70 | $72 | $73 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $70 | $72 | $73 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $47 | $49 | $50 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $24 | $26 | $28 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $24 | $28 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $24 | $25 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $24 | $25 | $27 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $25 | $27 | $29 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $21 | $23 | $26 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $22 | $25 | $29 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $11 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $18 | $24 | $31 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $15 | $21 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $316 | $332 | $369 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $254 | $256 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $102 | $123 | $137 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $5 | $14 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $101 | $107 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $50 | $55 | $65 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $203 | $215 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $124 | $131 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $235 | $242 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $36 | $36 | $36 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $5 | $93 | $166 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $78 | $104 | $125 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $78 | $107 | $130 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $96 | $111 | $125 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $70 | $134 | $211 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $86 | $171 | $244 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $5 | $64 | $124 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $72 | $137 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $68 | $115 | $159 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $68 | $91 | $114 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $5 | $80 | $116 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $78 | $133 | $191 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $88 | $121 | $189 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $42 | $78 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $31 | $31 | $31 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $54 | $54 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $331 | $331 | $331 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $331 | $331 | $331 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $120 | $120 | $120 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $153 | $153 | $153 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $103 | $103 | $103 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $129 | $250 | $370 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $287 | $346 | $406 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $95 | $209 | $378 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $210 | $249 | $289 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $169 | $322 | $474 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $294 | $435 | $823 |