| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $83 | $87 | $90 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $83 | $87 | $90 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $58 | $60 | $63 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $30 | $31 | $33 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $27 | $28 | $29 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $26 | $27 | $28 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $29 | $31 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $40 | $41 | $43 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $34 | $36 | $37 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $23 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $9 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $14 | $21 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $12 | $15 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $274 | $323 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $257 | $274 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $92 | $104 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $23 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $93 | $101 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $37 | $47 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $163 | $190 | $217 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $132 | $132 | $132 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $244 | $244 | $244 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $81 | $81 | $81 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $106 | $107 | $109 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $77 | $94 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $115 | $117 | $118 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $131 | $132 | $132 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $93 | $110 | $127 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $112 | $112 | $112 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $159 | $160 | $161 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $82 | $98 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $73 | $89 | $104 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $104 | $104 | $104 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $114 | $114 | $114 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $85 | $101 | $116 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $122 | $123 | $124 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $132 | $132 | $133 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $38 | $39 | $39 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $186 | $186 | $186 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $181 | $286 | $338 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $90 | $136 | $182 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $163 | $164 | $166 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $164 | $165 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $129 | $130 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $237 | $431 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $273 | $375 | $477 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $130 | $130 | $130 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $152 | $379 | $606 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $30 | $200 | $370 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $215 | $1,193 | $2,172 |