| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $132 | $132 | $132 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $89 | $89 | $89 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $44 | $44 | $44 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $44 | $44 | $44 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $41 | $41 | $41 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $43 | $43 | $43 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $47 | $47 | $47 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $42 | $42 | $42 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $39 | $40 | $40 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $20 | $20 | $20 |
| Immunization admin injection single CPT 90471 • Preventive Care | $31 | $37 | $40 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $16 | $18 | $21 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $336 | $365 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $231 | $251 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $105 | $114 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $22 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $100 | $109 | $117 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $40 | $50 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $196 | $213 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $133 | $137 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $242 | $262 | $282 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $33 | $33 | $33 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $136 | $161 | $186 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $148 | $171 | $194 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $99 | $150 | $202 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $111 | $143 | $176 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $158 | $190 | $223 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $185 | $222 | $258 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $148 | $214 | $279 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $109 | $138 | $167 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $122 | $150 | $178 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $86 | $132 | $178 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $99 | $124 | $149 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $134 | $144 | $153 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $147 | $180 | $214 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $164 | $170 | $176 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $53 | $53 | $53 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $86 | $86 | $86 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $302 | $305 | $307 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $307 | $435 | $562 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $149 | $149 | $149 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $276 | $276 | $276 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $184 | $184 | $184 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $463 | $490 | $516 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $509 | $537 | $566 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $250 | $361 | $473 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $505 | $534 | $563 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $604 | $633 | $662 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,454 | $1,457 | $1,461 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $129 | $129 | $129 |