| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $82 | $86 | $90 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $82 | $86 | $90 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $40 | $46 | $56 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $22 | $30 | $38 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $33 | $46 | $59 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $19 | $34 | $52 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $33 | $45 | $56 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $28 | $37 | $47 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $40 | $48 | $56 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $17 | $28 | $42 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $12 | $17 | $22 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $18 | $38 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $7 | $17 | $24 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $209 | $269 | $329 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $258 | $291 | $323 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $102 | $124 | $147 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $22 | $25 | $28 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $127 | $144 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $50 | $74 | $116 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $233 | $274 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $147 | $176 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $216 | $216 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $71 | $71 | $71 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $82 | $159 | $226 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $145 | $158 | $172 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $142 | $186 | $247 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $76 | $148 | $280 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $155 | $219 | $271 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $268 | $291 | $314 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $198 | $230 | $268 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $52 | $128 | $204 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $57 | $125 | $218 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $144 | $152 | $161 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $65 | $152 | $239 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $140 | $198 | $245 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $141 | $201 | $260 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $89 | $152 | $215 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $48 | $62 | $76 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $120 | $120 | $120 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $88 | $298 | $696 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $156 | $383 | $697 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $162 | $234 | $340 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $199 | $273 | $348 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $181 | $235 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $229 | $379 | $512 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $394 | $482 | $570 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $414 | $474 | $533 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $329 | $528 | $727 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $388 | $388 | $388 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $2,118 | $2,204 | $2,289 |