| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $84 | $86 | $88 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $88 | $88 | $88 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $32 | $50 | $67 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $31 | $34 | $37 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $35 | $42 | $49 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $26 | $32 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $24 | $29 | $34 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $23 | $29 | $36 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $25 | $28 | $30 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $16 | $28 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $11 | $16 |
| Immunization admin injection single CPT 90471 • Preventive Care | $19 | $30 | $39 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $18 | $20 | $25 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $274 | $334 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $258 | $332 | $427 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $112 | $112 | $112 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $24 | $30 | $37 |
| MMR vaccine CPT 90707 • Preventive Care | $75 | $85 | $106 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $55 | $59 | $64 |
| Varicella vaccine CPT 90716 • Preventive Care | $129 | $163 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $54 | $83 | $142 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $187 | $215 | $237 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $41 | $41 | $41 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $156 | $179 | $218 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $136 | $162 | $175 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $144 | $163 | $172 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $188 | $216 | $270 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $188 | $201 | $215 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $161 | $190 | $220 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $214 | $226 | $239 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $98 | $130 | $162 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $74 | $124 | $149 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $140 | $163 | $209 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $116 | $167 | $230 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $116 | $175 | $235 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $172 | $179 | $194 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $8 | $126 | $270 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $38 | $58 | $75 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $89 | $125 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $268 | $414 | $560 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $147 | $439 | $732 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $162 | $197 | $267 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $263 | $334 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $107 | $159 | $242 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $415 | $463 | $530 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $486 | $508 | $531 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $131 | $390 | $542 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $349 | $425 | $577 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $175 | $422 | $721 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $2,151 | $2,280 | $2,408 |