| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $79 | $81 | $83 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $79 | $81 | $83 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $54 | $56 | $58 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $30 | $33 | $36 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $27 | $29 | $32 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $26 | $28 | $31 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $30 | $32 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $40 | $43 | $45 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $34 | $36 | $39 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $11 | $14 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $9 | $13 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $11 | $14 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $13 |
| 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 | $47 | $83 | $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 | $44 | $44 | $44 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $106 | $107 | $107 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $80 | $96 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $115 | $115 | $115 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $131 | $132 | $133 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $126 | $126 | $127 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $147 | $148 | $149 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $123 | $141 | $159 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $95 | $95 | $95 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $7 | $60 | $101 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $103 | $103 | $103 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $111 | $112 | $113 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $86 | $86 | $86 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $121 | $121 | $122 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $66 | $99 | $131 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $27 | $33 | $38 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $111 | $167 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $18 | $226 | $338 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $169 | $246 | $323 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $120 | $149 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $161 | $162 | $163 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $109 | $118 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $134 | $243 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $257 | $265 | $273 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $245 | $245 | $245 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $154 | $251 | $348 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $172 | $261 | $349 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,049 | $1,164 | $1,278 |