| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $71 | $73 | $76 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $48 | $50 | $52 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $29 | $33 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $25 | $28 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $28 | $28 | $28 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $29 | $29 | $29 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $35 | $37 | $39 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $34 | $34 | $34 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $19 | $34 | $46 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $7 | $13 | $20 |
| Immunization admin injection single CPT 90471 • Preventive Care | $17 | $34 | $46 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $15 | $17 | $20 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $253 | $314 | $369 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $197 | $234 | $254 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $84 | $100 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $91 | $99 | $110 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $29 | $40 | $49 |
| Varicella vaccine CPT 90716 • Preventive Care | $184 | $196 | $215 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $114 | $129 | $147 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $207 | $220 | $242 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $69 | $69 | $69 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $101 | $136 | $172 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $90 | $135 | $180 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $94 | $140 | $187 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $113 | $162 | $212 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $129 | $167 | $204 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $98 | $162 | $238 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $200 | $200 | $200 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $91 | $123 | $155 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $104 | $135 | $165 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $82 | $111 | $165 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $90 | $106 | $137 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $71 | $118 | $185 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $80 | $129 | $197 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $95 | $130 | $160 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $32 | $46 | $60 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $89 | $89 | $89 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $496 | $496 | $496 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $496 | $496 | $496 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $199 | $199 | $199 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $266 | $266 | $266 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $87 | $129 | $180 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $371 | $371 | $371 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $211 | $211 | $211 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $386 | $386 | $386 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $520 | $520 | $520 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $553 | $553 | $553 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $353 | $353 | $353 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $147 | $147 | $147 |