CPT 90653 Medicare ASP Payment Limit 2026
Medicare's Part B payment limit for CPT 90653 is $122.52 per billing unit (1 dose) in the October 2026 ASP file, up 24.8% from $98.16 in 2025.
- Per 1 dose
- $122.52
- vs. 2025
- +24.8%
- Commercial national avg.
- $87.06
Filters
Select one or more years
Up to 5 codes · 4 remaining
Need commercial rates?
Compare Medicare against in-network rates from 180+ payers.
Run a free sample reportInfluenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003)
| Code | Month | Year | Payment Limit | Description |
|---|---|---|---|---|
| 90653 - CPT | Jan | 2025 | $83.49 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Apr | 2025 | $83.49 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Jul | 2025 | $83.49 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Oct | 2025 | $98.16 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Jan | 2026 | $98.16 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Apr | 2026 | $98.16 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Jul | 2026 | $98.16 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90653 - CPT | Oct | 2026 | $122.52 | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
90653 payment limit by quarter
Each row is one quarterly CMS ASP file. Change is against the quarter before.
| Quarter | Payment limit per 1 dose | Change |
|---|---|---|
| October 2026 | $122.52 | +24.8% |
| July 2026 | $98.16 | No change |
| April 2026 | $98.16 | No change |
| January 2026 | $98.16 | No change |
| October 2025 | $98.16 | +17.6% |
| July 2025 | $83.49 | No change |
| April 2025 | $83.49 | No change |
| January 2025 | $83.49 | - |
The payment limit is Medicare's allowed amount per billing unit: the average sales price plus the statutory add-on. Medicare generally pays 80% of it after the Part B deductible, and the patient's coinsurance covers the rest. CMS recalculates it every quarter from manufacturer-reported sales.
90653: Medicare vs. commercial national average
The commercial national average for 90653, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $87.06 per 1 dose, 71% of Medicare's $122.52.
- BCBS $79.21
- UnitedHealthcare $90.08
- Aetna $93.01
- Cigna $85.94
A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 90653 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its current ASP payment limit per billing unit. Payers may bill the drug in a different unit, so compare the two with care.
Nearby codes
Compare Medicare's rate for 90653 with published commercial rates
Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.
See what state Medicaid programs pay for 90653
50 state Medicaid agencies publish their own physician fee schedule. The 90653 page shows real published rates for several of them free, with effective dates and official sources.
17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.
Related codes
Methodology
Rates are sourced from CMS Part B Drug Average Sales Price (ASP) pricing files, published quarterly. Each HCPCS payment limit reflects the calculated ASP plus the statutory add-on for that quarter.
View CMS Part B ASP Pricing Files