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See a sample rate comparisonCPT 90476 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Oral Vaccine For Adenovirus, Vaccine Solution Given By Mouth To Prevent Illnesses Caused By Adenoviruses. Adenoviruses Commonly Cause Lung Illnesses Diarrhea And Eye Infections.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | SL 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90476 |
| Medicaid Fee Schedule | $26.84 median of the 2 states in the free preview · View Medicaid rates for 90476 |
National average reimbursement for CPT 90476 by major payers:
$28.93
$40.36
$127.53
$253.13
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CPT 90476
5 of 25 sample ratesHigher to lower in this preview
Fred Hutchinson Cancer Center
$115.00Published rateAll Ways Homecare Inc
$60.00Published rateLancaster Regional Hospital, Lp, Crescent Medical Center Lancaster
Lancaster Regional Hospital, Lp
$48.75Published rateAll Ways Homecare Inc
$40.00Published rateStephanie Hernandez
$18.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90476 vs. Other Vaccines, Toxoids Codes
The CPT 90476 code is part of the Medicine Services and Procedures services used for Vaccines, Toxoids. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90476 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90476-CPT | Low | Oral Vaccine For Adenovirus, Vaccine Solution Given By Mouth To Prevent Illnesses Caused By Adenoviruses. Adenoviruses Commonly Cause Lung Illnesses Diarrhea And Eye Infections. |
| 90477-CPT | Low | Oral Vaccine For Adenovirus, Vaccine Solution Given By Mouth To Prevent Illnesses Caused By Adenoviruses. Adenoviruses Commonly Cause Lung Illnesses Diarrhea And Eye Infections. |
| 90581-CPT | Low | Anthrax Vacc For Subcutane Or Intramuscul Use, Anthrax Vaccine For Subcutaneous Or Intramuscular Use |
| 90585-CPT | Low | Bacillus Calmette-Guerin Vacc (Bcg) For Tuberculosis Live, Bacillus Calmette-Guerin Vaccine (Bcg) For Tuberculosis Live For Per |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90476. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90476 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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