CPT 90480 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Vaccines, Toxoids |
| Common Place of Service | |
| Common Modifiers | |
| Complexity Level | Moderate |
National average reimbursement for CPT 90480 by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 90480 | ||||||
United | 90480 | $70.66 | 1801849559 - CHARLES MARCUCCILLI | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90480 | $76.06 | 1669598421 - CHANDRIKA SHANKAR | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90480 | $52.75 | 1922010230 - STEVAN WEINE | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 90480 | $38.86 | 1437438249 - KAPIL AEDMA | 370661223 - METHODIST MEDICAL CENTER OF ILLINOIS | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90480 | $47.06 | 1710275110 - PRAVESH DEOTALE | 430654872 - ST LOUIS UNIVERSITY | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90480 | $80.06 | 1730263617 - MARK ALTER | 910844563 | MT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90480 | $101.12 | 1992904197 - JOANNA BLACKBURN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90480 | $52.75 | 1497767719 - ELIZABETH CHARNEY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90480 | $39.93 | 1255692794 - MELISSA WAGNER-SCHUMAN | 311405915 | IL | Psychiatry Physician (2084P0800X) |
United | 90480 | $43.90 | 1144267865 - NITIN PATEL | 462706345 | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90480 | $83.09 | 1083622955 - ALMA BICKNESE | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90480 | $86.94 | 1225211600 - JOHN MILLICHAP | 383852646 - OSF MULTI-SPECIALTY GROUP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90480 | $64.76 | 1972778801 - JOSEPH MULLEN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90480 | $43.97 | 1922481530 - THOMAS LOBUR | 362709982 - (IL) PRESENCE BEHAVIORAL HEALTH | IL | Psychiatry Physician (2084P0800X) |
United | 90480 | $43.97 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 90480 vs. Other Vaccines, Toxoids Codes
The CPT 90480 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 90480 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 |
|---|---|---|
| 90480 | Moderate | Immunization Administration By Intramuscular Injection Of Severe Acute Respiratory Syndrome Coronavirus 2 (Sarsu0002cov-2) (Coronavirus Disease [Covid-19]) Vaccine Single Dose |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90480. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90480 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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