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See a sample rate comparisonCPT 90585 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.
Bacillus Calmette-Guerin Vacc (Bcg) For Tuberculosis Live, Bacillus Calmette-Guerin Vaccine (Bcg) For Tuberculosis Live For Per
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility 50 - Federally Qualified Health Center |
| Common Modifiers | UD 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90585 |
| Medicaid Fee Schedule | $144.375 median of the 8 states in the free preview · View Medicaid rates for 90585 |
National average reimbursement for CPT 90585 by major payers:
$168.76
$189.56
$179.59
$184.86
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CPT 90585
5 of 25 sample ratesHigher to lower in this preview
Kara Driscoll
UPMC
$304.30Published rateMegan Ginsburg
Advocate Health And Hospitals Corporation
$193.03Published rateHans Henriquez
Progressive Medical Center, S.C.
$188.47Published rateJohn Millichap
Advocate Health And Hospitals Corporation
$182.58Published rateKaiz Asif
Presence Healthcare Services
$163.35Published rate
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See a sample payer proposalCPT 90585 vs. Other Vaccines, Toxoids Codes
The CPT 90585 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 90585 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. |
| 90585-CPT | Low | Bacillus Calmette-Guerin Vacc (Bcg) For Tuberculosis Live, Bacillus Calmette-Guerin Vaccine (Bcg) For Tuberculosis Live For Per |
| 90626-CPT | Moderate | Tick-Borne Enceph Vacc Inactivated 0.25ml Im Use, Tick-Borne Encephalitis Virus Vaccine Inactivated; 0.25 Ml Dosage For Intramuscular Use |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90585 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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