Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 90626 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.
Tick-Borne Enceph Vacc Inactivated 0.25ml Im Use, Tick-Borne Encephalitis Virus Vaccine Inactivated; 0.25 Ml Dosage For Intramuscular Use
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | SL |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90626 |
| Medicaid Fee Schedule | $319.10 median of the 7 states in the free preview · View Medicaid rates for 90626 |
National average reimbursement for CPT 90626 by major payers:
$280.63
$331.43
$320.30
$341.60
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 90626.
CPT 90626
5 of 25 sample ratesHigher to lower in this preview
Miriam Baltuano Songhurst
Childrens Mercy Hospital
$642.53Published rateJames Mackenzie
Lurie Childrens Medical Group LLC
$351.76Published rateTrixie Lipke
Beaver Dam Community Hospitals Inc
$333.88Published rateJamie Evans
$298.10Published rateOday Alsarraf
Swedishamerican Hospital
$298.10Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 90626 vs. Other Vaccines, Toxoids Codes
The CPT 90626 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 90626 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 |
|---|---|---|
| 90621-CPT | Low | Meningitis Vaccine Solution, Meningococcal Vaccine Solution. The Vaccine Is Given To Prevent Infection With The Meningococcus Bacteria Which Can Cause Meningitis (Infection In The Tissue Surrounding The Brain) And Other Serious Infections. |
| 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 |
| 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 |
| 90627-CPT | Moderate | Tick-Borne Enceph Vacc Inactivated 0.5ml Im Use, Tick-Borne Encephalitis Virus Vaccine Inactivated; 0.5 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 90626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90626 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 90626) and we'll show you how you compare in 15 minutes or less.