CPT 90627 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 | • 11 - Office • 15 - Mobile Unit • 60 - Mass Immunization Center • 71 - Public Health Clinic |
| Common Modifiers | • None • GA - Required ABN issued and on file • GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Moderate |
National average reimbursement for CPT 90627 by major payers:
$278.86
$331.43
$320.90
$337.65
| 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 90627 | ||||||
United | 90627 | $398.54 | 1760778468 - NATHAN ONTROP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $298.10 | 1174859284 - MATTHEW NIEDZWIECKI | 910844563 | RI | Psychiatry Physician (2084P0800X) |
United | 90627 | $298.10 | 1922254911 - NINA LIU | 363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90627 | $298.10 | 1134236565 - WARREN KAMMERER | 611549647 - (IL) WARREN KAMMERER MD SC | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $333.88 | 1972984169 - DAVID SHOLTES | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $347.32 | 1215968755 - STACEY OCCOMY | 611630276 - FRANCISCAN PHYSICIAN NETWORK | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $333.88 | 1760419311 - PETER HEYDEMANN | 911780120 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90627 | $382.04 | 1295991701 - TRILOK SHAH | 465243116 - (IL) IN TOUCH PHYSICIANS LLC | WI | Psychiatry Physician (2084P0800X) |
United | 90627 | $298.10 | 1831335850 - CLAUDINE SINSIOCO | 540620889 - INOVA HEALTH CARE SERVICES | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $333.76 | 1255692794 - MELISSA WAGNER-SCHUMAN | 311405915 | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $295.22 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90627 | $426.88 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90627 | $336.85 | 1902226640 - KATIE RICHARDS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90627 | $398.54 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $351.76 | 1376040014 - JODY WONG | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | 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 90627 vs. Other Vaccines, Toxoids Codes
The CPT 90627 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 90627 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 |
|---|---|---|
| 90587 | Low | Dengue Vaccine, Quadrivalent, Live, 3 Dose Schedule, For Subcutaneous Use |
| 90611 | Moderate | Smallpox And Monkeypox Vaccine, Attenuated Vaccinia Virus, Live, Non-Replicating, Preservative Free, 0.5 Ml Dosage, Suspension, For Subcutaneous Injection |
| 90619 | Low | Meningococcal Conjugate Vaccine, Serogroups A, C, W, Y, Quadrivalent, Tetanus Toxoid Carrier (Menacwy-Tt), For Intramuscular Use |
| 90627 | Moderate | 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 90627. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90627 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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