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 | Vaccines, Toxoids Medicine Services and Procedures |
| 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 |
| Medicare Fee Schedule | View Medicare rates for 90627 |
National average reimbursement for CPT 90627 by major payers:
$278.86
$331.43
$320.90
$341.59
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90627 | $338.75 | 1104046630 - SYED WALIUDDIN | 262522053 - (IL) VALLEY PSYCHIATRY AND COUNSELING LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $351.76 | 1710244991 - ALBA PERGJIKA | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90627 | $357.73 | 1679526784 - ELTON SMITH | 911031583 | VA | Psychiatry Physician (2084P0800X) |
United | 90627 | $337.20 | 1780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION | 880133501 - CARSON MEDICAL GROUP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | 90627 | $357.73 | 1386755486 - DOUGLAS NORDLI | 362177139 - UNIVERSITY OF CHICAGO | 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 | $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 | $357.73 | 1245217942 - WALTER WHANG | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $347.32 | 1215968755 - STACEY OCCOMY | 611630276 - FRANCISCAN PHYSICIAN NETWORK | IN | Psychiatry Physician (2084P0800X) |
United | 90627 | $351.76 | 1083622955 - ALMA BICKNESE | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90627 | $331.20 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $336.85 | 1427067180 - ELIZABETH MCMASTERS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $298.10 | 1962664789 - JAMIE EVANS | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 90627 | $521.69 | 1225211600 - JOHN MILLICHAP | 800863895 | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
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 Medicine Services and Procedures Codes
The CPT 90627 code is part of the Vaccines, Toxoids services used for Medicine Services and Procedures. 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-CPT | Low | Dengue Vaccine Quadrivalent Live 3 Dose Schedule For Subcutaneous Use. This Code Is For A Sanofi Pasteur Chimeric Live Attenuated Tetravalent Vaccine That Is Not Yet Fda |
| 90611-CPT | Moderate | Smallpox Monkeypox Vac 0 5ml, Smallpox And Monkeypox Vaccine Attenuated Vaccinia Virus Live Non Replicating Preservative Free 0 5 Ml Dosage Suspension For Subcutaneous Use |
| 90619-CPT | Low | Meningococcal Conjugate Vaccin, Meningococcal Conjugate Vaccine Serogroups A C W Y Quadrivalent Tetanus Toxoid Carrier (Menacwy-Tt) 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 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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