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 90651 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.
Human Papillomavirus Vaccine Types 6 11 16 18 31 33 45 52 58 Nonavalent (9vhpv) 2 Or 3 Dose Schedule For Intramuscular Use (Desc Revised 7/1/2017) Second Or Third Opinion Intermediate Consult (Eff. 01011935 - Deleted 03312003)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | SL EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90651 |
| Medicaid Fee Schedule | $316.71 median of the 8 states in the free preview · View Medicaid rates for 90651 |
National average reimbursement for CPT 90651 by major payers:
$291.31
$343.32
$361.58
$338.05
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 90651.
CPT 90651
5 of 25 sample ratesHigher to lower in this preview
Janet Cruz
$1,456.70Published rateMichael Chmielewski
$363.04Published rateClint Anthony
District Medical Group Inc
$347.67Published rateKatherine Roberts
$307.60Published rateJohn Millichap
Grady Memorial Hospital Corporation
$261.51Published 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 90651 vs. Other Vaccines, Toxoids Codes
The CPT 90651 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 90651 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 |
|---|---|---|
| 90649-CPT | Low | Hpv Vaccine Solution, A Three-Dose Vaccine Of Hpv (Human Papillomavirus) To Protect Against An Infection That Can Cause Genital Warts And Cervical Cancer. |
| 90650-CPT | Low | Hpv Vaccine Solution, A Three-Dose Vaccine Of Hpv (Human Papillomavirus) To Protect Against An Infection That Can Cause Genital Warts And Cervical Cancer. |
| 90651-CPT | Moderate | Human Papillomavirus Vaccine Types 6 11 16 18 31 33 45 52 58 Nonavalent (9vhpv) 2 Or 3 Dose Schedule For Intramuscular Use (Desc Revised 7/1/2017) Second Or Third Opinion Intermediate Consult (Eff. 01011935 - Deleted 03312003) |
| 90707-CPT | Low | Mmr Vaccine Solution, The Mmr Solution Is A Live Vaccine Containing Measles Mumps And Rubella (German Measles). It Is Given To Protect Against Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90651. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90651 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 90651) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
To get an accurate estimate for a medical procedure based on your specific CPT code and location, we recommend using Payerprice. They offer a fee schedule lookup tool that allows you to search for pricing information tailored to your needs.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit alphanumeric codes used by medical professionals to describe medical, surgical, and diagnostic services provided to patients. They are essential for billing and processing healthcare claims.
Medicare publishes its fee schedules, and you can typically find this information on the official Medicare website. However, for specific cost estimates related to your individual situation, including CPT codes and your specific location, a tool like Payerprice can provide more granular and personalized information.
Insurance companies determine payments based on various factors, including negotiated rates with providers, fee schedules, the specific plan's benefits, deductibles, co-pays, co-insurance, and the medical necessity of the service. These rates are often the result of contracts between the insurer and the healthcare provider.
The 'billed charge' is the amount a healthcare provider initially charges for a service. The 'negotiated rate' (or allowed amount) is the discounted price that an insurance company and the provider have agreed upon for that service. Insured patients typically pay based on the negotiated rate, after deductibles, co-pays, and co-insurance, rather than the higher billed charge.
Comparing prices for healthcare services is crucial for managing costs. For accurate comparisons based on specific CPT codes and your location, we recommend using Payerprice. Their fee schedule lookup tool can help you research and compare potential costs from different providers.