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See a sample rate comparisonCPT 90661 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.
Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0 5 Ml Dosage For Intramuscular Use
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 60 - Mass Immunization Center |
| Common Modifiers | SL EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | $66.57 per 1 dose (October 2026 ASP) · View Medicare rates for 90661 |
| Medicaid Fee Schedule | $45.98 median of the 8 states in the free preview · View Medicaid rates for 90661 |
National average reimbursement for CPT 90661 by major payers:
$35.51
$36.31
$41.22
$41.96
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CPT 90661
5 of 25 sample ratesHigher to lower in this preview
P. Daniel Le Grange
$63.54Published rateAdam Wallace
Rockford Health Physicians
$42.66Published rateJada Johnson
Advocate Health And Hospitals Corporation
$39.61Published rateChandrika Shankar
$36.34Published rateHans Henriquez
Progressive Medical Center, S.C.
$23.45Published rate
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See a sample payer proposalCPT 90661 vs. Other Vaccines, Toxoids Codes
The CPT 90661 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 90661 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 |
|---|---|---|
| 90653-CPT | Low | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90655-CPT | Low | Influenza Virus Vaccine Triva, Influenza Virus Vaccine Trivalent (Iiv3) Split Virus Preservative Free When Administered To Children 6-35 Months Of Age For Intramuscular Use |
| 90656-CPT | Low | Influenza Virus Vaccine Triva, Influenza Virus Vaccine Trivalent (Iiv3) Split Virus Preservative Free When Administered To Individuals 3 Years And Older For Intramuscular Use |
| 90661-CPT | Low | Cciiv3 Vac No Prsv 0 5 Ml Im, Influenza Virus Vaccine Trivalent Cciiv3 Derived From Cell Cultures Subunit Preservative And Antibiotic Free 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 90661. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90661 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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