CPT 90670 Fee Schedule

Last Verified: January 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.

Pneumococcal Conjugate Vaccine 13 Valent (Pcv13) For Intramuscular Use (Desc Revised 7/1/2015)

Key Fact	Detail
Service Type	• Medicine Services and Procedures • Vaccines, Toxoids
Common Place of Service	• 11 - Office • 50 - Federally Qualified Health Center
Common Modifiers	• None • SL • EP - Residential facility to Physician's office
Complexity Level	Moderate

National average reimbursement for CPT 90670 by major payers:

$241.24

$279.25

$297.02

$275.75

Preview provider-level rates for...

For billing codeCPT 90670

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 90670
United	90670	$240.02	1538156609 - ADINARAYANAMURTHY NALLAMSHETTY	591198552	FL	Pediatrics Physician (208000000X)
United	90670	$344.79	1356872865 - LISA AWE	590634433	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1205839602 - DALYS GILLING	593140335	FL	Pediatrics Physician (208000000X)
United	90670	$275.80	1093020661 - LAURA STEELMAN	861141885	FL	Pediatrics Physician (208000000X)
United	90670	$271.57	1982044657 - DIANA RAMIREZ	274373875	FL	Pediatrics Physician (208000000X)
United	90670	$275.80	1255351599 - FATAH WALLIZADA	264231855	FL	Pediatrics Physician (208000000X)
United	90670	$275.80	1306251228 - MUDASSER IBRAHIM	470379754	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1548296569 - DENISE EDWARDS	237313346	FL	Pediatrics Physician (208000000X)
United	90670	$452.85	1861658650 - LATIA ILYADIS	922005219	FL	Pediatrics Physician (208000000X)
United	90670	$275.80	1922390988 - HUMAM ALABSI	592650464	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1184069742 - CORINNE WATSON	650556041	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1356800296 - ILANA GUNCZLER BENAIM	650356760	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1346243359 - REGINE BATAILLE	651051594	FL	Pediatrics Physician (208000000X)
United	90670	$226.42	1932257441 - TUONG QUY CHE	271822030	FL	Pediatrics Physician (208000000X)
United	90670	$249.07	1649381880 - HEATHER SVENSON	461921294	FL	Pediatrics Physician (208000000X)
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 90670 vs. Other Vaccines, Toxoids Codes

The CPT 90670 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 90670 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
90644-CPT	Low	Meningococcal Conjugate Vaccine Serogroups C & Y And Haemophilus Influenzae B Vaccine (Hib-Mency) 4 Dose Schedule When Administered To Children 6 Weeks-18 Months Of Age For Intramuscular Use (Description Revised 1/1/2016)
90647-CPT	Low	Hemophilus Influenza B Vaccine Prp-Omp Conjugate (3 Dose) For Intramuscular Use
90648-CPT	Low	Hemophilus Influenza B Vaccine Prp-T Conjugate (4 Dose) For Intramuscular Use
90670-CPT	Moderate	Pneumococcal Conjugate Vaccine 13 Valent (Pcv13) For Intramuscular Use (Desc Revised 7/1/2015)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90670. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 90670 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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