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See a sample rate comparisonCPT 90671 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.
Pneumonia Vaccine Solution, Solution For The Pneumococcal Vaccine Injection. This Vaccination Is Used To Help Prevent Pneumonia.
| 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 | $269.31 per 1 dose (October 2026 ASP) · View Medicare rates for 90671 |
| Medicaid Fee Schedule | $247.74 median of the 8 states in the free preview · View Medicaid rates for 90671 |
National average reimbursement for CPT 90671 by major payers:
$228.76
$257.28
$286.07
$279.51
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CPT 90671
5 of 25 sample ratesHigher to lower in this preview
Zakaria Almuwaqqat
Emory University
$671.48Published rateJames Towery
Birmingham Heart Clinic, PC
$274.89Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$266.91Published rateFiras Al Solaiman
$229.19Published rateChad Alford
Mobile Heart Specialists, P.C.
$210.86Published rate
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See a sample payer proposalCPT 90671 vs. Other Vaccines, Toxoids Codes
The CPT 90671 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 90671 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, Hib (Haemophilus Influenza B) Vaccine Solution. Hib Is A Bacteria That Can Cause Serious Infections (Such As Pneumonia Or Meningitis) For Infants And Children. The Vaccine Is Given As A Series Of Three To Four Shots. |
| 90670-CPT | Moderate | Pneumococcal Conjugat Vacc 13 Valent (Pcv13) For Intramuscul, Pneumococcal Conjugate Vaccine 13 Valent (Pcv13) For Intramuscular U |
| 90671-CPT | Moderate | Pneumonia Vaccine Solution, Solution For The Pneumococcal Vaccine Injection. This Vaccination Is Used To Help Prevent Pneumonia. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90671. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90671 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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