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See a sample rate comparisonCPT 90672 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.
Nfluenza Virus Vacc Quadrival Live (Laiv4) For Intranasal Us, Influenza Virus Vaccine Quadrivalent Live (Laiv4) For Intranasal Us
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 71 - Public Health Clinic |
| Common Modifiers | SL EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90672 |
| Medicaid Fee Schedule | $25.19 median of the 8 states in the free preview · View Medicaid rates for 90672 |
National average reimbursement for CPT 90672 by major payers:
$26.97
$27.91
$29.03
$38.16
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CPT 90672
5 of 25 sample ratesHigher to lower in this preview
Kathleen Bottum
Siu Physicians & Surgeons Inc
$58.50Published rateJohn Mcmillin
Advocate Health And Hospitals Corporation
$29.87Published rateKevin Schlessel
$27.79Published rateFarah Al Khitan
$24.70Published rateJohn Millichap
Grady Memorial Hospital Corporation
$21.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90672 vs. Other Vaccines, Toxoids Codes
The CPT 90672 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 90672 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) |
| 90666-CPT | Low | Flu Vac Pandem Prsrv Free Im, Influenza Virus Vaccine Iiv Pandemic Formulation Split Virus Preservative Free For Intramuscular Use |
| 90672-CPT | Low | Nfluenza Virus Vacc Quadrival Live (Laiv4) For Intranasal Us, Influenza Virus Vaccine Quadrivalent Live (Laiv4) For Intranasal Us |
| 90675-CPT | Moderate | Rabies Vaccine Solution, Rabies Vaccine. The Shot Is Given To Prevent Rabies A Virus That Is Spread By The Bite Of Infected Animals. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90672. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90672 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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