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See a sample rate comparisonCPT 90678 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.
Rsv Vaccine Pref Subunit Bivalent For Im Use, Respiratory Syncytial Virus Vaccine Pref Subunit Bivalent 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 | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments JZ - Zero drug amount discarded/not administered to any patient |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90678 |
| Medicaid Fee Schedule | $312.69 median of the 8 states in the free preview · View Medicaid rates for 90678 |
National average reimbursement for CPT 90678 by major payers:
$293.88
$330.64
$343.96
$348.35
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CPT 90678
5 of 25 sample ratesHigher to lower in this preview
Hossam Abdelsalam
Siu Physicians & Surgeons Inc
$560.50Published rateMy Phon Nguyen
Mount Sinai Community Foundation
$348.10Published rateJamie Evans
Loyola University Medical Center
$327.75Published rateCynthia Gordon
Illinois Professionals Health Progr
$295.00Published rateChristopher Raio
St Joseph Hospital
$265.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90678 vs. Other Vaccines, Toxoids Codes
The CPT 90678 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 90678 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 |
|---|---|---|
| 90677-CPT | Moderate | Pneumonia Vaccine Solution, Solution For The Pneumococcal Vaccine Injection. This Vaccination Is Used To Help Prevent Pneumonia. |
| 90678-CPT | Moderate | Rsv Vaccine Pref Subunit Bivalent For Im Use, Respiratory Syncytial Virus Vaccine Pref Subunit Bivalent For Intramuscular Use |
| 90679-CPT | Moderate | Rsv Vacc Pref Recombinant Adjuvanted For Im Use, Respiratory Syncytial Virus Vaccine Pref Recombinant Subunit Adjuvanted For Intramuscular Us |
| 90682-CPT | Low | Riv4 Vacc Recombinant Dna Im, Influenza Virus Vaccine Quadrivalent Riv4 Derived From Recombinant Dna Hemagglutinin Ha Protein Only Preservative And Antibiotic Free 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 90678. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90678 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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