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See a sample rate comparisonCPT 90679 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 Vacc Pref Recombinant Adjuvanted For Im Use, Respiratory Syncytial Virus Vaccine Pref Recombinant Subunit Adjuvanted For Intramuscular Us
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 60 - Mass Immunization Center |
| Common Modifiers | GY - Notice of Liability Not Issued, Not Required Under Payer Policy. JZ - Zero drug amount discarded/not administered to any patient |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90679 |
| Medicaid Fee Schedule | $316.85 median of the 8 states in the free preview · View Medicaid rates for 90679 |
National average reimbursement for CPT 90679 by major payers:
$285.15
$328.63
$333.90
$334.12
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CPT 90679
5 of 25 sample ratesHigher to lower in this preview
Blessing Hospital, Blessing Behavioral Center
Blessing Hospital
$558.59Published rateTanmoy Chandra
Edward Health Ventures
$336.00Published rateAbby Fredrickson
Loyola University Medical Center
$326.63Published rateChandragupta Vedak
Horizons Behavioral Health LLC
$309.98Published rateJamie Evans
$280.00Published rate
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See a sample payer proposalCPT 90679 vs. Other Vaccines, Toxoids Codes
The CPT 90679 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 90679 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 90679. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90679 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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