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CPT 90684 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, 21 Valent (Pcv21), For Intramuscular Use
Key FactDetail
Service Type

Medicine Services and Procedures

Vaccines, Toxoids

Complexity LevelModerate

National average reimbursement for CPT 90684 by major payers:

bcbs

$N/A

uhc

$N/A

aetna

$N/A

cigna

$N/A

Preview provider-level rates for...
For billing codeCPT 90684
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 90684

United
90684$352.421992905335 - PARAG MERAI362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATIONILChild & Adolescent Psychiatry Physician (2084P0804X)
United
90684$429.761013098631 - PAUL DOBRANSKY362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATIONILPsychiatry Physician (2084P0800X)
United
90684$439.261003049966 - GIRISHKUMAR DHORAJIA850703768 - (IL) CARLE WEST PHYSICIAN GROUP INCILPsychiatry Physician (2084P0800X)
United
90684$386.911710328703 - ALI ANWAR815143225 - (IL) COMMUNITY HOME PHYSICIANS LLC D/B/A COMMUNITY PHYSICIANSILPsychiatry Physician (2084P0800X)
United
90684$287.751114196995 - ANGELA GREEN910844563ILPsychiatry Physician (2084P0800X)
United
90684$386.911720532773 - ADULT AND PEDIATRIC NEUROLOGY813062689 - (IL) ADULT AND PEDIATRIC NEUROLOGYILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
90684$319.691689787426 - KAREN SEVERSON364015560 - LOYOLA UNIVERSITY MEDICAL CENTERILPsychiatry Physician (2084P0800X)
United
90684$316.521952560492 - TAKIJAH HEARD363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATESTXNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
90684$386.911699866186 - RAJIV SHARMA376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOISILPsychiatry Physician (2084P0800X)
United
90684$327.891609888320 - NANCY SCHELL364306053 - PATIENT FIRST INCILPsychiatry Physician (2084P0800X)
United
90684$327.891891774519 - LEON HOME HEALTH, LLC, LEON AT HOME261288029FLHome Health Agency (251E00000X)
United
90684$386.911578957676 - LAURA VERNON363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INNYNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
90684$325.161609187467 - FARAAZ FAKIH363149833 - NORTHWESTERN MEMORIAL HEALTHCAREILPsychiatry Physician (2084P0800X)
United
90684$386.911205213261 - TAMAR CACERES363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INILNeurodevelopmental Disabilities Physician (2084P0005X)
United
90684$364.291679968697 - JEREMIAH BREWER364015560 - LOYOLA UNIVERSITY MEDICAL CENTERTXPsychiatry Physician (2084P0800X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 90684 vs. Other Vaccines, Toxoids Codes

The CPT 90684 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 90684 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.

CodeComplexityDescription
90684-CPTModeratePneumococcal Conjugate Vaccine, 21 Valent (Pcv21), 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 90684. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 90684 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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