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See a sample rate comparisonCPT 90694 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.
Vacc Aiiv4 No Prsrv 0 5ml Im, Influenza Virus Vaccine Quadrivalent Aiiv4 Inactivated Adjuvanted Preservative Free 0 5 Ml Dosage 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 90694 |
| Medicaid Fee Schedule | $72.045 median of the 8 states in the free preview · View Medicaid rates for 90694 |
National average reimbursement for CPT 90694 by major payers:
$74.62
$87.07
$81.73
$89.61
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CPT 90694
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$186.75Published rateLekshmi Venugopal
Edward Health Ventures
$92.83Published rateColleen Buhrfiend
Rush University Medical Center
$86.63Published rateJohn Millichap
$81.43Published rateChristopher Raio
St Francis Hospital
$69.62Published rate
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See a sample payer proposalCPT 90694 vs. Other Vaccines, Toxoids Codes
The CPT 90694 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 90694 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) |
| 90673-CPT | Low | Influenza Virus Vaccine Triva, Influenza Virus Vaccine Trivalent (Riv3) Derivedfrom Recombinant Dna (Riv3) Hemagglutinin (Ha) P Rotein Only Preservative And Antibiotic Free Forintramuscular Use |
| 90681-CPT | Low | Oral Vaccine For Rotavirus, Rotavirus Vaccine Solution For Oral (By Mouth) Use. The Vaccine Is Given To Prevent Infection With The Rotavirus A Virus Which Causes Severe Diarrhea. |
| 90694-CPT | Low | Vacc Aiiv4 No Prsrv 0 5ml Im, Influenza Virus Vaccine Quadrivalent Aiiv4 Inactivated Adjuvanted Preservative Free 0 5 Ml Dosage 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 90694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90694 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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