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See a sample rate comparisonCPT 90715 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.
Tetanus Diphtheria Toxoids And, Tetanus Diphtheria Toxoids And Acellular Pertussisvaccine (Tdap) When Administered To Individuals 7 Years Or Older For Intramuscular Use
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | SL EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | $40.07 per 1 dose (October 2026 ASP) · View Medicare rates for 90715 |
| Medicaid Fee Schedule | $40.07 median of the 8 states in the free preview · View Medicaid rates for 90715 |
National average reimbursement for CPT 90715 by major payers:
$48.30
$52.81
$48.27
$50.19
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CPT 90715
5 of 25 sample ratesHigher to lower in this preview
Laura Irwin
$92.36Published rateRafael Jordan
$60.34Published rateJohn Nordeen
$53.88Published rateCari Graber Schuk
Ob Hospitalist Group, LLC
$49.25Published rateMalieri Colon-Rivera
Mcr Health Inc
$39.84Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90715 vs. Other Vaccines, Toxoids Codes
The CPT 90715 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 90715 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 |
|---|---|---|
| 90702-CPT | Low | Diphtheria And Tetanus Toxoids, Diphtheria And Tetanus Toxoids Adsorbed (Dt) When Administered To Individuals Younger Than 7 Years For Intramuscular Use |
| 90714-CPT | Low | Tetanus And Diphtheria Toxoids, Tetanus And Diphtheria Toxoids Adsorbed (Td) Preservative Free When Administered To Individuals 7 Years Or Older For Intramuscular Use |
| 90715-CPT | Low | Tetanus Diphtheria Toxoids And, Tetanus Diphtheria Toxoids And Acellular Pertussisvaccine (Tdap) When Administered To Individuals 7 Years Or Older For Intramuscular Use |
| 90723-CPT | Low | Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Hepatitis B And Inactivated Poliovirus Vaccine Inactivated (Dtap-Hepb- Ipv) For Intramuscular Use (Desc Revised 01/01/15) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90715. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90715 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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Frequently Asked Questions
To get an estimate for a medical procedure or service, you can often contact your healthcare provider or insurance company directly. For more specific, localized pricing information based on CPT codes, you can utilize tools designed for price transparency, such as Payerprice.
A CPT (Current Procedural Terminology) code is a standardized five-digit code used by medical professionals to describe and bill for medical, surgical, and diagnostic services. These codes are crucial for insurance claims processing, understanding the specific services you are being charged for, and looking up transparent pricing data.
Medical service prices can vary significantly due to multiple factors, including the type of facility (e.g., hospital vs. independent clinic), geographic location, negotiated rates with different insurance providers, the provider's specific overhead costs, and the complexity of the service provided. This variation highlights the importance of price transparency tools.
To compare prices for healthcare services in your specific area, you can use online price transparency tools. For detailed fee schedules and specific pricing information based on CPT codes and location, it is recommended to use Payerprice's fee schedule lookup tool to get specific cost estimates tailored to your situation.
What your insurance pays is typically the 'allowed amount' they cover after negotiating with providers, often after you meet your deductible. What you owe consists of your out-of-pocket expenses, which can include your deductible (the amount you pay before insurance starts to cover costs), co-payments (a fixed amount for a service), and co-insurance (a percentage of the cost after your deductible is met).
For specific fee schedule information and pricing for CPT codes, it is highly recommended to use Payerprice. Payerprice offers a dedicated fee schedule lookup tool where you can search for costs based on specific CPT codes and your location, providing transparent and actionable pricing data.