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See a sample rate comparisonCPT 90723 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.
Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Hepatitis B And Inactivated Poliovirus Vaccine Inactivated (Dtap-Hepb- Ipv) For Intramuscular Use (Desc Revised 01/01/15)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | SL EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90723 |
| Medicaid Fee Schedule | $72.51 median of the 7 states in the free preview · View Medicaid rates for 90723 |
National average reimbursement for CPT 90723 by major payers:
$105.36
$108.51
$116.88
$108.56
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CPT 90723
5 of 25 sample ratesHigher to lower in this preview
Maureen Novak
$188.91Published rateStephen Williams
$113.80Published rateMarisa Couluris
$97.97Published rateMiami Lakes Pediatrics PLLC
$97.97Published rateFiorella Queirolo Rodriguez
$58.77Published rate
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See a sample payer proposalCPT 90723 vs. Other Vaccines, Toxoids Codes
The CPT 90723 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 90723 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 |
|---|---|---|
| 90696-CPT | Low | Diphtheria Tetanus Toxoids A, Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine And Poliovirus Vaccine Inactivated (Dtap-Ipv) When Administered To Children 4 Years Through6 Years Of Age For Intramuscular Use |
| 90713-CPT | Low | Poliovirus Vacc Inactivat (Ipv) For Subcutane Or Intramuscul, Poliovirus Vaccine Inactivated (Ipv) For Subcutaneous Or Intramuscul |
| 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 90723. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90723 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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