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See a sample rate comparisonCPT 90743 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.
Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus.
| 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 UD |
| Complexity Level | Low |
| Medicare Fee Schedule | $75.15 per 1 dose (October 2026 ASP) · View Medicare rates for 90743 |
| Medicaid Fee Schedule | $71.46 median of the 7 states in the free preview · View Medicaid rates for 90743 |
National average reimbursement for CPT 90743 by major payers:
$73.96
$76.67
$81.95
$79.12
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CPT 90743
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$167.29Published rateLauren Prest
$82.41Published rateTushar Advani
Loyola University Medical Center
$76.44Published rateMary Fahrmeier
$68.80Published rateRestorative Health Rehabilitation Inc
$60.00Published rate
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See a sample payer proposalCPT 90743 vs. Other Vaccines, Toxoids Codes
The CPT 90743 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 90743 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 |
|---|---|---|
| 90739-CPT | Low | Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus. |
| 90743-CPT | Low | Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus. |
| 90744-CPT | Low | Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus. |
| 90746-CPT | Low | Hepatitis B Vaccine (Hepb) Adult Dosage 3 Dose Schedule For Intramuscular Use (Desc Revised 7/1/2015) Note: The Age Was Updated To Reflect The Manufacturers Age Allowance. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90743. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90743 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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