How much does Medicare pay for CPT 90471?

Medicare allowed an average of $19.61 per service and paid $13.89 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $48.15, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90471?

Administration of vaccine. It was billed 89,661 times to 83,753 Medicare beneficiaries by 3,967 providers in 2024.

Does 90471 pay differently in an office than a hospital?

Yes. The allowed amount averaged $19.62 in an office setting and $17.06 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 90471 most?

Family Practice, with 29,085 services from 1,407 clinicians. Next are Internal Medicine, Nurse Practitioner, Physician Assistant.

CPT 90471

Administration of vaccine

$19.61Medicare-allowed amount per service, averaged across 89,661 services

Providers submitted

$48.15

Asking price, not received

Medicare allowed

$19.61

The fee schedule figure

Medicare paid

$13.89

Balance is patient coinsurance

Providers submitted an average of $48.15 for this code and Medicare allowed $19.61 — 2.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $13.89 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $19.62
Hospital / facility: $17.06

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 89,572 services were billed in an office setting and 89 in a facility.

Services: 89,661
Beneficiaries: 83,753
Providers billing it: 3,967
Total allowed: $1,758,252

What Medicare pays for CPT 90471

Across 89,661 services billed by 3,967 providers to 83,753 beneficiaries, Medicare allowed an average of $19.61 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 90471

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	29,085	27,477	$19.85	1,407
Internal Medicine	28,180	25,429	$20.60	1,143
Nurse Practitioner	11,925	11,324	$17.02	631
Physician Assistant	6,343	6,182	$17.61	413
Centralized Flu	5,580	5,486	$19.60	1
Emergency Medicine	3,116	3,104	$21.20	172
Infectious Disease	1,077	920	$20.46	29
General Practice	806	686	$20.96	32
Pediatric Medicine	607	536	$18.89	14
Mass Immunizer Roster Biller	592	579	$19.67	31
Geriatric Medicine	291	267	$21.61	13
Pulmonary Disease	249	169	$22.75	8
Allergy/ Immunology	211	202	$21.27	9
Cardiology	201	125	$20.75	7
Obstetrics & Gynecology	187	182	$18.63	2

90471 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	10,161	$19.24	$17.44	215
Texas	8,417	$19.15	$13.70	404
Pennsylvania	8,184	$19.11	$13.42	410
New Jersey	7,823	$21.91	$14.25	347
Maryland	7,401	$20.15	$13.51	305
New York	5,560	$22.20	$14.43	266
Virginia	5,308	$20.44	$13.54	218
North Carolina	4,345	$18.48	$13.16	212
Georgia	3,316	$19.06	$13.41	134
South Carolina	2,759	$18.06	$13.46	147
Louisiana	2,344	$17.92	$13.74	82
Colorado	2,336	$20.37	$12.64	109
Oklahoma	2,181	$17.86	$13.49	103
California	2,113	$21.51	$14.15	115
Tennessee	2,042	$17.89	$12.96	106
Delaware	1,433	$18.66	$13.50	52
Massachusetts	1,233	$20.05	$12.81	74
Arkansas	1,228	$17.14	$13.34	53
Illinois	1,218	$20.25	$13.79	55
Mississippi	1,162	$16.37	$13.88	73
Alabama	1,009	$17.33	$13.93	49
New Mexico	811	$18.63	$13.19	32
District of Columbia	808	$22.37	$13.44	34
Arizona	707	$18.11	$12.48	40
Ohio	519	$19.22	$13.74	27
Indiana	490	$18.23	$13.83	33
Connecticut	410	$20.62	$13.63	23
Washington	377	$19.41	$12.75	22
Michigan	366	$18.99	$14.09	23
Rhode Island	357	$19.98	$14.49	14
Missouri	336	$17.72	$13.35	23
Iowa	312	$18.40	$13.34	19
Wisconsin	289	$18.88	$14.01	12
Alaska	252	$22.37	$13.51	15
West Virginia	227	$18.48	$14.24	13
Idaho	198	$17.54	$10.91	9
Kentucky	196	$18.51	$14.35	14
New Hampshire	192	$19.51	$13.58	13
Kansas	189	$16.74	$12.18	13
Nebraska	176	$18.33	$13.19	9
Montana	145	$17.46	$11.98	10
Oregon	141	$18.79	$12.80	8
Nevada	118	$20.42	$11.94	4
North Dakota	116	$18.77	$13.09	5
South Dakota	110	$17.77	$11.81	7
Minnesota	102	$20.30	$13.45	6
Wyoming	75	$19.11	$13.23	5
Maine	26	$19.17	$14.01	2
Hawaii	17	$21.44	$15.07	1
XX	15	$20.04	$14.53	1
U.S. Virgin Islands	11	$19.87	$10.27	1

Related codes

90480Admn sarscov2 vacc 1 dose$37.99
90472Administration of vaccine$13.94

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.