How much does Medicare pay for CPT 90480?

Medicare allowed an average of $37.99 per service and paid $37.99 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $49.99, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90480?

Admn sarscov2 vacc 1 dose. It was billed 8,303,881 times to 7,569,494 Medicare beneficiaries by 54,794 providers in 2024.

Does 90480 pay differently in an office than a hospital?

Yes. The allowed amount averaged $37.99 in an office setting and $42.07 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 90480 most?

Mass Immunizer Roster Biller, with 4,642,892 services from 24,792 clinicians. Next are Centralized Flu, Pharmacy, Family Practice.

CPT 90480

Admn sarscov2 vacc 1 dose

$37.99Medicare-allowed amount per service, averaged across 8,303,881 services

Providers submitted

$49.99

Asking price, not received

Medicare allowed

$37.99

The fee schedule figure

Medicare paid

$37.99

Balance is patient coinsurance

Providers submitted an average of $49.99 for this code and Medicare allowed $37.99 — 1.3× 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 $37.99 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $37.99
Hospital / facility: $42.07

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 8,301,652 services were billed in an office setting and 2,229 in a facility.

Services: 8,303,881
Beneficiaries: 7,569,494
Providers billing it: 54,794
Total allowed: $315,464,439

What Medicare pays for CPT 90480

Across 8,303,881 services billed by 54,794 providers to 7,569,494 beneficiaries, Medicare allowed an average of $37.99 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 90480

Specialty	Services	Beneficiaries	Avg allowed	Providers
Mass Immunizer Roster Biller	4,642,892	4,247,479	$35.49	24,792
Centralized Flu	2,661,200	2,395,734	$41.07	9,807
Pharmacy	284,380	256,935	$39.76	2,092
Family Practice	271,779	254,733	$41.64	7,681
Internal Medicine	249,310	230,618	$43.12	5,317
Nurse Practitioner	85,672	82,668	$41.07	3,273
Public Health or Welfare Agency	23,532	21,568	$38.66	152
Physician Assistant	20,805	19,966	$41.68	917
Clinical Laboratory	10,700	9,710	$38.44	77
Pediatric Medicine	9,105	8,908	$43.03	106
Geriatric Medicine	6,574	5,828	$41.87	121
Infectious Disease	6,446	5,889	$46.68	50
General Practice	4,320	4,128	$42.32	53
Emergency Medicine	4,060	3,761	$46.03	54
All Other Suppliers	3,826	3,389	$41.62	29

90480 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
California	790,065	$41.42	$41.50	4,483
Idaho	661,225	$42.79	$42.38	225
Florida	502,608	$39.77	$41.04	3,059
New York	423,333	$40.98	$41.82	2,588
Pennsylvania	378,645	$38.92	$40.82	3,052
Texas	352,637	$35.40	$38.63	3,288
Massachusetts	346,700	$40.82	$41.64	1,594
Illinois	312,816	$37.96	$41.73	2,140
Colorado	297,700	$36.90	$40.94	1,058
Virginia	276,019	$37.45	$40.00	1,688
Ohio	261,011	$35.14	$40.03	2,081
New Jersey	231,535	$40.76	$41.15	1,418
Maryland	229,351	$41.04	$40.97	1,396
North Carolina	226,101	$35.82	$40.07	2,107
Wisconsin	192,615	$35.19	$38.76	1,821
Washington	183,057	$37.86	$40.74	1,161
Michigan	176,136	$36.37	$39.87	1,559
Minnesota	175,179	$35.12	$40.63	1,974
Indiana	168,426	$35.08	$39.76	1,394
Iowa	155,914	$36.09	$39.82	916
Missouri	140,931	$34.39	$37.54	1,081
Arizona	139,871	$35.51	$39.48	909
Georgia	139,246	$36.35	$40.17	1,550
South Carolina	137,082	$35.53	$39.27	949
Tennessee	124,827	$33.97	$38.88	1,309
Kansas	114,728	$31.95	$37.79	649
Connecticut	101,655	$40.66	$41.34	836
Oregon	86,078	$35.27	$39.88	703
Kentucky	82,240	$32.64	$38.21	984
New Hampshire	73,977	$38.21	$39.40	281
Oklahoma	71,672	$30.20	$33.84	561
Nebraska	69,416	$35.34	$39.02	415
Arkansas	62,152	$30.23	$34.59	608
Utah	51,611	$31.84	$37.84	638
New Mexico	50,595	$32.80	$36.76	286
Nevada	48,577	$34.30	$37.86	318
Hawaii	45,179	$40.40	$41.66	145
Delaware	44,070	$38.93	$40.97	175
Alabama	40,929	$33.26	$36.90	672
Louisiana	40,675	$33.13	$36.30	560
Mississippi	37,356	$29.74	$35.54	310
Maine	35,993	$36.42	$38.64	274
Vermont	34,652	$35.39	$40.71	158
Montana	30,931	$35.36	$38.76	175
South Dakota	29,920	$33.28	$35.94	163
Rhode Island	29,332	$40.16	$41.61	204
West Virginia	24,153	$32.23	$36.58	267
North Dakota	22,845	$35.95	$37.55	178
Alaska	17,148	$41.18	$40.65	88
District of Columbia	16,398	$42.56	$41.89	169
Wyoming	15,009	$31.89	$36.67	113
Puerto Rico	2,556	$40.44	$42.56	49
U.S. Virgin Islands	416	$36.06	$42.56	4
Guam	384	$43.99	$42.56	5
AE	161	$45.14	$42.56	3
AP	30	$41.51	$42.56	2

Related codes

90471Administration of vaccine$19.61
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.