RxDoctor Payments Data

CPT 90670

Pneumococcal vaccine, 13-valent

$243.68Medicare-allowed amount per service, averaged across 2,508 services
Providers submitted
$356.76

Asking price, not received

Medicare allowed
$243.68

The fee schedule figure

Medicare paid
$243.68

Balance is patient coinsurance

Providers submitted an average of $356.76 for this code and Medicare allowed $243.681.5× 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 $243.68 (100%); the rest is the patient’s coinsurance and deductible.

Services
2,508

Medicare Part B, 2024

Beneficiaries
2,451
Providers billing it
105
Total allowed
$611,149

Services × allowed amount

What Medicare pays for CPT 90670

Across 2,508 services billed by 105 providers to 2,451 beneficiaries, Medicare allowed an average of $243.68 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.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills 90670

SpecialtyServicesBeneficiariesAvg allowedProviders
Internal Medicine964954$245.6647
Family Practice672669$237.2936
Centralized Flu426425$252.832
Nurse Practitioner189159$243.824
Pharmacy6666$240.634
Mass Immunizer Roster Biller4545$252.833
Pulmonary Disease3131$252.832
Medical Oncology2922$252.832
Nephrology2424$155.571
Hematology-Oncology1913$226.221
General Practice1616$252.831
Cardiology1515$235.971
Physician Assistant1212$252.831

90670 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.

StateServicesAllowedStandardized pmtProviders
California659$243.21$243.6021
Florida462$252.28$252.844
New York228$228.08$228.2614
Texas127$248.11$252.178
South Carolina112$251.98$252.394
Arizona101$249.96$250.066
Georgia99$223.85$223.854
Maryland94$252.83$252.835
New Jersey94$249.77$249.776
West Virginia66$229.97$229.972
Tennessee60$216.69$220.993
Massachusetts42$252.83$252.833
Virginia41$240.50$253.083
Michigan34$252.14$252.141
Ohio31$252.83$252.832
Illinois29$238.34$238.342
Kansas26$252.83$252.832
Pennsylvania25$215.60$215.601
Oklahoma22$252.83$252.832
Wyoming16$252.83$252.831
Iowa15$252.83$252.831
Oregon15$252.83$252.831
Indiana14$252.83$252.831
Connecticut14$252.83$252.831
U.S. Virgin Islands13$252.83$252.831
District of Columbia13$252.83$252.831
Kentucky12$252.83$252.831
Mississippi11$159.47$159.471
Washington11$252.83$252.831
Wisconsin11$252.83$252.831
North Carolina11$252.83$252.831

Related codes

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.