How much does Medicare pay for CPT 90673?

Medicare allowed an average of $75.77 per service and paid $75.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $89.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90673?

Influenza vaccine, trivalent derived from recombinant dna. It was billed 206,157 times to 206,072 Medicare beneficiaries by 3,927 providers in 2024.

Does 90673 pay differently in an office than a hospital?

Yes. The allowed amount averaged $75.76 in an office setting and $81.77 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 90673 most?

Centralized Flu, with 58,840 services from 16 clinicians. Next are Family Practice, Mass Immunizer Roster Biller, Internal Medicine.

CPT 90673

Influenza vaccine, trivalent derived from recombinant dna

$75.77Medicare-allowed amount per service, averaged across 206,157 services

Providers submitted

$89.22

Asking price, not received

Medicare allowed

$75.77

The fee schedule figure

Medicare paid

$75.77

Balance is patient coinsurance

Providers submitted an average of $89.22 for this code and Medicare allowed $75.77 — 1.2× 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 $75.77 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $75.76
Hospital / facility: $81.77

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 205,835 services were billed in an office setting and 322 in a facility.

Services: 206,157
Beneficiaries: 206,072
Providers billing it: 3,927
Total allowed: $15,620,516

What Medicare pays for CPT 90673

Across 206,157 services billed by 3,927 providers to 206,072 beneficiaries, Medicare allowed an average of $75.77 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 90673

Specialty	Services	Beneficiaries	Avg allowed	Providers
Centralized Flu	58,840	58,826	$81.82	16
Family Practice	47,231	47,208	$68.54	1,143
Mass Immunizer Roster Biller	42,964	42,963	$81.47	1,344
Internal Medicine	38,821	38,784	$72.07	785
Nurse Practitioner	9,226	9,224	$67.43	354
Physician Assistant	3,127	3,126	$64.84	132
Public Health or Welfare Agency	1,129	1,129	$77.70	11
Pharmacy	848	847	$81.82	40
General Practice	764	764	$65.24	15
Endocrinology	733	728	$79.34	11
Pulmonary Disease	677	676	$73.41	16
Rheumatology	373	373	$81.60	13
Cardiology	304	304	$77.87	5
Emergency Medicine	252	252	$63.82	7
Hospitalist	155	155	$55.53	7

90673 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
Idaho	50,850	$81.81	$81.81	25
Pennsylvania	28,625	$57.05	$57.25	766
Texas	13,898	$80.39	$80.59	301
Florida	8,820	$80.35	$80.51	83
California	8,790	$80.08	$80.31	173
Massachusetts	8,727	$79.71	$79.75	131
Maryland	8,608	$78.71	$79.04	169
Indiana	8,303	$57.29	$57.46	192
Virginia	7,095	$73.26	$73.69	166
New York	6,828	$77.03	$77.35	158
New Jersey	5,910	$79.91	$80.12	128
Illinois	4,028	$76.50	$76.64	105
Montana	3,440	$79.30	$79.41	40
Ohio	3,187	$81.44	$81.59	127
North Carolina	3,047	$80.83	$81.16	85
Washington	2,627	$79.86	$79.88	128
Georgia	2,617	$75.96	$76.52	48
Michigan	2,449	$80.51	$80.89	87
Oregon	2,379	$78.92	$79.12	90
Missouri	2,339	$68.20	$68.32	76
Utah	2,060	$78.80	$79.32	78
Alabama	2,048	$77.96	$78.90	49
Kansas	1,698	$81.01	$81.06	74
Colorado	1,578	$81.23	$81.54	75
Delaware	1,390	$81.38	$81.38	12
Mississippi	1,167	$80.38	$81.38	38
Wisconsin	1,160	$80.55	$80.77	39
Nevada	1,135	$81.77	$81.77	43
Maine	1,087	$79.56	$81.10	52
Minnesota	939	$75.61	$75.70	43
South Carolina	888	$81.06	$81.35	32
Alaska	757	$81.82	$81.82	13
Hawaii	757	$79.21	$79.21	17
Louisiana	746	$77.25	$77.25	23
Kentucky	725	$81.26	$81.83	29
Rhode Island	667	$81.64	$81.64	10
Oklahoma	597	$81.82	$81.82	35
Connecticut	563	$77.19	$77.44	21
New Hampshire	510	$81.50	$81.83	20
Arkansas	509	$81.64	$81.80	32
Tennessee	487	$81.48	$81.83	23
Arizona	448	$81.59	$81.78	18
District of Columbia	288	$81.60	$81.60	8
Vermont	266	$81.82	$81.82	8
Wyoming	261	$78.20	$78.20	12
New Mexico	202	$81.82	$81.82	14
West Virginia	181	$81.82	$81.82	13
Iowa	177	$81.82	$81.82	7
AP	130	$81.82	$81.82	1
South Dakota	78	$81.82	$81.82	5
Nebraska	56	$81.82	$81.82	4
North Dakota	35	$81.82	$81.82	1

Related codes

90662Influenza vaccine split virus$80.84
90653Influenza vaccine$81.38
90677Pneumococcal conjugate vaccine$287.84
90656Influenza vaccine$21.59
90661Influenza vaccine$35.62
90658Influenza vaccine$21.26
90694Influenza vaccine$74.67
90686Influenza vaccine$21.65
90684Pcv21 vaccine im$319.79
90671Pneumococcal conjugate vaccine$246.27
90688Influenza vaccine$20.25
90674Influenza vaccine$32.86

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.