How much does Medicare pay for CPT 90688?

Medicare allowed an average of $20.25 per service and paid $20.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $39.71, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90688?

Influenza vaccine, quadrivalent, 0.5 ml dosage. It was billed 3,037 times to 3,019 Medicare beneficiaries by 114 providers in 2024.

Which specialty bills 90688 most?

Internal Medicine, with 1,436 services from 47 clinicians. Next are Family Practice, Geriatric Medicine, Mass Immunizer Roster Biller.

CPT 90688

Influenza vaccine, quadrivalent, 0.5 ml dosage

$20.25Medicare-allowed amount per service, averaged across 3,037 services

Providers submitted

$39.71

Asking price, not received

Medicare allowed

$20.25

The fee schedule figure

Medicare paid

$20.25

Balance is patient coinsurance

Providers submitted an average of $39.71 for this code and Medicare allowed $20.25 — 2.0× 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 $20.25 (100%); the rest is the patient’s coinsurance and deductible.

Services: 3,037
Beneficiaries: 3,019
Providers billing it: 114
Total allowed: $61,499

What Medicare pays for CPT 90688

Across 3,037 services billed by 114 providers to 3,019 beneficiaries, Medicare allowed an average of $20.25 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 90688

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	1,436	1,432	$20.32	47
Family Practice	889	881	$20.13	42
Geriatric Medicine	144	140	$20.18	1
Mass Immunizer Roster Biller	142	142	$20.08	7
Nurse Practitioner	116	114	$20.46	5
Centralized Flu	98	98	$20.46	3
Physician Assistant	50	50	$20.46	1
General Practice	33	33	$20.46	1
Addiction Medicine	30	30	$20.46	1
Rheumatology	25	25	$20.46	1
Pulmonary Disease	17	17	$20.46	1
Allergy/ Immunology	16	16	$20.46	1
Clinical Laboratory	16	16	$20.46	1
Public Health or Welfare Agency	13	13	$17.19	1
Pediatric Medicine	12	12	$20.46	1

90688 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
Ohio	984	$20.34	$20.50	16
California	430	$20.01	$20.01	20
Texas	234	$20.46	$20.49	12
New Jersey	229	$20.46	$20.48	12
Guam	207	$20.36	$20.46	7
Kentucky	180	$20.35	$20.46	6
Maryland	119	$20.12	$20.47	6
Florida	111	$20.46	$20.46	3
Oklahoma	63	$20.46	$20.46	2
Idaho	45	$20.46	$20.46	2
Washington	44	$20.46	$20.46	1
New York	33	$20.46	$20.46	2
U.S. Virgin Islands	33	$20.46	$20.46	1
Utah	32	$17.46	$17.46	2
Georgia	31	$19.95	$19.95	2
Illinois	29	$16.88	$16.88	2
Arkansas	27	$20.46	$20.46	2
South Carolina	26	$19.67	$20.48	2
Louisiana	24	$20.46	$20.46	2
North Carolina	22	$20.46	$20.46	2
Massachusetts	22	$20.46	$20.46	2
Pennsylvania	22	$20.46	$20.46	2
Mississippi	21	$20.46	$20.46	1
Virginia	17	$20.46	$20.46	1
Arizona	16	$20.46	$20.46	1
Missouri	13	$20.46	$20.46	1
Alabama	12	$20.46	$20.46	1
Michigan	11	$20.46	$20.46	1

Related codes

90662Influenza vaccine split virus$80.84
90653Influenza vaccine$81.38
90677Pneumococcal conjugate vaccine$287.84
90656Influenza vaccine$21.59
90673Influenza vaccine$75.77
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
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.