RxDoctor Payments Data

CPT 90694

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

$74.67Medicare-allowed amount per service, averaged across 47,087 services
Providers submitted
$86.71

Asking price, not received

Medicare allowed
$74.67

The fee schedule figure

Medicare paid
$74.67

Balance is patient coinsurance

Providers submitted an average of $86.71 for this code and Medicare allowed $74.671.2× 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 $74.67 (100%); the rest is the patient’s coinsurance and deductible.

Services
47,087

Medicare Part B, 2024

Beneficiaries
47,048
Providers billing it
2,618
Total allowed
$3,515,986

Services × allowed amount

What Medicare pays for CPT 90694

Across 47,087 services billed by 2,618 providers to 47,048 beneficiaries, Medicare allowed an average of $74.67 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 90694

SpecialtyServicesBeneficiariesAvg allowedProviders
Mass Immunizer Roster Biller20,96420,962$75.791,341
Centralized Flu16,23716,227$73.56737
Internal Medicine3,9993,983$72.68228
Family Practice3,5933,586$74.94192
Pharmacy968968$75.8153
Nurse Practitioner485482$75.1132
Pediatric Medicine246246$75.643
Physician Assistant126125$74.416
Public Health or Welfare Agency101101$75.424
Pulmonary Disease6868$75.644
General Practice5858$74.502
Emergency Medicine4545$75.813
Cardiology3838$75.813
Nephrology2929$75.812
Preventive Medicine2525$72.021

90694 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
Florida8,961$75.47$75.49509
California8,213$75.04$75.05474
Colorado4,203$70.71$70.719
New York2,223$75.33$75.46156
Massachusetts1,725$75.65$75.65111
Maryland1,592$75.47$75.61109
South Carolina1,404$75.25$75.4386
Kentucky1,336$75.04$75.6240
Virginia1,323$75.20$75.3187
Texas1,235$74.67$74.8690
New Jersey1,091$75.24$75.2468
Ohio1,069$75.22$75.3839
Arizona955$75.07$75.0760
Washington919$75.19$75.1954
Iowa899$75.81$75.8159
Georgia809$75.57$75.5762
North Carolina611$74.72$74.7240
Pennsylvania607$75.81$75.8143
Hawaii580$75.67$75.6731
Illinois579$74.15$74.2435
Tennessee563$74.99$75.1739
Indiana482$75.13$75.2937
Oklahoma454$74.52$74.8633
Minnesota405$61.44$61.4420
Delaware399$75.22$75.2227
Nebraska370$75.42$75.6324
Missouri302$75.81$75.8120
New Hampshire294$74.86$74.8622
Nevada285$75.15$75.1519
Oregon277$75.11$75.1116
Wisconsin256$72.58$72.5820
New Mexico247$74.23$74.2314
Alaska242$75.18$75.8215
Montana213$74.46$74.4612
Mississippi207$71.30$71.3016
Connecticut190$75.51$75.5113
Kansas189$75.53$75.5315
Arkansas188$75.17$75.1713
Louisiana179$75.09$75.0913
Alabama171$75.38$75.3813
South Dakota161$75.42$75.4211
Utah105$75.16$75.167
Rhode Island104$75.25$75.258
North Dakota89$75.81$75.814
Vermont86$74.59$74.595
Michigan69$68.71$68.715
Idaho62$75.81$75.813
Maine38$75.81$75.813
Wyoming31$70.55$70.552
District of Columbia28$73.10$75.872
U.S. Virgin Islands26$75.81$75.812
AE16$75.81$75.811
Puerto Rico13$72.98$72.981
West Virginia12$75.81$75.811

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.