How much does Medicare pay for CPT 90715?

Medicare allowed an average of $37.48 per service and paid $26.88 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $84.28, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90715?

Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older). It was billed 13,292 times to 13,274 Medicare beneficiaries by 821 providers in 2024.

Which specialty bills 90715 most?

Family Practice, with 4,670 services from 280 clinicians. Next are Internal Medicine, Nurse Practitioner, Physician Assistant.

CPT 90715

Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)

$37.48Medicare-allowed amount per service, averaged across 13,292 services

Providers submitted

$84.28

Asking price, not received

Medicare allowed

$37.48

The fee schedule figure

Medicare paid

$26.88

Balance is patient coinsurance

Providers submitted an average of $84.28 for this code and Medicare allowed $37.48 — 2.2× 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 $26.88 (72%); the rest is the patient’s coinsurance and deductible.

Services: 13,292
Beneficiaries: 13,274
Providers billing it: 821
Total allowed: $498,184

What Medicare pays for CPT 90715

Across 13,292 services billed by 821 providers to 13,274 beneficiaries, Medicare allowed an average of $37.48 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 90715

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	4,670	4,659	$37.35	280
Internal Medicine	3,309	3,305	$37.57	181
Nurse Practitioner	2,240	2,239	$37.57	155
Physician Assistant	1,697	1,696	$37.57	120
Emergency Medicine	1,105	1,105	$37.80	69
Geriatric Medicine	61	60	$38.03	3
Hospitalist	50	50	$37.31	3
Infectious Disease	38	38	$36.93	2
General Practice	35	35	$38.22	3
General Surgery	24	24	$36.40	1
Gastroenterology	21	21	$38.15	1
Obstetrics & Gynecology	16	16	$38.05	1
Osteopathic Manipulative Medicine	14	14	$38.06	1
Addiction Medicine	12	12	$0.49	1

90715 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
New York	1,231	$37.92	$28.27	80
North Carolina	1,165	$37.67	$27.63	68
Pennsylvania	1,151	$37.95	$26.33	68
Virginia	994	$37.82	$27.26	64
New Jersey	945	$37.87	$27.50	54
California	910	$37.90	$28.10	55
Maryland	632	$37.97	$26.43	35
Tennessee	628	$37.50	$27.69	37
Florida	600	$37.96	$27.74	39
Texas	538	$37.76	$26.02	30
Georgia	506	$37.42	$28.62	29
South Carolina	499	$37.93	$27.85	35
Massachusetts	324	$36.82	$26.98	22
Illinois	315	$38.02	$27.49	17
Delaware	274	$38.00	$28.11	20
Alabama	254	$34.44	$25.56	15
Colorado	243	$37.96	$24.63	15
Iowa	208	$38.05	$25.47	12
Rhode Island	179	$17.03	$13.08	11
Louisiana	173	$37.60	$27.38	12
Mississippi	172	$38.02	$27.67	14
Nebraska	147	$38.08	$25.84	7
Missouri	143	$38.03	$26.44	10
Indiana	134	$37.87	$26.06	9
Oklahoma	101	$37.67	$26.85	7
Arkansas	94	$38.06	$25.65	6
Michigan	91	$37.62	$26.28	6
Washington	90	$38.07	$24.84	6
Oregon	80	$38.02	$26.58	5
Arizona	63	$37.98	$28.32	4
Kansas	60	$38.06	$24.41	5
New Hampshire	44	$37.98	$28.87	2
Connecticut	40	$38.08	$28.03	2
Minnesota	32	$38.04	$28.27	2
Wisconsin	31	$38.19	$20.84	2
West Virginia	24	$36.36	$30.58	2
Montana	24	$38.06	$27.75	2
District of Columbia	23	$37.95	$30.24	2
New Mexico	23	$38.04	$24.94	2
Wyoming	22	$38.17	$21.17	2
Guam	19	$38.07	$13.45	1
Hawaii	17	$38.10	$25.68	1
South Dakota	13	$38.05	$25.57	1
North Dakota	12	$37.99	$20.03	1
Maine	12	$36.00	$28.68	1
Nevada	11	$37.92	$30.21	1

Related codes

90791Psychiatric diagnostic evaluation$147.36
90792Psychiatric diagnostic evaluation$163.13
90785Psychiatric services complicated by communication factor$12.70
90732Pneumococcal vaccine$128.28
90714Diphtheria and tetanus vaccine (7 years or older)$27.84
90739Hepatitis b vaccine (hepb)$155.49
90746Hepatitis b vaccine$67.61
90756Influenza vaccine$31.36

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.