RxDoctor Payments Data

CPT 91304

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use

$156.81Medicare-allowed amount per service, averaged across 83,998 services
Providers submitted
$167.05

Asking price, not received

Medicare allowed
$156.81

The fee schedule figure

Medicare paid
$156.81

Balance is patient coinsurance

Services
83,998

Medicare Part B, 2024

Beneficiaries
83,113
Providers billing it
2,101
Total allowed
$13,171,726

Services × allowed amount

What Medicare pays for CPT 91304

Across 83,998 services billed by 2,101 providers to 83,113 beneficiaries, Medicare allowed an average of $156.81 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 91304

SpecialtyServicesBeneficiariesAvg allowedProviders
Mass Immunizer Roster Biller66,44966,021$157.371,473
Centralized Flu11,04310,694$156.30458
Pharmacy3,3423,303$156.83100
Internal Medicine1,2591,225$154.2326
Family Practice654646$148.4020
Public Health or Welfare Agency479465$124.735
Nurse Practitioner231229$139.316
Emergency Medicine196196$145.241
Physician Assistant131131$154.385
Clinical Laboratory112109$154.464
Infectious Disease6052$146.762
General Practice4242$157.691

91304 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
Michigan19,748$158.07$158.07153
Ohio9,689$158.07$158.07134
Indiana7,366$157.93$157.9380
California5,544$154.26$154.26234
Illinois4,379$157.57$157.5770
Florida3,719$156.74$156.74176
Colorado3,640$156.14$156.14105
Texas2,686$157.42$157.48106
Wisconsin2,514$155.39$155.3948
Washington2,460$155.46$155.4693
Virginia1,820$157.25$157.3471
Kentucky1,660$157.66$157.6637
Utah1,476$144.90$144.9042
Oregon1,432$155.92$156.0659
Maryland1,408$156.17$156.1759
North Carolina1,188$157.69$157.6964
South Carolina1,152$157.50$157.5046
Vermont925$156.12$156.129
Tennessee850$157.74$157.7440
Minnesota839$154.09$154.0922
Arizona769$156.58$156.5839
Massachusetts767$154.88$154.8844
Kansas707$154.66$154.6626
New York649$153.38$153.4336
New Jersey636$157.18$157.3723
Iowa635$153.63$153.6320
Georgia613$156.88$156.8835
Pennsylvania525$156.44$156.7533
Nebraska421$157.53$157.5311
Idaho398$156.18$156.1820
Missouri359$155.27$155.2712
New Mexico345$156.91$156.9117
Delaware242$156.64$156.6410
Hawaii221$154.23$154.2314
Oklahoma208$157.74$157.7411
New Hampshire207$155.85$155.8513
Montana193$153.78$153.7810
Nevada189$155.68$155.6811
Arkansas189$157.41$157.4110
South Dakota182$157.77$157.779
Wyoming177$158.24$158.248
Maine161$154.66$154.664
Alabama140$157.00$157.007
Louisiana136$158.02$158.027
Mississippi126$157.58$157.586
Alaska124$157.05$157.055
Connecticut76$156.76$156.765
District of Columbia66$154.53$154.534
Rhode Island28$157.84$157.842
West Virginia14$158.31$158.311

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.