How much does Medicare pay for CPT 91320?

Medicare allowed an average of $147.23 per service and paid $147.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $162.94, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 91320?

Sarscv2 vac 30mcg trs-suc im. It was billed 4,506,697 times to 4,183,572 Medicare beneficiaries by 36,800 providers in 2024.

Does 91320 pay differently in an office than a hospital?

Yes. The allowed amount averaged $147.23 in an office setting and $137.06 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 91320 most?

Mass Immunizer Roster Biller, with 2,377,966 services from 17,153 clinicians. Next are Centralized Flu, Internal Medicine, Family Practice.

CPT 91320

Sarscv2 vac 30mcg trs-suc im

$147.23Medicare-allowed amount per service, averaged across 4,506,697 services

Providers submitted

$162.94

Asking price, not received

Medicare allowed

$147.23

The fee schedule figure

Medicare paid

$147.23

Balance is patient coinsurance

Providers submitted an average of $162.94 for this code and Medicare allowed $147.23 — 1.1× 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 $147.23 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $147.23
Hospital / facility: $137.06

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 4,505,029 services were billed in an office setting and 1,668 in a facility.

Services: 4,506,697
Beneficiaries: 4,183,572
Providers billing it: 36,800
Total allowed: $663,520,999

What Medicare pays for CPT 91320

Across 4,506,697 services billed by 36,800 providers to 4,183,572 beneficiaries, Medicare allowed an average of $147.23 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 91320

Specialty	Services	Beneficiaries	Avg allowed	Providers
Mass Immunizer Roster Biller	2,377,966	2,219,307	$147.78	17,153
Centralized Flu	1,605,367	1,475,233	$147.64	7,768
Internal Medicine	154,073	143,327	$143.17	3,425
Family Practice	150,068	141,444	$143.19	4,445
Pharmacy	115,133	106,101	$146.61	1,069
Nurse Practitioner	49,869	48,144	$142.23	1,928
Public Health or Welfare Agency	11,283	10,602	$139.29	62
Physician Assistant	11,151	10,741	$142.69	508
Infectious Disease	5,355	4,886	$144.42	31
Geriatric Medicine	4,305	3,742	$142.48	82
Pediatric Medicine	3,017	2,923	$142.60	55
Hospitalist	2,515	2,357	$142.44	34
Emergency Medicine	2,426	2,210	$140.45	27
Clinical Laboratory	2,362	2,262	$145.96	38
General Practice	1,936	1,840	$142.57	32

91320 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
California	407,496	$144.73	$144.76	2,899
Idaho	378,714	$147.26	$147.27	179
Florida	297,797	$146.17	$146.18	2,443
New York	212,635	$148.04	$148.12	1,636
Texas	208,729	$147.54	$147.57	2,438
Pennsylvania	194,384	$148.17	$148.33	2,155
Massachusetts	180,062	$147.37	$147.40	1,123
Colorado	178,188	$147.27	$147.34	818
Illinois	166,885	$147.46	$147.49	1,334
Virginia	159,486	$147.64	$147.74	1,222
Ohio	140,519	$148.59	$148.62	1,328
New Jersey	120,466	$148.43	$148.49	949
North Carolina	118,145	$148.25	$148.30	1,323
Maryland	113,662	$147.21	$147.38	946
Indiana	97,258	$148.75	$148.81	943
Washington	94,807	$146.06	$146.13	808
Iowa	94,149	$148.24	$148.27	531
Minnesota	86,410	$145.55	$145.73	1,006
Missouri	81,955	$148.49	$148.53	733
Michigan	78,299	$147.77	$147.87	884
Georgia	78,006	$147.85	$147.91	1,148
Wisconsin	77,819	$147.76	$147.79	592
Arizona	77,508	$146.05	$146.08	603
South Carolina	77,239	$147.87	$147.99	729
Tennessee	75,492	$147.44	$147.57	951
Kansas	59,627	$148.21	$148.25	386
Kentucky	51,796	$147.25	$147.57	781
Connecticut	50,521	$148.19	$148.25	505
New Hampshire	48,746	$148.54	$148.59	254
Oregon	46,247	$146.38	$146.45	464
Nebraska	44,049	$147.44	$147.48	310
Oklahoma	36,101	$148.48	$148.51	350
Utah	34,186	$147.55	$147.76	561
Arkansas	31,981	$148.04	$148.07	406
Nevada	29,153	$146.75	$146.76	237
Louisiana	27,928	$148.35	$148.36	438
New Mexico	25,804	$146.20	$146.29	199
Alabama	25,641	$148.39	$148.46	496
Mississippi	25,287	$147.67	$147.68	249
Delaware	22,513	$147.76	$147.84	134
Maine	19,793	$146.35	$146.43	203
Montana	17,073	$146.68	$146.68	111
Hawaii	16,955	$143.14	$143.25	86
South Dakota	16,762	$147.71	$147.74	123
North Dakota	15,246	$148.23	$148.23	133
Rhode Island	15,208	$144.30	$144.30	119
West Virginia	13,753	$148.29	$148.30	200
Vermont	13,332	$145.85	$146.01	112
Alaska	8,109	$145.11	$145.11	44
Wyoming	7,158	$146.19	$146.19	67
District of Columbia	5,219	$146.36	$146.40	61
Puerto Rico	1,669	$148.03	$148.03	39
Guam	368	$141.34	$141.69	4
U.S. Virgin Islands	301	$147.45	$147.45	4
AE	31	$109.06	$112.77	1
AP	30	$149.08	$149.08	2

Related codes

91322Sarscov2 vac 50 mcg/0.5ml im$153.93
91304Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine$156.81

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.