How much does Medicare pay for HCPCS G0009?

Medicare allowed an average of $29.85 per service and paid $29.85 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $48.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0009?

Administration of pneumococcal vaccine. It was billed 1,392,182 times to 1,388,751 Medicare beneficiaries by 47,082 providers in 2024.

Does G0009 pay differently in an office than a hospital?

Yes. The allowed amount averaged $29.85 in an office setting and $30.30 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 G0009 most?

Mass Immunizer Roster Biller, with 405,932 services from 14,276 clinicians. Next are Family Practice, Centralized Flu, Internal Medicine.

HCPCS G0009

Administration of pneumococcal vaccine

$29.85Medicare-allowed amount per service, averaged across 1,392,182 services

Providers submitted

$48.11

Asking price, not received

Medicare allowed

$29.85

The fee schedule figure

Medicare paid

$29.85

Balance is patient coinsurance

Providers submitted an average of $48.11 for this code and Medicare allowed $29.85 — 1.6× 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 $29.85 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $29.85
Hospital / facility: $30.30

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,391,994 services were billed in an office setting and 187 in a facility.

Services: 1,392,182
Beneficiaries: 1,388,751
Providers billing it: 47,082
Total allowed: $41,556,633

What Medicare pays for HCPCS G0009

Across 1,392,182 services billed by 47,082 providers to 1,388,751 beneficiaries, Medicare allowed an average of $29.85 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.

Who bills G0009

Specialty	Services	Beneficiaries	Avg allowed	Providers
Mass Immunizer Roster Biller	405,932	404,837	$26.70	14,276
Family Practice	298,639	298,142	$31.24	12,081
Centralized Flu	283,929	283,404	$30.04	5,857
Internal Medicine	283,553	282,970	$32.21	9,618
Nurse Practitioner	48,930	48,797	$31.08	2,453
Pharmacy	22,523	22,339	$29.70	694
Physician Assistant	19,018	18,991	$30.99	997
Pulmonary Disease	6,399	6,376	$32.11	259
Geriatric Medicine	4,352	4,347	$33.21	148
General Practice	2,202	2,183	$31.30	82
Pediatric Medicine	1,753	1,746	$30.73	70
Hospitalist	1,731	1,730	$32.05	79
Public Health or Welfare Agency	1,601	1,585	$27.61	43
Allergy/ Immunology	1,212	1,169	$32.45	51
Emergency Medicine	1,195	1,193	$30.61	48

G0009 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
Florida	156,973	$30.56	$31.90	2,962
California	128,950	$32.75	$31.89	4,393
Texas	83,574	$27.64	$31.88	3,274
New York	71,763	$33.56	$31.92	2,525
Illinois	56,950	$30.11	$31.84	2,102
Pennsylvania	55,683	$30.41	$31.89	2,282
New Jersey	54,765	$32.92	$31.91	1,800
Virginia	50,610	$29.65	$31.90	1,791
Idaho	49,860	$32.80	$31.92	150
Massachusetts	43,080	$32.03	$31.89	1,533
Maryland	41,275	$31.95	$31.89	1,364
Ohio	40,553	$27.84	$31.91	1,827
North Carolina	38,598	$28.17	$31.88	1,613
Colorado	36,516	$28.82	$31.86	845
Indiana	34,766	$28.10	$31.91	1,418
Georgia	33,642	$28.60	$31.88	1,422
South Carolina	31,964	$28.04	$31.88	1,091
Tennessee	31,048	$27.26	$31.89	1,217
Arizona	29,263	$27.71	$31.87	1,033
Michigan	28,237	$28.06	$31.91	1,144
Washington	20,545	$30.20	$31.89	812
Kansas	19,981	$25.97	$31.88	670
Missouri	19,816	$28.34	$31.85	800
Iowa	17,164	$28.51	$31.91	563
Wisconsin	16,862	$26.89	$31.91	667
Oklahoma	15,270	$27.06	$31.85	611
Kentucky	14,263	$26.91	$31.91	651
Arkansas	12,986	$25.78	$31.86	495
Connecticut	12,849	$32.25	$31.91	595
Nebraska	12,377	$27.77	$31.91	395
Alabama	12,228	$26.95	$31.84	546
Mississippi	11,625	$25.24	$31.88	437
Louisiana	11,514	$27.86	$31.84	449
Oregon	9,808	$28.53	$31.90	413
Minnesota	9,404	$27.48	$31.81	430
Nevada	8,595	$26.38	$31.80	326
Utah	7,961	$26.13	$31.89	329
Delaware	7,934	$30.58	$31.89	234
New Hampshire	7,802	$30.14	$31.87	282
New Mexico	7,190	$26.67	$31.85	246
Hawaii	5,477	$30.09	$31.91	136
Rhode Island	4,197	$31.45	$31.92	188
West Virginia	3,999	$25.81	$31.72	182
Wyoming	3,954	$26.90	$31.67	110
Montana	3,457	$27.52	$31.90	139
South Dakota	3,221	$24.46	$30.55	94
District of Columbia	2,695	$34.58	$31.92	108
Vermont	2,536	$27.00	$31.92	83
Maine	2,447	$28.68	$31.90	107
Alaska	2,403	$33.01	$31.84	71
North Dakota	2,394	$30.35	$31.92	88
Puerto Rico	471	$27.29	$31.92	18
Guam	458	$31.87	$31.92	12
AE	106	$35.34	$31.92	2
U.S. Virgin Islands	81	$21.81	$31.92	4
ZZ	15	$34.56	$31.92	1

Related codes

G0008Administration of influenza virus vaccine$29.05
G0069Professional services for the administration of subcutaneous immunothe$29.26
G0022Community health integration services$52.97
G0068Professional services for the administration of anti-infective$78.73
G0010Administration of hepatitis b vaccine$30.96
G0070Professional services for the administration of intravenous chemothera$219.38
G0019Community health integration services performed by certified or traine$78.48
G0089Professional services$26.90
G0023Principal illness navigation services by certified or trained auxiliar$76.96
G0024Principal illness navigation services$51.25

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.