CPT code 90461: Vaccine administration, each additional component2026 Medicare rate & RVUs

Medicare pays $8.68 for 90461 nationally in the office. Local office rates run $8.19–$11.69.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 90461 covers

Code 90461 represents administration of an additional vaccine component for a patient age 18 or younger when a physician or other qualified health care professional provides immunization counseling. It is commonly relevant when a combination vaccine contains multiple components. The code counts components, not injections, so a single injection can involve more than one reportable component. The physician or qualified health care professional may provide the service in an office, clinic, or other setting where pediatric immunizations are administered.

Report 90461 only with 90460, which represents the first component; use one unit of 90461 for each additional component. Documentation should support the patient's age, counseling by the physician or qualified professional, vaccine administered, and the component count. CMS classifies 90461 as an add-on code: it cannot be billed alone, and its payment is within the primary procedure's global period. Do not use it to count additional injections when the service is administration without the counseling framework.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 90461 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90461 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 90461 rate is calculated

Each of 90461’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 90461

The CMS indicators that decide how 90461 is paid alongside other services.

90461 compared with similar codes

How to choose

90460Vaccine administrationFirst or only vaccine component

90460 reports the first vaccine component for a patient age 18 or younger when the counseling requirements are met. 90461 reports each component after that first one.

90471Immunization administrationFirst injectable vaccine

90471 reports immunization administration without the age-based counseling framework. Use 90460 and, when applicable, 90461 when counseling by a physician or qualified health care professional is part of the service.

90472Vaccine administrationEach additional vaccine

90472 reports an additional immunization administration under the non-counseling framework. 90461 counts an additional vaccine component when the 90460 counseling framework applies.

Codes related to 90461

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates