CPT code 90472: Vaccine administration, each additional vaccine2026 Medicare rate & RVUs

Medicare pays $16.03 for 90472 nationally in the office. Local office rates run $14.36–$21.15.

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

What 90472 covers

90472 represents administration of each additional vaccine after the first intramuscular or subcutaneous vaccine during an encounter. It covers the administration work, not the vaccine product; report the product separately when applicable. Nurses and other clinical staff commonly perform the service in an office or clinic. For pediatric visits, the standard administration codes may be appropriate when the face-to-face physician or qualified health professional counseling circumstance for 90460 and 90461 is not present.

Report 90471 for the first vaccine and 90472 for each additional vaccine administered by the intramuscular or subcutaneous route. Do not count the components of a combination vaccine as separate administrations. Documentation should identify the vaccine products, routes, and which administration was first versus additional. As an add-on, 90472 must be reported with a primary procedure and CMS payment is within that procedure’s global period. Under the CMS incident-to rule, report it only when performed under physician supervision.

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 90472 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

90472 rates by state

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

How the 90472 rate is calculated

Each of 90472’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 90472

The CMS indicators that decide how 90472 is paid alongside other services.

90472 compared with similar codes

How to choose

90471Immunization administrationFirst injectable vaccine

90471 reports the first intramuscular or subcutaneous vaccine in the encounter; 90472 reports each additional vaccine and requires a primary procedure.

90474Vaccine administrationAdditional oral or nasal vaccine

90474 is for each additional vaccine given orally or intranasally. Use 90472 for additional intramuscular or subcutaneous vaccine administrations.

90461Vaccine administrationEach additional component

90461 reports additional vaccine components in the qualifying pediatric counseling-based administration sequence. 90472 counts additional vaccines in the standard intramuscular or subcutaneous sequence.

Codes related to 90472

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