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

Reports administration of each additional intramuscular or subcutaneous vaccine after the first vaccine in an encounter, when the add-on requirements are met.

CMS RVU26DEffective Oct 1, 2026One payment locality23.8K Medicare services in 2024

In North Carolina, Medicare pays $15.20 for 90472 in the office.

$15.20Office (non-facility)
Not available in this settingHospital or facility
−5.2%vs the national office rate ($16.03)

Check a contract rate as a % of Medicare · 90472 nationwide

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

We’ll open 90472 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 90472 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How North Carolina compares for 90472

Across 109 of 109 payment localities, the office rate for 90472 runs from $14.36 in Arkansas to $21.15 in San Benito County, CA. North Carolina pays $15.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

90472 in North Carolina vs other payment areas
  1. North Carolina · this page$15.20
  2. Los Angeles, CA · California$18.08+$2.88
  3. Washington, DC area · District of Columbia$18.24+$3.04
  4. Miami, FL · Florida$16.98+$1.78
  5. Chicago, IL · Illinois$16.55+$1.35
  6. Manhattan, NY · New York$18.28+$3.08
  7. Alaska · Alaska$19.08+$3.88

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

90472 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$14.55—
ArkansasArkansas$14.36—
ArizonaArizona$15.65—
Bakersfield, CACalifornia$17.02—
Chico, CACalifornia$16.99—
El Centro, CACalifornia$16.99—
Fresno, CACalifornia$16.99—
Hanford, CACalifornia$16.99—

90472 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$14.36

$19.08

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90472 office rate range by state
State / territoryOffice rate rangeLocalities
AK$19.081
AL$14.551
AR$14.361
AZ$15.651
CA$16.99–$21.1529
CO$16.701
CT$17.031
DC$18.241
DE$15.901
FL$15.73–$16.983
GA$14.94–$16.292
GU$17.361
HI$17.361
IA$14.921
ID$15.001
IL$15.29–$16.614
IN$15.081
KS$14.841
KY$14.821
LA$14.79–$15.452
MA$16.61–$18.272
MD$16.18–$18.243
ME$15.05–$15.812
MI$15.15–$15.892
MN$16.111
MO$14.55–$15.523
MS$14.461
MT$16.031
NC$15.201
ND$15.831
NE$15.001
NH$16.431
NJ$17.25–$18.082
NM$15.211
NV$15.991
NY$15.40–$18.665
OH$15.111
OK$14.811
OR$15.89–$17.212
PA$15.14–$16.632
PR$16.141
RI$16.441
SC$15.171
SD$15.811
TN$14.911
TX$15.05–$16.628
UT$15.361
VA$15.75–$18.242
VI$16.141
VT$15.761
WA$16.58–$18.652
WI$15.351
WV$14.781
WY$15.951

See 90472 in every payment locality

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.

How the rate is built · 90472

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.15

0.15 RVUs× 1.000 GPCI

Practice expense0.32

0.32 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.4800

Conversion factor

$33.4009

Medicare rate

$16.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,415

Code
90472
Physician work
0.15
Practice expense
0.32
Malpractice
0.01

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 90472 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.15× 1.0000.1500
Practice expense0.32× 0.9330.2986
Malpractice0.01× 0.6390.0064
Total RVUs0.4550
Conversion factor× 33.4009

Office rate, North Carolina$15.20

Office: (0.15 × 1 + 0.32 × 0.933 + 0.01 × 0.639) × $33.4009 = $15.20

Open 90472 in the RVU calculator

Payment rules and modifiers for 90472

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

CMS payment indicators · 90472

Vaccine administration, each additional vaccine

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical5Incident-to service.

How 90472 has changed in North Carolina

90472 · Office / nonfacility

$15.20

Effective 2026-10-01

The base rate is $1.75 higher than on 2025-10-01, moving from $13.45 to $15.20 (13.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $13.45changed to$15.20

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.28 changed to 0.32
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $13.85changed to$13.45

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $13.62changed to$13.85

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $13.82changed to$13.62

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.27 changed to 0.28
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $12.22changed to$13.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.21 changed to 0.27
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $12.32changed to$12.22

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $12.40changed to$12.32

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.20 changed to 0.21
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $12.37changed to$12.40

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $12.35changed to$12.37

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $12.33changed to$12.35

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $11.97changed to$12.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.19 changed to 0.20
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $12.35changed to$11.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.20 changed to 0.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $12.29changed to$12.35

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $11.96changed to$12.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.19 changed to 0.20
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $11.96changed to$11.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.21 changed to 0.19
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $11.96

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$15.20Not available in this settingRVU26D
2026-07-01$15.20Not available in this settingRVU26C
2026-04-01$15.20Not available in this settingRVU26B
2026-01-01$15.20Not available in this settingRVU26A
2025-10-01$13.45Not available in this settingRVU25D
2025-07-01$13.45Not available in this settingRVU25C
2025-04-01$13.45Not available in this settingRVU25B
2025-01-01$13.45Not available in this settingRVU25A
2024-10-01$13.85Not available in this settingRVU24D
2024-07-01$13.85Not available in this settingRVU24C
2024-04-01$13.85Not available in this settingRVU24B
2024-03-09$13.85Not available in this settingRVU24AR
2024-01-01$13.62Not available in this settingRVU24A
2023-10-01$13.82Not available in this settingRVU23D
2023-07-01$13.82Not available in this settingRVU23C
2023-04-01$13.82Not available in this settingRVU23B
2023-01-01$13.82Not available in this settingRVU23A
2022-10-01$12.22Not available in this settingRVU22D
2022-07-01$12.22Not available in this settingRVU22C
2022-04-01$12.22Not available in this settingRVU22B
2022-01-01$12.22Not available in this settingRVU22A
2021-10-01$12.32Not available in this settingRVU21D
2021-07-01$12.32Not available in this settingRVU21C
2021-04-01$12.32Not available in this settingRVU21B
2021-01-01$12.32Not available in this settingRVU21A
2020-10-01$12.40Not available in this settingRVU20D
2020-07-01$12.40Not available in this settingRVU20C
2020-04-01$12.40Not available in this settingRVU20B
2020-01-01$12.40Not available in this settingRVU20A
2019-10-01$12.37Not available in this settingRVU19D
2019-07-01$12.37Not available in this settingRVU19C
2019-04-01$12.37Not available in this settingRVU19B
2019-01-01$12.37Not available in this settingRVU19A
2018-10-01$12.35Not available in this settingRVU18D
2018-07-01$12.35Not available in this settingRVU18C
2018-04-01$12.35Not available in this settingRVU18B
2018-01-01$12.35Not available in this settingRVU18AR1
2017-10-01$12.33Not available in this settingRVU17D
2017-07-01$12.33Not available in this settingRVU17C
2017-04-01$12.33Not available in this settingRVU17B
2017-01-01$12.33Not available in this settingRVU17A
2016-10-01$11.97Not available in this settingRVU16D
2016-07-01$11.97Not available in this settingRVU16C
2016-04-01$11.97Not available in this settingRVU16B
2016-01-01$11.97Not available in this settingRVU16A
2015-10-01$12.35Not available in this settingRVU15D
2015-07-01$12.35Not available in this settingRVU15C
2015-04-01$12.29Not available in this settingRVU15B
2015-01-01$12.29Not available in this settingRVU15A
2014-10-01$11.96Not available in this settingRVU14D
2014-07-01$11.96Not available in this settingRVU14C
2014-04-01$11.96Not available in this settingRVU14B
2014-01-01$11.96Not available in this settingRVU14A
2013-10-01$11.96Not available in this settingRVU13D
2013-07-01$11.96Not available in this settingRVU13C
2013-04-01$11.96Not available in this settingRVU13B
2013-01-01$11.96Not available in this settingRVU13AR

Price 90472 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

90472 billing questions

Which code reports the first intramuscular or subcutaneous vaccine?

Use 90471 for the first vaccine and 90472 for each additional vaccine administered by either route.

Can 90472 be reported without 90471?

No. It is an add-on code and must be reported with a qualifying primary procedure; for this administration sequence, report 90471 for the first vaccine.

Is the vaccine product included in 90472?

No. 90472 represents administration. Report the vaccine product separately when applicable.

How should a combination vaccine be counted?

Count the combination vaccine as one administered vaccine, not as separate administrations for each component.

What documentation supports reporting 90472?

Document the vaccine administered, its route, and that it was an additional vaccine after the first. CMS requires physician supervision for incident-to billing.

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

Show the CMS file lines behind this rate
RVUs for 90472PPRRVU2026_Oct_nonQPP.csv, line 11,415 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 90472 pays in North Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 90472 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist