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

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 Queens, NY, Medicare pays $18.45 for 90472 in the office.

$18.45Office (non-facility)
Not available in this settingHospital or facility
+15.1%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $18.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

90472 in Queens, NY vs other payment areas
  1. Queens, NY · this page$18.45
  2. Manhattan, NY · New York$18.28−$0.17
  3. NYC suburbs and Long Island, NY · New York$18.66+$0.21
  4. Rest of New York · New York$15.40−$3.05
  5. Los Angeles, CA · California$18.08−$0.37
  6. Washington, DC area · District of Columbia$18.24−$0.21

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

90472 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$16.98—
Chicago, ILIllinois$16.55—
AlaskaAlaska$19.08—
AlabamaAlabama$14.55—
ArkansasArkansas$14.36—
ArizonaArizona$15.65—
Bakersfield, CACalifornia$17.02—
Chico, 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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 90472 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.15× 1.0640.1596
Practice expense0.32× 1.1820.3782
Malpractice0.01× 1.4420.0144
Total RVUs0.5523
Conversion factor× 33.4009

Office rate, Queens, NY$18.45

Office: (0.15 × 1.064 + 0.32 × 1.182 + 0.01 × 1.442) × $33.4009 = $18.45

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 Queens, NY

90472 · Office / nonfacility

$18.45

Effective 2026-10-01

The base rate is $1.99 higher than on 2025-10-01, moving from $16.46 to $18.45 (12.1%).

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

    $16.46changed to$18.45

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.28 changed to 0.32
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $16.94changed to$16.46

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $16.67changed to$16.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $17.18changed to$16.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.27 changed to 0.28
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $15.33changed to$17.18

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.21 changed to 0.27
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $15.45changed to$15.33

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $15.33changed to$15.45

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.20 changed to 0.21
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $15.10changed to$15.33

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $15.08changed to$15.10

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $15.05changed to$15.08

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $14.59changed to$15.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.19 changed to 0.20
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $15.07changed to$14.59

    • 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

    $15.00changed to$15.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $14.48changed to$15.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.19 changed to 0.20
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $14.47changed to$14.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.21 changed to 0.19
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $14.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$18.45Not available in this settingRVU26D
2026-07-01$18.45Not available in this settingRVU26C
2026-04-01$18.45Not available in this settingRVU26B
2026-01-01$18.45Not available in this settingRVU26A
2025-10-01$16.46Not available in this settingRVU25D
2025-07-01$16.46Not available in this settingRVU25C
2025-04-01$16.46Not available in this settingRVU25B
2025-01-01$16.46Not available in this settingRVU25A
2024-10-01$16.94Not available in this settingRVU24D
2024-07-01$16.94Not available in this settingRVU24C
2024-04-01$16.94Not available in this settingRVU24B
2024-03-09$16.94Not available in this settingRVU24AR
2024-01-01$16.67Not available in this settingRVU24A
2023-10-01$17.18Not available in this settingRVU23D
2023-07-01$17.18Not available in this settingRVU23C
2023-04-01$17.18Not available in this settingRVU23B
2023-01-01$17.18Not available in this settingRVU23A
2022-10-01$15.33Not available in this settingRVU22D
2022-07-01$15.33Not available in this settingRVU22C
2022-04-01$15.33Not available in this settingRVU22B
2022-01-01$15.33Not available in this settingRVU22A
2021-10-01$15.45Not available in this settingRVU21D
2021-07-01$15.45Not available in this settingRVU21C
2021-04-01$15.45Not available in this settingRVU21B
2021-01-01$15.45Not available in this settingRVU21A
2020-10-01$15.33Not available in this settingRVU20D
2020-07-01$15.33Not available in this settingRVU20C
2020-04-01$15.33Not available in this settingRVU20B
2020-01-01$15.33Not available in this settingRVU20A
2019-10-01$15.10Not available in this settingRVU19D
2019-07-01$15.10Not available in this settingRVU19C
2019-04-01$15.10Not available in this settingRVU19B
2019-01-01$15.10Not available in this settingRVU19A
2018-10-01$15.08Not available in this settingRVU18D
2018-07-01$15.08Not available in this settingRVU18C
2018-04-01$15.08Not available in this settingRVU18B
2018-01-01$15.08Not available in this settingRVU18AR1
2017-10-01$15.05Not available in this settingRVU17D
2017-07-01$15.05Not available in this settingRVU17C
2017-04-01$15.05Not available in this settingRVU17B
2017-01-01$15.05Not available in this settingRVU17A
2016-10-01$14.59Not available in this settingRVU16D
2016-07-01$14.59Not available in this settingRVU16C
2016-04-01$14.59Not available in this settingRVU16B
2016-01-01$14.59Not available in this settingRVU16A
2015-10-01$15.07Not available in this settingRVU15D
2015-07-01$15.07Not available in this settingRVU15C
2015-04-01$15.00Not available in this settingRVU15B
2015-01-01$15.00Not available in this settingRVU15A
2014-10-01$14.48Not available in this settingRVU14D
2014-07-01$14.48Not available in this settingRVU14C
2014-04-01$14.48Not available in this settingRVU14B
2014-01-01$14.48Not available in this settingRVU14A
2013-10-01$14.47Not available in this settingRVU13D
2013-07-01$14.47Not available in this settingRVU13C
2013-04-01$14.47Not available in this settingRVU13B
2013-01-01$14.47Not available in this settingRVU13AR

Price 90472 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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