CPT code 90474: Vaccine administration, additional oral or nasal vaccine2026 Medicare rate & RVUs in Colorado

Reports administration of an additional oral or intranasal vaccine during an encounter after the initial vaccine administration service.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Colorado, Medicare pays $12.79 for 90474 in the office.

$12.79Office (non-facility)
Not available in this settingHospital or facility
+3.5%vs the national office rate ($12.36)

Check a contract rate as a % of Medicare · 90474 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 90474 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 90474 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 90474 covers

This code represents administration of an additional vaccine given by mouth or intranasally during the same encounter. Examples of these routes include oral rotavirus vaccine and intranasal influenza vaccine. A physician, nurse, or other qualified clinical staff member may administer the vaccine in a physician office or clinic; the vaccine product itself is not the service represented by this code.

Report one unit for each additional oral or intranasal vaccine administered, not for each component of a combination vaccine or each dose in a series. The record should identify the vaccine, route, and administration, and show which vaccine administration service is primary. CMS classifies 90474 as an add-on code: report it only with a primary procedure, and its payment is within that procedure's global period. For a first or only oral/nasal vaccine, 90473 is the route-specific initial service; when routes are mixed, select the additional-administration code according to the route of each additional vaccine.

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 Colorado compares for 90474

Across 109 of 109 payment localities, the office rate for 90474 runs from $11.21 in Arkansas to $15.85 in San Benito County, CA. Colorado pays $12.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

90474 in Colorado vs other payment areas
  1. Colorado · this page$12.79
  2. Los Angeles, CA · California$13.74+$0.95
  3. Washington, DC area · District of Columbia$13.92+$1.13
  4. Miami, FL · Florida$13.16+$0.37
  5. Chicago, IL · Illinois$12.86+$0.07
  6. Manhattan, NY · New York$14.01+$1.22
  7. Alaska · Alaska$15.17+$2.38

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

Every other payment area

90474 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$11.34—
ArkansasArkansas$11.21—
ArizonaArizona$12.09—
Bakersfield, CACalifornia$13.00—
Chico, CACalifornia$12.96—
El Centro, CACalifornia$12.96—
Fresno, CACalifornia$12.96—
Hanford, CACalifornia$12.96—

90474 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.

$11.21

$15.17

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

View every state and territory as a table
90474 office rate range by state
State / territoryOffice rate rangeLocalities
AK$15.171
AL$11.341
AR$11.211
AZ$12.091
CA$12.96–$15.8529
CO$12.791
CT$13.071
DC$13.921
DE$12.271
FL$12.22–$13.163
GA$11.66–$12.552
GU$13.181
HI$13.181
IA$11.561
ID$11.621
IL$11.94–$12.864
IN$11.671
KS$11.521
KY$11.551
LA$11.54–$11.992
MA$12.74–$13.892
MD$12.47–$13.923
ME$11.67–$12.172
MI$11.79–$12.342
MN$12.331
MO$11.38–$12.023
MS$11.301
MT$12.361
NC$11.771
ND$12.161
NE$11.611
NH$12.601
NJ$13.24–$13.822
NM$11.841
NV$12.311
NY$11.91–$14.295
OH$11.751
OK$11.531
OR$12.23–$13.132
PA$11.76–$12.802
PR$12.431
RI$12.651
SC$11.781
SD$12.141
TN$11.571
TX$11.70–$12.748
UT$11.901
VA$12.14–$13.922
VI$12.431
VT$12.121
WA$12.72–$14.142
WI$11.831
WV$11.581
WY$12.271

See 90474 in every payment locality

How the 90474 rate is calculated

Each of 90474’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 · 90474

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.15

0.15 RVUs× 1.000 GPCI

Practice expense0.21

0.21 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.3700

Conversion factor

$33.4009

Medicare rate

$12.36

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

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,417

Code
90474
Physician work
0.15
Practice expense
0.21
Malpractice
0.01

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 90474 in Colorado
ComponentRVULocality factorAdjusted
Physician work0.15× 1.0120.1518
Practice expense0.21× 1.0640.2234
Malpractice0.01× 0.7810.0078
Total RVUs0.3831
Conversion factor× 33.4009

Office rate, Colorado$12.79

Office: (0.15 × 1.012 + 0.21 × 1.064 + 0.01 × 0.781) × $33.4009 = $12.79

Open 90474 in the RVU calculator

Payment rules and modifiers for 90474

The CMS indicators that decide how 90474 is paid alongside other services.

CMS payment indicators · 90474

Vaccine administration, additional oral or nasal 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/technical0Physician service: no professional/technical split.

How 90474 has changed in Colorado

90474 · Office / nonfacility

$12.79

Effective 2026-10-01

The base rate is $0.82 higher than on 2025-10-01, moving from $11.97 to $12.79 (6.9%).

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

    $11.97changed to$12.79

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.20 changed to 0.21
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $12.32changed to$11.97

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $12.12changed to$12.32

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $12.14changed to$12.12

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.19 changed to 0.20
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827
  5. January 1, 2023

    RVU23A

    $13.07changed to$12.14

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.21 changed to 0.19
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $13.18changed to$13.07

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $13.20changed to$13.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.20 changed to 0.21
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $13.12changed to$13.20

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $13.10changed to$13.12

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $13.05changed to$13.10

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $12.64changed to$13.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.19 changed to 0.20
    • Practice expense GPCI 1.011 changed to 1.015
    • Malpractice GPCI 1.090 changed to 1.066

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $13.05changed to$12.64

    • 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

    $12.98changed to$13.05

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $12.59changed to$12.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.19 changed to 0.20
    • Practice expense GPCI 1.008 changed to 1.011
    • Malpractice GPCI 0.981 changed to 1.090

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $12.57changed to$12.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.21 changed to 0.19
    • Practice expense GPCI 1.004 changed to 1.008
    • Malpractice GPCI 0.872 changed to 0.981

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $12.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$12.79Not available in this settingRVU26D
2026-07-01$12.79Not available in this settingRVU26C
2026-04-01$12.79Not available in this settingRVU26B
2026-01-01$12.79Not available in this settingRVU26A
2025-10-01$11.97Not available in this settingRVU25D
2025-07-01$11.97Not available in this settingRVU25C
2025-04-01$11.97Not available in this settingRVU25B
2025-01-01$11.97Not available in this settingRVU25A
2024-10-01$12.32Not available in this settingRVU24D
2024-07-01$12.32Not available in this settingRVU24C
2024-04-01$12.32Not available in this settingRVU24B
2024-03-09$12.32Not available in this settingRVU24AR
2024-01-01$12.12Not available in this settingRVU24A
2023-10-01$12.14Not available in this settingRVU23D
2023-07-01$12.14Not available in this settingRVU23C
2023-04-01$12.14Not available in this settingRVU23B
2023-01-01$12.14Not available in this settingRVU23A
2022-10-01$13.07Not available in this settingRVU22D
2022-07-01$13.07Not available in this settingRVU22C
2022-04-01$13.07Not available in this settingRVU22B
2022-01-01$13.07Not available in this settingRVU22A
2021-10-01$13.18Not available in this settingRVU21D
2021-07-01$13.18Not available in this settingRVU21C
2021-04-01$13.18Not available in this settingRVU21B
2021-01-01$13.18Not available in this settingRVU21A
2020-10-01$13.20Not available in this settingRVU20D
2020-07-01$13.20Not available in this settingRVU20C
2020-04-01$13.20Not available in this settingRVU20B
2020-01-01$13.20Not available in this settingRVU20A
2019-10-01$13.12Not available in this settingRVU19D
2019-07-01$13.12Not available in this settingRVU19C
2019-04-01$13.12Not available in this settingRVU19B
2019-01-01$13.12Not available in this settingRVU19A
2018-10-01$13.10Not available in this settingRVU18D
2018-07-01$13.10Not available in this settingRVU18C
2018-04-01$13.10Not available in this settingRVU18B
2018-01-01$13.10Not available in this settingRVU18AR1
2017-10-01$13.05Not available in this settingRVU17D
2017-07-01$13.05Not available in this settingRVU17C
2017-04-01$13.05Not available in this settingRVU17B
2017-01-01$13.05Not available in this settingRVU17A
2016-10-01$12.64Not available in this settingRVU16D
2016-07-01$12.64Not available in this settingRVU16C
2016-04-01$12.64Not available in this settingRVU16B
2016-01-01$12.64Not available in this settingRVU16A
2015-10-01$13.05Not available in this settingRVU15D
2015-07-01$13.05Not available in this settingRVU15C
2015-04-01$12.98Not available in this settingRVU15B
2015-01-01$12.98Not available in this settingRVU15A
2014-10-01$12.59Not available in this settingRVU14D
2014-07-01$12.59Not available in this settingRVU14C
2014-04-01$12.59Not available in this settingRVU14B
2014-01-01$12.59Not available in this settingRVU14A
2013-10-01$12.57Not available in this settingRVU13D
2013-07-01$12.57Not available in this settingRVU13C
2013-04-01$12.57Not available in this settingRVU13B
2013-01-01$12.57Not available in this settingRVU13AR

Price 90474 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

90474 billing questions

When should 90474 be used instead of 90473?

Use 90473 for the first or only vaccine administered orally or intranasally. Use 90474 for each additional vaccine given by either of those routes during the encounter.

How is 90474 used when the encounter includes injected vaccines?

Choose the additional-administration code based on the route of each additional vaccine: 90474 for an oral or intranasal vaccine and 90472 for an injected vaccine. Report the applicable primary administration service as well.

Is 90474 reported per vaccine or per vaccine component?

Report one unit for each additional vaccine administered by mouth or intranasally. Do not count the components of a combination vaccine separately.

Does 90474 include the vaccine product?

No. It represents the administration service; the vaccine product is separate when separately reportable.

What documentation supports 90474?

Document the vaccine administered, its oral or intranasal route, and that it was an additional vaccine in the encounter. The record should also support the primary administration service.

Can 90474 be billed by itself?

No. CMS classifies it as an add-on code, so it must be reported with a primary procedure; payment is within that procedure's global period.

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 90474PPRRVU2026_Oct_nonQPP.csv, line 11,417 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 90474 pays in Colorado?

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 90474 and the rest of your codes on one sheet

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

Join the waitlist