Billing code 90474: Vaccine administrationMedicare rate & RVUs

Medicare pays $12.36 for 90474 nationally in the office. Local office rates run $11.21–$15.85.

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

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.

Where 90474 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

90474 rates by state

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

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.

Payment rules and modifiers for 90474

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

90474 compared with similar codes

How to choose

90473Vaccine administration

90473 represents the first or only oral or intranasal vaccine administration in the encounter; 90474 represents each additional vaccine administered by those routes.

90472Vaccine administration

Both describe additional vaccine administration, but 90472 applies to an injected vaccine and 90474 to an oral or intranasal vaccine.

90460Vaccine administration

90460 is used for qualifying pediatric vaccine administration with counseling and component-based counting. 90474 is route-based and counts additional oral or intranasal vaccines.

Codes related to 90474

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