Billing code 90461: Vaccine administrationMedicare rate & RVUs in Nevada
Report 90461 for each vaccine component beyond the first when a patient age 18 or younger receives immunization administration with physician or qualified professional counseling.
Medicare pays $8.63 for 90461 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 90461 covers
Code 90461 represents administration of an additional vaccine component for a patient age 18 or younger when a physician or other qualified health care professional provides immunization counseling. It is commonly relevant when a combination vaccine contains multiple components. The code counts components, not injections, so a single injection can involve more than one reportable component. The physician or qualified health care professional may provide the service in an office, clinic, or other setting where pediatric immunizations are administered.
Report 90461 only with 90460, which represents the first component; use one unit of 90461 for each additional component. Documentation should support the patient's age, counseling by the physician or qualified professional, vaccine administered, and the component count. CMS classifies 90461 as an add-on code: it cannot be billed alone, and its payment is within the primary procedure's global period. Do not use it to count additional injections when the service is administration without the counseling framework.
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.
90461 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $8.63 | Unavailable |
How the 90461 rate is calculated
Each of 90461’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 · 90461
RVUs × geographic indexes × conversion factor
Work0.18
0.18 RVUs× 1.000 GPCI
Practice expense0.07
0.07 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.2600
Conversion factor
$33.4009
Medicare rate
$8.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90461
The CMS indicators that decide how 90461 is paid alongside other services.
CMS payment indicators · 90461
Vaccine administration
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
90461 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90460Vaccine administration
- 90460 reports the first vaccine component for a patient age 18 or younger when the counseling requirements are met. 90461 reports each component after that first one.
- 90471Immunization administration
- 90471 reports immunization administration without the age-based counseling framework. Use 90460 and, when applicable, 90461 when counseling by a physician or qualified health care professional is part of the service.
- 90472Vaccine administration
- 90472 reports an additional immunization administration under the non-counseling framework. 90461 counts an additional vaccine component when the 90460 counseling framework applies.
90461 billing questions
What is the difference between 90460 and 90461?
90460 represents the first vaccine component when the age and counseling requirements are met. Report 90461 for each additional component.
Can 90461 be billed without 90460?
No. CMS identifies 90461 as an add-on code, so it must be reported with its primary code, 90460.
Are units based on injections or vaccine components?
Units reflect additional vaccine components, not additional injections. A single injection of a combination vaccine may contain multiple components.
What documentation supports reporting 90461?
Document the patient's age, the vaccine administered and its component count, and counseling provided by a physician or other qualified health care professional.
When is 90472 a better fit?
90472 is for an additional immunization administration when the service is reported under the administration framework without the counseling requirements for 90460 and 90461. It counts an additional administration, not an additional vaccine component.
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
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