Billing code 90474: Vaccine administrationMedicare rate & RVUs in Texas
Reports administration of an additional oral or intranasal vaccine during an encounter after the initial vaccine administration service.
Medicare pays $11.70–$12.74 for 90474 in the office in Texas, from Beaumont to Austin. 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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$11.70 to $12.74
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $12.74 | Unavailable |
| Beaumont | $11.70 | Unavailable |
| Brazoria | $12.26 | Unavailable |
| Dallas | $12.33 | Unavailable |
| Fort Worth | $12.26 | Unavailable |
| Galveston | $12.29 | Unavailable |
| Houston | $12.47 | Unavailable |
| Rest Of Texas | $11.97 | Unavailable |
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
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Work 0.15Practice expense 0.21Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 90474
The CMS indicators that decide how 90474 is paid alongside other services.
CMS payment indicators · 90474
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. |
90474 compared with similar codes
Compare codes
90474 vs 90473 vs 90472 vs 90460: national Medicare rates
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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.
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
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