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90471 Immunization admin

What 90471 is

CMS fee schedule short descriptor: Immunization admin.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 90471 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.170.480.010.66$22.04
Facility (hospital, ASC)0.170.480.010.66$22.04

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

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Medically Unlikely Edit (MUE)

Medicare caps 90471 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 90471? These codes are bundled into it

90471 is a Column 1 code in 61 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0591THlth&wb coaching indiv 1st1 - modifier may bypassCheck pair
0592THlth&wb coaching indiv f-up1 - modifier may bypassCheck pair
0593THlth&wb coaching group1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
90473Immune admin oral/nasal0 - no modifier bypassCheck pair
96160Pt-focused hlth risk assmt1 - modifier may bypassCheck pair
96161Caregiver health risk assmt1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
99202Office o/p new sf 15 min1 - modifier may bypassCheck pair
99203Office o/p new low 30 min1 - modifier may bypassCheck pair
99204Office o/p new mod 45 min1 - modifier may bypassCheck pair
99205Office o/p new hi 60 min1 - modifier may bypassCheck pair
99211Off/op est may x req phy/qhp1 - modifier may bypassCheck pair
99212Office o/p est sf 10 min1 - modifier may bypassCheck pair
99213Office o/p est low 20 min1 - modifier may bypassCheck pair
99214Office o/p est mod 30 min1 - modifier may bypassCheck pair
99215Office o/p est hi 40 min1 - modifier may bypassCheck pair
99242Off/op consltj new/est sf 201 - modifier may bypassCheck pair
99243Off/op cnsltj new/est low 301 - modifier may bypassCheck pair
99244Off/op cnsltj new/est mod 401 - modifier may bypassCheck pair
99245Off/op consltj new/est hi 551 - modifier may bypassCheck pair
99281Emr dpt vst mayx req phy/qhp1 - modifier may bypassCheck pair
99282Emergency dept visit sf mdm1 - modifier may bypassCheck pair
99283Emergency dept visit low mdm1 - modifier may bypassCheck pair
99284Emergency dept visit mod mdm1 - modifier may bypassCheck pair
99285Emergency dept visit hi mdm1 - modifier may bypassCheck pair
99381Init pm e/m new pat infant1 - modifier may bypassCheck pair
99382Init pm e/m new pat 1-4 yrs1 - modifier may bypassCheck pair
99383Prev visit new age 5-111 - modifier may bypassCheck pair

Showing 30 of 61 column 2 codes. Use the pair checker for any specific combination.

90471 is bundled into these codes

90471 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 90471 is the code that denies.

Column 1 codeShort descriptionModifier indicator
90460Im admin 1st/only component0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.