90685 Iiv4 vacc no prsv 0.25 ml im
What 90685 is
CMS fee schedule short descriptor: Iiv4 vacc no prsv 0.25 ml im.
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 90685 (CY2026)
This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.
Medically Unlikely Edit (MUE)
Medicare caps 90685 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 90685? These codes are bundled into it
90685 is a Column 1 code in 21 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 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
90653 | Iiv adjuvant vaccine im | 0 - no modifier bypass | Check pair |
90655 | Iiv3 vacc no prsv 0.25 ml im | 0 - no modifier bypass | Check pair |
90657 | Iiv3 vaccine splt 0.25 ml im | 0 - no modifier bypass | Check pair |
90658 | Iiv3 vaccine splt 0.5 ml im | 0 - no modifier bypass | Check pair |
90660 | Laiv3 vaccine intranasal | 0 - no modifier bypass | Check pair |
90661 | Cciiv3 vac abx fr 0.5 ml im | 0 - no modifier bypass | Check pair |
90662 | Iiv no prsv increased ag im | 0 - no modifier bypass | Check pair |
90664 | Laiv vacc pandemic intranasl | 1 - modifier may bypass | Check pair |
90666 | Flu vac pandem prsrv free im | 1 - modifier may bypass | Check pair |
90667 | Iiv vacc pandemic adjuvt im | 1 - modifier may bypass | Check pair |
90668 | Iiv vaccine pandemic im | 1 - modifier may bypass | Check pair |
90673 | Riv3 vaccine no preserv im | 0 - no modifier bypass | Check pair |
90686 | Iiv4 vacc no prsv 0.5 ml im | 0 - no modifier bypass | Check pair |
90687 | Iiv4 vaccine splt 0.25 ml im | 0 - no modifier bypass | Check pair |
90688 | Iiv4 vaccine splt 0.5 ml im | 0 - no modifier bypass | Check pair |
90689 | Vacc iiv4 no prsrv 0.25ml im | 0 - no modifier bypass | Check pair |
90756 | Cciiv4 vacc abx free im | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
Q2034 | Agriflu vaccine | 0 - no modifier bypass | Check pair |
90685 is bundled into these codes
90685 appears as a Column 2 code in 10 active edits. Reported with one of these Column 1 codes on the same date of service, 90685 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
90656 | Iiv3 vacc no prsv 0.5 ml im | 0 | Check pair |
90672 | Laiv4 vaccine intranasal | 0 | Check pair |
90674 | Cciiv4 vac no prsv 0.5 ml im | 0 | Check pair |
90682 | Riv4 vacc recombinant dna im | 0 | Check pair |
90694 | Vacc aiiv4 no prsrv 0.5ml im | 0 | Check pair |
Q2035 | Afluria vacc, 3 yrs & >, im | 0 | Check pair |
Q2036 | Flulaval vacc, 3 yrs & >, im | 0 | Check pair |
Q2037 | Fluvirin vacc, 3 yrs & >, im | 0 | Check pair |
Q2038 | Fluzone vacc, 3 yrs & >, im | 0 | Check pair |
Q2039 | Influenza virus vaccine, nos | 0 | Check 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.