90697 Dtap-ipv-hib-hepb vaccine im
What 90697 is
CMS fee schedule short descriptor: Dtap-ipv-hib-hepb vaccine 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 90697 (CY2026)
This code has no Physician Fee Schedule rate: Excluded from the Physician Fee Schedule (paid under another system or not priced here). 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 90697 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 90697? These codes are bundled into it
90697 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 |
90647 | Hib prp-omp vacc 3 dose im | 0 - no modifier bypass | Check pair |
90648 | Hib prp-t vaccine 4 dose im | 0 - no modifier bypass | Check pair |
90678 | Rsv vacc pref bivalent im | 0 - no modifier bypass | Check pair |
90696 | Dtap-ipv vaccine 4-6 yrs im | 0 - no modifier bypass | Check pair |
90698 | Dtap-ipv/hib vaccine im | 0 - no modifier bypass | Check pair |
90700 | Dtap vaccine < 7 yrs im | 0 - no modifier bypass | Check pair |
90702 | Dt vaccine under 7 yrs im | 0 - no modifier bypass | Check pair |
90713 | Poliovirus ipv sc/im | 0 - no modifier bypass | Check pair |
90714 | Td vacc no presv 7 yrs+ im | 0 - no modifier bypass | Check pair |
90715 | Tdap vaccine 7 yrs/> im | 0 - no modifier bypass | Check pair |
90739 | Hepb vacc 2/4 dose adult im | 0 - no modifier bypass | Check pair |
90740 | Hepb vacc 3 dose immunsup im | 0 - no modifier bypass | Check pair |
90743 | Hepb vacc 2 dose adolesc im | 0 - no modifier bypass | Check pair |
90744 | Hepb vacc 3 dose ped/adol im | 0 - no modifier bypass | Check pair |
90746 | Hepb vaccine 3 dose adult im | 0 - no modifier bypass | Check pair |
90747 | Hepb vacc 4 dose immunsup im | 0 - no modifier bypass | Check pair |
90748 | Hib-hepb vaccine im | 0 - no modifier bypass | Check pair |
90759 | Hep b vac 3ag 10mcg 3 dos im | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | 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.