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91304 Sarscov2 vac 5mcg/0.5ml im

What 91304 is

CMS fee schedule short descriptor: Sarscov2 vac 5mcg/0.5ml 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 91304 (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.

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Medically Unlikely Edit (MUE)

Medicare caps 91304 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.

91304 is bundled into these codes

91304 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 91304 is the code that denies.

Column 1 codeShort descriptionModifier indicator
91322Sarscov2 vac 50 mcg/0.5ml im0Check 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.