# CPT 90474: Immunization administration, intranasal or oral, each additional vaccine (add-on)

Medicare CPT 90474 pays $12.36 in a non-facility setting and $12.36 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $11.21 in Arkansas to $15.17 in Alaska, a 35% spread.

Web page: https://www.med-reveal.com/rates/90474-cpt-fee-schedule
Section: Medical and Therapeutic Services

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $12.36 |
| National facility | $12.36 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $15.17 | $15.17 |
| District of Columbia | $13.92 | $13.92 |
| California | $13.67 | $13.67 |
| New Jersey | $13.53 | $13.53 |
| New York | $13.53 | $13.53 |
| Washington | $13.43 | $13.43 |
| Massachusetts | $13.32 | $13.32 |
| Hawaii | $13.18 | $13.18 |
| Connecticut | $13.07 | $13.07 |
| Colorado | $12.79 | $12.79 |
| Maryland | $12.75 | $12.75 |
| Florida | $12.70 | $12.70 |
| Oregon | $12.68 | $12.68 |
| Rhode Island | $12.65 | $12.65 |
| New Hampshire | $12.60 | $12.60 |
| Illinois | $12.45 | $12.45 |
| Puerto Rico | $12.43 | $12.43 |
| Virgin Islands | $12.43 | $12.43 |
| Montana | $12.36 | $12.36 |
| Minnesota | $12.33 | $12.33 |
| Nevada | $12.31 | $12.31 |
| Pennsylvania | $12.28 | $12.28 |
| Delaware | $12.27 | $12.27 |
| Wyoming | $12.27 | $12.27 |
| Texas | $12.25 | $12.25 |
| North Dakota | $12.16 | $12.16 |
| South Dakota | $12.14 | $12.14 |
| Virginia | $12.14 | $12.14 |
| Vermont | $12.12 | $12.12 |
| Georgia | $12.11 | $12.11 |
| Arizona | $12.09 | $12.09 |
| Michigan | $12.07 | $12.07 |
| Maine | $11.92 | $11.92 |
| Utah | $11.90 | $11.90 |
| New Mexico | $11.84 | $11.84 |
| Wisconsin | $11.83 | $11.83 |
| South Carolina | $11.78 | $11.78 |
| Louisiana | $11.77 | $11.77 |
| Missouri | $11.77 | $11.77 |
| North Carolina | $11.77 | $11.77 |
| Ohio | $11.75 | $11.75 |
| Indiana | $11.67 | $11.67 |
| Idaho | $11.62 | $11.62 |
| Nebraska | $11.61 | $11.61 |
| West Virginia | $11.58 | $11.58 |
| Tennessee | $11.57 | $11.57 |
| Iowa | $11.56 | $11.56 |
| Kentucky | $11.55 | $11.55 |
| Oklahoma | $11.53 | $11.53 |
| Kansas | $11.52 | $11.52 |
| Alabama | $11.34 | $11.34 |
| Mississippi | $11.30 | $11.30 |
| Arkansas | $11.21 | $11.21 |

## Related codes

- 90460: Immunization administration through 18 years, with counseling, first vaccine component — https://www.med-reveal.com/rates/90460-cpt-fee-schedule
- 90461: Immunization administration, each additional vaccine component (add-on) — https://www.med-reveal.com/rates/90461-cpt-fee-schedule
- 90471: Immunization administration, one vaccine — https://www.med-reveal.com/rates/90471-cpt-fee-schedule
- 90472: Immunization administration, each additional vaccine (add-on) — https://www.med-reveal.com/rates/90472-cpt-fee-schedule
- 90473: Immunization administration, intranasal or oral, one vaccine — https://www.med-reveal.com/rates/90473-cpt-fee-schedule
- G0008: Administration of influenza virus vaccine — https://www.med-reveal.com/rates/G0008-hcpcs-fee-schedule
- G0009: Administration of pneumococcal vaccine — https://www.med-reveal.com/rates/G0009-hcpcs-fee-schedule
- G0010: Administration of hepatitis B vaccine — https://www.med-reveal.com/rates/G0010-hcpcs-fee-schedule

Commercial negotiated rates for 90474 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules