CPT 90460: Administration of Single Live Attenuated Vaccine, ≤18 Years
Medicare pays $24 and commercial payers pay $34 on average nationally for this procedure.
CPT code 90460 describes administration of a single live attenuated vaccine to a patient up to 18 years of age delivered by parenteral, oral, intranasal, intramuscular, or intravenous route; this is an immunization administration service typically performed during an outpatient visit or clinic-based preventive care encounter such as a pediatric or family medicine vaccination appointment.
For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.
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National Reimbursement Benchmarks
Medicare’s mean rate of $24.2 sits below BUCA’s average commercial mean of $34.4, indicating Medicare pays roughly $10.2 less on average for CPT 90460 than this commercial benchmark. That gap highlights a modest but meaningful difference between federal program reimbursement and a mid-sized commercial payer aggregate, with BUCA more aligned with other commercial means such as Aetna and Cigna.
Dispersion measured as P75 minus P25 is widest for Aetna at $66.8 (P75 $91.9 minus P25 $23.2) and narrowest for Blue Cross Blue Shield at $10.8 (P75 $32.6 minus P25 $21.8). UnitedHealth Group and Cigna show intermediate spreads of $18.2 and $13.7 respectively, while BUCA’s interquartile spread is $20.0 and Medicare’s IQR is $2.0, indicating Medicare rates are the tightest around the median.