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    v1.0.28
    OpenPayerBilling CodesVaccines, ToxoidsCPT cpt-90687-quadrivalent-split-virus-influenza-vaccine-025-ml-pediatric
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    CPT 90687: Quadrivalent Split-Virus Influenza Vaccine 0.25 mL IM

    CPT code 90687 describes a quadrivalent, split-virus influenza vaccine administered intramuscularly as a 0.25 mL dose for immunization against four influenza virus strains; this represents a routine immunization service typically delivered in outpatient settings such as pediatric clinics, primary care offices, and community vaccination sites and is billed as a vaccine administration service provided intramuscularly.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 2-year-old child presents to a pediatric clinic during influenza season for routine immunization. The child has no acute illness, is up to date on prior immunizations, and has parental consent for administration of the influenza vaccine. After a brief screening for contraindications and review of prior influenza vaccine history, a nurse prepares the age-appropriate intramuscular product and administers 90687 as a 0.25 mL split-virus quadrivalent influenza vaccine into the anterolateral thigh. The nurse documents vaccine lot number, manufacturer, administration site, route, date, patient’s weight, and VIS publication and date in the electronic medical record. The child is observed for 15 minutes for immediate adverse reactions and a vaccine record is provided to the parent. Billing is submitted for the vaccine using CPT 90687 with appropriate patient identifiers and, if applicable, an administration code and modifier describing payer or clinical circumstances.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    90460Immunization administration through 18 years of age via any route with counseling by physician/other qualified health care professional; first vaccine/toxoid administeredUsed when counseling and administration are provided for the first vaccine in the visit for patients under 19 years, often billed alongside vaccine product code 90687 when applicable
    90461Immunization administration through 18 years of age via any route with counseling; each additional vaccine/toxoidBilled for additional vaccines administered during the same encounter following the first administration code
    90685Influenza virus vaccine, quadrivalent, split virus, intramuscular, for intramuscular use; standard dose, for adults and children, 0.5 mLClinically related quadrivalent influenza product for different age/volume recommendations; used in alternate age groups
    90471Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular); one vaccine (single or combination vaccine/toxoid)An administration code used for adults or when payer requires this code instead of age-based pediatric administration codes
    90472Each additional vaccine (single or combination vaccine/toxoid) administered at the same visitBilled when multiple vaccines are given in the same visit along with 90687

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    122400000XDenturistA denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in rem…
    2080P0204XPediatric Emergency Medicine (Pediatrics) PhysicianA pediatrician who has special qualifications to manage emergencies in infants and children.
    364SN0800XNeuroscience Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    331L00000XBlood BankAn institution (organization or distinct part thereof) that performs, or is responsible for the performance of, the collection, processing, storage an…
    207ZN0500XNeuropathology PhysicianA neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurol…
    225100000XPhysical TherapistPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    B34.9Viral infection, unspecified
    E11.9Type 2 diabetes mellitus without complications
    E66.9Obesity, unspecified
    F17.210Nicotine dependence, cigarettes, uncomplicated
    I10Essential (primary) hypertension
    J00Acute nasopharyngitis [common cold]
    J02.9Acute pharyngitis, unspecified
    J06.9Acute upper respiratory infection, unspecified
    J10.1Influenza due to other identified influenza virus with other respiratory manifestations
    J11.1Influenza due to unidentified influenza virus with other respiratory manifestations

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    9 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    CPT-90476-ADENOVIRUS-TYPE-4-ORAL-VACCINE-ADMINISTRATION

    CPT 90476: Oral Live Vaccine for Adenovirus Type 4

    CPT-90477-ORAL-LIVE-ADENOVIRUS-TYPE-7-VACCINE

    CPT 90477: Oral Live Adenovirus Type 7 Vaccine Administration

    CPT-90581-ANTHRAX-VACCINE-INJECTION

    CPT 90581: Anthrax Vaccine, Injection

    CPT-90584-QUADRIVALENT-LIVE-DENGUE-VACCINE-SUBCUTANEOUS

    CPT 90584: Quadrivalent Live Dengue Vaccine, Subcutaneous, Two-Dose

    CPT-90585-TB-LIVE-INTRADERMAL-VACCINE

    CPT 90585: Live Tuberculosis Vaccine Administered Through the Skin

    CPT-90586-INTRAVESICAL-LIVE-VACCINE-BLADDER-CANCER

    CPT 90586: Intravesical Live Vaccine for Bladder Cancer

    CPT-90587-DENGUE-VACCINE-SUBCUTANEOUS-THREE-DOSE

    CPT 90587: Quadrivalent Live Dengue Vaccine, Subcutaneous, Three-Dose

    CPT-90589-CHIKUNGUNYA-VACCINE-INTRAMUSCULAR-LIVE-ATTENUATED

    CPT 90589: Chikungunya Vaccine, Live Attenuated, Intramuscular

    CPT-90593-RECOMBINANT-CHIKUNGUNYA-VACCINE-INTRAMUSCULAR

    CPT 90593: Recombinant Chikungunya Vaccine, Intramuscular

    CPT-90611-SMALLPOX-MONKEYPOX-VACCINE-SUBCUTANEOUS-05ML

    CPT 90611: Combined Smallpox and Monkeypox Vaccine, Subcutaneous 0.5 mL

    Showing 1–10 of 101

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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