CPT Code CPT description CVX Short Description CVX Code ...

CPT_Code 90281 90283 90287 90291 90296 90371 90375 90376 90378 90379 90389 90393 90396 90470 90476 90477 90581 90585 90611 90619 90620 90621 90622 90625 90626 90627 90630 90632 90633 90634 90636 90644 90645 90646 90647 90648 90649 90650 90651 90653 90654 90655 90656 90657 90658 90659 90660 90661 90662 90662 90663 90664 90665 90666 90668 90669 90670 90671 90672 90673 90674 90675 90676 90677 90680 90681 90682 90685 90686 90687 90688 90690 90691 90692 90693 90694 90696 90697 90698 90700 90701 90702 90703 90704 90705 90706 90707 90708 90710 90712 90713 90714 90715 90716 90717 90720 90721 90723 90724 90725 90726 90727 90728 90730 90731 90732 90733 90734 90735 90736 90737 90738 90739 90740 90741 90743 90744 90745 90746 90747 90748 90750 90756 90758 90759 91300 91301 91302 91303 91304 91305 91306 91307 91308 91309 91310 91311 91312 91313 91314 91315

CPT_description

CVX Short Description

Immune globulin (Ig), human, for intramuscular use

IG

Immune globulin (IgIV), human, for intravenous use

IGIV

Botulinum antitoxin, equine, any route

botulinum antitoxin

Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use

CMVIG

Diphtheria antitoxin, equine, any route

diphtheria antitoxin

Hepatitis B immune globulin (HBIg), human, for intramuscular use

HBIG

Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use

RIG

Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use RIG

Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each RSV-MAb

Respiratory syncytial virus immune globulin (RSV-IgIV), human, for intravenous use

RSV-IGIV

Tetanus immune globulin (TIg), human, for intramuscular use

TIG

Vaccinia immune globulin, human, for intramuscular use

vaccinia immune globulin

Varicella-zoster immune globulin, human, for intramuscular use

VZIG

H1N1 immunization administration (intramuscular, intranasal), including counseling when performed Novel Influenza-H1N1-09, all formulations

Adenovirus vaccine, type 4, live, for oral use

adenovirus, type 4

Adenovirus vaccine, type 7, live, for oral use

adenovirus, type 7

Anthrax vaccine, for subcutaneous or intramuscular use

anthrax

Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use

BCG

Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5Vaccinia, smallpox monkeypox vaccine live, PF, SQ or ID injection

Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWmeningococcal polysaccharide (groups A, C, Y, W-135) TT conjugate

Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), 2 domeningococcal B, OMV

Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for inmeningococcal B, recombinant

Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use

vaccinia (smallpox)

Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use

cholera, live attenuated

Tick-borne encephalitis virus vaccine, inactivated; 0.25 mL dosage, for intramuscular use

Tick-borne encephalitis, inactivated, PF, 0.25mL

Tick-borne encephalitis virus vaccine, inactivated; 0.5 mL dosage, for intramuscular use

Tick-borne encephalitis, inactivated, PF, 0.5mL

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use

influenza, intradermal, quadrivalent, preservative free

Hepatitis A vaccine (HepA), adult dosage, for intramuscular use

Hep A, adult

Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use

Hep A, ped/adol, 2 dose

Hepatitis A vaccine (HepA), pediatric/adolescent dosage-3 dose schedule, for intramuscular use

Hep A, ped/adol, 3 dose

Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use

Hep A-Hep B

Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MMeningococcal C/Y-HIB PRP

Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use

Hib (HbOC)

Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use

Hib (PRP-D)

Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular uHib (PRP-OMP)

Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use Hib (PRP-T)

Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramusHPV, quadrivalent

Human Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for intramuscular use HPV, bivalent

Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose sHPV9

Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use

influenza, trivalent, adjuvanted

Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use

influenza, seasonal, intradermal, preservative free

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular Influenza, seasonal, injectable, preservative free

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular uInfluenza, seasonal, injectable, preservative free

Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use

Influenza, seasonal, injectable

Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use

Influenza, seasonal, injectable

Influenza virus vaccine, whole virus, for intramuscular or jet injection use

influenza, whole

Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use

influenza, live, intranasal

Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, preservative and antibioticInfluenza, injectable, MDCK, preservative free

Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antig Influenza, high dose seasonal

Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antig influenza, high-dose, quadrivalent

Influenza virus vaccine, pandemic formulation, H1N1

Novel Influenza-H1N1-09, all formulations

Influenza virus vaccine, live (LAIV), pandemic formulation, for intranasal use

Novel Influenza-H1N1-09, nasal

Lyme disease vaccine, adult dosage, for intramuscular use

Lyme disease

Influenza virus vaccine (IIV), pandemic formulation, split virus, preservative free, for intramuscular use Novel influenza-H1N1-09, preservative-free

Influenza virus vaccine (IIV), pandemic formulation, split virus, for intramuscular use

Novel influenza-H1N1-09

Pneumococcal conjugate vaccine, 7 valent, for intramuscular use

pneumococcal conjugate PCV 7

Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use

Pneumococcal conjugate PCV 13

Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use

Pneumococcal conjugate PCV15, polysaccharide CRM197 conjugate, adjuvant, PF

Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use

influenza, live, intranasal, quadrivalent

Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein oninfluenza, recombinant, injectable, preservative free

Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibInfluenza, injectable, MDCK, preservative free, quadrivalent

Rabies vaccine, for intramuscular use

rabies, unspecified formulation

Rabies vaccine, for intradermal use

rabies, intradermal injection

Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use

Pneumococcal conjugate PCV20, polysaccharide CRM197 conjugate, adjuvant, PF

Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use

rotavirus, pentavalent

Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use

rotavirus, monovalent

Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) proteiinfluenza, recombinant, quadrivalent,injectable, preservative free

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramusc Influenza, injectable,quadrivalent, preservative free, pediatric

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscu influenza, injectable, quadrivalent, preservative free

Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use

influenza, injectable, quadrivalent

Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use

influenza, injectable, quadrivalent

Typhoid vaccine, live, oral

typhoid, oral

Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use

typhoid, ViCPs

Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use

typhoid, parenteral

Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)

typhoid, parenteral, AKD (U.S. military)

Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, Influenza vaccine, quadrivalent, adjuvanted

Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), wDTaP-IPV

Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus inf DTaP,IPV,Hib,HepB

Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivatedDTaP-Hib-IPV

Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals yoDTaP

Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use

DTP

Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, fDT (pediatric)

Tetanus toxoid adsorbed, for intramuscular use

tetanus toxoid, adsorbed

Mumps virus vaccine, live, for subcutaneous use

mumps

Measles virus vaccine, live, for subcutaneous use

measles

Rubella virus vaccine, live, for subcutaneous use

rubella

Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use

MMR

Measles and rubella virus vaccine, live, for subcutaneous use

M/R

Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use

MMRV

Poliovirus vaccine, (any type[s]) (OPV), live, for oral use

OPV, Unspecified

Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use

IPV

Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 yeTd (adult), 2 Lf tetanus toxoid, preservative free, adsorbed

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 yTdap

Varicella virus vaccine (VAR), live, for subcutaneous use

varicella

Yellow fever vaccine, live, for subcutaneous use

Yellow fever, unspecified formulation

Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-DTP-Hib

Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DTaP/ DTaP-Hib

Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine ( DTaP-Hep B-IPV

Influenza virus vaccine

influenza, unspecified formulation

Cholera vaccine for injectable use

cholera, unspecified formulation

Rabies vaccine

rabies, unspecified formulation

Plague vaccine, for intramuscular use

plague

BCG vaccine

BCG

Hepatitis A vaccine

Hep A, unspecified formulation

Hepatitis B vaccine

Hep B, unspecified formulation

Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage pneumococcal polysaccharide PPV23

Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutanemeningococcal MPSV4

Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenA meningococcal MCV4P

Japanese encephalitis virus vaccine, for subcutaneous use

Japanese encephalitis SC

Zoster (shingles) vaccine (HZV), live, for subcutaneous injection

zoster live

Hemophilus influenza B

Hib, unspecified formulation

Japanese encephalitis virus vaccine, inactivated, for intramuscular use

Japanese Encephalitis IM

Hepatitis B vaccine (HepB), adult dosage, 2 dose schedule, for intramuscular use

HepB-CpG

Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramu Hep B, dialysis

Immunization, passive; immune serum globulin, human (ISG)

IG, unspecified formulation

Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use

Hep B, adult

Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use

Hep B, adolescent or pediatric

Hepatitis B vaccine, adolescent/high risk infant dosage, for intramuscular use

Hep B, adolescent/high risk infant

Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use

Hep B, adult

Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramu Hep B, dialysis

Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use

Hib-Hep B

Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted, for intramuscular use

zoster recombinant

Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL Influenza, injectable, MDCK, quadrivalent, preservative

Zaire ebolavirus vaccine, live, for intramuscular use

Ebola Zaire vaccine, live, recombinant, 1mL dose

Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramus HepB recombinant, 3-antigen, Al(OH)3

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19 vaccine, vector-nr, rS-ChAdOx1, PF, 0.5 mL

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19 vaccine, vector-nr, rS-Ad26, PF, 0.5 mL

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, subunit, rS-nanoparticle+Matrix-M1 Adjuvant, PF, 0.5 mL

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 mL dose, tris-sucrose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, D614, recomb, preS dTM, AS03 adjuvant add, PF, 5mcg/0.5mL

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, PF, pediatric 25 mcg/0.25 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, bivalent booster, PF, 30 mcg/0.3 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, bivalent booster, PF, 50 mcg/0.5 mL or 25mcg/0.25 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, bivalent booster, PF, 50 mcg/0.5 mL or 25mcg/0.25 mL dose

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccinCOVID-19, mRNA, LNP-S, bivalent booster, PF, 10 mcg/0.2 mL dose

CVX Code 86 87 27 29 12 30 34 34 93 71 13 79 36 128 54 55 24 19 206 203 163 162 75 174 223 224 166 52 83 84 104 148 47 46 49 48 62 118 165 168 144 140 140 141 141 16 111 153 135 197 128 125 66 126 127 100 133 215 149 155 171 90 40 216 116 119 185 161 150 158 158 25 101 41 53 205 130 146 120 20 01 28 35 07 05 06 03 04 94 182 10 09 115 21 184 22 50 110 88 26 90 23 19 85 45 33 32 114 39 121 17 134 189 44 14 43 08 42 43 44 51 187 186 204 220 208 207 210 212 211 217 207 218 219 221 225 228 300 229 229 301

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last_updated CPT_Code_ID

14-Apr-20 169

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14-Apr-20 150

28-Feb-17 297

14-Apr-20 151

14-Apr-20 152

14-Apr-20 153

14-Apr-20 154

CPT Code to be used for JYNNEOS vaccine

27-Jul-22 356

28-Jul-20 337

14-Apr-20 314

14-Apr-20 313

CPT Code to be used for ACAM2000 vaccine

27-Jul-22 357

14-Apr-20 327

13-Sep-21 343

13-Sep-21 344

14-Apr-20 316

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28-Feb-17 181

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14-Apr-20 292

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28-Feb-17 183

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13-Sep-21 345

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13-Sep-21 346

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28-Feb-17 202

14-Apr-20 203

28-Feb-17 204

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28-Feb-17 206

14-Apr-20 207

Beginning in 2005, this CPT code maps to TD preservative free. Remapped to CVX code 09 10/2021 to s

8-Oct-21 208

14-Apr-20 210

14-Apr-20 211

14-Apr-20 212

28-Feb-17 214

28-Feb-17 215

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3-Mar-17 232

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3-Mar-17 235

14-Apr-20 236

Note that the NDCs for Engerix-B are mapped to CVX 43 which is not specific to dialysis use

14-Apr-20 237

14-Apr-20 238

25-Jun-18 334

Effective 1/1/2018

14-Apr-20 333

13-Sep-21 347

13-Sep-21 348

COVID-19 Vaccine - EUA authorized 12/11/2020

2-Sep-22 338

COVID-19 Vaccine - BLA Licensed and EUA authorized

2-Sep-22 339

COVID-19 Vaccine - EUA submission withdrawn

2-Sep-22 340

COVID-19 Vaccine - EUA authorized 2/27/2021

2-Sep-22 341

COVID-19 Vaccine - EUA authorized for ages 12+ yrs

2-Sep-22 342

COVID-19 Vaccine - EUA authorized for primary series and IC, EUA rescinded 8/31/202 for monovalent

2-Sep-22 349

COVID-19 Vaccine - EUA authorization rescinded 8/31/2022 for adult monovalent booster dose

2-Sep-22 350

COVID-19 Vaccine - EUA authorized, pediatric 5 yrs through 11 yrs dose requires dilution

2-Sep-22 351

COVID-19 Vaccine - EUA authorized for children under 5 yrs

2-Sep-22 352

COVID-19 Vaccine - EUA authorized for pediatric, EUA rescinded 8/31/2022 for adult monovalent boost

2-Sep-22 353

COVID-19 Vaccine - Potential EUA authorization booster dose

30-Aug-22 355

COVID-19 Vaccine - EUA authorized for ages 6 mo through 5 yrs

2-Sep-22 354

COVID-19 Vaccine - EUA authorized 8/31/2022 bivalent booster ages 12+ yrs

2-Sep-22 361

COVID-19 Vaccine - EUA authorized 8/31/2022 bivalent booster for ages 18+ yrs, potential EUA ages 6

2-Sep-22 360

COVID-19 Vaccine - Potential EUA authorization bivalent booster for ages 6 yrs through 11 yrs

2-Sep-22 359

COVID-19 Vaccine - Potential EUA authorization bivalent booster for ages 5 yrs through 11 yrs

2-Sep-22 358

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