CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Vaccines
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Prevnar 13 protects against 13 types of pneumococcal bacteria that can cause pneumonia, meningitis, and bloodstream infections.
- Typical setting: Pediatrician's office, clinic
- National avg charge (illustrative): $200–$250 per dose
- Most-disputed reason: Billing 90670 instead of 90671 (PCV15) or 90677 (PCV20) when the newer formulations were given — verify the actual product used
What it means
What 90670 actually means
Prevnar 13 protects against 13 types of pneumococcal bacteria that can cause pneumonia, meningitis, and bloodstream infections. It is used in children as part of the infant series, and in certain adults age 65+ or at high risk.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 90670 instead of 90671 (PCV15) or 90677 (PCV20) when the newer formulations were given — verify the actual product used
- Billing PCV13 for a Medicare patient when PCV15 or PCV20 may be the recommended choice per current guidelines
- Billing without administration code 90471 or 90472
If you see 90670 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 90670 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90686 — Influenza vaccine, quadrivalent, IM
Should be free under ACA. Any charge is likely a coding error.
Related BillBusted guides
Plain-English reads if you see 90670 on a bill.
90670 FAQ
Plain-English answers.
What does 90670 usually cost?
$200–$250 per dose. Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 90670?
Billing 90670 instead of 90671 (PCV15) or 90677 (PCV20) when the newer formulations were given — verify the actual product used
What should I do if I see 90670 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 90670 before paying.
Don't pay 90670 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.