CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Vaccines
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Prevnar 20 (PCV20) is the newest pneumococcal conjugate vaccine, protecting against 20 strains.
- Typical setting: Doctor's office, pharmacy, clinic
- National avg charge (illustrative): $250–$300 per dose
- Most-disputed reason: Billing both PCV20 (90677) and PPSV23 (90732) for the same patient without clinical documentation — current guidelines may not require both
What it means
What 90677 actually means
Prevnar 20 (PCV20) is the newest pneumococcal conjugate vaccine, protecting against 20 strains. CDC recommends it for adults 65+ and certain high-risk adults — a single dose may be sufficient without needing additional PPSV23 per current guidelines.
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 both PCV20 (90677) and PPSV23 (90732) for the same patient without clinical documentation — current guidelines may not require both
- Billing with wrong E&M modifier when given at a standalone vaccine visit
- Using 90670 (PCV13) instead of 90677 — always verify the actual product administered
If you see 90677 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 90677 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
90670 — Pneumococcal conjugate vaccine, 13 valent , 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
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 90677 on a bill.
90677 FAQ
Plain-English answers.
What does 90677 usually cost?
$250–$300 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 90677?
Billing both PCV20 (90677) and PPSV23 (90732) for the same patient without clinical documentation — current guidelines may not require both
What should I do if I see 90677 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 90677 before paying.
Don't pay 90677 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.