90460
Immunization administration, first vaccine/toxoid, with counseling
Immunization administration, first vaccine/toxoid, with counseling is the #139 most-billed Medicaid procedure code, with $1.32B in payments across 68.6M claims from 2018–2024. The national median cost per claim is $17.85. Costs vary widely — the 90th percentile is $41.24 per claim, 2.3× the median.
Total Paid
$1.32B
0.12% of all spending
Total Claims
68.6M
Providers
18K
Avg Cost/Claim
$19
National Cost Distribution
How much do providers bill per claim for 90460? Based on 16K providers billing this code nationally.
Median
$17.85
Average
$20.59
Std Dev
$17.74
Max
$673.33
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.67 and $30.87 per claim for this code.
90% bill between $2.04 and $41.24.
Top 1% bill above $59.19.
About This Procedure
HCPCS code 90460 (Immunization administration, first vaccine/toxoid, with counseling) was billed by 18K providers across 68.6M claims, totaling $1.32B in Medicaid payments from 2018–2024. This code was used for 52.8M unique beneficiaries.
Risk Assessment
This procedure is featured in our investigation: COVID Vaccine Drive
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$17.85
Providers Billing
16K
National Spending
$1.32B
Avg/Median Ratio
1.15×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 90460
| # | Provider | Total Paid |
|---|---|---|
| 1 | Topcare Medical Group Inc Dallas, TX · Pediatrics | $11.3M |
| 2 | 1326695255 | $8.5M |
| 3 | Saltzman Tanis Pittell Levin And Jacobson Hollywood, FL · Pediatrics | $8.1M |
| 4 | 1720220098 | $6.0M |
| 5 | Optum Medical Care Of New Jersey Pc Secaucus, NJ · Durable Medical Equipment & Medical Supplies | $5.8M |
| 6 | 1477742807 | $5.4M |
| 7 | 1366425274 | $5.3M |
| 8 | 1669404018 | $5.3M |
| 9 | 1720194053 | $5.3M |
| 10 | 1184016941 | $5.0M |
| 11 | The Arizona Partnership For Immunization Phoenix, AZ · Local Education Agency (LEA) | $4.7M |
| 12 | 1427125269 | $4.7M |
| 13 | 1255411294 | $4.5M |
| 14 | 1114196557 | $4.3M |
| 15 | 1487737912 | $4.0M |
| 16 | Prisma Health University Medical Group Greenville, SC · Internal Medicine | $4.0M |
| 17 | 1407191216 | $3.8M |
| 18 | 1235350901 | $3.7M |
| 19 | 1821288606 | $3.6M |
| 20 | Montefiore Medical Center Bronx, NY · Anesthesiology | $3.5M |
Showing top 20 of 18K providers billing this code