What is Pneumococcal Vaccine 23-valent (CPT 90732)?

Pneumococcal vaccine, 23-valent. This clinical code is utilized across practices and hospitals for diagnostic and therapeutic service documentation.

What do doctors typically charge for Pneumococcal Vaccine 23-valent?

The nationwide median physician charge for Pneumococcal Vaccine 23-valent (CPT 90732) is $179.39. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 90732?

The standard insurance baseline reimbursement rate is $130.80. This represents the customary allowable amount established across standard fee schedules.

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CPT 90732Medical Service

Pneumococcal Vaccine 23-valent

Pneumococcal vaccine, 23-valent. Clinical pricing breakdown and utilization metrics across 3,407 practicing doctors nationwide.

$179.39

Peer Median Charge

Gross billed rate

$130.80

Standard Baseline

Customary allowable

1.4x

National Markup

Charge vs baseline

3,407

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $179.39. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $130.80 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 90732 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"