Administration of nonavalent human papillomavirus vaccine, 2 or 3 doses, intramuscularly

Description

This procedure involves the intramuscular administration of the nonavalent human papillomavirus vaccine, which protects against nine HPV strains. The vaccine is typically given in a series of two or three doses, depending on the patient's age and health status, to provide effective immunization against HPV-related diseases.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT GYItem or service excluded from Medicare benefits(10.66%)

HCPCS/CPT JZZero drug amount discarded or not administered(4.96%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(2.85%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(2.85%)

HCPCS/CPT GCServices performed by a resident under the supervision of a teaching physician(1.73%)

HCPCS/CPT SLState-supplied vaccine modifier(1.24%)

HCPCS/CPT X1Continuous patient care services without planned endpoint(1.24%)

HCPCS/CPT CRCatastrophe or disaster-related service modifier(0.99%)

HCPCS/CPT JG340B drug pricing program discount for non-excepted off-campus departments(0.37%)

HCPCS/CPT Q1Routine clinical service in an approved clinical research study(0.12%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)