Adult vaccine price list versus the Medicare payment limit

What the CDC price list prices

The CDC Vaccine Price List is a purchasing document for public immunization programs, and its columns are easy to misread as retail prices. CDC's own note on the page says the lists "provide current vaccine contract prices" and "list the private sector vaccine prices for general information." Contract prices apply to immunization programs that receive CDC cooperative agreement funds: state health departments, certain large city projects and certain current and former U.S. territories. The same note says that "Private providers and private citizens cannot directly purchase vaccines through CDC contracts." The first price column, headed CDC cost per dose, is therefore a price almost no patient, clinic or pharmacy can use.

The second column, private-sector cost per dose, is described as the prices "reported by vaccine manufacturers annually to CDC," with questions about it directed to the manufacturers. It is closer to a market figure than the contract price, and it is still a single number per product, not a price list for pharmacies. The list has no column for an administration fee, a visit fee or a pharmacy markup, because it prices the vaccine product alone.

Three separate PDFs hold the adult data. CDC's page dates the main adult list September 30, 2026 (the file name reads 10-01-26), and the list has contract end dates of June 30, 2027. The adult influenza list carries October 27, 2026 on that page (file name 11-01-26) and reflects 2026-2027 flu contracts that end February 28, 2027. The adult COVID-19 list is dated September 24, 2026 and its contracts end May 31, 2027. The CDC page that links them shows "Prices last reviewed/updated: November 1, 2026." Footnotes on each list put a federal excise tax of $0.75 to $4.50 a dose inside the CDC cost for the vaccines they mark, so part of some contract prices is tax.

A second note on the page warns that the list "does not represent all possible routinely recommended vaccine presentations" in the United States, only those on CDC contracts. A vaccine missing from the lists is not necessarily missing from the market, and a vaccine that appears twice, such as two package types of the same brand, can carry slightly different prices. The table below keeps one presentation per product, and the two products whose presentations differ in price are named under it.

Twenty-two adult vaccines, three price columns

Each row is a product on the CDC adult lists. Part B rows are matched by National Drug Code to the CMS file that sets Medicare's payment limit, and show the limit for the matching billing code. The pneumococcal and hepatitis B limits are the October 2026 quarterly figures, effective October 1 through December 31, 2026. The flu and COVID-19 limits are the annual 2026-2027 season figures, effective August 1, 2026 through July 31, 2027. Part D rows show no limit: the CMS file has no row at all for Shingrix or the RSV products, and it carries Td and Tdap only as the treatment-vaccine codes covered further down.

Sources and dates: CDC adult, influenza and COVID-19 price lists as dated above; CMS Part B payment limit file and 2026-2027 seasonal vaccine price file, checked November 3, 2026. CDC cost for Engerix-B is the vial presentation; the syringe presentation (NDC 58160-0821-52) is listed at $37.657. CDC cost for Tenivac is the vial presentation; the syringe presentation (NDC 49281-0215-15) is $23.078. All prices are per dose.

The private-sector column runs from $21.08 for Fluzone to $321.053 for Arexvy, and the contract column peaks at $174.126 among these rows, for Prevnar 20 and Capvaxive, which print the same CDC cost. Across the fifteen Part B products, the payment limit is above the private-sector figure for fourteen and below it for one. The exception is Recombivax HB, whose private-sector cost of $78.645 sits $3.50 above its limit of $75.145. Among the products with a limit above the private-sector figure, the widest gap is Prevnar 20 at $62.168 and the narrowest is Engerix-B at $0.045. None of these gaps is a markup; they compare two data sources.

How the Part B limit is set

The Part B limit is not built from either CDC column. CMS's vaccine pricing page says the payment limit for influenza, COVID-19, pneumococcal and hepatitis B vaccines is "95% of AWP," meaning 95 percent of the average wholesale price published in pricing compendia. The quarterly file marks every such row with an AWP percentage of 95 and a coinsurance percentage of 0.000. The limit for Prevnar 20, $361.418, implies an average wholesale price of $380.44 for the product. That implied figure is arithmetic on the CMS number, not a published AWP.

The same file carries a coinsurance of 20.000 for most other Part B drugs, such as the infusion drugs in the guide to Part B infusion drug coinsurance. Vaccines are the exception. Medicare Claims Processing Manual chapter 18, section 10, says Part B "pays 100 percent of the Medicare allowed amount for pneumococcal, influenza, hepatitis B virus COVID-19 vaccines and their administration," and that "Part B deductible and coinsurance do not apply for pneumococcal, influenza, hepatitis virus and/or COVID-19 vaccine." Medicare.gov repeats the beneficiary side on each vaccine's page: you pay nothing if your doctor or other health care provider accepts assignment for giving the vaccine. The guide to Medicare excess charges explains what assignment means and what changes when a provider does not accept it.

The limit is the Part B payment rate for the vaccine product. It is not the rule everywhere: CMS's pricing page says that in certain settings, such as hospital outpatient departments, payment is based on reasonable cost instead, and chapter 18, section 10.2.2.1, names reasonable cost for hospitals on institutional claims. A row in the table is the anchor for the standard route, not a promise about every site of care.

The cadence matters when a price looks stale. CMS updates the pneumococcal and hepatitis B limits quarterly and the flu limits annually for August 1 through July 31. The COVID-19 limits are updated annually, and each billing code in the seasonal file has its own start date: the file lists the live intranasal flu code from August 24, 2026 and the COVID-19 codes from August 27, 2026. The October 2026 quarterly file repeats the same limits for all fifteen flu and COVID-19 codes the seasonal file carries, so the two files agree.

Pneumococcal: three vaccines, three limits

CMS assigns each pneumococcal product its own billing code, and the limits do not follow the order of the private-sector prices. The 20-valent conjugate vaccine (Prevnar 20, code 90677) has a limit of $361.418. The 21-valent conjugate vaccine (Capvaxive, code 90684) has a limit of $344.252, which is $17.166 lower. The CDC private-sector prices run the other way: Capvaxive at $302.10 is $2.85 above Prevnar 20 at $299.25. The CDC contract column prints $174.126 for both. The 23-valent polysaccharide vaccine (Pneumovax 23, code 90732) has a limit of $133.472, a CDC cost of $82.843 and a private-sector cost of $117.081.

The CMS file also carries a code for the 15-valent conjugate vaccine (Vaxneuvance, code 90671) at $269.306. The CDC adult list does not show that product, so it has no row in the table. The code is a reminder that a Part B limit exists for every product CMS has mapped to a code, whether or not the CDC contract list carries it.

Medicare.gov's pneumococcal page says Part B covers pneumococcal vaccines and that you pay nothing if your doctor or health care provider accepts assignment for giving the vaccine. Chapter 18 adds that a beneficiary may receive the pneumococcal vaccine on request without a physician's order. For a person with Medicare and assignment, the three limits above never reach the patient. They matter to someone comparing a quote, because they show how Medicare values each product in the fourth quarter of 2026. Medicare gives each of the three its own code, so no two share a limit.

Hepatitis B limits by dose schedule

The hepatitis B codes are separated by dose schedule and patient type, and the CMS descriptors state the schedule. Code 90739 is "Hepb vacc 2 dose adult im" and has a limit of $188.21 a dose. Code 90746, "Hepb vaccine 3 dose adult im," has a limit of $75.145 a dose and covers both Engerix-B and Recombivax HB, matched by National Drug Code; the Recombivax HB code also maps to the adolescent 2-dose code, 90743, at the same $75.145. The October crosswalk lists the Engerix-B NDCs under the immunosuppressed codes 90740 and 90747 as well, so which limit applies depends on the schedule the claim bills. The same file lists the 3-dose and 4-dose immunosuppressed codes (90740 and 90747) at $170.943 a dose and the 2-dose adolescent and 3-dose pediatric-adolescent codes (90743 and 90744) at $75.145 and $33.220.

Per dose, the 2-dose product has the higher limit and the 3-dose products have the lower one. Multiplying by the number of doses in each code descriptor gives a series total: $376.42 for two Heplisav-B doses at the limit, against $225.435 for three doses of an adult 3-dose product. On the CDC contract column, the same arithmetic gives $165.14 for two Heplisav-B doses, $99.414 for three Engerix-B vial doses ($112.971 for syringes) and $95.295 for three Recombivax HB doses. These series totals assume every dose in the series is the same product, and no source publishes them as a price.

In the private-sector column, Engerix-B at $75.10 and Recombivax HB at $78.645 are $3.545 apart, while Heplisav-B is $165.85 a dose. Engerix-B's private-sector cost is $0.045 below its limit and Recombivax HB's is $3.50 above the same limit, because both products sit under code 90746. A code that pays one rate to two products can look generous to one and tight to the other.

Coverage wording differs between the two federal sources. Medicare.gov says Part B covers hepatitis B vaccines if you are eligible and lists three conditions, of which you must meet at least one: you have never gotten a complete series, you do not know your vaccination history, or you have a health condition or situation that puts you at medium or high risk. Chapter 18, section 10.1.3 (revision 13091, effective January 1, 2025), says the vaccine is available to beneficiaries at high or intermediate risk, and that from January 1, 2025 a doctor's order is no longer necessary for administration under Part B. The two wordings are quoted as published, and neither source here settles who qualifies.

Flu shots: many brands, few limits

Flu vaccines show most clearly how little a Medicare code says about a brand. The 2026-2027 CMS crosswalk maps three adult products to the same code, 90656: Fluzone, Fluarix and FluLaval. Its limit is $23.889. The CDC contract cost is $14.707 for Fluzone and $13.916 for both Fluarix and FluLaval, and all three share a private-sector cost of $21.08. Medicare pays the same amount for each, and the table carries only Fluzone as the representative row.

The high-dose, adjuvanted and recombinant products, named that way in the CMS descriptors, form a second tier. Fluzone High-Dose (code 90662), Fluad (code 90653) and Flublok (code 90673) each carry a limit of $122.522, and each lists the same private-sector cost of $107.60. Their CDC contract costs differ slightly, from $51.63 to $54.85. Flucelvax (code 90661) sits between the tiers at $66.569, with a CDC cost of $24.806 and a private-sector cost of $58.519. The live intranasal FluMist (code 90660, listed for ages 2 to 49) has a limit of $30.581 against a CDC cost of $18.60 and a private-sector cost of $26.20.

The seasonal file also contains limits for products that have no row on the CDC adult list: $171.211 for the trivalent mRNA flu vaccine (code 90616, effective August 5, 2026), and $11.141 and $22.281 for the two split-virus codes (90657 and 90658). A code can exist, and carry a limit, without a product that a CDC contract lists.

Medicare.gov says Part B covers the seasonal flu vaccine, that this 2026-2027 season brings a trivalent vaccine protecting against three flu viruses, that frequency is "Usually once each flu season," and that you pay nothing for a flu vaccine if the provider accepts assignment. In the CMS file the coinsurance column reads 0.000 for every flu code. Within Medicare there is no price difference to the patient between the $23.889 code and the $122.522 codes, though the amount Medicare allows the provider differs by $98.633 per dose.

COVID-19 vaccines under the 2026-2027 file

The CMS crosswalk for the 2026-2027 season maps four of the vaccines on the CDC adult COVID-19 list to billing codes. Spikevax at the 0.5 mL, 50 microgram presentation (NDC 80777-0114-96) maps to code 91322 with a limit of $172.967. The mNexspike presentation (NDC 80777-0401-60) maps to code 91323 at $252.225. Comirnaty (NDC 00069-2631-10) maps to code 91320 at $230.405, and Nuvaxovid (NDC 49281-0026-50) maps to code 91304 at $232.218. Each limit is above the matching private-sector cost, by $10.968 at the smallest (Nuvaxovid) up to $30.975 at the largest (mNexspike).

The CDC columns hold one curiosity. mNexspike and Nuvaxovid report the same private-sector cost, $221.25, while their contract costs are $121.32 and $78.414. Spikevax has the lowest private-sector cost of the four at $151.726, and Nuvaxovid has the lowest CDC cost at $78.414.

Medicare.gov's COVID-19 vaccine page says Part B covers FDA-approved and FDA-authorized COVID-19 vaccines and that you pay nothing if your doctor or other provider accepts assignment. As checked on November 3, 2026, the page's coverage text still names the "2025–2026 formula" vaccines, while the CDC list and the CMS crosswalk are headed 2026-2027. The prices in this guide come from the 2026-2027 files.

COVID-19 administration has its own code and its own dated figures. The CMS vaccine pricing page shows code 90480 at $44.95 with an effective date of September 11, 2023. The 2026 geographically adjusted rate file, effective for dates of service January 1 through December 31, 2026, shows 90480 at $46.16 nationally and $46.71 in the Detroit locality. The 2026 file applies to dates of service in 2026, and this guide uses it.

Shingles, RSV and Tdap under Part D

Shingles, RSV and Tdap each have a Medicare.gov page of their own, and the three say the same thing. Medicare drug coverage (Part D) covers the shingles vaccine, and "You pay nothing for the shingles vaccine if you have Part D." The RSV page says "You pay nothing for the RSV vaccine if you have Part D." The Tdap page says "You pay nothing for the Tdap vaccine if you have Part D." The shingles page adds that Part D plans do not charge a copayment or apply a deductible for vaccines ACIP recommends, and that "Part D covers all adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that aren't covered under Medicare Part B (Medical Insurance), including the vaccines for Respiratory Syncytial Virus (RSV), whooping cough, measles, and more."

The rule behind those sentences is in the Part D regulations. 42 CFR 423.120(g) says that, for an ACIP-recommended adult vaccine, a Part D sponsor must "Not apply any deductible nor charge any cost sharing." Paragraph (g)(3) applies the same requirement to vaccines obtained from an in-network or out-of-network pharmacy or provider. Section 423.100 defines an ACIP-recommended adult vaccine as a covered Part D drug that is a vaccine licensed for adult populations "and administered in accordance with recommendations of the Advisory Committee on Immunization Practices," as adopted by the CDC Director. The zero cost share attaches to a vaccine that meets that definition. The Part D drug definition in the same section lists a licensed vaccine and, for administration on or after January 1, 2008, "its administration," which brings giving the vaccine within the definition.

The October 2026 Part B payment limit file contains no row for Shingrix or for any RSV vaccine, so CMS publishes no payment limit for them. The CDC list is the only public per-dose number. Shingrix is $135.412 on the contract column and $242.667 privately. The three RSV products run from $146.117 to $162.159 on the contract column and from $319.00 to $321.053 privately: Arexvy at $321.053, Abrysvo at $319.07 and mResvia at $319.00. These are the three highest private-sector costs in the main table. The Part D plan pays a negotiated price to the pharmacy or provider that the plan and the seller agree privately, and no source here shows it.

The Part D rows have an odd feature. The patient owes nothing, the plan's price is not public, and the only figures in the open are the CDC columns, which neither the patient nor the plan pays. The guides to the Part D out-of-pocket cap and the Medicare Prescription Payment Plan cover the drugs that do carry cost sharing. An ACIP-recommended vaccine carries none, so it has nothing to cap or spread.

A Part D vaccine in a doctor's office

Chapter 18 of the Medicare Claims Processing Manual makes the Part B vaccines a Part B matter in every setting: pneumococcal, influenza, hepatitis B and COVID-19 vaccines and their administration "are covered only under Medicare Part B, regardless of the setting in which they are furnished, even when provided to an inpatient during a hospital stay covered under Part A." The Part D vaccines are not tied to a setting that way, so the question for a shingles, RSV or Tdap shot is which benefit will be billed and whether the seller is in the plan's network.

The regulation speaks to the doctor's office directly. Section 423.124(a)(2) says a Part D sponsor must ensure that enrollees "have adequate access to vaccines and other covered Part D drugs appropriately dispensed and administered by a physician in a physician's office." Section 423.120(g)(3), quoted above, applies the no-cost-sharing rule to vaccines obtained from an out-of-network pharmacy or provider. Section 423.124(b) separately allows a plan with coverage other than defined standard coverage to require an enrollee to take financial responsibility for the differential between an out-of-network pharmacy's or provider's usual and customary price and the plan's allowance. The text of the two paragraphs does not say how the second interacts with the first for a vaccine, so a dollar answer is the plan's to give.

The practical step is a question asked before the appointment, to both parties: which benefit will this vaccine be billed to, is the office or pharmacy in the plan's network for vaccines, and will the plan pay the seller directly. The preventive-care guide on why a preventive visit came with a bill covers the other case, a separate visit charge added to a free service.

When Tdap is a Part B treatment vaccine

The Part B file contains a second pricing track that looks like a contradiction beside the Part D rows. It lists the Td vaccine (code 90714) at $39.567, the Tdap vaccine (code 90715) at $40.072, the adult hepatitis A vaccine (code 90632) at $74.924 and the rabies vaccine (code 90675) at $327.987. Each carries a coinsurance of 20.000 percent and has no AWP percentage in the file, the opposite of the preventive vaccines.

CMS's vaccine pricing page explains the split. It separates preventive vaccines, "used to prevent illness," from treatment vaccines, with examples "which are used as treatment after exposure to an illness," naming tetanus, rabies and hepatitis A. The treatment limit is "Generally, 106 % of ASP," updated quarterly. The same vaccine product can therefore reach Medicare through two routes. Medicare.gov says Tdap is Part D at no cost; the Part B file shows a Tdap code at $40.072 with a 20 percent coinsurance, which would be $8.01 on the limit. The file's own note says the presence of a code and limit "does not indicate whether Medicare covers a drug," so the row proves a payment rate, not coverage of your claim.

These treatment limits sit below the private-sector cost on the CDC list for every matching product. The Td limit of $39.567 is under Tenivac's $45.913. The Tdap limit of $40.072 is under Adacel's $51.078 and Boostrix's $50.141. The hepatitis A limit of $74.924 is under Havrix at $89.567 and Vaqta at $86.224. All five CDC private-sector costs are above their limits, the reverse of the pattern in the main table. The treatment limits are built on ASP and the preventive limits on AWP.

The administration line, code by code

The vaccine product is one line on a vaccine bill and the administration is another. Chapter 18, section 10.2.1, says "Vaccines and their administration are reported using separate codes." The table shows the administration anchors that sit next to the product limits above.

The amounts are Medicare anchors for 2026, checked November 3, 2026; Detroit is Michigan Locality 01, and another locality will differ. The G-code rates come from CMS's 2026 geographically adjusted file for dates of service January 1 through December 31, 2026. The 90471 and 90472 amounts come from the Physician Fee Schedule relative value file RVU26D, October 2026 release, with the CY2026 GPCIs for Detroit (work 1.000, practice expense 0.965, malpractice 1.686). Both PFS codes have only a nonfacility rate in the file; the facility rate is marked not applicable.

Chapter 18, section 10.3.1.1, traces how the G-code rate came to be. CMS wrote that G0008 and G0009 "are not paid on the MPFS," that from March 1, 2003 the three G-codes were reimbursed at the same rate as code 90471, that rates for 2020 and 2021 were frozen at 2019 levels, and that from January 1, 2022 the national rate for G0008, G0009 and G0010 is $30, adjusted by the geographic practice cost indices. The 2026 national figure in the table is $34.62. The G-code rate is now $12.58 above the 90471 anchor nationally, so the old link between the two is gone. A note in section 10.2.1 tells providers billing under the outpatient prospective payment system to report G0010 rather than 90471 or 90472 for hepatitis B administration, to ensure the correct waiver of coinsurance and deductible.

A patient with a plan or a cash price built on CPT codes rather than Medicare's G-codes will meet 90471 and 90472 instead. The code 90471 names the first vaccine in a visit and 90472 each additional one, so a visit with two vaccines carries both lines. The guide to preventive-care billing uses the same Detroit anchor of $21.71 for a single-vaccine visit. The Medicare anchor is a yardstick for judging a quoted administration fee, not a price the seller has to charge.

Which meter applies to which shot

The same visit can run on three different meters, and the right one depends on the vaccine, not on the clinic. The table puts the decision in one place.

The first row has the most published numbers and the second the fewest, though both are free to the patient. The third row is the only one where the CMS file prints a coinsurance above zero. A person who has Medicare reads the table by finding the vaccine, finding the row, and asking the seller which row its claim will use.

One pneumococcal dose, line by line

Take Prevnar 20 given in a Detroit-area physician's office in the fourth quarter of 2026 to a person with Medicare Part B whose provider accepts assignment. The product line is code 90677 with a payment limit of $361.418. The administration line is G0009 at $35.04. Medicare.gov says the person pays nothing. The other two prices in the table describe the market, not the claim: the CDC private-sector cost of $299.25 and the CDC contract cost of $174.126, which neither the office nor the patient can obtain.

Take Shingrix given at a network pharmacy to a person with a Part D plan. The CMS file has no limit for the product. The patient owes nothing under 42 CFR 423.120(g). The plan pays a negotiated price. The CDC columns show $135.412 and $242.667, and neither is the plan's price.

Neither example adds the lines into one total, because no source publishes a total, and the Medicare lines are payment limits to the seller rather than prices any patient is quoted. For someone without Medicare, the same layers exist and none of the numbers above is the quote. The product, its administration and any visit fee each need a price, and the guides on how to ask for the cash price and cash price versus using insurance give the wording for the call.

Fifteen more adult vaccines on the list

The CDC adult list carries fifteen more products that have no row in the main table. Havrix and Vaqta reappear in the treatment-vaccine section above; the rest have no Part B limit that this guide matches to them. The private-sector column runs from $47.811 for IPOL to $352.074 for Gardasil 9. The same two caveats apply: these are manufacturer-contract and manufacturer-reported figures, per dose of product.

Source: CDC Adult Vaccine Price List dated September 30, 2026, checked November 3, 2026. The Medicare.gov shingles page says Part D covers all adult vaccines ACIP recommends, and this guide makes no claim about which of these products that covers for any person.

Why none of this is a cash price

The three columns answer three different questions, and none of them is the one a patient without full coverage asks. The CDC contract cost says what a public immunization program pays under a federal contract. The private-sector cost says what manufacturers report to CDC. The Part B limit says what Medicare allows a provider. A seller's cash quote is a different construction: a product price, an administration fee and sometimes a visit fee. The CDC page itself sends questions about private-sector prices to the manufacturers.

Judge a quote against the right yardstick. A pharmacy quote for a pneumococcal vaccine can be set beside the Medicare limit, for example $361.418 for Prevnar 20, as an order-of-magnitude check on the product line. The administration part of the quote can be set beside $21.71 for 90471 or $35.04 for G0009 in Detroit. A quote for a product line far from the Medicare limit, or an administration fee several times the anchors, is a reason to ask what the extra covers. It is not proof that a price is wrong, and the anchors are not caps on what a seller may charge a patient who is not on Medicare.

A complete quote has four parts, and a seller who has the answers can give them in one call. The product name and package, so the price refers to a specific vaccine. The administration fee, named as a separate line. Any visit or facility fee that attaches to a clinic or hospital outpatient setting. And what happens if the insurance is billed: whether the quote is the cash price or the amount after a plan pays. The preventive-care billing guide lists the reasons a visit meant to be free arrives with a charge, and the same logic applies to an immunization appointment.

For Medicare patients the checks are shorter. For the four Part B vaccines, ask whether the provider accepts assignment, since Medicare.gov ties the zero cost to it. For the Part D vaccines, ask whether the seller is in the plan's network and which benefit it will bill. In both cases, ask for the answer in writing, because a verbal reassurance from the front desk is not a billing record.

Adult vaccine price questions

Where each vaccine figure comes from

• CDC, CDC Vaccine Price List page, "Prices last reviewed/updated: November 1, 2026": the notes on contract prices, private-sector prices and presentations. Checked November 3, 2026.
• CDC, Adult Vaccine Price List (PDF dated September 30, 2026), Adult Influenza Vaccine Price List (PDF dated October 27, 2026) and Adult COVID-19 Vaccine Price List (PDF dated September 24, 2026): CDC cost and private-sector cost per dose, National Drug Code, package and contract end date for every row. Checked November 3, 2026.
• CMS, October 2026 Medicare Part B Payment Limit File and NDC-HCPCS crosswalks (final file dated 09/16/2026, posted 09/17/2026; ASP data quarter 2Q26; effective October 1 through December 31, 2026): pneumococcal, hepatitis B, Td, Tdap, hepatitis A and rabies limits and coinsurance. Checked November 3, 2026; the page listed no later monthly file.
• CMS, Vaccine Pricing, with the 2026-2027 Seasonal Vaccine Price File and NDC-HCPCS Crosswalk for Seasonal Vaccines (issue date 08/27/2026; effective August 1, 2026 through July 31, 2027): flu and COVID-19 limits, start dates and the 95 percent of AWP rule. Checked November 3, 2026.
• CMS, 2026 Geographically-Adjusted Payment Rates for Influenza, Pneumococcal, Hepatitis B and for COVID-19 Vaccine Administration (dates of service 1/1/2026 to 12/31/2026): G0008, G0009, G0010 and 90480 amounts. Checked November 3, 2026.
• CMS, Physician Fee Schedule relative value file RVU26D (October 2026 release, released 08/26/2026) and CY2026 GPCIs, Michigan Locality 01, conversion factor $33.4009: 90471 and 90472 anchors. The RVU files page listed no 2027 file on November 3, 2026.
• CMS, Medicare Claims Processing Manual, chapter 18 (table of contents Rev. 13709, issued 04-02-26), section 10 and subsections 10.1, 10.2.1, 10.2.2.1 and 10.3.1.1: Part B payment of vaccines and administration, deductible and coinsurance, separate vaccine and administration codes, G-code rates. Checked November 3, 2026.
• Medicare.gov coverage pages for flu shots, pneumococcal shots, hepatitis B shots, COVID-19 vaccine, shingles shots, RSV shot and Tdap shots. Checked November 3, 2026.
• eCFR, 42 CFR 423.100 (definitions of ACIP-recommended adult vaccine and Part D drug), 423.120(g) and 423.124(a) and (b). Version in effect October 28, 2026, checked November 3, 2026.

General billing information, not medical, legal or insurance advice. The CDC columns are manufacturer-contract and manufacturer-reported prices per dose of vaccine product, not a pharmacy or clinic cash price. Medicare payment limits and administration anchors are not your bill, and Medicare Advantage plans and Medigap policies are not modeled here. Confirm your price in writing.