Appendixes
CPT copyright 2017 American Medical Association. All rights reserved.
II. Vaccine Products: Commonly Administered Pediatric Vaccines
This list was current as of July 1, 2017.
For updates, visit https://www.aap.org/en-us/Documents/coding_vaccine_coding_table.pdf.
CPT®
Product
Code
Separately report the administration with
Current Procedural Terminology (CPT®) codes
90460–90461 or 90471–90474
[Please see Immunization Administration (IA) Codes at bottom of table.]
Manufacturer Brand
# of Vaccine
Components
90620 Meningococcal recombinant protein and outer
membrane vesicle vaccine, serogroup B, 2 dose
schedule, for IM use
Novartis Bexsero 1
90621 Meningococcal recombinant lipoprotein vaccine,
serogroup B, 3 dose schedule, for IM use
Pfizer Trumenba 1
90630 Influenza virus vaccine, quadrivalent (IIV4), split
virus, preservative free, for intradermal use
Sanofi Pasteur Fluzone
Intradermal
Quadrivalent
1
90633 Hepatitis A vaccine (Hep A), pediatric/adolescent
dosage, 2 dose, for IM use
GlaxoSmithKline
Merck
HAVRIX
VAQTA
1
90644 Meningococcal conjugate vaccine, serogroups
C & Y and Hemophilus influenza B vaccine
(MenCY-Hib), 4-dose schedule, when admin-
istered to children 2–15 months of age, for
IM  use
GlaxoSmithKline MenHibrix 2
90647 Hemophilus influenza B vaccine (Hib), PRP-OMP
conjugate, 3 dose, for IM use
Merck PedvaxHIB 1
90648 Hemophilus influenza B vaccine (Hib), PRP-T
conjugate, 4 dose, for IM use
Sanofi Pasteur
GlaxoSmithKline
ActHIB
HIBERIX
1
90651 Human Papillomavirus vaccine types 6, 11, 16,
18, 31, 33, 58, nonavalent (HPV), 2 or 3 dose
schedule, for IM use
Merck GARDASIL 9 1
90656 Influenza virus vaccine, trivalent (IIV3), split virus,
preservative free, 0.5ml dosage, for IM use
Seqirus
Novartis
AFLURIA
Fluvirin
90658 Influenza virus vaccine, trivalent (IIV3), split virus,
0.5ml dosage, for IM use
Seqirus
Seqirus
AFLURIA
Fluvirin
1
90670 Pneumococcal conjugate vaccine, 13 valent
(PCV13), for IM use
Pfizer PREVNAR 13 1
90674 Influenza virus vaccine, quadrivalent (ccIIV4),
derived from cell cultures, subunit, preservative
and antibiotic free, 0.5 mL dosage, IM
Seqirus Flucelvax 1
90680 Rotavirus vaccine, pentavalent (RV5), 3 dose
schedule, live, for oral use
Merck RotaTeq 1
90681 Rotavirus vaccine, human, attenuated (RV1), 2
dose schedule, live, for oral use
GlaxoSmithKline ROTARIX 1
90685 Influenza virus vaccine, quadrivalent (IIV4), split
virus, preservative free, 0.25ml dose, for IM use
Sanofi Pasteur Fluzone
Quadrivalent
1
90686 Influenza virus vaccine, quadrivalent (IIV4), split
virus, preservative free, 0.5ml dosage, for IM use
Seqirus
Sanofi Pasteur
GlaxoSmithKline
GlaxoSmithKline
AFLURIA
Fluzone
Quadrivalent
FLUARIX
Quadrivalent
FLULAVAL
1
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