CPT procedures
CPT codes and drug billing
CPT describes the service — giving an injection, running an infusion — and, for vaccines, the product. This page shows where CPT fits alongside NDCs and HCPCS J-codes.
What Med-Code does and doesn't publish
CPT® is copyrighted by the American Medical Association and its descriptors are licensed. Med-Code does not reproduce CPT descriptor text or offer a CPT code lookup. It describes code families in its own words and lists CPT vaccine product codes for the vaccines in its directory. For full descriptors and guidelines, use the AMA’s CPT resources or a licensed coding product.
CPT code families used with drugs
The families below are where drug-related services usually fall. Choosing a code within a family depends on route, time, the drug and payer guidelines.
| Range | Family | Used for |
|---|---|---|
| 96360–96379 | Hydration, therapeutic, prophylactic and diagnostic injections and infusions | Administration of non-chemotherapy drugs by IV infusion or push, and by subcutaneous or intramuscular injection. |
| 96401–96549 | Chemotherapy and other highly complex drug or biologic administration | Administration of chemotherapy and other complex agents, such as many monoclonal antibodies. The drug's complexity, not the diagnosis, decides which family applies. |
| 90460–90474 | Immunization administration | Giving a vaccine or toxoid. Reported alongside the vaccine product code. |
| 90476–90759 | Vaccine and toxoid products | The vaccine itself. Vaccines use these CPT product codes rather than HCPCS J-codes. |
| 67028 | Intravitreal injection procedure | The injection into the eye; the drug (for example an anti-VEGF agent) is billed separately on its HCPCS code. |
How the lines fit on a claim
For a drug given in a clinic, a claim usually has two kinds of line:
- The drug — a HCPCS Level II code (often a J-code) with units from the code descriptor, and the 11-digit NDC with its unit qualifier and quantity.
- The service — a CPT administration code for giving the drug.
Vaccines differ: the vaccine is a CPT product code and giving it is a CPT immunization administration code. Self-administered drugs dispensed by a pharmacy have no administration line and are billed by NDC. Payer rules can change all of this.
Vaccine product codes in Med-Code’s directory
- CPT 90651Gardasil 9Vaccine product code for GARDASIL 9 (human papillomavirus 9-valent vaccine)
- CPT 90677Prevnar 20Vaccine product code for PREVNAR 20 (pneumococcal 20-valent conjugate vaccine)
- CPT 90678AbrysvoVaccine product code for ABRYSVO (respiratory syncytial virus vaccine, bivalent)
- CPT 90679ArexvyVaccine product code for AREXVY (respiratory syncytial virus vaccine, adjuvanted)
- CPT 90750ShingrixVaccine product code for SHINGRIX (zoster vaccine recombinant, adjuvanted)