Products billed under this code include Afluria Trivalent (2025/2026), Fluzone Trivalent (2025/2026).
Payment limit per 0.25 ML, by effective quarter, 4Q24 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Afluria Trivalent (2025/2026) | Seqirus Inc | 33332-0125-10 | 20 | $222.82 |
| Fluzone Trivalent (2025/2026) | Sanofi Pasteur | 49281-0643-15 | 20 | $222.82 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $11.141 | +$0.107 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted September 17, 2026 |
| 3Q26 | $11.034 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted September 15, 2026 |
| 2Q26 | $11.034 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted September 15, 2026 |
| 1Q26 | $11.034 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted September 15, 2026 |
| 4Q25 | $11.034 | +$0.105 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted September 8, 2026 |
| 3Q25 | $10.929 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted March 10, 2026 |
| 2Q25 | $10.929 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted March 10, 2026 |
| 1Q25 | $10.929 | $0.00 | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted December 19, 2025 |
| 4Q24 | $10.929 | – | 0.25 ML | IIV3 VACCINE SPLT 0.25 ML IM | v1, posted June 11, 2025 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
