Pcv20 vaccine im
Products billed under this code include PREVNAR 20.
Payment limit per 0.5 ML, by effective quarter, 4Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under 90677
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 |
|---|---|---|---|---|
| PREVNAR 20 | Pfizer | 00005-2000-02 | 1 | $361.418 |
| PREVNAR 20 | Pfizer | 00005-2000-10 | 10 | $3,614.18 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $361.418 | +$20.417 | 0.5 ML | Pcv20 vaccine im | v1, posted September 17, 2026 |
| 3Q26 | $341.001 | +$28.099 | 0.5 ML | Pcv20 vaccine im | v1, posted September 15, 2026 |
| 2Q26 | $312.902 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted September 15, 2026 |
| 1Q26 | $312.902 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted September 15, 2026 |
| 4Q25 | $312.902 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted September 8, 2026 |
| 3Q25 | $312.902 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted March 10, 2026 |
| 2Q25 | $312.902 | +$14.866 | 0.5 ML | Pcv20 vaccine im | v1, posted March 10, 2026 |
| 1Q25 | $298.036 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted December 19, 2025 |
| 4Q24 | $298.036 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 11, 2025 |
| 3Q24 | $298.036 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 11, 2025 |
| 2Q24 | $298.036 | +$9.372 | 0.5 ML | Pcv20 vaccine im | v1, posted March 11, 2025 |
| 1Q24 | $288.664 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted December 19, 2024 |
| 4Q23 | $288.664 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted October 10, 2024 |
| 3Q23 | $288.664 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 5, 2024 |
| 2Q23 | $288.664 | +$4.947 | 0.5 ML | Pcv20 vaccine im | v1, posted February 23, 2024 |
| 1Q23 | $283.717 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted December 6, 2023 |
| 4Q22 | $283.717 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 22, 2023 |
| 3Q22 | $283.717 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 9, 2023 |
| 2Q22 | $283.717 | +$18.98 | 0.5 ML | Pcv20 vaccine im | v1, posted December 14, 2022 |
| 1Q22 | $264.737 | $0.00 | 0.5 ML | Pcv20 vaccine im | v1, posted June 8, 2022 |
| 4Q21 | $264.737 | – | 0.5 ML | Pcv20 vaccine im | v1, posted June 2, 2022 |
“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.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022