CAPVAXIVE CPT Vaccine Code: 90684

Vaccine & Product Overview

HCPCS Descriptor Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use

Manufacturer Merck Sharp & Dohme Corp

Route of Administration Intramuscular

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution

About CAPVAXIVE

Capvaxive is a medication aligned to the HCPCS CPT Drug Code: 90684 for billing, pricing, and reimbursement purposes in the United States. It is a Vaccine drug administered via the intramuscular route and manufactured by Merck Sharp & Dohme Corp.

According to CMS Drug Use Information: This vaccine is used to help prevent pneumococcal disease, an infection caused by a certain bacteria (Streptococcus pneumoniae). This bacteria can cause ear infections or other more serious infections (such as pneumonia, meningitis, blood infection). Vaccination is the best way to protect against this disease. This vaccine works by increasing the body's natural defense (immunity) against the bacteria. Vaccines may not fully protect everyone who receives them.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

1 NDC package is crosswalked to 90684. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	CAPVAXIVE

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CAPVAXIVE Pricing & Reimbursement

90684 Private Payer Reimbursement

$343.15 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

CAPVAXIVE Vaccine Administration Codes

Medicare bills the administration of CAPVAXIVE with HCPCS code G0009, and allows simplified roster billing when vaccinating multiple patients. The CPT codes below apply to non-Medicare payers.

Code	Description
G0009	Administration of pneumococcal vaccine (Medicare)
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), one vaccine (single or combination vaccine/toxoid)
90472	Immunization administration (each additional vaccine or toxoid), when performed in conjunction with primary procedure.

CAPVAXIVE Medically Unlikely Edits (MUE)

The most billing units of 90684 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 ea.

Practitioner Office & Hospital Outpatient

1 unit / day

Same limit in both settings

MAI 2 · Date of Service Edit: Policy. Absolute per-day limit set by policy or regulation; units above it are not payable, and denials are not appealable on medical-necessity grounds. See all MUE limits →

CAPVAXIVE Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Invasive disease caused by Streptococcus pneumoniae serotypes 3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15B, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F, and 35B Pneumonia caused by S. pneumoniae serotypes 3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F, and 35B

Drug Class

Actively Acquired Immunity [PE]Inactivated Pneumococcal Vaccine [EPC]Pneumococcal Vaccines [CS]VaccinesInactivated [CS]

Frequently Asked Questions

Is there a manufacturer-published billing and coding guide for Capvaxive?

Billing and coding information for CAPVAXIVE can be found through MERCK SHARP & DOHME. Visit Here →

Are there any available patient assistance programs for Capvaxive?

CAPVAXIVE patient assistance information can be found through MERCK SHARP & DOHME. Visit Here →

Where can I find Capvaxive prescribing information?

Capvaxive prescribing information can be found at the link below. Visit Here →

Is there available side effect information for Capvaxive?

Side effect information for Capvaxive can be found through Medline Plus at the link below. Visit Here →

Does billing CAPVAXIVE require JZ/JW wastage modifiers?

CMS does not include CAPVAXIVE (90684) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing 90684. For more information, visit the link below.

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