Home › Drug Codes › CPT Codes › 91304 · NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED
Updated October 1st, 2026

NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED CPT Vaccine Code: 91304

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use

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Medicare Payment Limit ?
$232.218
2026–27 Season rate · per dose
CDC Cost / Dose ?
$•••.••
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Private Sector Cost / Dose ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
3
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Medicare Coverage Medicare Part B covers NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED as a preventive vaccine — the Part B deductible and coinsurance do not apply.

Vaccine & Product Overview

HCPCS Descriptor Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use
Manufacturer Sanofi
Route of Administration Intramuscular
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Suspension

About NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED

Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted is a medication aligned to the HCPCS CPT Drug Code: 91304 for billing, pricing, and reimbursement purposes in the United States. This COVID-19 medication is administered via the intramuscular route and manufactured by Sanofi.

According to CMS Drug Use Information: This vaccine is used to help prevent coronavirus disease, also known as COVID-19. It works by increasing the body's natural defense (immunity) against the virus. This vaccine may prevent the illness, or reduce the seriousness of it. The FDA is allowing this vaccine to be given for emergency use in people 12 years old and older. Health Canada has approved this vaccine for use in people 12 years and older. 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

3 NDC packages are crosswalked to 91304. Package detail is available to logged-in subscribers.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
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NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED
NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED
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NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED Pricing & Reimbursement

91304 Private Payer Reimbursement
$190.85 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q4 2026

Medicare vaccine payment limits reset each season (effective August 1) — year-over-year steps in the chart reflect the new season's pricing, not data errors.

NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED Vaccine Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
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.

NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED Medically Unlikely Edits (MUE)

The most billing units of 91304 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.5 ml.

Practitioner Office & Hospital Outpatient
1 unit / day
= 0.5 ml per day

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 →

ml Enter a dose to see how many billing units it is and whether it is under the limit.

NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED 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.

COVID-19

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Frequently Asked Questions

Is there a manufacturer-published billing and coding guide for Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted?
Billing and coding information for NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED can be found through Novavax. Visit Here →
Are there any available patient assistance programs for Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted?
Our team has not identified a source of patient assistance information for Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted.
Where can I find Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted prescribing information?
Our team has not identified a source of prescribing information for this medication
Is there available side effect information for Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted?
Our team has not identified a source of side effect information for Novavax Covid-19 Vaccine, 2023-2024 Adjuvanted.
Does billing NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED require JZ/JW wastage modifiers?
CMS does not include NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED (91304) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing 91304. For more information, visit the link below.

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