Penbraya CPT Vaccine Code: 90623

Medicare Coverage CMS publishes no Medicare Part B payment limit for Penbraya. Vaccines given for routine prevention are generally covered under Medicare Part D rather than Part B.

Vaccine & Product Overview

HCPCS Descriptor Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use

Manufacturer Pfizer

Generic Status Single-Source; Branded

Dosage Form Kit

About Penbraya

Penbraya is a medication aligned to the HCPCS CPT Drug Code: 90623 for billing, pricing, and reimbursement purposes in the United States. It is a Vaccine drug manufactured by Pfizer.

Manufacturers, reach out to us to add more information.

NDC Code Information

3 NDC packages are crosswalked to 90623. Package detail is available to logged-in subscribers.

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

Login to view 3 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

Penbraya Vaccine Administration Codes

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.

Penbraya Medically Unlikely Edits (MUE)

The most billing units of 90623 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 dose.

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 →

Frequently Asked Questions

Is there an available Penbraya billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for Penbraya.

Are there any available Penbraya patient assistance programs?

Our team has not identified a manufacturer-published source of patient assistance information for Penbraya.

Where can I find Penbraya prescribing information?

Penbraya prescribing information can be found at the link below. Please reach out to us if you believe this information to be inaccurate or out of date. Visit Here →

Where can I find Penbraya side effect information?

Our team has not yet identified a source of side effects information for Penbraya. Please check back in a few weeks.

Does billing Penbraya require JZ/JW wastage modifiers?

CMS does not include Penbraya (90623) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing 90623. For more information, visit the link below.

About BuyandBill.com:

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