Home › Drug Codes › CPT Codes › 91319 · PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12
Updated October 1st, 2026

PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 CPT Vaccine Code: 91319

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use

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Medicare Payment Limit ?
$103.33
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 PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 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, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
Manufacturer Pfizer
Route of Administration Intramuscular
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Suspension

About PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12

Pfizer-biontech Covid-19 Vaccine 2023-2024 Age5<12 is a medication aligned to the HCPCS CPT Drug Code: 91319 for billing, pricing, and reimbursement purposes in the United States. This COVID-19 medication is administered via the intramuscular route and manufactured by Pfizer.

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. 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 91319. Package detail is available to logged-in subscribers.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
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PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12
PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12
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PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 Pricing & Reimbursement

91319 Private Payer Reimbursement
$94.96 / 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.

PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 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
90460 Immunization administration via any route, first vaccine/toxoid component
90461 Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component (List separately in addition to code for primary procedure).

PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 Medically Unlikely Edits (MUE)

The most billing units of 91319 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.3 ml.

Practitioner Office & Hospital Outpatient
1 unit / day
= 0.3 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.

PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 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 Pfizer-Biontech Covid-19 Vaccine 2023-2024 Age5<12?
Our team has not identified a manufacturer-published source of billing and coding information for PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12.
Are there any available patient assistance programs for Pfizer-Biontech Covid-19 Vaccine 2023-2024 Age5<12?
PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 patient assistance information can be found through Pfizer. Visit Here →
Where can I find Pfizer-Biontech Covid-19 Vaccine 2023-2024 Age5<12 prescribing information?
Our team has not identified a source of prescribing information for this medication
Is there available side effect information for Pfizer-Biontech Covid-19 Vaccine 2023-2024 Age5<12?
Our team has not identified a source of side effect information for Pfizer-Biontech Covid-19 Vaccine 2023-2024 Age5<12.
Does billing PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 require JZ/JW wastage modifiers?
CMS does not include PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12 (91319) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing 91319. For more information, visit the link below.

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Related Drug Codes

Explore billing, coding, and pricing for drugs related to PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12.

91322SPIKEVAX 2023-2024 FORMULASevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular useModerna91320COMIRNATY 2023-2024 AGE 12 AND OLDERSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular usePfizer91321COVID-19 VACCINE 2023-2024Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular useModerna91323mNEXSPIKE 2025-26 (12Y UP)Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular useModerna91304NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTEDSevere 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 useNovavaxJ0248VEKLURYInjection, remdesivir, 1 mgGilead SciencesAdded December 23, 202191318COVID-19 VACCINE 2023-2024Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular usePfizerQ0222BEBTELOVIMABInjection, bebtelovimab, 175 mgEli Lilly and CompanyAdded February 11, 2022Q0234TofidenceInjection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mgBiogenAdded July 1, 2026Q0237AvtozmaInjection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mgCelltrion USAAdded January 24, 2025