ROTARIX CPT Vaccine Code: 90681

Vaccine & Product Overview

HCPCS Descriptor Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use

Manufacturer Glaxo Smithkline Pharmaceuticals

Route of Administration Oral

Generic Status Single-Source; Branded

Dosage Form Solution

About ROTARIX

Rotarix is a medication aligned to the HCPCS CPT Drug Code: 90681 for billing, pricing, and reimbursement purposes in the United States. It is a Vaccine drug administered via the oral route and manufactured by Glaxo Smithkline Pharmaceuticals.

Manufacturers, reach out to us to add more information.

NDC Code Information

1 NDC package is crosswalked to 90681. Package detail is available to logged-in subscribers.

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

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ROTARIX Pricing & Reimbursement

90681 Private Payer Reimbursement

$166.98 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

ROTARIX Vaccine Administration Codes

CPT Code	Description
90473	Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid).
90474	Immunization administration by intranasal or oral route; each additional vaccine or toxoid.

ROTARIX Medically Unlikely Edits (MUE)

The most billing units of 90681 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 →

ROTARIX 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.

Rotavirus gastroenteritis (prevention)

Drug Class

Actively Acquired Immunity [PE]Live Attenuated Rotavirus Vaccine [EPC]Rotavirus Vaccines [CS]VaccinesAttenuated [CS]

Frequently Asked Questions

Is there an available Rotarix billing and coding guide?

Billing and coding information for ROTARIX can be found through GSK. Visit Here →

Are there any available Rotarix patient assistance programs?

ROTARIX patient assistance information can be found through GSK. Visit Here →

Where can I find Rotarix prescribing information?

ROTARIX prescribing information can be found at the link below: Visit Here →

Where can I find Rotarix side effect information?

Information regarding ROTARIX's side effects can be found at MedlinePlus Visit Here →

Does billing ROTARIX require JZ/JW wastage modifiers?

CMS does not include ROTARIX (90681) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing 90681. For more information, visit the link below.

About BuyandBill.com:

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