Cost analysis for CPT G0009 — Administration of pneumococcal vaccine
Average Medicare Payment
$27.20
2023 data
Total Payments (2023)
$48.3M
Services (2023)
1.8M
Price Change (2014–2023)
+24.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $21.80 | $35.4M | 1.6M | — |
| 2015 | $21.80 | $122.3M | 5.4M | 0.0% |
| 2016 | $22.58 | $94.1M | 4.1M | +3.6% |
| 2017 | $22.99 | $76.6M | 3.4M | +1.8% |
| 2018 | $19.61 | $58.1M | 3.0M | -14.7% |
| 2019 | $16.10 | $44.4M | 2.8M | -17.9% |
| 2020 | $15.88 | $38.5M | 2.4M | -1.4% |
| 2021 | $16.32 | $17.5M | 1.1M | +2.8% |
| 2022 | $28.18 | $35.6M | 1.3M | +72.7% |
| 2023 | $27.20 | $48.3M | 1.8M | -3.5% |
The most expensive state pays 1.7x more than the cheapest for this procedure. AK averages $33.14 vs HI at $19.00.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $33.14 | $109.0K | 3.3K | 82 |
| ID | $31.36 | $1.5M | 48.1K | 171 |
| DC | $30.20 | $95.7K | 3.2K | 125 |
| WA | $30.07 | $925.8K | 30.8K | 1.2K |
| CO | $30.00 | $1.7M | 56.6K | 1.0K |
| NJ | $29.49 | $1.8M | 62.7K | 2.0K |
| NY | $29.49 | $2.4M | 82.2K | 2.9K |
| GU | $29.40 | $10.4K | 353 | 11 |
| MD | $29.26 | $1.4M | 48.4K | 1.6K |
| IL | $29.21 | $2.3M | 78.4K | 2.7K |
| CT | $29.16 | $486.9K | 16.7K | 756 |
| DE | $28.69 | $272.7K | 9.5K | 271 |
| OR | $27.95 | $373.2K | 13.3K | 565 |
| PA | $27.91 | $2.3M | 83.1K | 3.1K |
| FL | $27.63 | $5.0M | 179.8K | 3.5K |
| VA | $27.59 | $1.6M | 57.7K | 2.0K |
| NH | $27.56 | $239.1K | 8.7K | 337 |
| MA | $27.52 | $1.5M | 54.8K | 1.9K |
| CA | $27.31 | $4.6M | 167.4K | 5.4K |
| OH | $27.23 | $1.5M | 56.0K | 2.4K |
| ND | $27.22 | $80.9K | 3.0K | 112 |
| MT | $26.80 | $133.5K | 5.0K | 183 |
| IA | $26.74 | $560.6K | 21.0K | 702 |
| MO | $26.67 | $769.2K | 28.8K | 1.1K |
| NC | $26.65 | $1.4M | 51.0K | 2.0K |
| KY | $26.65 | $571.0K | 21.4K | 887 |
| MI | $26.62 | $943.7K | 35.4K | 1.5K |
| UT | $26.55 | $270.9K | 10.2K | 447 |
| MN | $26.52 | $423.0K | 15.9K | 804 |
| LA | $26.51 | $375.3K | 14.2K | 554 |
| PR | $26.50 | $25.5K | 963 | 38 |
| IN | $26.35 | $1.1M | 43.0K | 1.7K |
| NE | $26.30 | $353.8K | 13.5K | 468 |
| RI | $26.23 | $139.8K | 5.3K | 213 |
| AZ | $26.20 | $937.9K | 35.8K | 1.2K |
| WI | $26.04 | $706.5K | 27.1K | 1.2K |
| TX | $25.83 | $2.7M | 103.6K | 3.8K |
| KS | $25.78 | $551.1K | 21.4K | 718 |
| OK | $25.69 | $581.6K | 22.6K | 768 |
| GA | $25.66 | $1.1M | 42.7K | 1.7K |
| ME | $25.60 | $55.5K | 2.2K | 97 |
| NM | $25.59 | $213.5K | 8.3K | 273 |
| TN | $25.51 | $1.1M | 43.5K | 1.5K |
| AR | $25.34 | $431.7K | 17.0K | 602 |
| WY | $25.03 | $115.8K | 4.6K | 132 |
| NV | $24.92 | $286.7K | 11.5K | 379 |
| MS | $24.91 | $396.8K | 15.9K | 512 |
| VT | $24.78 | $44.9K | 1.8K | 74 |
| SC | $24.76 | $1.1M | 43.3K | 1.3K |
| WV | $24.66 | $128.8K | 5.2K | 226 |
| AL | $23.67 | $398.7K | 16.8K | 728 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Vaxcare Corporation | Centralized Flu | FL | $2.0M | 66.8K | $29.84 |
| Walgreen Co | Centralized Flu | CO | $975.5K | 31.6K | $30.85 |
| Safeway Inc | Centralized Flu | ID | $536.4K | 16.8K | $31.88 |
| Albertsons Llc | Centralized Flu | ID | $224.4K | 7.3K | $30.73 |
| American Drug Stores Llc | Centralized Flu | ID | $222.5K | 7.0K | $31.79 |
| Nai Saturn Eastern Llc | Centralized Flu | ID | $144.6K | 4.3K | $33.34 |
| Vons Companies Inc | Centralized Flu | ID | $101.4K | 3.1K | $32.74 |
| Acme Markets Inc | Centralized Flu | ID | $68.7K | 2.1K | $32.55 |
| Geri Script L L C | Mass Immunizer Roster Biller | NJ | $57.0K | 1.7K | $33.97 |
| Randalls Food & Drugs Lp | Centralized Flu | ID | $54.6K | 1.8K | $30.35 |
| United Supermarkets Llc | Centralized Flu | TX | $47.0K | 1.6K | $29.46 |
| Shaws Supermarkets Inc | Centralized Flu | ID | $34.8K | 1.1K | $31.51 |
| Dania Discount Drugs Inc | Centralized Flu | FL | $27.4K | 937 | $29.23 |
| Pharmacy Relief Services, Pllc | Pharmacy | IA | $16.6K | 586 | $28.34 |
| Casey O'donnell | Physical Medicine and Rehabilitation | MA | $16.3K | 538 | $30.24 |
| Giant Of Maryland Llc | Centralized Flu | MD | $15.8K | 464 | $34.02 |
| Carr-Gottstein Foods Co | Centralized Flu | AK | $14.6K | 373 | $39.01 |
| Pharmcare Usa Of Edison, Inc. | Pharmacy | NJ | $14.3K | 425 | $33.65 |
| Genoa Healthcare Llc | Centralized Flu | WA | $13.6K | 441 | $30.79 |
| Ltc Pharmacy Management Services, Llc | Pharmacy | IN | $13.3K | 468 | $28.34 |
Based on the data, CPT G0009 shows a 1.7x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 24.8% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.