90% of what?
I assume you mean a 90% HHV efficiency. Most smaller units that meet the 90% HHV efficiency use pulsed combustion and partial condensing of the fluegas. 2 issues with this are (a) noise from the pulsed combustion and (b) stack corrosion and required fan head to pressurize the stack to exhaust the fluegas. For smaller units a CPVC stack might meet building codes, but for larger units it might not meet fire code, and a pressurized exhaust is a risk to occupants.