CPT code 95004: Allergy skin prick test, percutaneous, immediate reaction, per test2026 Medicare rate & RVUs in Nevada

Percutaneous scratch, prick, or puncture testing with allergenic extracts evaluates immediate allergic reactions and is reported for each individual test performed.

CMS RVU26DEffective Oct 1, 2026One payment locality8.6M Medicare services in 2024

In Nevada, Medicare pays $3.62 for 95004 in the office.

$3.62Office (non-facility)
Not available in this settingHospital or facility
−1.4%vs the national office rate ($3.67)

Check a contract rate as a % of Medicare · 95004 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 95004 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 95004 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 95004 covers

Allergists, otolaryngologists, and some primary care clinicians perform percutaneous testing to evaluate suspected immediate allergies, including allergic rhinitis, asthma triggers, and food allergy. Small amounts of allergenic extract are introduced through a scratch, prick, or puncture on the forearm or back. The resulting wheal and flare are read shortly afterward. Typical extracts include pollens, dust mites, animal dander, molds, and foods. Clinical staff may apply and read the tests under physician supervision; interpretation and a report are included in the service.

Report one unit for each individual percutaneous test performed, rather than one unit for the panel. Document the extracts, controls, test sites, reactions, read time, and interpretation to support the reported count. When clinically indicated, separately performed intradermal immediate-reaction tests with allergenic extracts are reported with 95024 and their own test count. Do not bill separately for the interpretation of 95004. A significant, separately identifiable office evaluation on the same date may be reported with an appropriate E/M code and modifier 25 on the E/M service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Nevada compares for 95004

Across 109 of 109 payment localities, the office rate for 95004 runs from $3.09 in Arkansas to $4.88 in San Benito County, CA. Nevada pays $3.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

95004 in Nevada vs other payment areas
  1. Nevada · this page$3.62
  2. Los Angeles, CA · California$4.13+$0.51
  3. Washington, DC area · District of Columbia$4.26+$0.64
  4. Miami, FL · Florida$4.31+$0.69
  5. Chicago, IL · Illinois$4.12+$0.50
  6. Manhattan, NY · New York$4.38+$0.76
  7. Alaska · Alaska$3.89+$0.27

Other areas in Nevada first, then benchmark localities. Bars start at $0.

Every other payment area

95004 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$3.15—
ArkansasArkansas$3.09—
ArizonaArizona$3.53—
Bakersfield, CACalifornia$3.84—
Chico, CACalifornia$3.81—
El Centro, CACalifornia$3.82—
Fresno, CACalifornia$3.81—
Hanford, CACalifornia$3.81—

95004 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$3.09

$4.35

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95004 office rate range by state
State / territoryOffice rate rangeLocalities
AK$3.891
AL$3.151
AR$3.091
AZ$3.531
CA$3.81–$4.8829
CO$3.801
CT$3.981
DC$4.261
DE$3.611
FL$3.71–$4.313
GA$3.41–$3.792
GU$3.951
HI$3.951
IA$3.221
ID$3.261
IL$3.60–$4.124
IN$3.281
KS$3.221
KY$3.311
LA$3.31–$3.542
MA$3.77–$4.232
MD$3.69–$4.263
ME$3.31–$3.522
MI$3.46–$3.802
MN$3.531
MO$3.25–$3.533
MS$3.171
MT$3.671
NC$3.351
ND$3.481
NE$3.231
NH$3.761
NJ$4.00–$4.202
NM$3.491
NV$3.621
NY$3.42–$4.555
OH$3.421
OK$3.281
OR$3.56–$3.932
PA$3.41–$3.872
PR$3.701
RI$3.741
SC$3.401
SD$3.451
TN$3.251
TX$3.38–$3.818
UT$3.461
VA$3.52–$4.262
VI$3.701
VT$3.481
WA$3.76–$4.312
WI$3.321
WV$3.421
WY$3.591

See 95004 in every payment locality

How the 95004 rate is calculated

Each of 95004’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 95004

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.01

0.01 RVUs× 1.000 GPCI

Practice expense0.09

0.09 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.1100

Conversion factor

$33.4009

Medicare rate

$3.67

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,457

Code
95004
Physician work
0.01
Practice expense
0.09
Malpractice
0.01

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 95004 in Nevada
ComponentRVULocality factorAdjusted
Physician work0.01× 1.0000.0100
Practice expense0.09× 1.0010.0901
Malpractice0.01× 0.8330.0083
Total RVUs0.1084
Conversion factor× 33.4009

Office rate, Nevada$3.62

Office: (0.01 × 1 + 0.09 × 1.001 + 0.01 × 0.833) × $33.4009 = $3.62

Open 95004 in the RVU calculator

Payment rules and modifiers for 95004

95004 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 95004

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$3.67

Higher because the practice carries its own overhead.

How 95004 has changed in Nevada

95004 · Office / nonfacility

$3.62

Effective 2026-10-01

The base rate is $0.11 higher than on 2025-10-01, moving from $3.51 to $3.62 (3.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $3.51changed to$3.62

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $3.61changed to$3.51

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $3.55changed to$3.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $4.10changed to$3.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.10 changed to 0.09
    • Malpractice GPCI 1.098 changed to 0.844
  5. January 1, 2023

    RVU23A

    $4.28changed to$4.10

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $4.31changed to$4.28

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $4.38changed to$4.31

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $4.35changed to$4.38

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $5.45changed to$4.35

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.13 changed to 0.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $7.01changed to$5.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.17 changed to 0.13
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $7.11changed to$7.01

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $6.76changed to$7.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.16 changed to 0.17

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $6.72changed to$6.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $6.80changed to$6.72

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $7.24changed to$6.80

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.18 changed to 0.16
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$7.24

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$3.62Not available in this settingRVU26D
2026-07-01$3.62Not available in this settingRVU26C
2026-04-01$3.62Not available in this settingRVU26B
2026-01-01$3.62Not available in this settingRVU26A
2025-10-01$3.51Not available in this settingRVU25D
2025-07-01$3.51Not available in this settingRVU25C
2025-04-01$3.51Not available in this settingRVU25B
2025-01-01$3.51Not available in this settingRVU25A
2024-10-01$3.61Not available in this settingRVU24D
2024-07-01$3.61Not available in this settingRVU24C
2024-04-01$3.61Not available in this settingRVU24B
2024-03-09$3.61Not available in this settingRVU24AR
2024-01-01$3.55Not available in this settingRVU24A
2023-10-01$4.10Not available in this settingRVU23D
2023-07-01$4.10Not available in this settingRVU23C
2023-04-01$4.10Not available in this settingRVU23B
2023-01-01$4.10Not available in this settingRVU23A
2022-10-01$4.28Not available in this settingRVU22D
2022-07-01$4.28Not available in this settingRVU22C
2022-04-01$4.28Not available in this settingRVU22B
2022-01-01$4.28Not available in this settingRVU22A
2021-10-01$4.31Not available in this settingRVU21D
2021-07-01$4.31Not available in this settingRVU21C
2021-04-01$4.31Not available in this settingRVU21B
2021-01-01$4.31Not available in this settingRVU21A
2020-10-01$4.38Not available in this settingRVU20D
2020-07-01$4.38Not available in this settingRVU20C
2020-04-01$4.38Not available in this settingRVU20B
2020-01-01$4.38Not available in this settingRVU20A
2019-10-01$4.35Not available in this settingRVU19D
2019-07-01$4.35Not available in this settingRVU19C
2019-04-01$4.35Not available in this settingRVU19B
2019-01-01$4.35Not available in this settingRVU19A
2018-10-01$5.45Not available in this settingRVU18D
2018-07-01$5.45Not available in this settingRVU18C
2018-04-01$5.45Not available in this settingRVU18B
2018-01-01$5.45Not available in this settingRVU18AR1
2017-10-01$7.01Not available in this settingRVU17D
2017-07-01$7.01Not available in this settingRVU17C
2017-04-01$7.01Not available in this settingRVU17B
2017-01-01$7.01Not available in this settingRVU17A
2016-10-01$7.11Not available in this settingRVU16D
2016-07-01$7.11Not available in this settingRVU16C
2016-04-01$7.11Not available in this settingRVU16B
2016-01-01$7.11Not available in this settingRVU16A
2015-10-01$6.76Not available in this settingRVU15D
2015-07-01$6.76Not available in this settingRVU15C
2015-04-01$6.72Not available in this settingRVU15B
2015-01-01$6.72Not available in this settingRVU15A
2014-10-01$6.80Not available in this settingRVU14D
2014-07-01$6.80Not available in this settingRVU14C
2014-04-01$6.80Not available in this settingRVU14B
2014-01-01$6.80Not available in this settingRVU14A
2013-10-01$7.24Not available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 95004 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

95004 billing questions

How many units of 95004 are reported for a skin test panel?

Report one unit per individual percutaneous test performed, not one unit for the panel. The record should identify the tested extracts so the count can be verified.

Can 95004 and 95024 be billed on the same day?

Yes, when both percutaneous and clinically indicated intradermal immediate-reaction testing with allergenic extracts are performed. Report each code with its own test count and document which extracts received each method.

Should 95004 be used for insect venom or drug allergy testing?

Use 95017 for stinging insect venom testing and 95018 for drug or biological testing. Those codes cover percutaneous testing, intradermal testing, or a combination, as performed.

Is the physician interpretation billed separately?

No. Interpretation and reporting of the skin test results are included in 95004. A significant, separately identifiable E/M service may be reported with modifier 25 on the E/M code.

What documentation supports 95004?

Record the extracts and controls, percutaneous method, test sites, wheal and flare measurements or grading, read time, and interpretation. The documented tests should support the number of units billed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 95004PPRRVU2026_Oct_nonQPP.csv, line 12,457 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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