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.
In Nevada, Medicare pays $3.62 for 95004 in the office.
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.
On this page 11 sections
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.
- Nevada · this page$3.62
- Los Angeles, CA · California$4.13+$0.51
- Washington, DC area · District of Columbia$4.26+$0.64
- Miami, FL · Florida$4.31+$0.69
- Chicago, IL · Illinois$4.12+$0.50
- Manhattan, NY · New York$4.38+$0.76
- Alaska · Alaska$3.89+$0.27
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $3.81 | — |
| Merced, CACalifornia | $3.81 | — |
| Modesto, CACalifornia | $3.81 | — |
| Napa, CACalifornia | $4.49 | — |
| Oxnard, CACalifornia | $4.10 | — |
| Redding, CACalifornia | $3.81 | — |
| Rest of CaliforniaCalifornia | $3.81 | — |
| Riverside, CACalifornia | $3.92 | — |
| Sacramento, CACalifornia | $4.02 | — |
| Salinas, CACalifornia | $4.01 | — |
| San Diego, CACalifornia | $4.12 | — |
| Marin County, CACalifornia | $4.76 | — |
| San Francisco, CACalifornia | $4.75 | — |
| San Benito County, CACalifornia | $4.88 | — |
| Santa Clara County, CACalifornia | $4.84 | — |
| San Luis Obispo, CACalifornia | $3.94 | — |
| Santa Cruz, CACalifornia | $4.17 | — |
| Santa Maria, CACalifornia | $4.03 | — |
| Santa Rosa, CACalifornia | $4.21 | — |
| Stockton, CACalifornia | $3.81 | — |
| Vallejo, CACalifornia | $4.47 | — |
| Visalia, CACalifornia | $3.81 | — |
| Yuba City, CACalifornia | $3.81 | — |
| ColoradoColorado | $3.80 | — |
| ConnecticutConnecticut | $3.98 | — |
| DelawareDelaware | $3.61 | — |
| Fort Lauderdale, FLFlorida | $3.98 | — |
| Rest of FloridaFlorida | $3.71 | — |
| Atlanta, GAGeorgia | $3.79 | — |
| Rest of GeorgiaGeorgia | $3.41 | — |
| Hawaii, Guam, HIHawaii | $3.95 | — |
| IowaIowa | $3.22 | — |
| IdahoIdaho | $3.26 | — |
| East St. Louis, ILIllinois | $3.77 | — |
| Rest of IllinoisIllinois | $3.60 | — |
| Suburban Chicago, ILIllinois | $4.02 | — |
| IndianaIndiana | $3.28 | — |
| KansasKansas | $3.22 | — |
| KentuckyKentucky | $3.31 | — |
| New Orleans, LALouisiana | $3.54 | — |
| Rest of LouisianaLouisiana | $3.31 | — |
| Metropolitan Boston, MAMassachusetts | $4.23 | — |
| Rest of MassachusettsMassachusetts | $3.77 | — |
| Baltimore area, MDMaryland | $3.98 | — |
| Rest of MarylandMaryland | $3.69 | — |
| Rest of MaineMaine | $3.31 | — |
| Southern Maine, MEMaine | $3.52 | — |
| Detroit, MIMichigan | $3.80 | — |
| Rest of MichiganMichigan | $3.46 | — |
| MinnesotaMinnesota | $3.53 | — |
| Metropolitan Kansas City, MOMissouri | $3.48 | — |
| Metropolitan St. Louis, MOMissouri | $3.53 | — |
| Rest of MissouriMissouri | $3.25 | — |
| MississippiMississippi | $3.17 | — |
| MontanaMontana | $3.67 | — |
| North CarolinaNorth Carolina | $3.35 | — |
| North DakotaNorth Dakota | $3.48 | — |
| NebraskaNebraska | $3.23 | — |
| New HampshireNew Hampshire | $3.76 | — |
| Northern New JerseyNew Jersey | $4.20 | — |
| Rest of New JerseyNew Jersey | $4.00 | — |
| New MexicoNew Mexico | $3.49 | — |
| NYC suburbs and Long Island, NYNew York | $4.55 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $4.04 | — |
| Queens, NYNew York | $4.39 | — |
| Rest of New YorkNew York | $3.42 | — |
| OhioOhio | $3.42 | — |
| OklahomaOklahoma | $3.28 | — |
| Portland, OROregon | $3.93 | — |
| Rest of OregonOregon | $3.56 | — |
| Metropolitan Philadelphia, PAPennsylvania | $3.87 | — |
| Rest of PennsylvaniaPennsylvania | $3.41 | — |
| Puerto RicoPuerto Rico | $3.70 | — |
| Rhode IslandRhode Island | $3.74 | — |
| South CarolinaSouth Carolina | $3.40 | — |
| South DakotaSouth Dakota | $3.45 | — |
| TennesseeTennessee | $3.25 | — |
| Austin, TXTexas | $3.81 | — |
| Beaumont, TXTexas | $3.38 | — |
| Brazoria, TXTexas | $3.58 | — |
| Dallas, TXTexas | $3.62 | — |
| Fort Worth, TXTexas | $3.59 | — |
| Galveston, TXTexas | $3.60 | — |
| Houston, TXTexas | $3.78 | — |
| Rest of TexasTexas | $3.49 | — |
| UtahUtah | $3.46 | — |
| VirginiaVirginia | $3.52 | — |
| Virgin Islands, VIUnited States Virgin Islands | $3.70 | — |
| VermontVermont | $3.48 | — |
| Rest of WashingtonWashington | $3.76 | — |
| King County, WAWashington | $4.31 | — |
| WisconsinWisconsin | $3.32 | — |
| West VirginiaWest Virginia | $3.42 | — |
| WyomingWyoming | $3.59 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $3.89 | 1 |
| AL | $3.15 | 1 |
| AR | $3.09 | 1 |
| AZ | $3.53 | 1 |
| CA | $3.81–$4.88 | 29 |
| CO | $3.80 | 1 |
| CT | $3.98 | 1 |
| DC | $4.26 | 1 |
| DE | $3.61 | 1 |
| FL | $3.71–$4.31 | 3 |
| GA | $3.41–$3.79 | 2 |
| GU | $3.95 | 1 |
| HI | $3.95 | 1 |
| IA | $3.22 | 1 |
| ID | $3.26 | 1 |
| IL | $3.60–$4.12 | 4 |
| IN | $3.28 | 1 |
| KS | $3.22 | 1 |
| KY | $3.31 | 1 |
| LA | $3.31–$3.54 | 2 |
| MA | $3.77–$4.23 | 2 |
| MD | $3.69–$4.26 | 3 |
| ME | $3.31–$3.52 | 2 |
| MI | $3.46–$3.80 | 2 |
| MN | $3.53 | 1 |
| MO | $3.25–$3.53 | 3 |
| MS | $3.17 | 1 |
| MT | $3.67 | 1 |
| NC | $3.35 | 1 |
| ND | $3.48 | 1 |
| NE | $3.23 | 1 |
| NH | $3.76 | 1 |
| NJ | $4.00–$4.20 | 2 |
| NM | $3.49 | 1 |
| NV | $3.62 | 1 |
| NY | $3.42–$4.55 | 5 |
| OH | $3.42 | 1 |
| OK | $3.28 | 1 |
| OR | $3.56–$3.93 | 2 |
| PA | $3.41–$3.87 | 2 |
| PR | $3.70 | 1 |
| RI | $3.74 | 1 |
| SC | $3.40 | 1 |
| SD | $3.45 | 1 |
| TN | $3.25 | 1 |
| TX | $3.38–$3.81 | 8 |
| UT | $3.46 | 1 |
| VA | $3.52–$4.26 | 2 |
| VI | $3.70 | 1 |
| VT | $3.48 | 1 |
| WA | $3.76–$4.31 | 2 |
| WI | $3.32 | 1 |
| WV | $3.42 | 1 |
| WY | $3.59 | 1 |
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
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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.01 | × 1.000 | 0.0100 |
| Practice expense | 0.09 | × 1.001 | 0.0901 |
| Malpractice | 0.01 | × 0.833 | 0.0083 |
| Total RVUs | 0.1084 | ||
| 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
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.
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
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.
January 1, 2025
RVU25A
$3.61changed to$3.51
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$3.55changed to$3.61
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
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
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.
January 1, 2022
RVU22A
$4.31changed to$4.28
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
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.
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.
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.
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.
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.
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.
July 1, 2015
RVU15C
$6.72changed to$6.76
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
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.
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.
October 1, 2013
RVU13D
No ratechanged to$7.24
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $3.62 | Not available in this setting | RVU26D |
| 2026-07-01 | $3.62 | Not available in this setting | RVU26C |
| 2026-04-01 | $3.62 | Not available in this setting | RVU26B |
| 2026-01-01 | $3.62 | Not available in this setting | RVU26A |
| 2025-10-01 | $3.51 | Not available in this setting | RVU25D |
| 2025-07-01 | $3.51 | Not available in this setting | RVU25C |
| 2025-04-01 | $3.51 | Not available in this setting | RVU25B |
| 2025-01-01 | $3.51 | Not available in this setting | RVU25A |
| 2024-10-01 | $3.61 | Not available in this setting | RVU24D |
| 2024-07-01 | $3.61 | Not available in this setting | RVU24C |
| 2024-04-01 | $3.61 | Not available in this setting | RVU24B |
| 2024-03-09 | $3.61 | Not available in this setting | RVU24AR |
| 2024-01-01 | $3.55 | Not available in this setting | RVU24A |
| 2023-10-01 | $4.10 | Not available in this setting | RVU23D |
| 2023-07-01 | $4.10 | Not available in this setting | RVU23C |
| 2023-04-01 | $4.10 | Not available in this setting | RVU23B |
| 2023-01-01 | $4.10 | Not available in this setting | RVU23A |
| 2022-10-01 | $4.28 | Not available in this setting | RVU22D |
| 2022-07-01 | $4.28 | Not available in this setting | RVU22C |
| 2022-04-01 | $4.28 | Not available in this setting | RVU22B |
| 2022-01-01 | $4.28 | Not available in this setting | RVU22A |
| 2021-10-01 | $4.31 | Not available in this setting | RVU21D |
| 2021-07-01 | $4.31 | Not available in this setting | RVU21C |
| 2021-04-01 | $4.31 | Not available in this setting | RVU21B |
| 2021-01-01 | $4.31 | Not available in this setting | RVU21A |
| 2020-10-01 | $4.38 | Not available in this setting | RVU20D |
| 2020-07-01 | $4.38 | Not available in this setting | RVU20C |
| 2020-04-01 | $4.38 | Not available in this setting | RVU20B |
| 2020-01-01 | $4.38 | Not available in this setting | RVU20A |
| 2019-10-01 | $4.35 | Not available in this setting | RVU19D |
| 2019-07-01 | $4.35 | Not available in this setting | RVU19C |
| 2019-04-01 | $4.35 | Not available in this setting | RVU19B |
| 2019-01-01 | $4.35 | Not available in this setting | RVU19A |
| 2018-10-01 | $5.45 | Not available in this setting | RVU18D |
| 2018-07-01 | $5.45 | Not available in this setting | RVU18C |
| 2018-04-01 | $5.45 | Not available in this setting | RVU18B |
| 2018-01-01 | $5.45 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $7.01 | Not available in this setting | RVU17D |
| 2017-07-01 | $7.01 | Not available in this setting | RVU17C |
| 2017-04-01 | $7.01 | Not available in this setting | RVU17B |
| 2017-01-01 | $7.01 | Not available in this setting | RVU17A |
| 2016-10-01 | $7.11 | Not available in this setting | RVU16D |
| 2016-07-01 | $7.11 | Not available in this setting | RVU16C |
| 2016-04-01 | $7.11 | Not available in this setting | RVU16B |
| 2016-01-01 | $7.11 | Not available in this setting | RVU16A |
| 2015-10-01 | $6.76 | Not available in this setting | RVU15D |
| 2015-07-01 | $6.76 | Not available in this setting | RVU15C |
| 2015-04-01 | $6.72 | Not available in this setting | RVU15B |
| 2015-01-01 | $6.72 | Not available in this setting | RVU15A |
| 2014-10-01 | $6.80 | Not available in this setting | RVU14D |
| 2014-07-01 | $6.80 | Not available in this setting | RVU14C |
| 2014-04-01 | $6.80 | Not available in this setting | RVU14B |
| 2014-01-01 | $6.80 | Not available in this setting | RVU14A |
| 2013-10-01 | $7.24 | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
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
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
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