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CPT code 95079: Ingestion challenge, each additional 60 minutes2026 Medicare rate & RVUs in Miami, FL

Reports each additional 60 minutes of supervised oral ingestion challenge testing after the initial challenge period, such as evaluation of suspected food or drug reactions.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Miami, FL, Medicare pays $88.91 for 95079 in the office and $60.40 when it’s performed in a hospital or facility.

$88.91Office (non-facility)
$60.40Hospital or facility
+4.8%vs the national office rate ($84.84)

Check a contract rate as a % of Medicare · 95079 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 95079 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Miami, FL
  2. What 95079 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 95079 covers

This code accounts for additional time spent administering a supervised oral challenge in sequential, incremental doses and observing for a reaction. Allergy specialists commonly use ingestion challenges to assess suspected food allergy or drug allergy, or to determine whether a patient can tolerate a food or medication. The service may take place in an office or facility equipped to monitor the patient during the challenge.

Report 95079 for each additional 60 minutes after the initial ingestion challenge service, and only with the primary challenge code 95076. Documentation should support the challenge items and dose sequence, monitoring and response, and the additional testing time. CMS classifies 95079 as an add-on code: it must be billed with the primary procedure, and its payment is made within that procedure's global period.

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 Miami, FL compares for 95079

Across 109 of 109 payment localities, the office rate for 95079 runs from $78.80 in Arkansas to $109.54 in Alaska. Miami, FL pays $88.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

95079 in Miami, FL vs other payment areas
  1. Miami, FL · this page$88.91
  2. Fort Lauderdale, FL · Florida$86.67−$2.24
  3. Rest of Florida · Florida$84.05−$4.86
  4. Los Angeles, CA · California$92.95+$4.04
  5. Washington, DC area · District of Columbia$94.12+$5.21
  6. Chicago, IL · Illinois$87.51−$1.40
  7. Manhattan, NY · New York$94.77+$5.86

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

Every other payment area

95079 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$109.54$80.38
AlabamaAlabama$79.48$55.51
ArkansasArkansas$78.80$55.27
ArizonaArizona$83.45$56.91
Bakersfield, CACalifornia$88.62$58.60
Chico, CACalifornia$88.41$58.39
El Centro, CACalifornia$88.41$58.40
Fresno, CACalifornia$88.41$58.39

95079 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$78.80

$109.54

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

View every state and territory as a table
95079 office rate range by state
State / territoryOffice rate rangeLocalities
AK$109.541
AL$79.481
AR$78.801
AZ$83.451
CA$88.41–$105.5229
CO$87.401
CT$88.971
DC$94.121
DE$84.461
FL$84.05–$88.913
GA$81.15–$85.912
GU$89.211
HI$89.211
IA$80.681
ID$80.991
IL$82.55–$87.514
IN$81.271
KS$80.451
KY$80.581
LA$80.50–$82.882
MA$87.20–$93.742
MD$85.61–$94.123
ME$81.24–$83.892
MI$81.83–$84.692
MN$84.741
MO$79.68–$83.063
MS$79.251
MT$84.831
NC$81.751
ND$83.851
NE$80.941
NH$86.151
NJ$90.25–$93.792
NM$82.101
NV$84.601
NY$82.49–$96.235
OH$81.631
OK$80.501
OR$84.19–$89.262
PA$81.71–$87.512
PR$85.221
RI$86.761
SC$81.771
SD$83.731
TN$80.691
TX$81.38–$86.898
UT$82.441
VA$83.72–$94.122
VI$85.221
VT$83.641
WA$87.00–$95.252
WI$82.131
WV$80.701
WY$84.401

See 95079 in every payment locality

How the 95079 rate is calculated

Each of 95079’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 · 95079

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.38

1.38 RVUs× 1.000 GPCI

Practice expense1.11

1.11 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.5400

Conversion factor

$33.4009

Medicare rate

$84.84

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

The exact Miami, FL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,471

Code
95079
Physician work
1.38
Practice expense
1.11
Malpractice
0.05

GPCI2026.csv

42

Locality
Miami, FL
Physician work
1.000
Practice expense
1.041
Malpractice
2.529
Office calculation for 95079 in Miami, FL
ComponentRVULocality factorAdjusted
Physician work1.38× 1.0001.3800
Practice expense1.11× 1.0411.1555
Malpractice0.05× 2.5290.1265
Total RVUs2.6620
Conversion factor× 33.4009

Office rate, Miami, FL$88.91

Office: (1.38 × 1 + 1.11 × 1.041 + 0.05 × 2.529) × $33.4009 = $88.91

Facility: (1.38 × 1 + 0.29 × 1.041 + 0.05 × 2.529) × $33.4009 = $60.40

Open 95079 in the RVU calculator

Payment rules and modifiers for 95079

The CMS indicators that decide how 95079 is paid alongside other services.

CMS payment indicators · 95079

Ingestion challenge, each additional 60 minutes

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 95079

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95079
CodeHow it relatesOffice range, Miami, FL
Primary code
95076Ingestion challenge, initial 120 minutesPrimary ingestion challenge service required when reporting 95079.$129.23
Used instead
95070Bronchial challenge, technical testingUsed for bronchial inhalation challenge testing rather than an oral ingestion challenge.$42.87
95018Drug allergy testing, percutaneous and intracutaneous testsDrug skin testing evaluates reactivity by a different method than supervised drug ingestion.$20.12

How 95079 has changed in Miami, FL

95079 · Office / nonfacility

$88.91

Effective 2026-10-01

The base rate is $2.03 higher than on 2025-10-01, moving from $86.88 to $88.91 (2.3%).

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

    $86.88changed to$88.91

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.15 changed to 1.11
    • Practice expense GPCI 1.027 changed to 1.041
    • Malpractice GPCI 2.500 changed to 2.529

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $89.22changed to$86.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.12 changed to 1.15
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $87.76changed to$89.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $89.14changed to$87.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.07 changed to 1.12
    • Practice expense GPCI 1.025 changed to 1.027
    • Malpractice GPCI 2.564 changed to 2.500

  5. January 1, 2023

    RVU23A

    $89.12changed to$89.14

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.04 changed to 1.07
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 1.023 changed to 1.025
    • Malpractice GPCI 2.629 changed to 2.564

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $88.79changed to$89.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.01 changed to 1.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $90.41changed to$88.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.97 changed to 1.01
    • Practice expense GPCI 1.026 changed to 1.023
    • Malpractice GPCI 2.598 changed to 2.629

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $91.07changed to$90.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.99 changed to 0.97
    • Practice expense GPCI 1.029 changed to 1.026
    • Malpractice GPCI 2.566 changed to 2.598

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $89.49changed to$91.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.95 changed to 0.99

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $87.73changed to$89.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.91 changed to 0.95
    • Practice expense GPCI 1.031 changed to 1.029
    • Malpractice GPCI 2.528 changed to 2.566

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $87.52changed to$87.73

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.033 changed to 1.031
    • Malpractice GPCI 2.490 changed to 2.528

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $86.95changed to$87.52

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.04 changed to 0.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $86.51changed to$86.95

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $88.59changed to$86.51

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.92 changed to 0.91
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 2.653 changed to 2.490

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $87.24changed to$88.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.99 changed to 0.92
    • Practice expense GPCI 1.054 changed to 1.044
    • Malpractice GPCI 2.815 changed to 2.653

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $87.24

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$88.91$60.40RVU26D
2026-07-01$88.91$60.40RVU26C
2026-04-01$88.91$60.40RVU26B
2026-01-01$88.91$60.40RVU26A
2025-10-01$86.88$68.28RVU25D
2025-07-01$86.88$68.28RVU25C
2025-04-01$86.88$68.28RVU25B
2025-01-01$86.88$68.28RVU25A
2024-10-01$89.22$70.42RVU24D
2024-07-01$89.22$70.42RVU24C
2024-04-01$89.22$70.42RVU24B
2024-03-09$89.22$70.42RVU24AR
2024-01-01$87.76$69.27RVU24A
2023-10-01$89.14$71.43RVU23D
2023-07-01$89.14$71.43RVU23C
2023-04-01$89.14$71.43RVU23B
2023-01-01$89.14$71.43RVU23A
2022-10-01$89.12$71.78RVU22D
2022-07-01$89.12$71.78RVU22C
2022-04-01$89.12$71.78RVU22B
2022-01-01$89.12$71.78RVU22A
2021-10-01$88.79$72.01RVU21D
2021-07-01$88.79$72.01RVU21C
2021-04-01$88.79$72.01RVU21B
2021-01-01$88.79$72.01RVU21A
2020-10-01$90.41$74.12RVU20D
2020-07-01$90.41$74.12RVU20C
2020-04-01$90.41$74.12RVU20B
2020-01-01$90.41$74.12RVU20A
2019-10-01$91.07$74.38RVU19D
2019-07-01$91.07$74.38RVU19C
2019-04-01$91.07$74.38RVU19B
2019-01-01$91.07$74.38RVU19A
2018-10-01$89.49$72.82RVU18D
2018-07-01$89.49$72.82RVU18C
2018-04-01$89.49$72.82RVU18B
2018-01-01$89.49$72.82RVU18AR1
2017-10-01$87.73$71.45RVU17D
2017-07-01$87.73$71.45RVU17C
2017-04-01$87.73$71.45RVU17B
2017-01-01$87.73$71.45RVU17A
2016-10-01$87.52$71.25RVU16D
2016-07-01$87.52$71.25RVU16C
2016-04-01$87.52$71.25RVU16B
2016-01-01$87.52$71.25RVU16A
2015-10-01$86.95$70.61RVU15D
2015-07-01$86.95$70.61RVU15C
2015-04-01$86.51$70.26RVU15B
2015-01-01$86.51$70.26RVU15A
2014-10-01$88.59$72.51RVU14D
2014-07-01$88.59$72.51RVU14C
2014-04-01$88.59$72.51RVU14B
2014-01-01$88.59$72.51RVU14A
2013-10-01$87.24$70.03RVU13D
2013-07-01$87.24$70.03RVU13C
2013-04-01$87.24$70.03RVU13B
2013-01-01$87.24$70.03RVU13AR

Price 95079 for an earlier date of service

Where the Miami, FL rate applies

Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.

  • Miami
  • Aventura
  • Bal Harbour
  • Bay Harbor Islands
  • Big Coppitt Key
  • Big Pine Key
  • Biscayne Gardens
  • Biscayne Park

Browse all communities in Florida

95079 billing questions

Can 95079 be billed without 95076?

No. Report 95079 only with the primary ingestion challenge code 95076.

How many units of 95079 should be reported?

Report a unit for each additional 60 minutes of ingestion challenge testing beyond the initial service. Document the additional testing time.

What documentation supports additional challenge time?

Document the items and incremental doses administered, patient monitoring and response, and the time spent in the additional challenge period.

Is 95079 used for an inhaled challenge?

No. It is for additional time in an oral ingestion challenge. Inhalation bronchial challenge testing is represented by a different service, such as 95070.

Does 95079 have a separate global period?

No separate period is described for this add-on. CMS specifies that it is paid within the primary procedure's global period.

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 95079PPRRVU2026_Oct_nonQPP.csv, line 12,471 (RVU26D)
Geographic factors for Miami, FLGPCI2026.csv, line 42 (RVU26D)

Open CMS sourceHow we calculate rates

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