CPT code 95117: Allergy shots, two or more injections, extract not included2026 Medicare rate & RVUs in Guam
Report allergen immunotherapy administration when two or more injections are given in one session; preparation and provision of the extract are separate services.
Medicare pays $13.87 for 95117 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 95117 covers
This service covers two or more subcutaneous allergen immunotherapy injections in one session, such as prescribed injections from separate pollen and dust mite extract vials. A nurse or medical assistant commonly administers the shots in an allergist’s, primary care, or ENT office under a physician’s immunotherapy plan. The service includes drawing up the ordered doses, giving the injections, and observing the patient afterward for local or systemic reactions. Patients may receive injections during buildup or maintenance treatment.
Report one unit for a session with two or more injections, regardless of the number of shots; use 95115 for a single injection. Record the extracts used, doses, injection sites, observation, and any reaction. This administration code excludes preparation and provision of the allergenic extract. When separately furnished and documented, extract preparation may be reported under the appropriate antigen code, with units based on doses prepared. CMS assigns no physician work value to 95117. Medicare treats it as an incident-to service, billable only when performed under physician supervision; the supervising physician must be in the office suite and immediately available during the injections.
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.
95117 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $13.87 | Unavailable |
How the 95117 rate is calculated
Each of 95117’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 · 95117
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.36
0.36 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.3700
Conversion factor
$33.4009
Medicare rate
$12.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95117
The CMS indicators that decide how 95117 is paid alongside other services.
CMS payment indicators · 95117
Allergy shots, two or more injections, extract not included
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
95117 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95115Allergy shotSingle injection, extract not included
- Count injections in the session. One injection uses 95115; two or more use 95117, reported once for that session.
- 95125Allergen immunotherapyTwo or more injections
- 95125 describes a service that includes provision of allergenic extract along with two or more injections. Code 95117 describes administration without extract provision.
- 95131Venom immunotherapyTwo insect venoms
- 95131 describes immunotherapy for two stinging insect venoms with venom provision. Code 95117 counts injections administered without extract provision; the number of venoms is not necessarily the number of injections.
- 95165Allergy extract preparationMultidose vials, per dose
- 95165 describes preparation and provision of allergenic extract, with units based on doses prepared. Code 95117 describes administering two or more injections in a session.
95117 billing questions
How many units are reported when a patient receives three or four allergy shots?
One unit for the session. Two or more injections are covered by 95117, so additional shots in that session do not add units.
Can the single-injection code be billed with this code for the same session?
No. Choose by injection count: one shot uses 95115; two or more use 95117.
Is the allergenic extract included?
No. Code 95117 covers administration. When separately furnished and documented, preparation and provision of extract may be reported under the appropriate antigen code; its units reflect doses prepared, not shots given.
Can an office visit be billed on the injection date?
Yes, if a medically necessary, significant, separately identifiable E/M service is documented, such as evaluation of an asthma flare beyond the routine pre-shot check. Append modifier 25 to the E/M code.
Who can give the injections for Medicare billing?
A nurse or medical assistant may administer them as an incident-to service when the supervising physician is in the office suite and immediately available during the injections.
Can a practice bill this code if the patient brings extract prepared elsewhere?
Yes, if that practice administers two or more injections in the session. It reports 95117 for administration; any separately reported extract preparation must be supported by the service the furnishing practice performed.
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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