CPT code 95131: Venom immunotherapy, two insect venoms2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 95131 in California.

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

What 95131 covers

95131 identifies a venom-allergy immunotherapy visit involving two stinging-insect venoms. An allergy specialist reports it for treatment administered during a patient's care for insect-venom allergy. The code distinguishes the visit by the number of venoms addressed, rather than by the count of injections. It is separate from codes describing preparation and provision of allergen extracts.

Medicare assigns status I to 95131: Medicare does not accept this CPT code and uses a different code to report and pay for the service. Within the CPT venom-immunotherapy family, the neighboring codes distinguish visits by the number of stinging-insect venoms involved. Antigen preparation and provision are represented separately from the venom-immunotherapy visit.

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.

Where 95131 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 95131 rate is calculated

Each of 95131’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.

Payment rules and modifiers for 95131

95131 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.

95131 compared with similar codes

How to choose

95130Venom immunotherapyOne insect venom

95130 identifies a visit involving one stinging-insect venom; 95131 identifies a visit involving two.

95132Venom immunotherapyThree venoms

95132 identifies a visit involving three stinging-insect venoms; 95131 identifies a visit involving two.

95117Allergy shotsTwo or more injections, extract not included

95117 describes allergen immunotherapy involving two or more injections. 95131 distinguishes venom immunotherapy by the number of stinging-insect venoms.

95146Venom antigen preparationTwo venom types

95146 concerns antigen preparation and provision for two stinging-insect venoms; 95131 identifies the venom-immunotherapy visit.

Codes related to 95131

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

Open CMS sourceHow we calculate rates