CPT code 95165: Allergy extract preparation, multidose vials, per dose2026 Medicare rate & RVUs in Washington, DC area

Physician-supervised preparation of allergen extract in multidose vials for allergy shots, reported by doses prepared rather than injections administered.

CMS RVU26DEffective Oct 1, 2026One payment locality5.9M Medicare services in 2024

In Washington, DC area, Medicare pays $20.19 for 95165 in the office and $2.88 when it’s performed in a hospital or facility.

$20.19Office (non-facility)
$2.88Hospital or facility
+16.2%vs the national office rate ($17.37)

Check a contract rate as a % of Medicare · 95165 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 95165 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 95165 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 95165 covers

This service covers an allergist's selection of allergens and concentrations and supervision of custom extract preparation in multidose vials. Allergy and immunology practices typically prepare extracts after testing and clinical history identify relevant sensitivities to pollens, molds, dust mites, or animal dander. The preparing practice may administer the shots or send the extract to another office, such as a primary care clinic. Preparation does not include administering an injection.

Report units based on doses prepared, not shots given. For Medicare, one dose is a 1 mL aliquot from a multidose vial, regardless of the volume injected at a visit; a 10 mL vial therefore supports 10 units. The record should identify each vial's allergens, concentration, volume, preparation date, and supervising physician. When administered, injections are reported separately with 95115 for one injection or 95117 for two or more. CMS assigns substantially more practice-expense RVUs to this service in the office than in a facility.

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 Washington, DC area compares for 95165

Across 109 of 109 payment localities, the office rate for 95165 runs from $15.09 in Arkansas to $24.08 in San Benito County, CA. Washington, DC area pays $20.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

95165 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$20.19
  2. Los Angeles, CA · California$20.09−$0.10
  3. Miami, FL · Florida$18.50−$1.69
  4. Chicago, IL · Illinois$17.89−$2.30
  5. Manhattan, NY · New York$20.13−$0.06
  6. Alaska · Alaska$19.20−$0.99
  7. Alabama · Alabama$15.34−$4.85

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

95165 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$15.09$2.46
ArizonaArizona$16.85$2.61
Bakersfield, CACalifornia$18.72$2.61
Chico, CACalifornia$18.69$2.58
El Centro, CACalifornia$18.69$2.58
Fresno, CACalifornia$18.69$2.58
Hanford, CACalifornia$18.69$2.58
Madera, CACalifornia$18.69$2.58

95165 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.

$15.09

$21.38

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

View every state and territory as a table
95165 office rate range by state
State / territoryOffice rate rangeLocalities
AK$19.201
AL$15.341
AR$15.091
AZ$16.851
CA$18.69–$24.0829
CO$18.281
CT$18.641
DC$20.191
DE$17.161
FL$16.88–$18.503
GA$15.81–$17.682
GU$19.291
HI$19.291
IA$15.891
ID$15.991
IL$16.25–$18.054
IN$16.101
KS$15.761
KY$15.671
LA$15.63–$16.532
MA$18.13–$20.332
MD$17.54–$20.193
ME$16.04–$17.112
MI$16.10–$17.072
MN$17.571
MO$15.29–$16.653
MS$15.191
MT$17.371
NC$16.241
ND$17.171
NE$16.001
NH$17.941
NJ$18.86–$19.922
NM$16.191
NV$17.331
NY$16.52–$20.625
OH$16.061
OK$15.691
OR$17.21–$18.982
PA$16.12–$18.092
PR$17.531
RI$17.871
SC$16.181
SD$17.151
TN$15.851
TX$15.99–$18.218
UT$16.431
VA$17.01–$20.192
VI$17.531
VT$17.051
WA$18.11–$20.822
WI$16.511
WV$15.541
WY$17.281

See 95165 in every payment locality

How the 95165 rate is calculated

Each of 95165’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 · 95165

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.06

0.06 RVUs× 1.000 GPCI

Practice expense0.45

0.45 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.5200

Conversion factor

$33.4009

Medicare rate

$17.37

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,487

Code
95165
Physician work
0.06
Practice expense
0.45
Malpractice
0.01

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 95165 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.06× 1.0540.0632
Practice expense0.45× 1.1780.5301
Malpractice0.01× 1.1130.0111
Total RVUs0.6045
Conversion factor× 33.4009

Office rate, Washington, DC area$20.19

Office: (0.06 × 1.054 + 0.45 × 1.178 + 0.01 × 1.113) × $33.4009 = $20.19

Facility: (0.06 × 1.054 + 0.01 × 1.178 + 0.01 × 1.113) × $33.4009 = $2.88

Open 95165 in the RVU calculator

Payment rules and modifiers for 95165

95165 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 · 95165

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$17.37

Non-facility (office)
$17.37
Facility
$2.67

Higher because the practice carries its own overhead.

How 95165 has changed in Washington, DC area

95165 · Office / nonfacility

$20.19

Effective 2026-10-01

The base rate is $3.88 higher than on 2025-10-01, moving from $16.31 to $20.19 (23.8%).

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

    $16.31changed to$20.19

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.36 changed to 0.45
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $17.18changed to$16.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.37 changed to 0.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $16.90changed to$17.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $18.20changed to$16.90

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.38 changed to 0.37
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $19.32changed to$18.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.39 changed to 0.38
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $19.48changed to$19.32

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $17.71changed to$19.48

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.34 changed to 0.39
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $17.05changed to$17.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.33 changed to 0.34
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $15.72changed to$17.05

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.30 changed to 0.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $15.69changed to$15.72

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $15.23changed to$15.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.29 changed to 0.30
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $15.28changed to$15.23

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $15.21changed to$15.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $15.18changed to$15.21

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $15.57changed to$15.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.32 changed to 0.29
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $15.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$20.19$2.88RVU26D
2026-07-01$20.19$2.88RVU26C
2026-04-01$20.19$2.88RVU26B
2026-01-01$20.19$2.88RVU26A
2025-10-01$16.31$3.59RVU25D
2025-07-01$16.31$3.59RVU25C
2025-04-01$16.31$3.59RVU25B
2025-01-01$16.31$3.59RVU25A
2024-10-01$17.18$3.69RVU24D
2024-07-01$17.18$3.69RVU24C
2024-04-01$17.18$3.69RVU24B
2024-03-09$17.18$3.69RVU24AR
2024-01-01$16.90$3.63RVU24A
2023-10-01$18.20$3.80RVU23D
2023-07-01$18.20$3.80RVU23C
2023-04-01$18.20$3.80RVU23B
2023-01-01$18.20$3.80RVU23A
2022-10-01$19.32$3.49RVU22D
2022-07-01$19.32$3.49RVU22C
2022-04-01$19.32$3.49RVU22B
2022-01-01$19.32$3.49RVU22A
2021-10-01$19.48$3.52RVU21D
2021-07-01$19.48$3.52RVU21C
2021-04-01$19.48$3.52RVU21B
2021-01-01$19.48$3.52RVU21A
2020-10-01$17.71$3.61RVU20D
2020-07-01$17.71$3.61RVU20C
2020-04-01$17.71$3.61RVU20B
2020-01-01$17.71$3.61RVU20A
2019-10-01$17.05$3.58RVU19D
2019-07-01$17.05$3.58RVU19C
2019-04-01$17.05$3.58RVU19B
2019-01-01$17.05$3.58RVU19A
2018-10-01$15.72$3.58RVU18D
2018-07-01$15.72$3.58RVU18C
2018-04-01$15.72$3.58RVU18B
2018-01-01$15.72$3.58RVU18AR1
2017-10-01$15.69$3.58RVU17D
2017-07-01$15.69$3.58RVU17C
2017-04-01$15.69$3.58RVU17B
2017-01-01$15.69$3.58RVU17A
2016-10-01$15.23$3.58RVU16D
2016-07-01$15.23$3.58RVU16C
2016-04-01$15.23$3.58RVU16B
2016-01-01$15.23$3.58RVU16A
2015-10-01$15.28$3.59RVU15D
2015-07-01$15.28$3.59RVU15C
2015-04-01$15.21$3.57RVU15B
2015-01-01$15.21$3.57RVU15A
2014-10-01$15.18$3.55RVU14D
2014-07-01$15.18$3.55RVU14C
2014-04-01$15.18$3.55RVU14B
2014-01-01$15.18$3.55RVU14A
2013-10-01$15.57$3.75RVU13D
2013-07-01$15.57$3.75RVU13C
2013-04-01$15.57$3.75RVU13B
2013-01-01$15.57$3.75RVU13AR

Price 95165 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

95165 billing questions

How many units should be billed for a multidose vial?

Medicare counts one unit per 1 mL aliquot from the vial: a 5 mL vial supports 5 units, and a 10 mL vial supports 10. The volume injected at each visit does not change that count.

Can 95165 be billed on the same day as an injection code?

Yes, when extract preparation and administration both occur that day. Report preparation with 95165 and administration with 95115 for one injection or 95117 for two or more.

What if the allergist prepares the extract but another physician gives the shots?

The preparing practice reports 95165 for the doses prepared. The administering practice reports 95115 or 95117 for injections it gives, rather than reporting 95165 for extract it did not prepare.

Should the complete-service codes 95120 through 95134 be used for Medicare patients?

No. Medicare does not recognize those combined injection-and-extract codes. Report the appropriate injection and antigen preparation codes separately when both services are furnished.

When is 95144 used instead of 95165?

Use 95144 for extract prepared in single-dose vials. Use 95165 for extract prepared in multidose vials, with units based on the doses the vials contain.

Can an E/M visit be billed on an injection day?

A separately identifiable evaluation of new symptoms may be reported when it goes beyond routine injection screening and is documented. Append modifier 25 to the E/M code.

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 95165PPRRVU2026_Oct_nonQPP.csv, line 12,487 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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