CPT code 95165: Allergy extract preparation, multidose vials, per dose2026 Medicare rate & RVUs in Missouri
Physician-supervised preparation of allergen extract in multidose vials for allergy shots, reported by doses prepared rather than injections administered.
Medicare pays $15.29–$16.65 for 95165 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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 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.
Where 95165 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$15.29 to $16.65
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $16.44 | $2.64 |
| Metropolitan St. Louis, MO | $16.65 | $2.66 |
| Rest of Missouri | $15.29 | $2.62 |
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
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.
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.
95165 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95144Allergen preparationSingle-dose vial set
- 95144 is for single-dose vials. 95165 is for multidose vials, with Medicare units based on 1 mL aliquots from each vial.
- 95146Venom antigen preparationTwo venom types
- 95146 covers preparation of two stinging-insect venoms. 95165 covers multidose extracts for non-venom allergens, such as pollens or dust mites.
- 95117Allergy shotsTwo or more injections, extract not included
- 95117 reports administering two or more allergy shots at a visit. 95165 reports preparation of the extract, whether or not an injection occurs that day.
- 95125Allergen immunotherapyTwo or more injections
- 95125 combines extract provision with two or more injections and is not recognized by Medicare. When both services are furnished for non-venom immunotherapy, report the appropriate 95117 and 95165 units separately.
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
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