CPT code 95165: Allergy extract preparation, multidose vials, per dose2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $20.38 for 95165 in the office and $3.01 when it’s performed in a hospital or facility.

$20.38Office (non-facility)
$3.01Hospital or facility
+17.3%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $20.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

95165 in Queens, NY vs other payment areas
  1. Queens, NY · this page$20.38
  2. Manhattan, NY · New York$20.13−$0.25
  3. NYC suburbs and Long Island, NY · New York$20.62+$0.24
  4. Rest of New York · New York$16.52−$3.86
  5. Los Angeles, CA · California$20.09−$0.29
  6. Washington, DC area · District of Columbia$20.19−$0.19

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

Every other payment area

95165 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$18.50$3.20
Chicago, ILIllinois$17.89$3.12
AlaskaAlaska$19.20$3.55
AlabamaAlabama$15.34$2.49
ArkansasArkansas$15.09$2.46
ArizonaArizona$16.85$2.61
Bakersfield, CACalifornia$18.72$2.61
Chico, 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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 95165 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.06× 1.0640.0638
Practice expense0.45× 1.1820.5319
Malpractice0.01× 1.4420.0144
Total RVUs0.6102
Conversion factor× 33.4009

Office rate, Queens, NY$20.38

Office: (0.06 × 1.064 + 0.45 × 1.182 + 0.01 × 1.442) × $33.4009 = $20.38

Facility: (0.06 × 1.064 + 0.01 × 1.182 + 0.01 × 1.442) × $33.4009 = $3.01

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 Queens, NY

95165 · Office / nonfacility

$20.38

Effective 2026-10-01

The base rate is $3.92 higher than on 2025-10-01, moving from $16.46 to $20.38 (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

    $16.46changed to$20.38

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.36 changed to 0.45
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $17.33changed to$16.46

    • 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

    $17.05changed to$17.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $18.46changed to$17.05

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.38 changed to 0.37
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $19.69changed to$18.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.39 changed to 0.38
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $19.85changed to$19.69

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $18.04changed to$19.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.34 changed to 0.39
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $17.31changed to$18.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.33 changed to 0.34
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $16.00changed to$17.31

    • 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

    $15.96changed to$16.00

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $15.49changed to$15.96

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.29 changed to 0.30
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $15.55changed to$15.49

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $15.47changed to$15.55

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $15.36changed to$15.47

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $15.69changed to$15.36

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.32 changed to 0.29
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $15.69

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$20.38$3.01RVU26D
2026-07-01$20.38$3.01RVU26C
2026-04-01$20.38$3.01RVU26B
2026-01-01$20.38$3.01RVU26A
2025-10-01$16.46$3.70RVU25D
2025-07-01$16.46$3.70RVU25C
2025-04-01$16.46$3.70RVU25B
2025-01-01$16.46$3.70RVU25A
2024-10-01$17.33$3.81RVU24D
2024-07-01$17.33$3.81RVU24C
2024-04-01$17.33$3.81RVU24B
2024-03-09$17.33$3.81RVU24AR
2024-01-01$17.05$3.74RVU24A
2023-10-01$18.46$4.09RVU23D
2023-07-01$18.46$4.09RVU23C
2023-04-01$18.46$4.09RVU23B
2023-01-01$18.46$4.09RVU23A
2022-10-01$19.69$3.96RVU22D
2022-07-01$19.69$3.96RVU22C
2022-04-01$19.69$3.96RVU22B
2022-01-01$19.69$3.96RVU22A
2021-10-01$19.85$4.00RVU21D
2021-07-01$19.85$4.00RVU21C
2021-04-01$19.85$4.00RVU21B
2021-01-01$19.85$4.00RVU21A
2020-10-01$18.04$4.02RVU20D
2020-07-01$18.04$4.02RVU20C
2020-04-01$18.04$4.02RVU20B
2020-01-01$18.04$4.02RVU20A
2019-10-01$17.31$3.90RVU19D
2019-07-01$17.31$3.90RVU19C
2019-04-01$17.31$3.90RVU19B
2019-01-01$17.31$3.90RVU19A
2018-10-01$16.00$3.90RVU18D
2018-07-01$16.00$3.90RVU18C
2018-04-01$16.00$3.90RVU18B
2018-01-01$16.00$3.90RVU18AR1
2017-10-01$15.96$3.90RVU17D
2017-07-01$15.96$3.90RVU17C
2017-04-01$15.96$3.90RVU17B
2017-01-01$15.96$3.90RVU17A
2016-10-01$15.49$3.90RVU16D
2016-07-01$15.49$3.90RVU16C
2016-04-01$15.49$3.90RVU16B
2016-01-01$15.49$3.90RVU16A
2015-10-01$15.55$3.91RVU15D
2015-07-01$15.55$3.91RVU15C
2015-04-01$15.47$3.89RVU15B
2015-01-01$15.47$3.89RVU15A
2014-10-01$15.36$3.79RVU14D
2014-07-01$15.36$3.79RVU14C
2014-04-01$15.36$3.79RVU14B
2014-01-01$15.36$3.79RVU14A
2013-10-01$15.69$3.89RVU13D
2013-07-01$15.69$3.89RVU13C
2013-04-01$15.69$3.89RVU13B
2013-01-01$15.69$3.89RVU13AR

Price 95165 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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