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

In Puerto Rico, Medicare pays $17.53 for 95165 in the office and $2.67 when it’s performed in a hospital or facility.

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.

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 Puerto Rico 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. Puerto Rico pays $17.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

95165 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

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.

Codes related to 95165

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

How 95165 has changed in Puerto Rico

Price 95165 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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