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

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 Vermont, Medicare pays $17.05 for 95165 in the office and $2.50 when it’s performed in a hospital or facility.

$17.05Office (non-facility)
$2.50Hospital or facility
−1.8%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 Vermont
  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 Vermont 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. Vermont pays $17.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

95165 in Vermont vs other payment areas
  1. Vermont · this page$17.05
  2. Los Angeles, CA · California$20.09+$3.04
  3. Washington, DC area · District of Columbia$20.19+$3.14
  4. Miami, FL · Florida$18.50+$1.45
  5. Chicago, IL · Illinois$17.89+$0.84
  6. Manhattan, NY · New York$20.13+$3.08
  7. Alaska · Alaska$19.20+$2.15

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

Every other payment area

95165 in every other Medicare payment locality
Payment localityOfficeFacility
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
El Centro, CACalifornia$18.69$2.58
Fresno, CACalifornia$18.69$2.58
Hanford, 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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 95165 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.06× 1.0000.0600
Practice expense0.45× 0.9900.4455
Malpractice0.01× 0.5060.0051
Total RVUs0.5106
Conversion factor× 33.4009

Office rate, Vermont$17.05

Office: (0.06 × 1 + 0.45 × 0.99 + 0.01 × 0.506) × $33.4009 = $17.05

Facility: (0.06 × 1 + 0.01 × 0.99 + 0.01 × 0.506) × $33.4009 = $2.50

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 Vermont

95165 · Office / nonfacility

$17.05

Effective 2026-10-01

The base rate is $3.38 higher than on 2025-10-01, moving from $13.67 to $17.05 (24.7%).

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

    $13.67changed to$17.05

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.36 changed to 0.45
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $14.40changed to$13.67

    • 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

    $14.16changed to$14.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $15.06changed to$14.16

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.38 changed to 0.37
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $15.78changed to$15.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.39 changed to 0.38
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $15.91changed to$15.78

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $14.74changed to$15.91

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.34 changed to 0.39
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $14.45changed to$14.74

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.33 changed to 0.34
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $13.34changed to$14.45

    • 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

    $13.26changed to$13.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $12.82changed to$13.26

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.29 changed to 0.30
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $12.86changed to$12.82

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $12.80changed to$12.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $12.82changed to$12.80

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$12.82

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$17.05$2.50RVU26D
2026-07-01$17.05$2.50RVU26C
2026-04-01$17.05$2.50RVU26B
2026-01-01$17.05$2.50RVU26A
2025-10-01$13.67$3.07RVU25D
2025-07-01$13.67$3.07RVU25C
2025-04-01$13.67$3.07RVU25B
2025-01-01$13.67$3.07RVU25A
2024-10-01$14.40$3.16RVU24D
2024-07-01$14.40$3.16RVU24C
2024-04-01$14.40$3.16RVU24B
2024-03-09$14.40$3.16RVU24AR
2024-01-01$14.16$3.11RVU24A
2023-10-01$15.06$3.23RVU23D
2023-07-01$15.06$3.23RVU23C
2023-04-01$15.06$3.23RVU23B
2023-01-01$15.06$3.23RVU23A
2022-10-01$15.78$2.97RVU22D
2022-07-01$15.78$2.97RVU22C
2022-04-01$15.78$2.97RVU22B
2022-01-01$15.78$2.97RVU22A
2021-10-01$15.91$2.99RVU21D
2021-07-01$15.91$2.99RVU21C
2021-04-01$15.91$2.99RVU21B
2021-01-01$15.91$2.99RVU21A
2020-10-01$14.74$3.10RVU20D
2020-07-01$14.74$3.10RVU20C
2020-04-01$14.74$3.10RVU20B
2020-01-01$14.74$3.10RVU20A
2019-10-01$14.45$3.11RVU19D
2019-07-01$14.45$3.11RVU19C
2019-04-01$14.45$3.11RVU19B
2019-01-01$14.45$3.11RVU19A
2018-10-01$13.34$3.10RVU18D
2018-07-01$13.34$3.10RVU18C
2018-04-01$13.34$3.10RVU18B
2018-01-01$13.34$3.10RVU18AR1
2017-10-01$13.26$3.11RVU17D
2017-07-01$13.26$3.11RVU17C
2017-04-01$13.26$3.11RVU17B
2017-01-01$13.26$3.11RVU17A
2016-10-01$12.82$3.11RVU16D
2016-07-01$12.82$3.11RVU16C
2016-04-01$12.82$3.11RVU16B
2016-01-01$12.82$3.11RVU16A
2015-10-01$12.86$3.12RVU15D
2015-07-01$12.86$3.12RVU15C
2015-04-01$12.80$3.11RVU15B
2015-01-01$12.80$3.11RVU15A
2014-10-01$12.82$3.09RVU14D
2014-07-01$12.82$3.09RVU14C
2014-04-01$12.82$3.09RVU14B
2014-01-01$12.82$3.09RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 95165 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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