CPT code 95170: Allergen therapy, whole-body extract2026 Medicare rate & RVUs
Report one unit for physician-supervised allergen immunotherapy involving provision of a whole-body extract, such as an insect extract, in the prescribing practice.
Medicare pays $10.69 for 95170 nationally in the office and $2.67 in a hospital or facility. Local office rates run $9.35–$14.44.
Medicare rate · 95170
Allergen therapy, whole-body extract
- Work RVUs
- 0.06
- Total RVUs
- 0.32
- Global days
- XXX
National rate · 2026
$10.69
Office setting, before claim adjustments.
See every locality for 95170 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 95170 covers
CPT 95170 represents allergen immunotherapy using a whole-body extract, with the extract provided as part of the service. Allergy specialists commonly use this approach for whole-body insect extracts, such as fire-ant extract. The service is associated with the prescribing physician’s practice or institution and supports treatment under an established allergy immunotherapy plan.
Report units that match the whole-body extract service documented for the patient. Records should identify the extract and connect its preparation or provision to the prescribed immunotherapy. The code includes the extract, unlike 95165, which describes antigen services that exclude provision of allergenic extracts. CMS assigns physician work and practice expense values to 95170 under the physician fee schedule; the code’s included extract is not a separate supply service within this code.
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 95170 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$9.35 to $14.44
109 of 109 payment localities
95170 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.
$9.35
$12.91
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $12.08 | 1 |
| AL | $9.50 | 1 |
| AR | $9.35 | 1 |
| AZ | $10.38 | 1 |
| CA | $11.37–$14.44 | 29 |
| CO | $11.17 | 1 |
| CT | $11.44 | 1 |
| DC | $12.32 | 1 |
| DE | $10.56 | 1 |
| FL | $10.49–$11.54 | 3 |
| GA | $9.85–$10.90 | 2 |
| GU | $11.69 | 1 |
| HI | $11.69 | 1 |
| IA | $9.78 | 1 |
| ID | $9.84 | 1 |
| IL | $10.15–$11.19 | 4 |
| IN | $9.91 | 1 |
| KS | $9.72 | 1 |
| KY | $9.73 | 1 |
| LA | $9.71–$10.24 | 2 |
| MA | $11.10–$12.35 | 2 |
| MD | $10.78–$12.32 | 3 |
| ME | $9.89–$10.49 | 2 |
| MI | $10.00–$10.63 | 2 |
| MN | $10.70 | 1 |
| MO | $9.53–$10.29 | 3 |
| MS | $9.44 | 1 |
| MT | $10.69 | 1 |
| NC | $10.01 | 1 |
| ND | $10.49 | 1 |
| NE | $9.84 | 1 |
| NH | $10.99 | 1 |
| NJ | $11.57–$12.17 | 2 |
| NM | $10.06 | 1 |
| NV | $10.64 | 1 |
| NY | $10.17–$12.68 | 5 |
| OH | $9.96 | 1 |
| OK | $9.72 | 1 |
| OR | $10.56–$11.56 | 2 |
| PA | $9.99–$11.13 | 2 |
| PR | $10.78 | 1 |
| RI | $10.97 | 1 |
| SC | $10.00 | 1 |
| SD | $10.47 | 1 |
| TN | $9.77 | 1 |
| TX | $9.91–$11.14 | 8 |
| UT | $10.15 | 1 |
| VA | $10.45–$12.32 | 2 |
| VI | $10.78 | 1 |
| VT | $10.44 | 1 |
| WA | $11.08–$12.62 | 2 |
| WI | $10.11 | 1 |
| WV | $9.74 | 1 |
| WY | $10.60 | 1 |
How the 95170 rate is calculated
Each of 95170’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 · 95170
RVUs × geographic indexes × conversion factor
Work0.06
0.06 RVUs× 1.000 GPCI
Practice expense0.25
0.25 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.3200
Conversion factor
$33.4009
Medicare rate
$10.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95170
95170 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 · 95170
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$10.69
- Non-facility (office)
- $10.69
- Facility
- $2.67
Higher because the practice carries its own overhead.
95170 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95165Allergy extract preparationMultidose vials, per dose
- 95170 includes provision of a whole-body extract. 95165 covers antigen services that exclude provision of allergenic extracts.
- 95144Allergen preparationSingle-dose vial set
- 95144 is associated with single-dose vial antigen services. Choose 95170 for a whole-body extract service.
- 95145Venom antigenOne insect venom
- 95145 is for antigen services involving one stinging-insect venom. 95170 describes whole-body extract immunotherapy.
- 95130Venom immunotherapyOne insect venom
- 95130 covers office immunotherapy involving one stinging-insect venom. 95170 concerns a whole-body extract, not a venom-count service.
95170 billing questions
When should 95170 be chosen instead of 95165?
Use 95170 for allergen immunotherapy involving a whole-body extract that is provided as part of the service. Code 95165 is for antigen services that do not include provision of the allergenic extract.
Does 95170 include the allergenic extract?
Yes. The whole-body extract is part of the service represented by 95170.
Is 95170 counted by injection or by extract unit?
It is reported by unit for the whole-body extract service, not by counting the number of injections administered.
What documentation supports 95170?
Document the prescribed immunotherapy plan, the whole-body extract used, and the units provided. The record should make clear that the service involved a whole-body extract rather than a different antigen preparation.
How does 95170 differ from venom immunotherapy codes?
95170 is for whole-body extract immunotherapy. Codes such as 95145 identify antigen services for specific numbers of stinging-insect venoms.
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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