CPT code 95170: Allergen therapy, whole-body extract2026 Medicare rate & RVUs in North Carolina
Report one unit for physician-supervised allergen immunotherapy involving provision of a whole-body extract, such as an insect extract, in the prescribing practice.
In North Carolina, Medicare pays $10.01 for 95170 in the office and $2.53 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 95170 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How North Carolina compares for 95170
Across 109 of 109 payment localities, the office rate for 95170 runs from $9.35 in Arkansas to $14.44 in San Benito County, CA. North Carolina pays $10.01. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$10.01
- Los Angeles, CA · California$12.19+$2.18
- Washington, DC area · District of Columbia$12.32+$2.31
- Miami, FL · Florida$11.54+$1.53
- Chicago, IL · Illinois$11.18+$1.17
- Manhattan, NY · New York$12.37+$2.36
- Alaska · Alaska$12.08+$2.07
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $9.50 | $2.49 |
| ArkansasArkansas | $9.35 | $2.46 |
| ArizonaArizona | $10.38 | $2.61 |
| Bakersfield, CACalifornia | $11.40 | $2.61 |
| Chico, CACalifornia | $11.37 | $2.58 |
| El Centro, CACalifornia | $11.37 | $2.58 |
| Fresno, CACalifornia | $11.37 | $2.58 |
| Hanford, CACalifornia | $11.37 | $2.58 |
| Madera, CACalifornia | $11.37 | $2.58 |
| Merced, CACalifornia | $11.37 | $2.58 |
| Modesto, CACalifornia | $11.37 | $2.58 |
| Napa, CACalifornia | $13.31 | $2.74 |
| Oxnard, CACalifornia | $12.14 | $2.66 |
| Redding, CACalifornia | $11.37 | $2.58 |
| Rest of CaliforniaCalifornia | $11.37 | $2.58 |
| Riverside, CACalifornia | $11.48 | $2.69 |
| Sacramento, CACalifornia | $11.97 | $2.64 |
| Salinas, CACalifornia | $11.92 | $2.63 |
| San Diego, CACalifornia | $12.23 | $2.64 |
| Marin County, CACalifornia | $14.12 | $2.82 |
| San Francisco, CACalifornia | $14.11 | $2.81 |
| San Benito County, CACalifornia | $14.44 | $2.89 |
| Santa Clara County, CACalifornia | $14.40 | $2.84 |
| San Luis Obispo, CACalifornia | $11.73 | $2.60 |
| Santa Cruz, CACalifornia | $12.37 | $2.63 |
| Santa Maria, CACalifornia | $11.98 | $2.63 |
| Santa Rosa, CACalifornia | $12.50 | $2.65 |
| Stockton, CACalifornia | $11.37 | $2.58 |
| Vallejo, CACalifornia | $13.29 | $2.72 |
| Visalia, CACalifornia | $11.37 | $2.58 |
| Yuba City, CACalifornia | $11.37 | $2.58 |
| ColoradoColorado | $11.17 | $2.64 |
| ConnecticutConnecticut | $11.44 | $2.81 |
| DelawareDelaware | $10.56 | $2.64 |
| Fort Lauderdale, FLFlorida | $11.07 | $2.95 |
| Rest of FloridaFlorida | $10.49 | $2.83 |
| Atlanta, GAGeorgia | $10.90 | $2.75 |
| Rest of GeorgiaGeorgia | $9.85 | $2.70 |
| Hawaii, Guam, HIHawaii | $11.69 | $2.58 |
| IowaIowa | $9.78 | $2.44 |
| IdahoIdaho | $9.84 | $2.47 |
| East St. Louis, ILIllinois | $10.36 | $2.98 |
| Rest of IllinoisIllinois | $10.15 | $2.83 |
| Suburban Chicago, ILIllinois | $11.19 | $2.95 |
| IndianaIndiana | $9.91 | $2.48 |
| KansasKansas | $9.72 | $2.47 |
| KentuckyKentucky | $9.73 | $2.61 |
| New Orleans, LALouisiana | $10.24 | $2.70 |
| Rest of LouisianaLouisiana | $9.71 | $2.62 |
| Metropolitan Boston, MAMassachusetts | $12.35 | $2.78 |
| Rest of MassachusettsMassachusetts | $11.10 | $2.65 |
| Baltimore area, MDMaryland | $11.41 | $2.81 |
| Rest of MarylandMaryland | $10.78 | $2.67 |
| Rest of MaineMaine | $9.89 | $2.52 |
| Southern Maine, MEMaine | $10.49 | $2.55 |
| Detroit, MIMichigan | $10.63 | $2.89 |
| Rest of MichiganMichigan | $10.00 | $2.69 |
| MinnesotaMinnesota | $10.70 | $2.45 |
| Metropolitan Kansas City, MOMissouri | $10.17 | $2.64 |
| Metropolitan St. Louis, MOMissouri | $10.29 | $2.66 |
| Rest of MissouriMissouri | $9.53 | $2.62 |
| MississippiMississippi | $9.44 | $2.54 |
| MontanaMontana | $10.69 | $2.67 |
| North DakotaNorth Dakota | $10.49 | $2.47 |
| NebraskaNebraska | $9.84 | $2.44 |
| New HampshireNew Hampshire | $10.99 | $2.64 |
| Northern New JerseyNew Jersey | $12.17 | $2.87 |
| Rest of New JerseyNew Jersey | $11.57 | $2.82 |
| New MexicoNew Mexico | $10.06 | $2.71 |
| NevadaNevada | $10.64 | $2.62 |
| NYC suburbs and Long Island, NYNew York | $12.68 | $3.15 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $11.64 | $2.86 |
| Queens, NYNew York | $12.48 | $3.01 |
| Rest of New YorkNew York | $10.17 | $2.56 |
| OhioOhio | $9.96 | $2.65 |
| OklahomaOklahoma | $9.72 | $2.56 |
| Portland, OROregon | $11.56 | $2.66 |
| Rest of OregonOregon | $10.56 | $2.57 |
| Metropolitan Philadelphia, PAPennsylvania | $11.13 | $2.79 |
| Rest of PennsylvaniaPennsylvania | $9.99 | $2.63 |
| Puerto RicoPuerto Rico | $10.78 | $2.67 |
| Rhode IslandRhode Island | $10.97 | $2.69 |
| South CarolinaSouth Carolina | $10.00 | $2.60 |
| South DakotaSouth Dakota | $10.47 | $2.45 |
| TennesseeTennessee | $9.77 | $2.49 |
| Austin, TXTexas | $11.14 | $2.66 |
| Beaumont, TXTexas | $9.91 | $2.62 |
| Brazoria, TXTexas | $10.56 | $2.61 |
| Dallas, TXTexas | $10.63 | $2.64 |
| Fort Worth, TXTexas | $10.55 | $2.64 |
| Galveston, TXTexas | $10.59 | $2.63 |
| Houston, TXTexas | $10.77 | $2.81 |
| Rest of TexasTexas | $10.23 | $2.62 |
| UtahUtah | $10.15 | $2.62 |
| VirginiaVirginia | $10.45 | $2.57 |
| Virgin Islands, VIUnited States Virgin Islands | $10.78 | $2.67 |
| VermontVermont | $10.44 | $2.50 |
| Rest of WashingtonWashington | $11.08 | $2.64 |
| King County, WAWashington | $12.62 | $2.79 |
| WisconsinWisconsin | $10.11 | $2.43 |
| West VirginiaWest Virginia | $9.74 | $2.77 |
| WyomingWyoming | $10.60 | $2.59 |
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.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,488
- Code
- 95170
- Physician work
- 0.06
- Practice expense
- 0.25
- Malpractice
- 0.01
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.06 | × 1.000 | 0.0600 |
| Practice expense | 0.25 | × 0.933 | 0.2333 |
| Malpractice | 0.01 | × 0.639 | 0.0064 |
| Total RVUs | 0.2996 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$10.01
Office: (0.06 × 1 + 0.25 × 0.933 + 0.01 × 0.639) × $33.4009 = $10.01
Facility: (0.06 × 1 + 0.01 × 0.933 + 0.01 × 0.639) × $33.4009 = $2.53
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.
How 95170 has changed in North Carolina
95170 · Office / nonfacility
$10.01
Effective 2026-10-01
The base rate is $0.37 higher than on 2025-10-01, moving from $9.64 to $10.01 (3.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$9.64changed to$10.01
- Conversion factor 32.3465 changed to 33.4009
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$10.23changed to$9.64
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.26 changed to 0.25
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$10.07changed to$10.23
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$10.77changed to$10.07
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.27 changed to 0.26
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$11.03changed to$10.77
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$11.12changed to$11.03
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$10.49changed to$11.12
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.24 changed to 0.27
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$10.13changed to$10.49
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.23 changed to 0.24
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$9.45changed to$10.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.21 changed to 0.23
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$9.10changed to$9.45
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.20 changed to 0.21
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$9.08changed to$9.10
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$9.12changed to$9.08
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$9.07changed to$9.12
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$9.07changed to$9.07
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$9.22changed to$9.07
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.22 changed to 0.20
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $9.22
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $10.01 | $2.53 | RVU26D |
| 2026-07-01 | $10.01 | $2.53 | RVU26C |
| 2026-04-01 | $10.01 | $2.53 | RVU26B |
| 2026-01-01 | $10.01 | $2.53 | RVU26A |
| 2025-10-01 | $9.64 | $3.05 | RVU25D |
| 2025-07-01 | $9.64 | $3.05 | RVU25C |
| 2025-04-01 | $9.64 | $3.05 | RVU25B |
| 2025-01-01 | $9.64 | $3.05 | RVU25A |
| 2024-10-01 | $10.23 | $2.84 | RVU24D |
| 2024-07-01 | $10.23 | $2.84 | RVU24C |
| 2024-04-01 | $10.23 | $2.84 | RVU24B |
| 2024-03-09 | $10.23 | $2.84 | RVU24AR |
| 2024-01-01 | $10.07 | $2.79 | RVU24A |
| 2023-10-01 | $10.77 | $2.91 | RVU23D |
| 2023-07-01 | $10.77 | $2.91 | RVU23C |
| 2023-04-01 | $10.77 | $2.91 | RVU23B |
| 2023-01-01 | $10.77 | $2.91 | RVU23A |
| 2022-10-01 | $11.03 | $3.00 | RVU22D |
| 2022-07-01 | $11.03 | $3.00 | RVU22C |
| 2022-04-01 | $11.03 | $3.00 | RVU22B |
| 2022-01-01 | $11.03 | $3.00 | RVU22A |
| 2021-10-01 | $11.12 | $3.03 | RVU21D |
| 2021-07-01 | $11.12 | $3.03 | RVU21C |
| 2021-04-01 | $11.12 | $3.03 | RVU21B |
| 2021-01-01 | $11.12 | $3.03 | RVU21A |
| 2020-10-01 | $10.49 | $3.11 | RVU20D |
| 2020-07-01 | $10.49 | $3.11 | RVU20C |
| 2020-04-01 | $10.49 | $3.11 | RVU20B |
| 2020-01-01 | $10.49 | $3.11 | RVU20A |
| 2019-10-01 | $10.13 | $3.08 | RVU19D |
| 2019-07-01 | $10.13 | $3.08 | RVU19C |
| 2019-04-01 | $10.13 | $3.08 | RVU19B |
| 2019-01-01 | $10.13 | $3.08 | RVU19A |
| 2018-10-01 | $9.45 | $3.08 | RVU18D |
| 2018-07-01 | $9.45 | $3.08 | RVU18C |
| 2018-04-01 | $9.45 | $3.08 | RVU18B |
| 2018-01-01 | $9.45 | $3.08 | RVU18AR1 |
| 2017-10-01 | $9.10 | $3.08 | RVU17D |
| 2017-07-01 | $9.10 | $3.08 | RVU17C |
| 2017-04-01 | $9.10 | $3.08 | RVU17B |
| 2017-01-01 | $9.10 | $3.08 | RVU17A |
| 2016-10-01 | $9.08 | $3.09 | RVU16D |
| 2016-07-01 | $9.08 | $3.09 | RVU16C |
| 2016-04-01 | $9.08 | $3.09 | RVU16B |
| 2016-01-01 | $9.08 | $3.09 | RVU16A |
| 2015-10-01 | $9.12 | $3.10 | RVU15D |
| 2015-07-01 | $9.12 | $3.10 | RVU15C |
| 2015-04-01 | $9.07 | $3.08 | RVU15B |
| 2015-01-01 | $9.07 | $3.08 | RVU15A |
| 2014-10-01 | $9.07 | $3.08 | RVU14D |
| 2014-07-01 | $9.07 | $3.08 | RVU14C |
| 2014-04-01 | $9.07 | $3.08 | RVU14B |
| 2014-01-01 | $9.07 | $3.08 | RVU14A |
| 2013-10-01 | $9.22 | $2.91 | RVU13D |
| 2013-07-01 | $9.22 | $2.91 | RVU13C |
| 2013-04-01 | $9.22 | $2.91 | RVU13B |
| 2013-01-01 | $9.22 | $2.91 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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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