CPT code 95180: Rapid desensitization, hourly service2026 Medicare rate & RVUs in Missouri
Reports monitored, stepwise medication desensitization performed over multiple hours to help a patient with drug hypersensitivity receive a needed therapy.
Medicare pays $128.15–$134.35 for 95180 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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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What 95180 covers
An allergist uses rapid desensitization to gradually increase a patient’s exposure to a medication that has caused or may cause an immediate hypersensitivity reaction. Examples include antibiotics, aspirin, chemotherapy agents, and biologic drugs when desensitization is needed to permit treatment. The clinician administers escalating doses under close observation for reactions, commonly in a monitored outpatient setting or hospital environment equipped to respond to acute symptoms.
Report 95180 by the hour, supported by documentation of the procedure’s duration and the dosing protocol. The record should identify the medication, dose escalation, monitoring, any reactions, and whether the protocol was completed or stopped. Physician supervision and interpretation are included in the service. This is distinct from routine scheduled allergen immunotherapy injections, which do not involve a prolonged medication desensitization protocol.
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 95180 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$128.15 to $134.35
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $133.40 | $85.73 |
| Metropolitan St. Louis, MO | $134.35 | $86.01 |
| Rest of Missouri | $128.15 | $84.38 |
How the 95180 rate is calculated
Each of 95180’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 · 95180
RVUs × geographic indexes × conversion factor
Work2.01
2.01 RVUs× 1.000 GPCI
Practice expense2.04
2.04 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
4.1200
Conversion factor
$33.4009
Medicare rate
$137.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95180
95180 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 · 95180
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$137.61
- Non-facility (office)
- $137.61
- Facility
- $86.84
Higher because the practice carries its own overhead.
95180 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95115Allergy shotSingle injection, extract not included
- 95115 describes routine allergen immunotherapy administration involving one injection. Choose 95180 for a monitored, stepwise medication desensitization protocol performed over hours.
- 95117Allergy shotsTwo or more injections, extract not included
- 95117 is for routine allergen immunotherapy administration involving multiple injections. It does not describe the prolonged dose escalation used for rapid medication desensitization.
- 95165Allergy extract preparationMultidose vials, per dose
- 95165 covers preparation and provision of allergen immunotherapy antigens. It is not the code for administering escalating medication doses during desensitization.
95180 billing questions
When should 95180 be used instead of routine allergy injection codes?
Use 95180 for a prolonged, monitored escalation of medication doses to desensitize a patient. Routine allergen immunotherapy injections are reported with codes such as 95115 or 95117.
How are units reported?
The code is reported by the hour. Document the procedure’s duration and dosing protocol to support the units billed.
Is physician supervision separately reported?
Physician supervision and interpretation are included in 95180. The clinician’s monitoring and response to dose-related symptoms should be documented as part of the procedure.
What details should the medical record include?
Document the medication being desensitized, the dose-escalation steps, procedure duration, patient monitoring, any reaction and treatment, and whether the protocol was completed.
Can 95180 be used for ordinary venom or environmental allergy shots?
No. Those are routine allergen immunotherapy services; 95180 describes a rapid desensitization procedure involving stepwise medication dosing.
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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