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CPT code 95199: Unlisted service, allergy or immunology2026 Medicare rate & RVUs

Reports an allergy or clinical immunology service or procedure when no specific CPT code describes the work performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 95199

Unlisted service, allergy or immunology

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 95199 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 95199 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 95199 covers

Code 95199 is the unlisted CPT entry for an allergy or clinical immunology service or procedure that has no specific code describing the work. Allergy and immunology clinicians may report it when the work does not fit a listed code in this service area. Listed codes separately identify immunotherapy injections, antigen therapy services, and rapid desensitization. Those codes are the better match when they describe the service performed.

For Medicare, 95199 has physician fee schedule status C, carrier priced. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Selection turns on whether a listed allergy or immunology code describes the service performed.

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 95199 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

95199 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

95199 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
95199 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 95199 rate is calculated

Each of 95199’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 · 95199

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 95199

95199 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 · 95199

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

95199 isn’t priced in this setting.

95199 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 95199

    Unlisted service, allergy or immunology0 wRVU

    Not priced

  • 95115

    Allergy shot, single injection, extract not included0 wRVU

    $10.35

  • 95117

    Allergy shots, two or more injections, extract not included0 wRVU

    $12.36

  • 95165

    Allergy extract preparation, multidose vials, per dose0.06 wRVU

    $17.37

  • 95180

    Rapid desensitization, hourly service2.01 wRVU

    $137.61

How to choose

95115Allergy shotSingle injection, extract not included
95115 identifies a specific immunotherapy injection service. Use 95199 only when no specific code describes the allergy or clinical immunology service performed.
95117Allergy shotsTwo or more injections, extract not included
95117 identifies a specific immunotherapy injection service. 95199 is for a service or procedure not represented by a specific code.
95165Allergy extract preparationMultidose vials, per dose
95165 identifies antigen therapy services. Use 95199 when no specific code describes the allergy or clinical immunology service performed.
95180Rapid desensitizationHourly service
95180 identifies rapid desensitization. Use 95199 when the procedure performed is not represented by a specific code.

Codes related to 95199

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

Codes related to 95199
CodeHow it relatesNational office range
Used instead
95115Allergy shot, single injection, extract not includedIdentifies a specific immunotherapy injection service when that code describes the work.$8.78–$14.63
95117Allergy shots, two or more injections, extract not includedIdentifies a specific immunotherapy injection service when that code describes the work.$10.50–$17.52
95165Allergy extract preparation, multidose vials, per doseIdentifies antigen therapy services when that code describes the work.$15.09–$24.08
95180Rapid desensitization, hourly serviceIdentifies rapid desensitization when that code describes the procedure.$126.87–$174.56

95199 billing questions

When should 95199 be used instead of a listed allergy code?

Use 95199 for an allergy or clinical immunology service or procedure that has no specific CPT code describing it. Use a listed code when it describes the service performed.

How does 95199 differ from 95115?

95115 identifies a specific immunotherapy injection service. 95199 is for an allergy or clinical immunology service or procedure without a specific code.

How does 95199 differ from 95117?

95117 identifies a specific immunotherapy injection service. Use 95199 when no specific code describes the service performed.

How does Medicare price 95199?

It has physician fee schedule status C, carrier priced. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

How does 95199 differ from 95180?

95180 identifies rapid desensitization. 95199 is for a service or procedure not represented by a specific code such as 95180.

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

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