CPT code 95199: Unlisted service, allergy or immunology2026 Medicare rate & RVUs in Maryland
Reports an allergy or clinical immunology service or procedure when no specific CPT code describes the work performed.
CMS doesn’t publish an office rate for 95199 in Maryland.
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 9 sections
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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
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
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
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.
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
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