Billing code 95065: Nasal allergy testMedicare rate & RVUs
Reports direct testing of the nasal lining for an allergen-related response, commonly used when evaluating suspected allergic rhinitis or nasal triggers.
Medicare pays $28.06 for 95065 nationally in the office. Local office rates run $23.99–$40.16.
Medicare rate · 95065
Nasal allergy test
Swap in your local Medicare rate.
- Work RVUs
- 0
- Total RVUs
- 0.84
- Global days
- XXX
National rate · 2026
$28.06
Office setting, before claim adjustments.
See every locality for 95065 → · 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.
On this page 10 sections
What 95065 covers
An allergist or other clinician evaluating allergic rhinitis may apply an allergen directly to the nasal lining and assess the local response. This target-organ test can help evaluate a suspected nasal trigger; it is distinct from testing reactivity on the skin or challenging the lower airways. It is typically performed in an outpatient allergy setting.
Report 95065 for the direct nasal mucous-membrane testing service, rather than for skin testing or bronchial challenge. Documentation should identify the clinical reason, substances tested, testing method, observed nasal response, and personnel involved. CMS classifies 95065 as technical-component-only: its valuation includes no physician work, and a separate code covers interpretation. Treat the test and its professional interpretation as separately represented services, not as a single global service.
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 95065 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
$23.99 to $40.16
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $24.45 | Unavailable |
| Alaska* | $29.71 | Unavailable |
| Arizona | $27.15 | Unavailable |
| Arkansas | $23.99 | Unavailable |
| Atlanta | $28.57 | Unavailable |
| Austin | $29.63 | Unavailable |
| Bakersfield | $30.59 | Unavailable |
| Baltimore/Surr. Cntys | $30.16 | Unavailable |
| Beaumont | $25.54 | Unavailable |
| Brazoria | $27.73 | Unavailable |
| Chicago | $28.63 | Unavailable |
| Chico | $30.56 | Unavailable |
| Colorado | $29.76 | Unavailable |
| Connecticut | $30.26 | Unavailable |
| Dallas | $27.90 | Unavailable |
| Dc + Md/Va Suburbs | $33.03 | Unavailable |
| Delaware | $27.69 | Unavailable |
| Detroit | $27.32 | Unavailable |
| East St. Louis | $26.18 | Unavailable |
| El Centro | $30.56 | Unavailable |
| Fort Lauderdale | $28.69 | Unavailable |
| Fort Worth | $27.63 | Unavailable |
| Fresno | $30.56 | Unavailable |
| Galveston | $27.81 | Unavailable |
| Hanford-Corcoran | $30.56 | Unavailable |
| Hawaii, Guam | $31.71 | Unavailable |
| Houston | $27.99 | Unavailable |
| Idaho | $25.66 | Unavailable |
| Indiana | $25.86 | Unavailable |
| Iowa | $25.50 | Unavailable |
| Kansas | $25.23 | Unavailable |
| Kentucky | $24.95 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $33.02 | Unavailable |
| Madera | $30.56 | Unavailable |
| Manhattan | $32.74 | Unavailable |
| Merced | $30.56 | Unavailable |
| Metropolitan Boston | $33.40 | Unavailable |
| Metropolitan Kansas City | $26.36 | Unavailable |
| Metropolitan Philadelphia | $29.26 | Unavailable |
| Metropolitan St. Louis | $26.73 | Unavailable |
| Miami | $29.70 | Unavailable |
| Minnesota | $28.63 | Unavailable |
| Mississippi | $24.12 | Unavailable |
| Modesto | $30.56 | Unavailable |
| Montana** | $28.06 | Unavailable |
| Napa | $36.71 | Unavailable |
| Nebraska | $25.71 | Unavailable |
| Nevada** | $28.03 | Unavailable |
| New Hampshire | $29.15 | Unavailable |
| New Mexico | $25.82 | Unavailable |
| New Orleans | $26.47 | Unavailable |
| North Carolina | $26.08 | Unavailable |
| North Dakota** | $27.86 | Unavailable |
| Northern Nj | $32.52 | Unavailable |
| Nyc Suburbs/Long Island | $33.58 | Unavailable |
| Ohio | $25.65 | Unavailable |
| Oklahoma | $25.02 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $32.98 | Unavailable |
| Portland | $31.05 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $30.76 | Unavailable |
| Puerto Rico | $28.36 | Unavailable |
| Queens | $33.25 | Unavailable |
| Redding | $30.56 | Unavailable |
| Rest Of California | $30.56 | Unavailable |
| Rest Of Florida | $27.00 | Unavailable |
| Rest Of Georgia | $25.13 | Unavailable |
| Rest Of Illinois | $25.83 | Unavailable |
| Rest Of Louisiana | $24.85 | Unavailable |
| Rest Of Maine | $25.71 | Unavailable |
| Rest Of Maryland | $28.36 | Unavailable |
| Rest Of Massachusetts | $29.46 | Unavailable |
| Rest Of Michigan | $25.69 | Unavailable |
| Rest Of Missouri | $24.22 | Unavailable |
| Rest Of New Jersey | $30.64 | Unavailable |
| Rest Of New York | $26.57 | Unavailable |
| Rest Of Oregon | $27.85 | Unavailable |
| Rest Of Pennsylvania | $25.77 | Unavailable |
| Rest Of Texas | $26.61 | Unavailable |
| Rest Of Washington | $29.45 | Unavailable |
| Rhode Island | $28.94 | Unavailable |
| Riverside-San Bernardino-Ontario | $30.67 | Unavailable |
| Sacramento-Roseville-Folsom | $32.42 | Unavailable |
| Salinas | $32.31 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $33.34 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $39.24 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $39.23 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $40.16 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $40.11 | Unavailable |
| San Luis Obispo-Paso Robles | $31.76 | Unavailable |
| Santa Cruz-Watsonville | $33.86 | Unavailable |
| Santa Maria-Santa Barbara | $32.50 | Unavailable |
| Santa Rosa-Petaluma | $34.22 | Unavailable |
| Seattle (King Cnty) | $34.29 | Unavailable |
| South Carolina | $25.90 | Unavailable |
| South Dakota** | $27.83 | Unavailable |
| Southern Maine | $27.68 | Unavailable |
| Stockton | $30.56 | Unavailable |
| Suburban Chicago | $29.06 | Unavailable |
| Tennessee | $25.38 | Unavailable |
| Utah | $26.36 | Unavailable |
| Vallejo | $36.69 | Unavailable |
| Vermont | $27.61 | Unavailable |
| Virgin Islands | $28.36 | Unavailable |
| Virginia | $27.49 | Unavailable |
| Visalia | $30.56 | Unavailable |
| West Virginia | $24.57 | Unavailable |
| Wisconsin | $26.66 | Unavailable |
| Wyoming** | $27.97 | Unavailable |
| Yuba City | $30.56 | Unavailable |
95065 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.
$23.99
$35.36
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 | $29.71 | 1 |
| AL | $24.45 | 1 |
| AR | $23.99 | 1 |
| AZ | $27.15 | 1 |
| CA | $30.56–$40.16 | 29 |
| CO | $29.76 | 1 |
| CT | $30.26 | 1 |
| DC | $33.03 | 1 |
| DE | $27.69 | 1 |
| FL | $27.00–$29.70 | 3 |
| GA | $25.13–$28.57 | 2 |
| GU | $31.71 | 1 |
| HI | $31.71 | 1 |
| IA | $25.50 | 1 |
| ID | $25.66 | 1 |
| IL | $25.83–$29.06 | 4 |
| IN | $25.86 | 1 |
| KS | $25.23 | 1 |
| KY | $24.95 | 1 |
| LA | $24.85–$26.47 | 2 |
| MA | $29.46–$33.40 | 2 |
| MD | $28.36–$33.03 | 3 |
| ME | $25.71–$27.68 | 2 |
| MI | $25.69–$27.32 | 2 |
| MN | $28.63 | 1 |
| MO | $24.22–$26.73 | 3 |
| MS | $24.12 | 1 |
| MT | $28.06 | 1 |
| NC | $26.08 | 1 |
| ND | $27.86 | 1 |
| NE | $25.71 | 1 |
| NH | $29.15 | 1 |
| NJ | $30.64–$32.52 | 2 |
| NM | $25.82 | 1 |
| NV | $28.03 | 1 |
| NY | $26.57–$33.58 | 5 |
| OH | $25.65 | 1 |
| OK | $25.02 | 1 |
| OR | $27.85–$31.05 | 2 |
| PA | $25.77–$29.26 | 2 |
| PR | $28.36 | 1 |
| RI | $28.94 | 1 |
| SC | $25.90 | 1 |
| SD | $27.83 | 1 |
| TN | $25.38 | 1 |
| TX | $25.54–$29.63 | 8 |
| UT | $26.36 | 1 |
| VA | $27.49–$33.03 | 2 |
| VI | $28.36 | 1 |
| VT | $27.61 | 1 |
| WA | $29.45–$34.29 | 2 |
| WI | $26.66 | 1 |
| WV | $24.57 | 1 |
| WY | $27.97 | 1 |
How the 95065 rate is calculated
Each of 95065’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 · 95065
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 0.83Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95065
The CMS indicators that decide how 95065 is paid alongside other services.
CMS payment indicators · 95065
Nasal allergy test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
95065 compared with similar codes
Compare codes
95065 vs 95060 vs 95070 vs 95004 vs 95024: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95060Ophthalmic allergy test
- Choose 95065 for direct testing of the nasal lining; choose 95060 when the test targets the ophthalmic mucous membrane.
- 95070Bronchial challenge
- 95065 concerns a nasal mucous-membrane response. 95070 is for inhalation bronchial challenge testing.
- 95004Allergy skin prick test
- 95004 reports percutaneous skin testing with allergenic extracts. It does not describe direct nasal mucous-membrane testing.
- 95024Intradermal allergy test
- 95024 reports intracutaneous allergen testing. Use 95065 when the testing is performed directly at the nasal lining.
95065 billing questions
How does 95065 differ from 95060?
95065 is for direct testing of the nasal lining. 95060 is for testing the ophthalmic mucous membrane.
Is interpretation included in 95065?
No. CMS identifies 95065 as technical-component-only; a separate code covers interpretation.
How does this differ from 95070?
95065 evaluates a response at the nasal lining. 95070 is used for inhalation bronchial challenge testing.
What documentation supports 95065?
Record the reason for nasal testing, substances tested, method, observed response, and personnel involved.
Should 95065 be selected instead of skin testing?
Use 95065 for direct nasal mucous-membrane testing. Percutaneous and intracutaneous allergy tests use different codes, such as 95004 and 95024.
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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