Billing code 95115: Allergy shotMedicare rate & RVUs

Medicare pays $10.35 for 95115 nationally in the office. Local office rates run $8.78–$14.63.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 95115 covers

This service is the administration of one allergy shot, usually into the upper arm, during a build-up or maintenance schedule. Staff observe the patient for a reaction after the injection. Nurses or medical assistants commonly administer shots in allergy, ENT, and primary care offices under a physician’s treatment plan. The extract may have been prepared by that practice or supplied by another allergy practice.

Report one unit for an encounter in which one allergen immunotherapy injection is given; use 95117 when two or more are given during the encounter. The administration code excludes preparation and supply of the extract, which may be reported separately when performed and supported. Document the extract or vial, dose, concentration, injection site, observation, and any reaction. CMS classifies this as an incident-to service, payable only when performed under physician supervision; its physician work RVU is zero. For Medicare, use the separate administration and extract preparation codes rather than the combined injection-and-extract codes.

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 95115 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

95115 rates by state

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

How the 95115 rate is calculated

Each of 95115’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.

Payment rules and modifiers for 95115

The CMS indicators that decide how 95115 is paid alongside other services.

95115 compared with similar codes

How to choose

95117Allergy shots

95115 is for one allergen immunotherapy injection during an encounter; 95117 is for two or more. Do not bill 95115 per injection when 95117 describes the injections given.

95120Immunotherapy one injection

95120 combines a single injection with provision of the extract. Medicare uses 95115 for the administration and a separate preparation code when extract preparation is performed and reportable.

96372SC/IM injection

96372 describes administration of a therapeutic or prophylactic substance. Use 95115, rather than 96372, for one subcutaneous allergen immunotherapy injection.

95165Allergy extract preparation

95165 describes preparation and provision of immunotherapy extract doses; 95115 describes administering one injection. Preparation may take place on a different date from the shot.

Codes related to 95115

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

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