Billing code 95117: Allergy shotsMedicare rate & RVUs

Medicare pays $12.36 for 95117 nationally in the office. Local office rates run $10.50–$17.52.

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

What 95117 covers

This service covers two or more subcutaneous allergen immunotherapy injections in one session, such as prescribed injections from separate pollen and dust mite extract vials. A nurse or medical assistant commonly administers the shots in an allergist’s, primary care, or ENT office under a physician’s immunotherapy plan. The service includes drawing up the ordered doses, giving the injections, and observing the patient afterward for local or systemic reactions. Patients may receive injections during buildup or maintenance treatment.

Report one unit for a session with two or more injections, regardless of the number of shots; use 95115 for a single injection. Record the extracts used, doses, injection sites, observation, and any reaction. This administration code excludes preparation and provision of the allergenic extract. When separately furnished and documented, extract preparation may be reported under the appropriate antigen code, with units based on doses prepared. CMS assigns no physician work value to 95117. Medicare treats it as an incident-to service, billable only when performed under physician supervision; the supervising physician must be in the office suite and immediately available during the injections.

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 95117 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

95117 rates by state

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

How the 95117 rate is calculated

Each of 95117’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 95117

The CMS indicators that decide how 95117 is paid alongside other services.

95117 compared with similar codes

How to choose

95115Allergy shot

Count injections in the session. One injection uses 95115; two or more use 95117, reported once for that session.

95125Immunotherapy 2/> injections

95125 describes a service that includes provision of allergenic extract along with two or more injections. Code 95117 describes administration without extract provision.

95131Immntx 2 sting insects

95131 describes immunotherapy for two stinging insect venoms with venom provision. Code 95117 counts injections administered without extract provision; the number of venoms is not necessarily the number of injections.

95165Allergy extract preparation

95165 describes preparation and provision of allergenic extract, with units based on doses prepared. Code 95117 describes administering two or more injections in a session.

Codes related to 95117

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