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.
On this page
CMS RVU26D · Effective 2026-10-01
95115 in Madera
Office / nonfacility
$11.16
Base rate per service
Facility setting
Not available in this setting
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Allergy and immunology
About 95115: Single allergen immunotherapy injection administration
Administration of one subcutaneous allergen immunotherapy injection during an encounter, reported separately from any preparation and supply of the allergenic extract.
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.
CMS billing rules for 95115
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.30 · 97%
- Malpractice RVU0.01 · 3%
681.1K
Medicare services in 2024 · #188 by national volume
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.
95115 compared with similar codes
Office rates for Madera, from the same CMS release.
Immunotherapy 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.
96372 describes administration of a therapeutic or prophylactic substance. Use 95115, rather than 96372, for one subcutaneous allergen immunotherapy injection.
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.
The same code, a different location
How does Madera compare?
In Bakersfield, the office rate for 95115 is $11.19—$0.03 higher than the $11.16 rate in Madera. Both use the same code, release and participation basis.
95115 across payment areas
Same release and payment basis · bars start at $0
Madera · This locality
$11.16
$11.19
$0.03 higher than Madera
$11.16
The same base rate than Madera
$11.16
The same base rate than Madera
$11.16
The same base rate than Madera
$11.16
The same base rate than Madera
$0.92 higher than Madera
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, 95115 ranges from $8.78 in Arkansas to $14.63 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Modesto
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Napa
California · 95115
Office
$13.38
Facility
Unavailable
$2.22 higher than Madera for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 95115
Office
$12.05
Facility
Unavailable
$0.89 higher than Madera for the office setting.
Redding
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Rest Of California
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Riverside-San Bernardino-Ontario
California · 95115
Office
$11.27
Facility
Unavailable
$0.11 higher than Madera for the office setting.
Sacramento-Roseville-Folsom
California · 95115
Office
$11.83
Facility
Unavailable
$0.67 higher than Madera for the office setting.
Salinas
California · 95115
Office
$11.79
Facility
Unavailable
$0.63 higher than Madera for the office setting.
San Diego-Chula Vista-Carlsbad
California · 95115
Office
$12.17
Facility
Unavailable
$1.01 higher than Madera for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 95115
Office
$14.28
Facility
Unavailable
$3.12 higher than Madera for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 95115
Office
$14.27
Facility
Unavailable
$3.11 higher than Madera for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 95115
Office
$14.63
Facility
Unavailable
$3.47 higher than Madera for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 95115
Office
$14.58
Facility
Unavailable
$3.42 higher than Madera for the office setting.
San Luis Obispo-Paso Robles
California · 95115
Office
$11.59
Facility
Unavailable
$0.43 higher than Madera for the office setting.
Santa Cruz-Watsonville
California · 95115
Office
$12.35
Facility
Unavailable
$1.19 higher than Madera for the office setting.
Santa Maria-Santa Barbara
California · 95115
Office
$11.86
Facility
Unavailable
$0.70 higher than Madera for the office setting.
Santa Rosa-Petaluma
California · 95115
Office
$12.48
Facility
Unavailable
$1.32 higher than Madera for the office setting.
Stockton
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Vallejo
California · 95115
Office
$13.36
Facility
Unavailable
$2.20 higher than Madera for the office setting.
Visalia
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Yuba City
California · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 95115
Office
$12.18
Facility
Unavailable
$1.02 higher than Madera for the office setting.
Miami
Florida · 95115
Office
$11.28
Facility
Unavailable
$0.12 higher than Madera for the office setting.
Chicago
Illinois · 95115
Office
$10.84
Facility
Unavailable
$0.32 lower than Madera for the office setting.
Manhattan
New York · 95115
Office
$12.17
Facility
Unavailable
$1.01 higher than Madera for the office setting.
Alaska*
Alaska · 95115
Office
$10.86
Facility
Unavailable
$0.30 lower than Madera for the office setting.
Alabama
Alabama · 95115
Office
$8.96
Facility
Unavailable
$2.20 lower than Madera for the office setting.
Arkansas
Arkansas · 95115
Office
$8.78
Facility
Unavailable
$2.38 lower than Madera for the office setting.
Arizona
Arizona · 95115
Office
$10.00
Facility
Unavailable
$1.16 lower than Madera for the office setting.
Colorado
Colorado · 95115
Office
$10.92
Facility
Unavailable
$0.24 lower than Madera for the office setting.
Connecticut
Connecticut · 95115
Office
$11.20
Facility
Unavailable
$0.04 higher than Madera for the office setting.
Delaware
Delaware · 95115
Office
$10.20
Facility
Unavailable
$0.96 lower than Madera for the office setting.
Fort Lauderdale
Florida · 95115
Office
$10.75
Facility
Unavailable
$0.41 lower than Madera for the office setting.
Rest Of Florida
Florida · 95115
Office
$10.08
Facility
Unavailable
$1.08 lower than Madera for the office setting.
Atlanta
Georgia · 95115
Office
$10.58
Facility
Unavailable
$0.58 lower than Madera for the office setting.
Rest Of Georgia
Georgia · 95115
Office
$9.34
Facility
Unavailable
$1.82 lower than Madera for the office setting.
Hawaii, Guam
Hawaii · 95115
Office
$11.59
Facility
Unavailable
$0.43 higher than Madera for the office setting.
Iowa
Iowa · 95115
Office
$9.30
Facility
Unavailable
$1.86 lower than Madera for the office setting.
Idaho
Idaho · 95115
Office
$9.38
Facility
Unavailable
$1.78 lower than Madera for the office setting.
East St. Louis
Illinois · 95115
Office
$9.89
Facility
Unavailable
$1.27 lower than Madera for the office setting.
Rest Of Illinois
Illinois · 95115
Office
$9.67
Facility
Unavailable
$1.49 lower than Madera for the office setting.
Suburban Chicago
Illinois · 95115
Office
$10.88
Facility
Unavailable
$0.28 lower than Madera for the office setting.
Indiana
Indiana · 95115
Office
$9.45
Facility
Unavailable
$1.71 lower than Madera for the office setting.
Kansas
Kansas · 95115
Office
$9.23
Facility
Unavailable
$1.93 lower than Madera for the office setting.
Kentucky
Kentucky · 95115
Office
$9.21
Facility
Unavailable
$1.95 lower than Madera for the office setting.
New Orleans
Louisiana · 95115
Office
$9.81
Facility
Unavailable
$1.35 lower than Madera for the office setting.
Rest Of Louisiana
Louisiana · 95115
Office
$9.19
Facility
Unavailable
$1.97 lower than Madera for the office setting.
Metropolitan Boston
Massachusetts · 95115
Office
$12.26
Facility
Unavailable
$1.10 higher than Madera for the office setting.
Rest Of Massachusetts
Massachusetts · 95115
Office
$10.82
Facility
Unavailable
$0.34 lower than Madera for the office setting.
Baltimore/Surr. Cntys
Maryland · 95115
Office
$11.16
Facility
Unavailable
The same base rate than Madera for the office setting.
Rest Of Maryland
Maryland · 95115
Office
$10.45
Facility
Unavailable
$0.71 lower than Madera for the office setting.
Rest Of Maine
Maine · 95115
Office
$9.43
Facility
Unavailable
$1.73 lower than Madera for the office setting.
Southern Maine
Maine · 95115
Office
$10.14
Facility
Unavailable
$1.02 lower than Madera for the office setting.
Detroit
Michigan · 95115
Office
$10.23
Facility
Unavailable
$0.93 lower than Madera for the office setting.
Rest Of Michigan
Michigan · 95115
Office
$9.53
Facility
Unavailable
$1.63 lower than Madera for the office setting.
Minnesota
Minnesota · 95115
Office
$10.41
Facility
Unavailable
$0.75 lower than Madera for the office setting.
Metropolitan Kansas City
Missouri · 95115
Office
$9.74
Facility
Unavailable
$1.42 lower than Madera for the office setting.
Metropolitan St. Louis
Missouri · 95115
Office
$9.87
Facility
Unavailable
$1.29 lower than Madera for the office setting.
Rest Of Missouri
Missouri · 95115
Office
$8.96
Facility
Unavailable
$2.20 lower than Madera for the office setting.
Mississippi
Mississippi · 95115
Office
$8.87
Facility
Unavailable
$2.29 lower than Madera for the office setting.
Montana**
Montana · 95115
Office
$10.35
Facility
Unavailable
$0.81 lower than Madera for the office setting.
North Carolina
North Carolina · 95115
Office
$9.56
Facility
Unavailable
$1.60 lower than Madera for the office setting.
North Dakota**
North Dakota · 95115
Office
$10.16
Facility
Unavailable
$1.00 lower than Madera for the office setting.
Nebraska
Nebraska · 95115
Office
$9.37
Facility
Unavailable
$1.79 lower than Madera for the office setting.
New Hampshire
New Hampshire · 95115
Office
$10.72
Facility
Unavailable
$0.44 lower than Madera for the office setting.
Northern Nj
New Jersey · 95115
Office
$11.98
Facility
Unavailable
$0.82 higher than Madera for the office setting.
Rest Of New Jersey
New Jersey · 95115
Office
$11.31
Facility
Unavailable
$0.15 higher than Madera for the office setting.
New Mexico
New Mexico · 95115
Office
$9.59
Facility
Unavailable
$1.57 lower than Madera for the office setting.
Nevada**
Nevada · 95115
Office
$10.31
Facility
Unavailable
$0.85 lower than Madera for the office setting.
Nyc Suburbs/Long Island
New York · 95115
Office
$12.53
Facility
Unavailable
$1.37 higher than Madera for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 95115
Office
$11.38
Facility
Unavailable
$0.22 higher than Madera for the office setting.
Queens
New York · 95115
Office
$12.33
Facility
Unavailable
$1.17 higher than Madera for the office setting.
Rest Of New York
New York · 95115
Office
$9.75
Facility
Unavailable
$1.41 lower than Madera for the office setting.
Ohio
Ohio · 95115
Office
$9.49
Facility
Unavailable
$1.67 lower than Madera for the office setting.
Oklahoma
Oklahoma · 95115
Office
$9.21
Facility
Unavailable
$1.95 lower than Madera for the office setting.
Portland
Oregon · 95115
Office
$11.38
Facility
Unavailable
$0.22 higher than Madera for the office setting.
Rest Of Oregon
Oregon · 95115
Office
$10.21
Facility
Unavailable
$0.95 lower than Madera for the office setting.
Metropolitan Philadelphia
Pennsylvania · 95115
Office
$10.83
Facility
Unavailable
$0.33 lower than Madera for the office setting.
Rest Of Pennsylvania
Pennsylvania · 95115
Office
$9.51
Facility
Unavailable
$1.65 lower than Madera for the office setting.
Puerto Rico
Puerto Rico · 95115
Office
$10.46
Facility
Unavailable
$0.70 lower than Madera for the office setting.
Rhode Island
Rhode Island · 95115
Office
$10.65
Facility
Unavailable
$0.51 lower than Madera for the office setting.
South Carolina
South Carolina · 95115
Office
$9.54
Facility
Unavailable
$1.62 lower than Madera for the office setting.
South Dakota**
South Dakota · 95115
Office
$10.13
Facility
Unavailable
$1.03 lower than Madera for the office setting.
Tennessee
Tennessee · 95115
Office
$9.29
Facility
Unavailable
$1.87 lower than Madera for the office setting.
Austin
Texas · 95115
Office
$10.90
Facility
Unavailable
$0.26 lower than Madera for the office setting.
Beaumont
Texas · 95115
Office
$9.43
Facility
Unavailable
$1.73 lower than Madera for the office setting.
Brazoria
Texas · 95115
Office
$10.19
Facility
Unavailable
$0.97 lower than Madera for the office setting.
Dallas
Texas · 95115
Office
$10.27
Facility
Unavailable
$0.89 lower than Madera for the office setting.
Fort Worth
Texas · 95115
Office
$10.17
Facility
Unavailable
$0.99 lower than Madera for the office setting.
Galveston
Texas · 95115
Office
$10.23
Facility
Unavailable
$0.93 lower than Madera for the office setting.
Houston
Texas · 95115
Office
$10.41
Facility
Unavailable
$0.75 lower than Madera for the office setting.
Rest Of Texas
Texas · 95115
Office
$9.81
Facility
Unavailable
$1.35 lower than Madera for the office setting.
Utah
Utah · 95115
Office
$9.72
Facility
Unavailable
$1.44 lower than Madera for the office setting.
Virginia
Virginia · 95115
Office
$10.09
Facility
Unavailable
$1.07 lower than Madera for the office setting.
Virgin Islands
United States Virgin Islands · 95115
Office
$10.46
Facility
Unavailable
$0.70 lower than Madera for the office setting.
Vermont
Vermont · 95115
Office
$10.09
Facility
Unavailable
$1.07 lower than Madera for the office setting.
Rest Of Washington
Washington · 95115
Office
$10.81
Facility
Unavailable
$0.35 lower than Madera for the office setting.
Seattle (King Cnty)
Washington · 95115
Office
$12.57
Facility
Unavailable
$1.41 higher than Madera for the office setting.
Wisconsin
Wisconsin · 95115
Office
$9.70
Facility
Unavailable
$1.46 lower than Madera for the office setting.
West Virginia
West Virginia · 95115
Office
$9.19
Facility
Unavailable
$1.97 lower than Madera for the office setting.
Wyoming**
Wyoming · 95115
Office
$10.27
Facility
Unavailable
$0.89 lower than Madera for the office setting.
See how rates vary across the country
95115 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$8.78
$12.90
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $10.86 | 1 |
| AL | $8.96 | 1 |
| AR | $8.78 | 1 |
| AZ | $10.00 | 1 |
| CA | $11.16–$14.63 | 29 |
| CO | $10.92 | 1 |
| CT | $11.20 | 1 |
| DC | $12.18 | 1 |
| DE | $10.20 | 1 |
| FL | $10.08–$11.28 | 3 |
| GA | $9.34–$10.58 | 2 |
| GU | $11.59 | 1 |
| HI | $11.59 | 1 |
| IA | $9.30 | 1 |
| ID | $9.38 | 1 |
| IL | $9.67–$10.88 | 4 |
| IN | $9.45 | 1 |
| KS | $9.23 | 1 |
| KY | $9.21 | 1 |
| LA | $9.19–$9.81 | 2 |
| MA | $10.82–$12.26 | 2 |
| MD | $10.45–$12.18 | 3 |
| ME | $9.43–$10.14 | 2 |
| MI | $9.53–$10.23 | 2 |
| MN | $10.41 | 1 |
| MO | $8.96–$9.87 | 3 |
| MS | $8.87 | 1 |
| MT | $10.35 | 1 |
| NC | $9.56 | 1 |
| ND | $10.16 | 1 |
| NE | $9.37 | 1 |
| NH | $10.72 | 1 |
| NJ | $11.31–$11.98 | 2 |
| NM | $9.59 | 1 |
| NV | $10.31 | 1 |
| NY | $9.75–$12.53 | 5 |
| OH | $9.49 | 1 |
| OK | $9.21 | 1 |
| OR | $10.21–$11.38 | 2 |
| PA | $9.51–$10.83 | 2 |
| PR | $10.46 | 1 |
| RI | $10.65 | 1 |
| SC | $9.54 | 1 |
| SD | $10.13 | 1 |
| TN | $9.29 | 1 |
| TX | $9.43–$10.90 | 8 |
| UT | $9.72 | 1 |
| VA | $10.09–$12.18 | 2 |
| VI | $10.46 | 1 |
| VT | $10.09 | 1 |
| WA | $10.81–$12.57 | 2 |
| WI | $9.70 | 1 |
| WV | $9.19 | 1 |
| WY | $10.27 | 1 |
Where does this rate apply?
Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 95115 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$12.28
$11.16 × 110% = $12.28
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95115 in Madera.
PPRRVU2026_Oct_nonQPP.csv
12,472
- Code
- 95115
- Physician work
- 0.00
- Practice expense
- 0.30
- Malpractice
- 0.01
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.017 | 0.0000 |
| Practice expense | 0.30 | × 1.096 | 0.3288 |
| Malpractice | 0.01 | × 0.536 | 0.0054 |
| Total RVUs | 0.3342 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Madera$11.16
Open 95115 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.017 |
| Practice expense | 0.3 | 1.096 |
| Malpractice | 0.01 | 0.536 |
(0 × 1.017 + 0.3 × 1.096 + 0.01 × 0.536) × $33.4009 = $11.16
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
95115 · Office / nonfacility
$11.16
Effective 2026-10-01
The base rate is $0.02 higher than on 2025-10-01, moving from $11.14 to $11.16 (0.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$11.14changed to$11.16
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.31 changed to 0.30
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $11.14
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $11.16 | Not available in this setting | RVU26D |
| 2026-07-01 | $11.16 | Not available in this setting | RVU26C |
| 2026-04-01 | $11.16 | Not available in this setting | RVU26B |
| 2026-01-01 | $11.16 | Not available in this setting | RVU26A |
| 2025-10-01 | $11.14 | Not available in this setting | RVU25D |
| 2025-07-01 | $11.14 | Not available in this setting | RVU25C |
| 2025-04-01 | $11.14 | Not available in this setting | RVU25B |
| 2025-01-01 | $11.14 | Not available in this setting | RVU25A |
95115 billing questions
When should 95117 be reported instead of 95115?
Use 95117 when two or more allergen immunotherapy injections are given during an encounter, such as injections from separate vials. Do not report one unit of 95115 for each shot or report both codes for the same set of injections.
Does 95115 include the allergenic extract?
No. It covers administration of the injection. Preparation and supply may be reported separately when performed and documented, such as with 95165 for doses prepared for immunotherapy.
Can an E/M visit be billed on the same day as an allergy shot?
A significant, separately identifiable E/M service beyond the routine pre-injection check may be reported with modifier 25 on the E/M code. Do not separately report 99211 solely for the routine check before the shot.
Who can perform the injection for Medicare billing?
Clinical staff such as nurses or medical assistants commonly administer it. CMS treats 95115 as an incident-to service, so physician supervision requirements must be met.
Should 96372 be used for allergy shots?
No. Allergen immunotherapy injections have dedicated administration codes: 95115 for one injection and 95117 for two or more during an encounter.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
