Use 95004 when an allergenic extract is introduced by scratch, prick, or puncture and read for an immediate reaction. Use 95024 for intradermal extract testing read for an immediate reaction.
On this page
CMS RVU26D · Effective 2026-10-01
95004 in Merced
Office / nonfacility
$3.81
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 testing
About 95004: Percutaneous allergy skin testing, immediate reaction
Percutaneous scratch, prick, or puncture testing with allergenic extracts evaluates immediate allergic reactions and is reported for each individual test performed.
Allergists, otolaryngologists, and some primary care clinicians perform percutaneous testing to evaluate suspected immediate allergies, including allergic rhinitis, asthma triggers, and food allergy. Small amounts of allergenic extract are introduced through a scratch, prick, or puncture on the forearm or back. The resulting wheal and flare are read shortly afterward. Typical extracts include pollens, dust mites, animal dander, molds, and foods. Clinical staff may apply and read the tests under physician supervision; interpretation and a report are included in the service.
Report one unit for each individual percutaneous test performed, rather than one unit for the panel. Document the extracts, controls, test sites, reactions, read time, and interpretation to support the reported count. When clinically indicated, separately performed intradermal immediate-reaction tests with allergenic extracts are reported with 95024 and their own test count. Do not bill separately for the interpretation of 95004. A significant, separately identifiable office evaluation on the same date may be reported with an appropriate E/M code and modifier 25 on the E/M service.
Where the value comes from
- Work RVU0.01 · 9%
- Practice expense (office) RVU0.09 · 82%
- Malpractice RVU0.01 · 9%
8.6M
Medicare services in 2024 · #25 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.
95004 compared with similar codes
Office rates for Merced, from the same CMS release.
Use 95017 for stinging insect venom tests performed percutaneously, intradermally, or by both methods. Do not also report 95004 for the same venom tests.
Patch testing applies allergens to the skin to evaluate delayed contact reactions, generally read over days. Tests under 95004 evaluate immediate reactions after a scratch, prick, or puncture.
Use 95018 for testing with drugs or biologicals, whether percutaneous, intradermal, or combined. Use 95004 for percutaneous immediate-reaction tests with allergenic extracts, such as pollen or food extracts.
The same code, a different location
How does Merced compare?
In Bakersfield, the office rate for 95004 is $3.84—$0.03 higher than the $3.81 rate in Merced. Both use the same code, release and participation basis.
95004 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
$3.81
$3.84
$0.03 higher than Merced
$3.81
The same base rate than Merced
$3.82
$0.01 higher than Merced
$3.81
The same base rate than Merced
$3.81
The same base rate than Merced
$0.32 higher than Merced
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, 95004 ranges from $3.09 in Arkansas to $4.88 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
Madera
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Modesto
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Napa
California · 95004
Office
$4.49
Facility
Unavailable
$0.68 higher than Merced for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 95004
Office
$4.10
Facility
Unavailable
$0.29 higher than Merced for the office setting.
Redding
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Rest Of California
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Riverside-San Bernardino-Ontario
California · 95004
Office
$3.92
Facility
Unavailable
$0.11 higher than Merced for the office setting.
Sacramento-Roseville-Folsom
California · 95004
Office
$4.02
Facility
Unavailable
$0.21 higher than Merced for the office setting.
Salinas
California · 95004
Office
$4.01
Facility
Unavailable
$0.20 higher than Merced for the office setting.
San Diego-Chula Vista-Carlsbad
California · 95004
Office
$4.12
Facility
Unavailable
$0.31 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 95004
Office
$4.76
Facility
Unavailable
$0.95 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 95004
Office
$4.75
Facility
Unavailable
$0.94 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 95004
Office
$4.88
Facility
Unavailable
$1.07 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 95004
Office
$4.84
Facility
Unavailable
$1.03 higher than Merced for the office setting.
San Luis Obispo-Paso Robles
California · 95004
Office
$3.94
Facility
Unavailable
$0.13 higher than Merced for the office setting.
Santa Cruz-Watsonville
California · 95004
Office
$4.17
Facility
Unavailable
$0.36 higher than Merced for the office setting.
Santa Maria-Santa Barbara
California · 95004
Office
$4.03
Facility
Unavailable
$0.22 higher than Merced for the office setting.
Santa Rosa-Petaluma
California · 95004
Office
$4.21
Facility
Unavailable
$0.40 higher than Merced for the office setting.
Stockton
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Vallejo
California · 95004
Office
$4.47
Facility
Unavailable
$0.66 higher than Merced for the office setting.
Visalia
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Yuba City
California · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 95004
Office
$4.26
Facility
Unavailable
$0.45 higher than Merced for the office setting.
Miami
Florida · 95004
Office
$4.31
Facility
Unavailable
$0.50 higher than Merced for the office setting.
Chicago
Illinois · 95004
Office
$4.12
Facility
Unavailable
$0.31 higher than Merced for the office setting.
Manhattan
New York · 95004
Office
$4.38
Facility
Unavailable
$0.57 higher than Merced for the office setting.
Alaska*
Alaska · 95004
Office
$3.89
Facility
Unavailable
$0.08 higher than Merced for the office setting.
Alabama
Alabama · 95004
Office
$3.15
Facility
Unavailable
$0.66 lower than Merced for the office setting.
Arkansas
Arkansas · 95004
Office
$3.09
Facility
Unavailable
$0.72 lower than Merced for the office setting.
Arizona
Arizona · 95004
Office
$3.53
Facility
Unavailable
$0.28 lower than Merced for the office setting.
Colorado
Colorado · 95004
Office
$3.80
Facility
Unavailable
$0.01 lower than Merced for the office setting.
Connecticut
Connecticut · 95004
Office
$3.98
Facility
Unavailable
$0.17 higher than Merced for the office setting.
Delaware
Delaware · 95004
Office
$3.61
Facility
Unavailable
$0.20 lower than Merced for the office setting.
Fort Lauderdale
Florida · 95004
Office
$3.98
Facility
Unavailable
$0.17 higher than Merced for the office setting.
Rest Of Florida
Florida · 95004
Office
$3.71
Facility
Unavailable
$0.10 lower than Merced for the office setting.
Atlanta
Georgia · 95004
Office
$3.79
Facility
Unavailable
$0.02 lower than Merced for the office setting.
Rest Of Georgia
Georgia · 95004
Office
$3.41
Facility
Unavailable
$0.40 lower than Merced for the office setting.
Hawaii, Guam
Hawaii · 95004
Office
$3.95
Facility
Unavailable
$0.14 higher than Merced for the office setting.
Iowa
Iowa · 95004
Office
$3.22
Facility
Unavailable
$0.59 lower than Merced for the office setting.
Idaho
Idaho · 95004
Office
$3.26
Facility
Unavailable
$0.55 lower than Merced for the office setting.
East St. Louis
Illinois · 95004
Office
$3.77
Facility
Unavailable
$0.04 lower than Merced for the office setting.
Rest Of Illinois
Illinois · 95004
Office
$3.60
Facility
Unavailable
$0.21 lower than Merced for the office setting.
Suburban Chicago
Illinois · 95004
Office
$4.02
Facility
Unavailable
$0.21 higher than Merced for the office setting.
Indiana
Indiana · 95004
Office
$3.28
Facility
Unavailable
$0.53 lower than Merced for the office setting.
Kansas
Kansas · 95004
Office
$3.22
Facility
Unavailable
$0.59 lower than Merced for the office setting.
Kentucky
Kentucky · 95004
Office
$3.31
Facility
Unavailable
$0.50 lower than Merced for the office setting.
New Orleans
Louisiana · 95004
Office
$3.54
Facility
Unavailable
$0.27 lower than Merced for the office setting.
Rest Of Louisiana
Louisiana · 95004
Office
$3.31
Facility
Unavailable
$0.50 lower than Merced for the office setting.
Metropolitan Boston
Massachusetts · 95004
Office
$4.23
Facility
Unavailable
$0.42 higher than Merced for the office setting.
Rest Of Massachusetts
Massachusetts · 95004
Office
$3.77
Facility
Unavailable
$0.04 lower than Merced for the office setting.
Baltimore/Surr. Cntys
Maryland · 95004
Office
$3.98
Facility
Unavailable
$0.17 higher than Merced for the office setting.
Rest Of Maryland
Maryland · 95004
Office
$3.69
Facility
Unavailable
$0.12 lower than Merced for the office setting.
Rest Of Maine
Maine · 95004
Office
$3.31
Facility
Unavailable
$0.50 lower than Merced for the office setting.
Southern Maine
Maine · 95004
Office
$3.52
Facility
Unavailable
$0.29 lower than Merced for the office setting.
Detroit
Michigan · 95004
Office
$3.80
Facility
Unavailable
$0.01 lower than Merced for the office setting.
Rest Of Michigan
Michigan · 95004
Office
$3.46
Facility
Unavailable
$0.35 lower than Merced for the office setting.
Minnesota
Minnesota · 95004
Office
$3.53
Facility
Unavailable
$0.28 lower than Merced for the office setting.
Metropolitan Kansas City
Missouri · 95004
Office
$3.48
Facility
Unavailable
$0.33 lower than Merced for the office setting.
Metropolitan St. Louis
Missouri · 95004
Office
$3.53
Facility
Unavailable
$0.28 lower than Merced for the office setting.
Rest Of Missouri
Missouri · 95004
Office
$3.25
Facility
Unavailable
$0.56 lower than Merced for the office setting.
Mississippi
Mississippi · 95004
Office
$3.17
Facility
Unavailable
$0.64 lower than Merced for the office setting.
Montana**
Montana · 95004
Office
$3.67
Facility
Unavailable
$0.14 lower than Merced for the office setting.
North Carolina
North Carolina · 95004
Office
$3.35
Facility
Unavailable
$0.46 lower than Merced for the office setting.
North Dakota**
North Dakota · 95004
Office
$3.48
Facility
Unavailable
$0.33 lower than Merced for the office setting.
Nebraska
Nebraska · 95004
Office
$3.23
Facility
Unavailable
$0.58 lower than Merced for the office setting.
New Hampshire
New Hampshire · 95004
Office
$3.76
Facility
Unavailable
$0.05 lower than Merced for the office setting.
Northern Nj
New Jersey · 95004
Office
$4.20
Facility
Unavailable
$0.39 higher than Merced for the office setting.
Rest Of New Jersey
New Jersey · 95004
Office
$4.00
Facility
Unavailable
$0.19 higher than Merced for the office setting.
New Mexico
New Mexico · 95004
Office
$3.49
Facility
Unavailable
$0.32 lower than Merced for the office setting.
Nevada**
Nevada · 95004
Office
$3.62
Facility
Unavailable
$0.19 lower than Merced for the office setting.
Nyc Suburbs/Long Island
New York · 95004
Office
$4.55
Facility
Unavailable
$0.74 higher than Merced for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 95004
Office
$4.04
Facility
Unavailable
$0.23 higher than Merced for the office setting.
Queens
New York · 95004
Office
$4.39
Facility
Unavailable
$0.58 higher than Merced for the office setting.
Rest Of New York
New York · 95004
Office
$3.42
Facility
Unavailable
$0.39 lower than Merced for the office setting.
Ohio
Ohio · 95004
Office
$3.42
Facility
Unavailable
$0.39 lower than Merced for the office setting.
Oklahoma
Oklahoma · 95004
Office
$3.28
Facility
Unavailable
$0.53 lower than Merced for the office setting.
Portland
Oregon · 95004
Office
$3.93
Facility
Unavailable
$0.12 higher than Merced for the office setting.
Rest Of Oregon
Oregon · 95004
Office
$3.56
Facility
Unavailable
$0.25 lower than Merced for the office setting.
Metropolitan Philadelphia
Pennsylvania · 95004
Office
$3.87
Facility
Unavailable
$0.06 higher than Merced for the office setting.
Rest Of Pennsylvania
Pennsylvania · 95004
Office
$3.41
Facility
Unavailable
$0.40 lower than Merced for the office setting.
Puerto Rico
Puerto Rico · 95004
Office
$3.70
Facility
Unavailable
$0.11 lower than Merced for the office setting.
Rhode Island
Rhode Island · 95004
Office
$3.74
Facility
Unavailable
$0.07 lower than Merced for the office setting.
South Carolina
South Carolina · 95004
Office
$3.40
Facility
Unavailable
$0.41 lower than Merced for the office setting.
South Dakota**
South Dakota · 95004
Office
$3.45
Facility
Unavailable
$0.36 lower than Merced for the office setting.
Tennessee
Tennessee · 95004
Office
$3.25
Facility
Unavailable
$0.56 lower than Merced for the office setting.
Austin
Texas · 95004
Office
$3.81
Facility
Unavailable
The same base rate than Merced for the office setting.
Beaumont
Texas · 95004
Office
$3.38
Facility
Unavailable
$0.43 lower than Merced for the office setting.
Brazoria
Texas · 95004
Office
$3.58
Facility
Unavailable
$0.23 lower than Merced for the office setting.
Dallas
Texas · 95004
Office
$3.62
Facility
Unavailable
$0.19 lower than Merced for the office setting.
Fort Worth
Texas · 95004
Office
$3.59
Facility
Unavailable
$0.22 lower than Merced for the office setting.
Galveston
Texas · 95004
Office
$3.60
Facility
Unavailable
$0.21 lower than Merced for the office setting.
Houston
Texas · 95004
Office
$3.78
Facility
Unavailable
$0.03 lower than Merced for the office setting.
Rest Of Texas
Texas · 95004
Office
$3.49
Facility
Unavailable
$0.32 lower than Merced for the office setting.
Utah
Utah · 95004
Office
$3.46
Facility
Unavailable
$0.35 lower than Merced for the office setting.
Virginia
Virginia · 95004
Office
$3.52
Facility
Unavailable
$0.29 lower than Merced for the office setting.
Virgin Islands
United States Virgin Islands · 95004
Office
$3.70
Facility
Unavailable
$0.11 lower than Merced for the office setting.
Vermont
Vermont · 95004
Office
$3.48
Facility
Unavailable
$0.33 lower than Merced for the office setting.
Rest Of Washington
Washington · 95004
Office
$3.76
Facility
Unavailable
$0.05 lower than Merced for the office setting.
Seattle (King Cnty)
Washington · 95004
Office
$4.31
Facility
Unavailable
$0.50 higher than Merced for the office setting.
Wisconsin
Wisconsin · 95004
Office
$3.32
Facility
Unavailable
$0.49 lower than Merced for the office setting.
West Virginia
West Virginia · 95004
Office
$3.42
Facility
Unavailable
$0.39 lower than Merced for the office setting.
Wyoming**
Wyoming · 95004
Office
$3.59
Facility
Unavailable
$0.22 lower than Merced for the office setting.
See how rates vary across the country
95004 · 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.
$3.09
$4.35
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 | $3.89 | 1 |
| AL | $3.15 | 1 |
| AR | $3.09 | 1 |
| AZ | $3.53 | 1 |
| CA | $3.81–$4.88 | 29 |
| CO | $3.80 | 1 |
| CT | $3.98 | 1 |
| DC | $4.26 | 1 |
| DE | $3.61 | 1 |
| FL | $3.71–$4.31 | 3 |
| GA | $3.41–$3.79 | 2 |
| GU | $3.95 | 1 |
| HI | $3.95 | 1 |
| IA | $3.22 | 1 |
| ID | $3.26 | 1 |
| IL | $3.60–$4.12 | 4 |
| IN | $3.28 | 1 |
| KS | $3.22 | 1 |
| KY | $3.31 | 1 |
| LA | $3.31–$3.54 | 2 |
| MA | $3.77–$4.23 | 2 |
| MD | $3.69–$4.26 | 3 |
| ME | $3.31–$3.52 | 2 |
| MI | $3.46–$3.80 | 2 |
| MN | $3.53 | 1 |
| MO | $3.25–$3.53 | 3 |
| MS | $3.17 | 1 |
| MT | $3.67 | 1 |
| NC | $3.35 | 1 |
| ND | $3.48 | 1 |
| NE | $3.23 | 1 |
| NH | $3.76 | 1 |
| NJ | $4.00–$4.20 | 2 |
| NM | $3.49 | 1 |
| NV | $3.62 | 1 |
| NY | $3.42–$4.55 | 5 |
| OH | $3.42 | 1 |
| OK | $3.28 | 1 |
| OR | $3.56–$3.93 | 2 |
| PA | $3.41–$3.87 | 2 |
| PR | $3.70 | 1 |
| RI | $3.74 | 1 |
| SC | $3.40 | 1 |
| SD | $3.45 | 1 |
| TN | $3.25 | 1 |
| TX | $3.38–$3.81 | 8 |
| UT | $3.46 | 1 |
| VA | $3.52–$4.26 | 2 |
| VI | $3.70 | 1 |
| VT | $3.48 | 1 |
| WA | $3.76–$4.31 | 2 |
| WI | $3.32 | 1 |
| WV | $3.42 | 1 |
| WY | $3.59 | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 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 95004 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$4.19
$3.81 × 110% = $4.19
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 95004 in Merced.
PPRRVU2026_Oct_nonQPP.csv
12,457
- Code
- 95004
- Physician work
- 0.01
- Practice expense
- 0.09
- Malpractice
- 0.01
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.01 | × 1.017 | 0.0102 |
| Practice expense | 0.09 | × 1.096 | 0.0986 |
| Malpractice | 0.01 | × 0.536 | 0.0054 |
| Total RVUs | 0.1142 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Merced$3.81
Open 95004 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.01 | 1.017 |
| Practice expense | 0.09 | 1.096 |
| Malpractice | 0.01 | 0.536 |
(0.01 × 1.017 + 0.09 × 1.096 + 0.01 × 0.536) × $33.4009 = $3.81
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
95004 · Office / nonfacility
$3.81
Effective 2026-10-01
The base rate is $0.12 higher than on 2025-10-01, moving from $3.69 to $3.81 (3.3%).
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
$3.69changed to$3.81
- Conversion factor 32.3465 changed to 33.4009
- 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: $3.69
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 | $3.81 | Not available in this setting | RVU26D |
| 2026-07-01 | $3.81 | Not available in this setting | RVU26C |
| 2026-04-01 | $3.81 | Not available in this setting | RVU26B |
| 2026-01-01 | $3.81 | Not available in this setting | RVU26A |
| 2025-10-01 | $3.69 | Not available in this setting | RVU25D |
| 2025-07-01 | $3.69 | Not available in this setting | RVU25C |
| 2025-04-01 | $3.69 | Not available in this setting | RVU25B |
| 2025-01-01 | $3.69 | Not available in this setting | RVU25A |
95004 billing questions
How many units of 95004 are reported for a skin test panel?
Report one unit per individual percutaneous test performed, not one unit for the panel. The record should identify the tested extracts so the count can be verified.
Can 95004 and 95024 be billed on the same day?
Yes, when both percutaneous and clinically indicated intradermal immediate-reaction testing with allergenic extracts are performed. Report each code with its own test count and document which extracts received each method.
Should 95004 be used for insect venom or drug allergy testing?
Use 95017 for stinging insect venom testing and 95018 for drug or biological testing. Those codes cover percutaneous testing, intradermal testing, or a combination, as performed.
Is the physician interpretation billed separately?
No. Interpretation and reporting of the skin test results are included in 95004. A significant, separately identifiable E/M service may be reported with modifier 25 on the E/M code.
What documentation supports 95004?
Record the extracts and controls, percutaneous method, test sites, wheal and flare measurements or grading, read time, and interpretation. The documented tests should support the number of units billed.
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.
