Billing code 95170: Allergen therapyMedicare rate & RVUs in Alaska

Report one unit for physician-supervised allergen immunotherapy involving provision of a whole-body extract, such as an insect extract, in the prescribing practice.

CMS RVU26DEffective Oct 1, 20261 payment locality9K Medicare services in 2024

Medicare pays $12.08 for 95170 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$12.08Office (non-facility)
$3.55Hospital or facility

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

We’ll open 95170 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 95170 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 95170 covers

billing code 95170 represents allergen immunotherapy using a whole-body extract, with the extract provided as part of the service. Allergy specialists commonly use this approach for whole-body insect extracts, such as fire-ant extract. The service is associated with the prescribing physician’s practice or institution and supports treatment under an established allergy immunotherapy plan.

Report units that match the whole-body extract service documented for the patient. Records should identify the extract and connect its preparation or provision to the prescribed immunotherapy. The code includes the extract, unlike 95165, which describes antigen services that exclude provision of allergenic extracts. CMS assigns physician work and practice expense values to 95170 under the physician fee schedule; the code’s included extract is not a separate supply service within this code.

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.

95170 in Alaska*

95170 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$12.08$3.55

How the 95170 rate is calculated

Each of 95170’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 · 95170

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.06Practice expense 0.25Malpractice 0.01

0.3200 adjusted RVUs×$33.4009 conversion factor=$10.69

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 95170

95170 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 95170

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

Non-facility (office) rate · national

$10.69

The facility rate would be $2.67 (+$8.02). In a facility, the facility bills its own costs separately.

95170 compared with similar codes

Compare codes

95170 vs 95165 vs 95144 vs 95145 vs 95130: national Medicare rates

Swap in your local Medicare rate.

  • 95170
    Allergen therapy · 0.06 wRVU
    $10.69
  • 95165
    Allergy extract preparation · 0.06 wRVU
    $17.37+$6.68
  • 95144
    Allergen preparation · 0.06 wRVU
    $21.04+$10.35
  • 95145
    Venom antigen · 0.06 wRVU
    $34.07+$23.38
  • 95130
    · 0 wRVU
    —

How to choose

95165Allergy extract preparation
95170 includes provision of a whole-body extract. 95165 covers antigen services that exclude provision of allergenic extracts.
95144Allergen preparation
95144 is associated with single-dose vial antigen services. Choose 95170 for a whole-body extract service.
95145Venom antigen
95145 is for antigen services involving one stinging-insect venom. 95170 describes whole-body extract immunotherapy.
95130Immntx 1 sting insect
95130 covers office immunotherapy involving one stinging-insect venom. 95170 concerns a whole-body extract, not a venom-count service.

95170 billing questions

When should 95170 be chosen instead of 95165?

Use 95170 for allergen immunotherapy involving a whole-body extract that is provided as part of the service. Code 95165 is for antigen services that do not include provision of the allergenic extract.

Does 95170 include the allergenic extract?

Yes. The whole-body extract is part of the service represented by 95170.

Is 95170 counted by injection or by extract unit?

It is reported by unit for the whole-body extract service, not by counting the number of injections administered.

What documentation supports 95170?

Document the prescribed immunotherapy plan, the whole-body extract used, and the units provided. The record should make clear that the service involved a whole-body extract rather than a different antigen preparation.

How does 95170 differ from venom immunotherapy codes?

95170 is for whole-body extract immunotherapy. Codes such as 95145 identify antigen services for specific numbers of stinging-insect venoms.

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
RVUs for 95170PPRRVU2026_Oct_nonQPP.csv, line 12,488 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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