$11.59
Count injections in the session. One injection uses 95115; two or more use 95117, reported once for that session.
On this page
CMS RVU26D · Effective 2026-10-01
95117 Allergy shots Medicare reimbursement rates in Hawaii
Report allergen immunotherapy administration when two or more injections are given in one session; preparation and provision of the extract are separate services. Compare 95117 office and facility rates across CMS payment localities in Hawaii.
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.
What does Medicare pay for 95117 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$13.87
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Allergy and immunology
About 95117: Allergen immunotherapy service, two or more injections
Report allergen immunotherapy administration when two or more injections are given in one session; preparation and provision of the extract are separate services.
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.
CMS billing rules for 95117
- 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) RVU0.36 · 97%
- Malpractice RVU0.01 · 3%
2.3M
Medicare services in 2024 · #73 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.
95117 compared with similar codes
Office rates for Hawaii, from the same CMS release.
95125
No office rateImmunotherapy 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.
95131
No office rateImmntx 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.
$19.29
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.
Compare 95117 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$13.87
Facility
Unavailable
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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 95117 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,473
- Code
- 95117
- Physician work
- 0.00
- Practice expense
- 0.36
- Malpractice
- 0.01
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 0.36 | × 1.137 | 0.4093 |
| Malpractice | 0.01 | × 0.579 | 0.0058 |
| Total RVUs | 0.4151 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$13.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 0.36 | 1.137 |
| Malpractice | 0.01 | 0.579 |
(0 × 1 + 0.36 × 1.137 + 0.01 × 0.579) × $33.4009 = $13.87
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.
95117 billing questions
How many units are reported when a patient receives three or four allergy shots?
One unit for the session. Two or more injections are covered by 95117, so additional shots in that session do not add units.
Can the single-injection code be billed with this code for the same session?
No. Choose by injection count: one shot uses 95115; two or more use 95117.
Is the allergenic extract included?
No. Code 95117 covers administration. When separately furnished and documented, preparation and provision of extract may be reported under the appropriate antigen code; its units reflect doses prepared, not shots given.
Can an office visit be billed on the injection date?
Yes, if a medically necessary, significant, separately identifiable E/M service is documented, such as evaluation of an asthma flare beyond the routine pre-shot check. Append modifier 25 to the E/M code.
Who can give the injections for Medicare billing?
A nurse or medical assistant may administer them as an incident-to service when the supervising physician is in the office suite and immediately available during the injections.
Can a practice bill this code if the patient brings extract prepared elsewhere?
Yes, if that practice administers two or more injections in the session. It reports 95117 for administration; any separately reported extract preparation must be supported by the service the furnishing practice 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 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.
12,47095076,,Ingest challenge ini 120 min,A,,1.50,2.13,,0.31,,0.06,3.69,1.87,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47195079,,Ingest challenge addl 60 min,A,,1.38,1.11,,0.29,,0.05,2.54,1.72,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47295115,,Immunotherapy one injection,A,,0.00,0.30,,0.30,NA,0.01,0.31,0.31,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47395117,,Immunotherapy injections,A,,0.00,0.36,,0.36,NA,0.01,0.37,0.37,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47495120,,Immunotherapy one injection,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47595125,,Immunotherapy 2/> injections,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47695130,,Immntx 1 sting insect,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014