Billing code 95060: Ophthalmic allergy testMedicare rate & RVUs in Washington
Reports testing of the ocular mucous membrane, typically by allergen exposure, when evaluating a suspected allergic response involving the eye.
Medicare pays $42.81–$49.86 for 95060 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 95060 covers
Code 95060 describes testing the ocular mucous membrane, generally by exposing the conjunctiva to a selected allergen to assess a local response. Allergists and ophthalmologists may perform this test when evaluating suspected allergic conjunctivitis or another allergy-related eye complaint. It is distinct from skin testing because the test site is the eye rather than the skin.
Select 95060 when the service is ocular mucous membrane testing, not nasal mucosal testing or percutaneous or intracutaneous allergen testing. Documentation should identify the clinical indication, test site, allergen or material used, and the procedure and observed response. CMS classifies 95060 as a technical-component-only code; interpretation is covered by a separate code. Report the interpretation separately when performed and supported by documentation.
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 95060 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $42.81 | Unavailable |
| Seattle (King Cnty) | $49.86 | Unavailable |
How the 95060 rate is calculated
Each of 95060’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 · 95060
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense1.21
1.21 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.2200
Conversion factor
$33.4009
Medicare rate
$40.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95060
The CMS indicators that decide how 95060 is paid alongside other services.
CMS payment indicators · 95060
Ophthalmic allergy test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
95060 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95065Nasal allergy test
- 95060 is for the ocular mucous membrane; 95065 is for direct testing of the nasal mucous membrane.
- 95004Allergy skin prick test
- 95004 describes percutaneous allergen skin testing. Choose 95060 when the test is performed on the ocular mucous membrane.
- 95024Intradermal allergy test
- 95024 is intracutaneous allergen testing, while 95060 tests the ocular mucous membrane.
- 95044Patch testing
- 95044 describes patch or application testing for delayed contact reactions on the skin, not ocular mucous membrane testing.
95060 billing questions
When should 95060 be selected instead of 95065?
Use 95060 for testing at the ocular mucous membrane and 95065 for direct testing of the nasal mucous membrane. The test site distinguishes the codes.
Does 95060 include physician interpretation?
No. CMS identifies 95060 as technical-component-only; interpretation is covered by a separate code.
How does 95060 differ from routine allergy skin testing?
95060 tests the ocular mucous membrane. Codes such as 95004 and 95024 describe percutaneous and intracutaneous allergen testing, respectively.
What documentation supports reporting 95060?
Document the eye-related indication, ocular test site, allergen or material used, testing performed, and observed response. Keep interpretation documentation distinct because it is represented separately.
Can 95060 be used for patch testing of contact allergy?
No. 95060 is for ocular mucous membrane testing; 95044 describes patch or application testing for delayed contact reactions.
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
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