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See a sample rate comparisonCPT 95028 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Allergy Skin Tests, Test For Allergies To Pollen Animal Dander Drugs Or Other Substances. The Test Is Performed By Placing A Small Amount Of The Suspected Allergen Under The Skin And Monitoring To See If A Reaction Occurs.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Allergy and Clinical Immunology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.36 national non-facility rate (2026) · View Medicare rates for 95028 |
| Medicaid Fee Schedule | $9.855 median of the 8 states in the free preview · View Medicaid rates for 95028 |
National average reimbursement for CPT 95028 by major payers:
$16.28
$22.92
$15.09
$18.06
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CPT 95028
5 of 25 sample ratesHigher to lower in this preview
John Millichap
$45.13Published rateLubov Romantseva
$23.88Published rateJody Wong
The Board Of Trustees Of The University Of Illinois
$20.60Published rateMohammed Homsi
Homsi Pediatric Neurology Inc
$16.56Published rateThomas Herrmann
Hoopeston Community Memorial Hospital
$11.31Published rate
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See a sample payer proposalCPT 95028 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95028 code is part of the Medicine Services and Procedures services used for Allergy and Clinical Immunology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 95028 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95004-CPT | Low | Allergy Skin Tests, Test For Allergies To Pollen Animal Dander Drugs Or Other Substances. The Test Is Performed By Placing A Small Amount Of The Suspected Allergen Under The Skin And Monitoring To See If A Reaction Occurs. |
| 95017-CPT | Low | Allergy Testing Any Combination Of Percutaneous (Scratch Puncture Prick) And Intracutaneous (Intradermal) Sequential And Incremental With Venoms Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Tests(Reinstated) Sensitivity Skin Tests 11-15 (Intradermal) (Old Description Deleted 03/31/2003) |
| 95018-CPT | Low | Allergy Testing Any Combination Of Percutaneous (Scratch Puncture Prick) And Intracutaneous (Intradermal) Sequential And Incremental With Drugs Or Biologicals Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Tests (Reinstated) Sensitivity Skin Tests 15+ (Intradermal) (Old Description Deleted 03/31/2003) |
| 95028-CPT | Low | Allergy Skin Tests, Test For Allergies To Pollen Animal Dander Drugs Or Other Substances. The Test Is Performed By Placing A Small Amount Of The Suspected Allergen Under The Skin And Monitoring To See If A Reaction Occurs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95028. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95028 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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