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See a sample rate comparisonCPT 95170 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.
Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy; Whole Body Extract Of Biting Insect Or Other Arthropod (Specify Number Of Doses)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Allergy and Clinical Immunology Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 76 - Repeat procedure by same physician 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $10.69 national non-facility rate (2026) · View Medicare rates for 95170 |
| Medicaid Fee Schedule | $8.37 median of the 8 states in the free preview · View Medicaid rates for 95170 |
National average reimbursement for CPT 95170 by major payers:
$10.69
$10.85
$11.00
$14.96
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CPT 95170
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateMegan Ginsburg
Advocate Health And Hospitals Corporation
$22.29Published rateDavid Kemp
Advocate Health And Hospitals Corporation
$19.32Published ratePaloma Reinoso
The Board Of Trustees Of The University Of Illinois
$14.23Published rateWarren Kammerer
Warren Kammerer Md Sc
$4.34Published rate
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See a sample payer proposalCPT 95170 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95170 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 95170 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 |
|---|---|---|
| 95144-CPT | Low | Professional Services For The, Professional Services For The Supervision And Provision Ofantigens For Allergen Immunotherapy Single Or Multiple Antigens Single Dose Vials (Specify Number Of Vials) |
| 95145-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy (Specify Number Of Doses); Single Stinging Insect Venom |
| 95146-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy (Specify Number Of Doses); Two Single Stinging Insect Venoms |
| 95170-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy; Whole Body Extract Of Biting Insect Or Other Arthropod (Specify Number Of Doses) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95170. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95170 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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