CPT 95180 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Allergy and Clinical Immunology Procedures |
| Common Place of Service | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 76 - Repeat procedure by same physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95180 |
National average reimbursement for CPT 95180 by major payers:
$169.51
$172.08
$174.40
$199.53
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 95180 | ||||||
United | 95180 | $95.80 | 1306062955 - ASSOCIATED SPECIALISTS IN MEDICINE, PC | 431520650 - (MO) ASSOCIATED SPECIALISTS IN MEDICINE PC | MO | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $286.95 | 1467474536 - KAREN ZIEMKE | 824198770 - (NJ) ATLANTIC HEALTH PARTNERS | NJ | Allergy Physician (207KA0200X) |
United | 95180 | $177.86 | 1164427175 - NGOC VU | 561249571 - ALLERGY PARTNERS, PLLC | VA | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $230.27 | 1205852464 - JIN GUO | 271348772 - VIRTUA MEDICAL GROUP PA | NJ | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $187.33 | 1184921421 - NEHA PATEL | 463233706 - VANEATA DOWELL | MO | Allergy & Immunology (Internal Medicine) Physician (207RA0201X) |
United | 95180 | $346.88 | 1174615397 - DAVID ROSENTHAL | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NY | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $331.39 | 1144670217 - COURTNEY RAMOS | 870737749 | CA | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $109.93 | 1447202510 - VIRGINIA CENTER FOR ALLERGY, ASTHMA AND SINUS, PC, ACCREDITED ALLERGY CENTER OF SPRINGFIELD | 203246631 - (VA) VIRGINIA CENTER FOR ALLERGY ASTHMA AND SINUS PC | VA | Allergy Physician (207KA0200X) |
United | 95180 | $131.03 | 1295932366 - SARAH BOZEMAN | 611389493 - PSF, PLLC D/B/A FAMILY ALLERGY AND ASTHMA | KY | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $123.69 | 1144268749 - YASMIN BHASIN | 222762431 - YASMIN BHASIN | NJ | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $111.58 | 1538230099 - WON BAIK-HAN | 1538230099 - (NY) WON BAIK-HAN | NY | Pediatric Allergy/Immunology Physician (2080P0201X) |
United | 95180 | $161.05 | 1053541581 - CHET THARPE | 873609925 - (WI) OPENLOOP HEALTHCARE PARTNERS WISCONSIN SC | CA | Allergy Physician (207KA0200X) |
United | 95180 | $178.19 | 1184621310 - GENA BONITATIBUS | 300712207 - (GA) AUGUSTA ALLERGY AND ASTHMA, LLC | GA | Allergy & Immunology Physician (207K00000X) |
United | 95180 | $74.91 | 1982690590 - JEFFREY SUGAR | 134036330 - JEFFREY SUGAR, MD | NY | Allergy Physician (207KA0200X) |
United | 95180 | $138.22 | 1912471616 - WESTMORELAND ALLERGY & ASTHMA ASSOCIATES PC | 832079059 - (PA) WESTMORELAND ALLERGY ASTHMA ASSOCIATES PC | PA | Allergy & Immunology Physician (207K00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 95180 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95180 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 95180 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 Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy; Single Dose Vial(S) (Specify Number Of Vials) |
| 95145-CPT | Low | 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 | Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy (Specify Number Of Doses); Two Single Stinging Insect Venoms |
| 95180-CPT | Low | Rapid Desensitization Proced,Ea Hr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95180. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95180 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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