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See a sample rate comparisonCPT 95180 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.
Therapy To Treat Drug Allergy, Hourly Therapy To Treat A Drug Allergy Such As An Allergy To Insulin Or Penicillin (Rapid Desensitization Test).
| 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 | 59 - Distinct Procedural Service 76 - Repeat procedure by same physician |
| Complexity Level | Low |
| Medicare Fee Schedule | $137.61 national non-facility rate (2026) · View Medicare rates for 95180 |
| Medicaid Fee Schedule | $112.11 median of the 8 states in the free preview · View Medicaid rates for 95180 |
National average reimbursement for CPT 95180 by major payers:
$169.51
$172.08
$174.40
$197.71
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CPT 95180
5 of 25 sample ratesHigher to lower in this preview
Bernard Durante
Bernard J. Durante, M.D. P.C.
$459.91Published rateNeha Patel
Vaneata Dowell
$187.33Published rateChet Tharpe
Openloop Healthcare Partners Wisconsin Sc
$161.05Published rateEdward Kleiman
Yakov Levy Md PC
$118.88Published rateJeffrey Sugar
Jeffrey Sugar, Md
$74.91Published rate
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See a sample payer proposalCPT 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, 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 |
| 95180-CPT | Low | Therapy To Treat Drug Allergy, Hourly Therapy To Treat A Drug Allergy Such As An Allergy To Insulin Or Penicillin (Rapid Desensitization Test). |
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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