How much does Medicare pay for CPT 95117?

Medicare allowed an average of $11.66 per service and paid $8.37 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $36.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95117?

Professional service for multiple injections of allergen. It was billed 2,140,086 times to 221,129 Medicare beneficiaries by 4,073 providers in 2024.

Which specialty bills 95117 most?

Allergy/ Immunology, with 1,428,855 services from 1,976 clinicians. Next are Otolaryngology, Nurse Practitioner, Physician Assistant.

CPT 95117

Professional service for multiple injections of allergen

$11.66Medicare-allowed amount per service, averaged across 2,140,086 services

Providers submitted

$36.37

Asking price, not received

Medicare allowed

$11.66

The fee schedule figure

Medicare paid

$8.37

Balance is patient coinsurance

Providers submitted an average of $36.37 for this code and Medicare allowed $11.66 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $8.37 (72%); the rest is the patient’s coinsurance and deductible.

Services: 2,140,086
Beneficiaries: 221,129
Providers billing it: 4,073
Total allowed: $24,953,403

What Medicare pays for CPT 95117

Across 2,140,086 services billed by 4,073 providers to 221,129 beneficiaries, Medicare allowed an average of $11.66 per service. That is 9.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95117

Specialty	Services	Beneficiaries	Avg allowed	Providers
Allergy/ Immunology	1,428,855	128,238	$11.93	1,976
Otolaryngology	449,230	48,781	$11.43	1,144
Nurse Practitioner	106,421	23,195	$9.60	415
Physician Assistant	50,568	10,903	$9.94	272
Internal Medicine	42,406	4,568	$12.17	104
Family Practice	21,162	1,714	$11.43	68
Pediatric Medicine	14,655	1,600	$11.74	32
Pulmonary Disease	11,531	983	$12.07	27
Rheumatology	6,070	422	$11.61	10
Dermatology	4,261	240	$11.37	7
Plastic and Reconstructive Surgery	1,879	172	$10.74	4
General Practice	1,214	42	$12.78	1
Hospitalist	1,164	118	$11.49	3
Osteopathic Manipulative Medicine	256	11	$10.74	1
Ophthalmology	183	19	$12.69	1

95117 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	228,123	$11.42	$8.68	411
California	182,406	$13.92	$8.75	245
Florida	160,652	$11.81	$8.67	347
Tennessee	135,400	$10.36	$8.52	197
Virginia	115,007	$11.86	$8.67	166
Kentucky	105,171	$10.56	$8.75	116
Arizona	100,769	$11.56	$8.61	118
Pennsylvania	92,673	$11.63	$8.76	184
South Carolina	90,633	$11.09	$8.73	137
New York	87,294	$13.49	$8.83	211
North Carolina	87,131	$10.91	$8.53	195
Ohio	65,110	$10.86	$8.58	121
Georgia	55,825	$10.94	$8.56	130
New Jersey	49,704	$13.56	$8.79	111
Michigan	45,745	$11.69	$8.64	97
Massachusetts	42,826	$12.55	$8.56	114
Indiana	39,857	$10.85	$8.65	99
Missouri	37,345	$10.77	$8.61	91
Illinois	36,695	$12.26	$8.57	94
Maryland	33,923	$12.83	$8.64	99
Oklahoma	32,511	$10.47	$8.67	44
New Mexico	28,552	$10.84	$8.62	29
Kansas	26,810	$10.45	$8.66	53
Colorado	25,504	$12.17	$8.41	65
Louisiana	24,126	$10.71	$8.96	52
Arkansas	22,021	$10.18	$8.78	35
Alabama	21,869	$10.05	$8.66	42
Nevada	19,675	$11.76	$8.53	29
Washington	18,467	$12.64	$8.48	62
Delaware	18,446	$11.85	$8.57	33
Mississippi	14,331	$10.02	$8.89	33
West Virginia	12,470	$10.26	$8.94	19
Connecticut	11,580	$13.09	$8.56	36
Iowa	11,435	$10.58	$8.58	33
Oregon	10,315	$11.91	$8.48	37
Utah	7,750	$11.12	$8.51	37
Nebraska	6,131	$10.67	$8.44	30
Idaho	6,014	$10.77	$8.46	20
Rhode Island	5,328	$12.36	$8.71	13
District of Columbia	5,092	$13.48	$9.15	5
Wisconsin	4,160	$11.46	$8.30	24
New Hampshire	3,948	$12.55	$8.69	9
Minnesota	3,856	$12.08	$8.55	17
Wyoming	1,937	$11.38	$8.41	7
Montana	1,925	$11.43	$8.38	6
Maine	916	$12.25	$8.67	5
South Dakota	772	$11.93	$8.56	4
Alaska	754	$12.46	$8.69	6
Vermont	742	$11.61	$8.46	2
North Dakota	233	$11.68	$8.19	2
Hawaii	127	$13.59	$9.35	1

Related codes

95165Professional service for preparation and provision of 1 or more antige$13.88
95115Professional service for single injection of allergen$9.48
95144Professional service for preparation and provision of single-dose vial$15.85
95180Injection for rapid desensitization to allergen$136.44
95170Professional service for preparation and provision of whole body extra$10.50
95148Professional service for preparation and provision of 4 stinging insec$89.39
95149Professional service for preparation and provision of 5 stinging insec$118.84

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.