CPT 95180
Global XXX ActiveRapid desensitization
CPT 95180 Billing & Documentation Guide
CPT code 95180 (Rapid desensitization) is classified under Allergy/Immunology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.01, a non-facility practice expense RVU of 2.04, and a malpractice RVU of 0.07, a total non-facility RVU of 4.12 and facility RVU of 2.6. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $141.62, though rates vary from $126.87 to $174.56 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95180, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95180 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 6 units of 95180 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95180
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.01 | 2.01 |
| Practice Expense RVU | 2.04 | 0.52 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 4.12 | 2.6 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95180
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $151.44 | $91.36 | $144.21 - $174.03 | 29 |
| Florida | $140.05 | $89.11 | $135.79 - $143.98 | 3 |
| Georgia | $135.04 | $86.61 | $130.7 - $139.37 | 2 |
| Illinois | $137.68 | $88.62 | $133 - $141.73 | 4 |
| Michigan | $134.41 | $86.74 | $131.99 - $136.83 | 2 |
| North Carolina | $132.2 | $84.83 | $132.2 - $132.2 | 1 |
| New York | $149.51 | $92.87 | $133.51 - $156.79 | 5 |
| Ohio | $131.7 | $85.35 | $131.7 - $131.7 | 1 |
| Pennsylvania | $136.99 | $87.25 | $131.9 - $142.07 | 2 |
| Texas | $136.76 | $86.78 | $131.31 - $141.43 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95180
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95180 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0405T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0591T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0592T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0593T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0776T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 90760 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 95180
What does CPT code 95180 mean? +
CPT code 95180 represents: Rapid desensitization. It's in the Allergy/Immunology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95180? +
The 2026 Medicare national average non-facility payment for CPT 95180 is $141.62. Rates range from $126.87 to $174.56 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95180? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95180? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team