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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 95165
  4. Cost Analysis

How Much Does Professional service for preparation and provision of 1 or more antigens Cost on Medicare?

Cost analysis for CPT 95165 — Professional service for preparation and provision of 1 or more antigens

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Average Medicare Payment

$10.71

2023 data

Total Payments (2023)

$58.5M

Services (2023)

5.3M

Price Change (2014–2023)

+17.2%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$9.14$53.3M5.8M—
2015$9.10$55.8M6.1M-0.4%
2016$9.01$58.3M6.4M-1.0%
2017$9.18$58.2M6.3M+1.9%
2018$9.23$61.6M6.6M+0.5%
2019$10.21$70.1M6.8M+10.6%
2020$10.52$63.1M5.9M+3.0%
2021$11.51$69.5M5.9M+9.4%
2022$11.13$63.9M5.6M-3.3%
2023$10.71$58.5M5.3M-3.8%

🗺️ State-by-State Cost Variation

The most expensive state pays 2.0x more than the cheapest for this procedure. DC averages $13.94 vs ND at $6.86.

StateAvg PaymentTotal PaymentsServicesProviders
DC$13.94$160.1K11.5K8
CA$12.98$5.9M454.6K212
NJ$12.97$1.9M147.4K86
NY$12.79$3.2M253.2K139
AK$12.35$12.2K9914
MD$12.29$1.0M84.2K56
HI$12.28$73.6K6.0K5
CT$12.08$267.2K22.1K31
WA$11.92$725.1K60.8K43
MA$11.90$1.2M98.9K62
RI$11.72$142.5K12.2K14
CO$11.30$688.1K60.9K44
DE$11.20$295.1K26.3K17
VA$11.20$2.9M254.8K130
VT$11.17$20.0K1.8K2
WY$11.17$84.4K7.6K7
FL$11.16$4.5M403.6K245
OR$11.13$326.6K29.4K36
NH$11.11$153.4K13.8K13
IL$11.08$985.8K89.0K81
PA$11.01$2.3M208.7K145
NV$10.97$565.7K51.6K20
TX$10.91$7.3M670.1K386
PR$10.75$24.5K2.3K3
AZ$10.72$2.9M269.6K87
WI$10.61$106.6K10.0K19
MI$10.57$1.0M96.6K94
UT$10.42$192.2K18.4K21
NC$10.31$1.8M176.5K139
GA$10.30$1.3M121.8K83
NM$10.26$486.8K47.4K22
MN$10.19$123.1K12.1K22
OH$10.08$1.2M123.0K88
NE$10.06$227.6K22.6K22
SC$10.01$2.0M198.5K95
IN$9.99$1.0M101.1K79
LA$9.95$846.1K85.0K60
OK$9.91$1.2M118.3K40
TN$9.89$3.0M307.6K133
ID$9.87$114.0K11.6K16
IA$9.81$300.3K30.6K29
MO$9.79$1.1M112.7K77
WV$9.76$405.3K41.5K23
ME$9.73$18.1K1.9K4
AL$9.70$951.4K98.0K73
SD$9.70$81.1K8.4K15
KS$9.68$549.4K56.7K46
KY$9.65$1.5M155.0K79
AR$9.53$658.0K69.1K48
MS$9.26$545.5K58.9K35
MT$9.05$89.3K9.9K10

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Matthew MillerNurse PractitionerAZ$438.4K44.7K$9.81
Stacy SilversAllergy/ ImmunologyTX$280.1K25.0K$11.19
Peter LogalboAllergy/ ImmunologyNY$239.6K17.0K$14.08
George BenschAllergy/ ImmunologyCA$235.5K19.0K$12.42
Jessica GerhartNurse PractitionerTX$232.0K22.4K$10.36
Murtaza GhadialiOtolaryngologyTX$226.1K19.8K$11.43
Marek PienkowskiAllergy/ ImmunologyTN$211.0K21.1K$10.01
Jason AcevedoOtolaryngologyTX$198.6K17.3K$11.51
Alan KeyesOtolaryngologyVA$190.5K17.0K$11.22
Michael MccormickAllergy/ ImmunologyCA$186.5K15.5K$12.07
Claudia MaciasNurse PractitionerAZ$185.3K19.0K$9.76
Hava LadinskyAllergy/ ImmunologyMD$169.1K13.4K$12.65
Dimple AgarwalInternal MedicineCA$166.5K12.8K$13.05
Tidence PrinceAllergy/ ImmunologyTN$164.6K15.7K$10.48
William CainAllergy/ ImmunologyTN$163.8K15.8K$10.34
Laura ChongAllergy/ ImmunologyOK$162.6K16.2K$10.01
Safa NsouliAllergy/ ImmunologyCA$160.7K10.5K$15.35
Chad GunnlaugssonOtolaryngologySC$160.0K15.5K$10.36
Dean AtkinsonAllergy/ ImmunologyOK$158.0K16.2K$9.75
Thomas BellerAllergy/ ImmunologySC$154.0K17.3K$8.90

🤔 Is Professional service for preparation and provision of 1 or more antigens Overpriced?

Based on the data, CPT 95165 shows a 2.0x variation in pricing across states — moderate variation by Medicare standards.

Costs have increased 17.2% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.