CPT code 99151: Moderate sedation, same proceduralist, under five2026 Medicare rate & RVUs in Vallejo, CA

Moderate sedation performed by the procedure’s physician or qualified health professional for a patient younger than five, during the initial time interval.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Vallejo, CA, Medicare pays $76.76 for 99151 in the office and $22.61 when it’s performed in a hospital or facility.

$76.76Office (non-facility)
$22.61Hospital or facility
+23.5%vs the national office rate ($62.13)

Check a contract rate as a % of Medicare · 99151 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99151 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vallejo, CA
  2. What 99151 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99151 covers

This code describes moderate sedation delivered by the physician or qualified health professional who also performs the diagnostic or therapeutic procedure. An independent trained observer assists with monitoring the patient’s consciousness and physiologic status. A typical situation is an image-guided procedure, such as a biopsy, when the proceduralist provides the sedation. The patient must be younger than five years.

Report this code for the initial 15-minute intra-service interval. Documentation should identify the patient’s age, the supported procedure, the clinician providing both services, the observer, and sedation start and stop times. Use a different code when another physician or qualified health professional provides the sedation. Additional intra-service time is reported with 99153 when supported by the service and documentation. Medicare fee-schedule valuation is shown separately from this description.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Vallejo, CA compares for 99151

Across 109 of 109 payment localities, the office rate for 99151 runs from $55.38 in Arkansas to $83.13 in San Benito County, CA. Vallejo, CA pays $76.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

99151 in Vallejo, CA vs other payment areas
  1. Vallejo, CA · this page$76.76
  2. Bakersfield, CA · California$66.32−$10.44
  3. Chico, CA · California$66.21−$10.55
  4. El Centro, CA · California$66.21−$10.55
  5. Fresno, CA · California$66.21−$10.55
  6. Hanford, CA · California$66.21−$10.55
  7. Los Angeles, CA · California$70.60−$6.16

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

99151 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$66.21$21.18
Merced, CACalifornia$66.21$21.18
Modesto, CACalifornia$66.21$21.18
Napa, CACalifornia$76.81$22.66
Oxnard, CACalifornia$70.30$21.74
Redding, CACalifornia$66.21$21.18
Rest of CaliforniaCalifornia$66.21$21.18
Riverside, CACalifornia$66.54$21.52

99151 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$55.38

$74.67

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99151 office rate range by state
State / territoryOffice rate rangeLocalities
AK$72.911
AL$56.141
AR$55.381
AZ$60.601
CA$66.21–$83.1329
CO$64.951
CT$66.091
DC$71.051
DE$61.571
FL$60.68–$65.483
GA$57.52–$63.092
GU$67.791
HI$67.791
IA$57.751
ID$58.041
IL$58.82–$64.224
IN$58.371
KS$57.361
KY$57.111
LA$56.97–$59.642
MA$64.54–$71.322
MD$62.74–$71.053
ME$58.19–$61.362
MI$58.39–$61.262
MN$62.711
MO$55.97–$60.003
MS$55.691
MT$62.121
NC$58.791
ND$61.531
NE$58.081
NH$63.821
NJ$66.98–$70.352
NM$58.641
NV$62.001
NY$59.61–$72.455
OH$58.271
OK$57.151
OR$61.65–$67.072
PA$58.43–$64.442
PR$62.601
RI$63.801
SC$58.601
SD$61.461
TN$57.621
TX$58.06–$64.628
UT$59.361
VA$61.08–$71.052
VI$62.601
VT$61.191
WA$64.46–$72.862
WI$59.571
WV$56.741
WY$61.871

See 99151 in every payment locality

How the 99151 rate is calculated

Each of 99151’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99151

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.50

0.50 RVUs× 1.000 GPCI

Practice expense1.33

1.33 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

1.8600

Conversion factor

$33.4009

Medicare rate

$62.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vallejo, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,989

Code
99151
Physician work
0.50
Practice expense
1.33
Malpractice
0.03

GPCI2026.csv

33

Locality
Vallejo, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office calculation for 99151 in Vallejo, CA
ComponentRVULocality factorAdjusted
Physician work0.50× 1.0630.5315
Practice expense1.33× 1.3181.7529
Malpractice0.03× 0.4590.0138
Total RVUs2.2982
Conversion factor× 33.4009

Office rate, Vallejo, CA$76.76

Office: (0.5 × 1.063 + 1.33 × 1.318 + 0.03 × 0.459) × $33.4009 = $76.76

Facility: (0.5 × 1.063 + 0.1 × 1.318 + 0.03 × 0.459) × $33.4009 = $22.61

Open 99151 in the RVU calculator

Payment rules and modifiers for 99151

99151 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99151

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$62.13

Non-facility (office)
$62.13
Facility
$21.04

Higher because the practice carries its own overhead.

How 99151 has changed in Vallejo, CA

99151 · Office / nonfacility

$76.76

Effective 2026-10-01

The base rate is $5.80 higher than on 2025-10-01, moving from $70.96 to $76.76 (8.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $70.96changed to$76.76

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.26 changed to 1.33
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.33changed to$70.96

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.29 changed to 1.26

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $73.12changed to$74.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $72.48changed to$73.12

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.26 changed to 1.29
    • Malpractice RVU 0.04 changed to 0.03
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $82.94changed to$72.48

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.52 changed to 1.26
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $103.81changed to$82.94

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.99 changed to 1.52
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $89.08changed to$103.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.55 changed to 1.99
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $90.90changed to$89.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.57 changed to 1.55
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $94.42changed to$90.90

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.65 changed to 1.57

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $94.17changed to$94.42

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.63 changed to 1.65
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$94.17

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$76.76$22.61RVU26D
2026-07-01$76.76$22.61RVU26C
2026-04-01$76.76$22.61RVU26B
2026-01-01$76.76$22.61RVU26A
2025-10-01$70.96$25.19RVU25D
2025-07-01$70.96$25.19RVU25C
2025-04-01$70.96$25.19RVU25B
2025-01-01$70.96$25.19RVU25A
2024-10-01$74.33$25.93RVU24D
2024-07-01$74.33$25.93RVU24C
2024-04-01$74.33$25.93RVU24B
2024-03-09$74.33$25.93RVU24AR
2024-01-01$73.12$25.50RVU24A
2023-10-01$72.48$26.18RVU23D
2023-07-01$72.48$26.18RVU23C
2023-04-01$72.48$26.18RVU23B
2023-01-01$72.48$26.18RVU23A
2022-10-01$82.94$26.78RVU22D
2022-07-01$82.94$26.78RVU22C
2022-04-01$82.94$26.78RVU22B
2022-01-01$82.94$26.78RVU22A
2021-10-01$103.81$26.76RVU21D
2021-07-01$103.81$26.76RVU21C
2021-04-01$103.81$26.76RVU21B
2021-01-01$103.81$26.76RVU21A
2020-10-01$89.08$25.19RVU20D
2020-07-01$89.08$25.19RVU20C
2020-04-01$89.08$25.19RVU20B
2020-01-01$89.08$25.19RVU20A
2019-10-01$90.90$27.53RVU19D
2019-07-01$90.90$27.53RVU19C
2019-04-01$90.90$27.53RVU19B
2019-01-01$90.90$27.53RVU19A
2018-10-01$94.42$26.60RVU18D
2018-07-01$94.42$26.60RVU18C
2018-04-01$94.42$26.60RVU18B
2018-01-01$94.42$26.60RVU18AR1
2017-10-01$94.17$25.30RVU17D
2017-07-01$94.17$25.30RVU17C
2017-04-01$94.17$25.30RVU17B
2017-01-01$94.17$25.30RVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99151 for an earlier date of service

Where the Vallejo, CA rate applies

Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Vallejo
  • Allendale
  • Benicia
  • Dixon
  • Elmira
  • Fairfield
  • Green Valley
  • Hartley

Browse all communities in California

99151 billing questions

When should 99151 be used instead of 99152?

Use 99151 for a patient younger than five when the proceduralist provides the moderate sedation. Code 99152 is for the same-proceduralist service when the patient is five or older.

Does 99151 apply when a different clinician provides the sedation?

No. For a patient younger than five, 99155 is the corresponding initial service when a different physician or qualified health professional provides the sedation.

What time does 99151 represent?

It represents the initial 15-minute intra-service interval. Additional qualifying intra-service time may be reported with 99153.

What documentation supports reporting 99151?

Document the patient’s age, the procedure supported by sedation, the proceduralist’s role in providing sedation, the trained observer, monitoring, and intra-service start and stop times.

Is medication administration alone enough to report 99151?

No. The record should support the moderate-sedation service, including the proceduralist’s role and the observer’s monitoring assistance, rather than medication administration alone.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99151PPRRVU2026_Oct_nonQPP.csv, line 12,989 (RVU26D)
Geographic factors for Vallejo, CAGPCI2026.csv, line 33 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 99151 pays in Vallejo, CA?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 99151 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist