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

In Vermont, Medicare pays $61.19 for 99151 in the office and $20.51 when it’s performed in a hospital or facility.

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.

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 Vermont 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. Vermont pays $61.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99151 rates by state

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

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.

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.

Codes related to 99151

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99151 has changed in Vermont

Price 99151 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates