CPT code 99152: Moderate sedation, same provider, age 5+, initial period2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $59.49 for 99152 in the office and $11.88 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 99152 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 99152 covers

99152 covers moderate sedation directed by the physician or other qualified health care professional performing the underlying procedure for a patient age 5 or older. During a bronchoscopy, cardiac catheterization, transesophageal echocardiogram, or image-guided intervention, the proceduralist remains face-to-face with the patient while an independent trained observer, often a nurse, monitors consciousness and physiologic status. These services occur in catheterization labs, hospital procedure suites, and equipped offices.

Report 99152 once for the initial sedation period when at least 10 minutes of intraservice time are documented. Time begins when the sedating agent is administered and ends when the proceduralist’s continuous face-to-face attendance ends. Add 99153 at 23 minutes, with further units at 38 minutes and each subsequent 15-minute mark. Exclude preassessment and recovery from intraservice time; document agents, doses, the observer, monitoring, and start and stop times. For Medicare GI endoscopy with sedation directed by the endoscopist, report G0500 instead. The office practice-expense value reflects resources supplied by the practice rather than a facility.

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 Washington, DC area compares for 99152

Across 109 of 109 payment localities, the office rate for 99152 runs from $45.02 in Arkansas to $70.49 in San Benito County, CA. Washington, DC area pays $59.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99152 rates by state

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

See 99152 in every payment locality

How the 99152 rate is calculated

Each of 99152’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 99152

99152 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 99152

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

How 99152 has changed in Washington, DC area

Price 99152 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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