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

Report initial moderate sedation for a patient age 5 or older when the procedure provider directs it with an independent trained observer.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4M Medicare services in 2024

In Iowa, Medicare pays $47.26 for 99152 in the office and $10.28 when it’s performed in a hospital or facility.

$47.26Office (non-facility)
$10.28Hospital or facility
−8.1%vs the national office rate ($51.44)

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.

We’ll open 99152 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 99152 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 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 Iowa 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. Iowa pays $47.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

99152 in Iowa vs other payment areas
  1. Iowa · this page$47.26
  2. Los Angeles, CA · California$59.14+$11.88
  3. Washington, DC area · District of Columbia$59.49+$12.23
  4. Miami, FL · Florida$54.69+$7.43
  5. Chicago, IL · Illinois$53.00+$5.74
  6. Manhattan, NY · New York$59.38+$12.12
  7. Alaska · Alaska$57.90+$10.64

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

Every other payment area

99152 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$45.74$10.38
ArkansasArkansas$45.02$10.30
ArizonaArizona$49.99$10.83
Bakersfield, CACalifornia$55.24$10.95
Chico, CACalifornia$55.15$10.86
El Centro, CACalifornia$55.16$10.86
Fresno, CACalifornia$55.15$10.86
Hanford, CACalifornia$55.15$10.86

99152 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.

$45.02

$62.82

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

View every state and territory as a table
99152 office rate range by state
State / territoryOffice rate rangeLocalities
AK$57.901
AL$45.741
AR$45.021
AZ$49.991
CA$55.15–$70.4929
CO$54.011
CT$55.061
DC$59.491
DE$50.871
FL$50.09–$54.693
GA$47.08–$52.342
GU$56.781
HI$56.781
IA$47.261
ID$47.541
IL$48.34–$53.414
IN$47.851
KS$46.901
KY$46.681
LA$46.56–$49.092
MA$53.60–$59.832
MD$51.94–$59.493
ME$47.69–$50.692
MI$47.91–$50.652
MN$51.951
MO$45.60–$49.423
MS$45.331
MT$51.441
NC$48.261
ND$50.841
NE$47.571
NH$53.041
NJ$55.74–$58.772
NM$48.151
NV$51.311
NY$49.04–$60.785
OH$47.781
OK$46.711
OR$50.97–$55.992
PA$47.93–$53.512
PR$51.891
RI$52.881
SC$48.091
SD$50.771
TN$47.141
TX$47.58–$53.788
UT$48.811
VA$50.43–$59.492
VI$51.891
VT$50.521
WA$53.54–$61.222
WI$48.981
WV$46.361
WY$51.181

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.

How the rate is built · 99152

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.25

0.25 RVUs× 1.000 GPCI

Practice expense1.26

1.26 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

1.5400

Conversion factor

$33.4009

Medicare rate

$51.44

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,990

Code
99152
Physician work
0.25
Practice expense
1.26
Malpractice
0.03

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 99152 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.25× 1.0000.2500
Practice expense1.26× 0.9151.1529
Malpractice0.03× 0.3970.0119
Total RVUs1.4148
Conversion factor× 33.4009

Office rate, Iowa$47.26

Office: (0.25 × 1 + 1.26 × 0.915 + 0.03 × 0.397) × $33.4009 = $47.26

Facility: (0.25 × 1 + 0.05 × 0.915 + 0.03 × 0.397) × $33.4009 = $10.28

Open 99152 in the RVU calculator

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.

Place of service · 99152

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$51.44

Non-facility (office)
$51.44
Facility
$11.02

Higher because the practice carries its own overhead.

How 99152 has changed in Iowa

99152 · Office / nonfacility

$47.26

Effective 2026-10-01

The base rate is $2.70 higher than on 2025-10-01, moving from $44.56 to $47.26 (6.1%).

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

    $44.56changed to$47.26

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.22 changed to 1.26
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $46.16changed to$44.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.23 changed to 1.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $45.41changed to$46.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $46.38changed to$45.41

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.21 changed to 1.23
    • Malpractice RVU 0.04 changed to 0.03
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $47.53changed to$46.38

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.22 changed to 1.21
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $48.26changed to$47.53

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.24 changed to 1.22
    • Malpractice RVU 0.02 changed to 0.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $47.30changed to$48.26

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.16 changed to 1.24
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $47.56changed to$47.30

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.17 changed to 1.16
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $47.99changed to$47.56

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.18 changed to 1.17
    • Malpractice RVU 0.03 changed to 0.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $47.50changed to$47.99

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.02 changed to 0.03
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$47.50

    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$47.26$10.28RVU26D
2026-07-01$47.26$10.28RVU26C
2026-04-01$47.26$10.28RVU26B
2026-01-01$47.26$10.28RVU26A
2025-10-01$44.56$10.89RVU25D
2025-07-01$44.56$10.89RVU25C
2025-04-01$44.56$10.89RVU25B
2025-01-01$44.56$10.89RVU25A
2024-10-01$46.16$11.21RVU24D
2024-07-01$46.16$11.21RVU24C
2024-04-01$46.16$11.21RVU24B
2024-03-09$46.16$11.21RVU24AR
2024-01-01$45.41$11.03RVU24A
2023-10-01$46.38$11.54RVU23D
2023-07-01$46.38$11.54RVU23C
2023-04-01$46.38$11.54RVU23B
2023-01-01$46.38$11.54RVU23A
2022-10-01$47.53$11.75RVU22D
2022-07-01$47.53$11.75RVU22C
2022-04-01$47.53$11.75RVU22B
2022-01-01$47.53$11.75RVU22A
2021-10-01$48.26$11.87RVU21D
2021-07-01$48.26$11.87RVU21C
2021-04-01$48.26$11.87RVU21B
2021-01-01$48.26$11.87RVU21A
2020-10-01$47.30$11.95RVU20D
2020-07-01$47.30$11.95RVU20C
2020-04-01$47.30$11.95RVU20B
2020-01-01$47.30$11.95RVU20A
2019-10-01$47.56$11.93RVU19D
2019-07-01$47.56$11.93RVU19C
2019-04-01$47.56$11.93RVU19B
2019-01-01$47.56$11.93RVU19A
2018-10-01$47.99$12.07RVU18D
2018-07-01$47.99$12.07RVU18C
2018-04-01$47.99$12.07RVU18B
2018-01-01$47.99$12.07RVU18AR1
2017-10-01$47.50$11.89RVU17D
2017-07-01$47.50$11.89RVU17C
2017-04-01$47.50$11.89RVU17B
2017-01-01$47.50$11.89RVU17A
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 99152 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

99152 billing questions

What is the minimum time needed to report 99152?

At least 10 minutes of intraservice time is required. Sedation lasting under 10 minutes is not reported separately.

When is 99153 added?

Report one unit of 99153 when total intraservice time reaches 23 minutes. Additional units begin at 38 minutes, 53 minutes, and each subsequent 15-minute mark.

Can 99152 be billed if no independent observer is present?

No. This code requires a trained observer to monitor the patient while the proceduralist directs sedation and performs the procedure.

How does this differ from sedation provided by a separate clinician?

For a patient age 5 or older, a separate physician or qualified health care professional providing sedation reports 99156, adding 99157 only when the time warrants it. For a younger patient, the separate-provider initial code is 99155.

Should 99152 be used with a Medicare screening or diagnostic colonoscopy?

No. When the endoscopist provides moderate sedation for Medicare GI endoscopy to a patient age 5 or older, report G0500 instead of 99152.

Does the presedation evaluation count toward sedation time?

No. Presedation assessment, consent, and recovery monitoring after the proceduralist’s face-to-face attendance ends are excluded from intraservice time.

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 99152PPRRVU2026_Oct_nonQPP.csv, line 12,990 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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