CPT code 99153: Moderate sedation, each additional 15 minutes2026 Medicare rate & RVUs in Oregon
Reports each additional 15-minute increment of moderate sedation when the physician or qualified health care professional also performs the underlying procedure.
Medicare pays $12.11–$13.48 for 99153 in the office in Oregon, from Rest of Oregon to Portland, OR. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 99153 covers
Code 99153 represents additional intraservice time for moderate sedation provided by the physician or qualified health care professional performing the procedure that requires sedation. It may be relevant during services such as endoscopy, cardiac catheterization, or image-guided intervention when the procedural clinician provides the sedation and a trained observer assists with monitoring the patient’s level of consciousness and physiological status. Count the time spent providing the sedation service, not recovery time.
Report 99153 only with the related primary procedure and the appropriate initial same-provider sedation code, 99151 or 99152. Documentation should identify who performed the procedure and sedation, the observer, the patient’s monitored status, and the intraservice time supporting each additional unit. CMS treats this as an add-on code paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation.
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.
Where 99153 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | $13.48 | Unavailable |
| Rest of Oregon | $12.11 | Unavailable |
How the 99153 rate is calculated
Each of 99153’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 · 99153
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.35
0.35 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.3700
Conversion factor
$33.4009
Medicare rate
$12.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99153
The CMS indicators that decide how 99153 is paid alongside other services.
CMS payment indicators · 99153
Moderate sedation, each additional 15 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 9 | The concept doesn’t apply. |
| Bilateral (modifier 50) | 9 | The concept doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 9 | The concept doesn’t apply. |
| Team surgery (66) | 9 | The concept doesn’t apply. |
| Professional/technical | 3 | Technical component only. |
99153 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99151Moderate sedationSame proceduralist, under five
- 99151 reports the initial same-provider sedation service for a patient younger than 5 years; 99153 reports additional time after the initial service.
- 99152Moderate sedationSame provider, age 5+, initial period
- 99152 reports the initial same-provider sedation service for a patient age 5 or older. Use 99153 for additional time, not as a substitute for the initial code.
- 99157Moderate sedationAdditional time, separate clinician
- 99153 applies when the procedural clinician provides the sedation; 99157 applies to additional time when a different physician or qualified health care professional provides it.
99153 billing questions
Can 99153 be reported by itself?
No. It is an add-on code and must be reported with the related primary procedure and the appropriate initial same-provider sedation code.
Should 99153 be paired with 99151 or 99152?
Use 99151 for the initial same-provider sedation service for a patient younger than 5 years, or 99152 for a patient age 5 or older. Code 99153 reports additional time.
When is 99157 used instead?
99157 is for additional moderate-sedation time when a physician or qualified health care professional other than the procedural clinician provides the sedation.
What time should the record support?
Document the intraservice sedation time and the additional time represented by the units billed. Recovery time is not the additional sedation time reported with 99153.
Does 99153 include an interpretation service?
No. CMS classifies 99153 as technical-component-only, with interpretation covered by a separate code.
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
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