CPT code 99156: Moderate sedation, other clinician, age 5+2026 Medicare rate & RVUs in Hawaii, Guam, HI

In Hawaii, Guam, HI, Medicare pays $69.80 for 99156 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99156 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 99156 covers

99156 represents a physician’s or qualified health care professional’s work to provide moderate sedation for a patient aged 5 or older while another clinician performs the diagnostic or therapeutic procedure. A common setting is an image-guided intervention in which a separate clinician manages sedation and monitors the patient. The sedation clinician’s service includes intraservice care, with a trained observer assisting with monitoring.

Report one unit for the initial 15 minutes of intraservice time, supported by documentation identifying the sedation clinician and recording the time, medications, patient response, and monitoring. Do not include preparation or recovery time in the intraservice time. Report 99157 with 99156 for qualifying additional time. Use 99152 when the same physician or qualified professional provides sedation and performs the procedure, or 99155 when a separate clinician provides sedation to a child younger than 5.

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 Hawaii, Guam, HI compares for 99156

Across 109 of 109 payment localities, the facility rate for 99156 runs from $66.35 in Wisconsin to $96.48 in Alaska. Hawaii, Guam, HI pays $69.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99156 rates by state

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

See 99156 in every payment locality

How the 99156 rate is calculated

Each of 99156’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 99156

99156 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 99156

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

How 99156 has changed in Hawaii, Guam, HI

Price 99156 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

• Ahuimanu
• Aiea
• Ainaloa
• Anahola
• Black Sands
• Captain Cook
• Discovery Harbour
• East Honolulu

Browse all communities in Hawaii

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