CPT code 99157: Moderate sedation, additional time, separate clinician2026 Medicare rate & RVUs in Arkansas
Report 99157 for each additional 15 minutes of moderate sedation furnished by a physician or qualified professional other than the proceduralist.
In Arkansas, Medicare pays $50.76 for 99157 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 99157 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 99157 covers
99157 captures each additional 15 minutes of moderate sedation provided by a physician or qualified health care professional who is not performing the underlying procedure. A separate sedation clinician may support procedures such as an endoscopic or image-guided intervention, managing sedation and observing the patient while the proceduralist performs the service. The code represents additional sedation time, not the work of the procedure itself.
Pair 99157 with 99155 for a patient younger than 5 or 99156 for a patient age 5 or older, and report the eligible primary procedure. Select units from the documented additional sedation time. The record should identify the sedation clinician, patient age, sedation start and stop times, and the monitoring and sedation management provided. CMS classifies 99157 as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period.
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 Arkansas compares for 99157
Across 109 of 109 payment localities, the facility rate for 99157 runs from $50.55 in Wisconsin to $73.38 in Alaska. Arkansas pays $50.76. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arkansas · this page$50.76
- Los Angeles, CA · California$55.66+$4.90
- Washington, DC area · District of Columbia$58.26+$7.50
- Miami, FL · Florida$61.57+$10.81
- Chicago, IL · Illinois$60.50+$9.74
- Manhattan, NY · New York$60.77+$10.01
- Alaska · Alaska$73.38+$22.62
Other areas in Arkansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $51.12 |
| ArizonaArizona | — | $53.20 |
| Bakersfield, CACalifornia | — | $53.81 |
| Chico, CACalifornia | — | $53.39 |
| El Centro, CACalifornia | — | $53.41 |
| Fresno, CACalifornia | — | $53.39 |
| Hanford, CACalifornia | — | $53.39 |
| Madera, CACalifornia | — | $53.39 |
| Merced, CACalifornia | — | $53.39 |
| Modesto, CACalifornia | — | $53.39 |
| Napa, CACalifornia | — | $56.88 |
| Oxnard, CACalifornia | — | $54.91 |
| Redding, CACalifornia | — | $53.39 |
| Rest of CaliforniaCalifornia | — | $53.39 |
| Riverside, CACalifornia | — | $54.91 |
| Sacramento, CACalifornia | — | $54.69 |
| Salinas, CACalifornia | — | $54.46 |
| San Diego, CACalifornia | — | $54.73 |
| Marin County, CACalifornia | — | $58.70 |
| San Francisco, CACalifornia | — | $58.54 |
| San Benito County, CACalifornia | — | $59.93 |
| Santa Clara County, CACalifornia | — | $59.28 |
| San Luis Obispo, CACalifornia | — | $53.72 |
| Santa Cruz, CACalifornia | — | $54.47 |
| Santa Maria, CACalifornia | — | $54.38 |
| Santa Rosa, CACalifornia | — | $54.94 |
| Stockton, CACalifornia | — | $53.39 |
| Vallejo, CACalifornia | — | $56.65 |
| Visalia, CACalifornia | — | $53.39 |
| Yuba City, CACalifornia | — | $53.39 |
| ColoradoColorado | — | $54.08 |
| ConnecticutConnecticut | — | $56.52 |
| DelawareDelaware | — | $53.75 |
| Fort Lauderdale, FLFlorida | — | $57.99 |
| Rest of FloridaFlorida | — | $56.12 |
| Atlanta, GAGeorgia | — | $55.30 |
| Rest of GeorgiaGeorgia | — | $54.18 |
| Hawaii, Guam, HIHawaii | — | $53.19 |
| IowaIowa | — | $50.64 |
| IdahoIdaho | — | $51.03 |
| East St. Louis, ILIllinois | — | $58.24 |
| Rest of IllinoisIllinois | — | $56.07 |
| Suburban Chicago, ILIllinois | — | $58.22 |
| IndianaIndiana | — | $51.15 |
| KansasKansas | — | $51.05 |
| KentuckyKentucky | — | $52.86 |
| New Orleans, LALouisiana | — | $54.29 |
| Rest of LouisianaLouisiana | — | $53.03 |
| Metropolitan Boston, MAMassachusetts | — | $56.80 |
| Rest of MassachusettsMassachusetts | — | $54.24 |
| Baltimore area, MDMaryland | — | $56.45 |
| Rest of MarylandMaryland | — | $54.24 |
| Rest of MaineMaine | — | $51.73 |
| Southern Maine, MEMaine | — | $52.31 |
| Detroit, MIMichigan | — | $57.05 |
| Rest of MichiganMichigan | — | $54.04 |
| MinnesotaMinnesota | — | $51.04 |
| Metropolitan Kansas City, MOMissouri | — | $53.53 |
| Metropolitan St. Louis, MOMissouri | — | $53.75 |
| Rest of MissouriMissouri | — | $52.93 |
| MississippiMississippi | — | $51.82 |
| MontanaMontana | — | $54.10 |
| North CarolinaNorth Carolina | — | $51.91 |
| North DakotaNorth Dakota | — | $51.33 |
| NebraskaNebraska | — | $50.61 |
| New HampshireNew Hampshire | — | $53.84 |
| Northern New JerseyNew Jersey | — | $58.29 |
| Rest of New JerseyNew Jersey | — | $56.94 |
| New MexicoNew Mexico | — | $54.41 |
| NevadaNevada | — | $53.34 |
| NYC suburbs and Long Island, NYNew York | — | $62.24 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $57.70 |
| Queens, NYNew York | — | $60.25 |
| Rest of New YorkNew York | — | $52.34 |
| OhioOhio | — | $53.48 |
| OklahomaOklahoma | — | $52.24 |
| Portland, OROregon | — | $54.43 |
| Rest of OregonOregon | — | $52.69 |
| Metropolitan Philadelphia, PAPennsylvania | — | $56.08 |
| Rest of PennsylvaniaPennsylvania | — | $53.22 |
| Puerto RicoPuerto Rico | — | $54.12 |
| Rhode IslandRhode Island | — | $54.65 |
| South CarolinaSouth Carolina | — | $52.82 |
| South DakotaSouth Dakota | — | $51.00 |
| TennesseeTennessee | — | $51.25 |
| Austin, TXTexas | — | $54.11 |
| Beaumont, TXTexas | — | $53.09 |
| Brazoria, TXTexas | — | $53.35 |
| Dallas, TXTexas | — | $53.79 |
| Fort Worth, TXTexas | — | $53.77 |
| Galveston, TXTexas | — | $53.59 |
| Houston, TXTexas | — | $56.15 |
| Rest of TexasTexas | — | $53.26 |
| UtahUtah | — | $53.17 |
| VirginiaVirginia | — | $52.60 |
| Virgin Islands, VIUnited States Virgin Islands | — | $54.12 |
| VermontVermont | — | $51.72 |
| Rest of WashingtonWashington | — | $53.94 |
| King County, WAWashington | — | $57.09 |
| WisconsinWisconsin | — | $50.55 |
| West VirginiaWest Virginia | — | $55.12 |
| WyomingWyoming | — | $52.89 |
99157 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 99157 rate is calculated
Each of 99157’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 · 99157
RVUs × geographic indexes × conversion factor
Work1.25
1.25 RVUs× 1.000 GPCI
Practice expense0.23
0.23 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
1.6200
Conversion factor
$33.4009
Medicare rate
$54.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arkansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,994
- Code
- 99157
- Physician work
- 1.25
- Practice expense
- 0.23
- Malpractice
- 0.14
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.000 | 1.2500 |
| Practice expense | 0.23 | × 0.859 | 0.1976 |
| Malpractice | 0.14 | × 0.515 | 0.0721 |
| Total RVUs | 1.5197 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$50.76
Facility: (1.25 × 1 + 0.23 × 0.859 + 0.14 × 0.515) × $33.4009 = $50.76
Payment rules and modifiers for 99157
The CMS indicators that decide how 99157 is paid alongside other services.
CMS payment indicators · 99157
Moderate sedation, additional time, separate clinician
| 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 | 9 | The concept doesn’t apply. |
How 99157 has changed in Arkansas
99157 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
January 1, 2017
RVU17A
No ratechanged toNo rate
Held through RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $50.76 | RVU26D |
| 2026-07-01 | Not available in this setting | $50.76 | RVU26C |
| 2026-04-01 | Not available in this setting | $50.76 | RVU26B |
| 2026-01-01 | Not available in this setting | $50.76 | RVU26A |
| 2025-10-01 | Not available in this setting | $51.79 | RVU25D |
| 2025-07-01 | Not available in this setting | $51.79 | RVU25C |
| 2025-04-01 | Not available in this setting | $51.79 | RVU25B |
| 2025-01-01 | Not available in this setting | $51.79 | RVU25A |
| 2024-10-01 | Not available in this setting | $54.96 | RVU24D |
| 2024-07-01 | Not available in this setting | $54.96 | RVU24C |
| 2024-04-01 | Not available in this setting | $54.96 | RVU24B |
| 2024-03-09 | Not available in this setting | $54.96 | RVU24AR |
| 2024-01-01 | Not available in this setting | $54.06 | RVU24A |
| 2023-10-01 | Not available in this setting | $57.78 | RVU23D |
| 2023-07-01 | Not available in this setting | $57.78 | RVU23C |
| 2023-04-01 | Not available in this setting | $57.78 | RVU23B |
| 2023-01-01 | Not available in this setting | $57.78 | RVU23A |
| 2022-10-01 | Not available in this setting | $58.51 | RVU22D |
| 2022-07-01 | Not available in this setting | $58.51 | RVU22C |
| 2022-04-01 | Not available in this setting | $58.51 | RVU22B |
| 2022-01-01 | Not available in this setting | $58.51 | RVU22A |
| 2021-10-01 | Not available in this setting | $59.29 | RVU21D |
| 2021-07-01 | Not available in this setting | $59.29 | RVU21C |
| 2021-04-01 | Not available in this setting | $59.29 | RVU21B |
| 2021-01-01 | Not available in this setting | $59.29 | RVU21A |
| 2020-10-01 | Not available in this setting | $61.37 | RVU20D |
| 2020-07-01 | Not available in this setting | $61.37 | RVU20C |
| 2020-04-01 | Not available in this setting | $61.37 | RVU20B |
| 2020-01-01 | Not available in this setting | $61.37 | RVU20A |
| 2019-10-01 | Not available in this setting | $61.89 | RVU19D |
| 2019-07-01 | Not available in this setting | $61.89 | RVU19C |
| 2019-04-01 | Not available in this setting | $61.89 | RVU19B |
| 2019-01-01 | Not available in this setting | $61.89 | RVU19A |
| 2018-10-01 | Not available in this setting | $56.07 | RVU18D |
| 2018-07-01 | Not available in this setting | $56.07 | RVU18C |
| 2018-04-01 | Not available in this setting | $56.07 | RVU18B |
| 2018-01-01 | Not available in this setting | $56.07 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $55.48 | RVU17D |
| 2017-07-01 | Not available in this setting | $55.48 | RVU17C |
| 2017-04-01 | Not available in this setting | $55.48 | RVU17B |
| 2017-01-01 | Not available in this setting | $55.48 | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Arkansas rate applies
Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.
- Acorn
- Adona
- Alexander
- Alicia
- Alix
- Alleene
- Allport
- Alma
99157 billing questions
Which initial sedation code accompanies 99157?
Use 99155 when the patient is younger than 5 and 99156 when the patient is age 5 or older. The sedation clinician must be different from the clinician performing the procedure.
Can 99157 be reported by itself?
No. It is an add-on code and must be reported with the primary procedure and the applicable initial sedation service.
How many units should be reported?
Report units based on documented additional 15-minute periods of moderate sedation. The record should support the actual sedation time and the clinician who furnished it.
Does 99157 apply when the proceduralist provides the sedation?
No. When the same physician or qualified professional performs the procedure and provides sedation, the applicable additional-time code is 99153.
What documentation supports 99157?
Document the patient's age, the separate sedation clinician, start and stop times, and the sedation management and patient observation provided.
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
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