CPT code 99453: RPM setup, initial setup and education2026 Medicare rate & RVUs in California

Medicare pays $23.42–$30.70 for 99453 in the office in California, from Chico, CA to San Benito County, CA. 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.

What 99453 covers

99453 covers initiating remote physiologic monitoring equipment and teaching the patient how to use it. Primary care and specialty practices may use it when starting home monitoring for conditions such as hypertension or heart failure, with devices that collect measures such as blood pressure, weight, or oxygen saturation. The service may involve clinical staff who configure the equipment and explain its use, with the treating practitioner directing the monitoring plan.

Select 99453 for the initial setup and education—not for recurring device data collection or time spent managing transmitted results. Document the clinical reason for monitoring, the parameter and equipment, when setup occurred, and the instruction provided. CMS’s fee-schedule inputs assign practice-expense and malpractice resources to the code, with no physician-work RVUs; the service represents equipment onboarding rather than time-based management.

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 99453 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 99453 rate is calculated

Each of 99453’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 99453

99453 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.

99453 compared with similar codes

How to choose

99445RPM device supply2–15 transmission days

99445 covers device supply and data transmission over a short monitoring period. Use 99453 for the initial equipment setup and patient instruction.

99454RPM device supply16-30 days of readings

99454 represents ongoing device supply and data transmission; 99453 represents the initial setup and education service.

99457RPM managementFirst 20 minutes per month

99457 is for remote monitoring treatment-management work, including required interactive communication and time. It is not the setup-and-instruction code.

Codes related to 99453

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

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