$64.62
Both apply to patients younger than five, but 99151 is for sedation by the procedural clinician; 99155 is for sedation by a separate clinician.
On this page
CMS RVU26D · Effective 2026-10-01
99155 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$81.29
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Moderate sedation
About 99155: Moderate sedation by separate clinician, child under five
Reports the initial moderate-sedation service for a patient younger than five when a separate physician or qualified health care professional provides the sedation.
This code describes the initial 15 minutes of moderate sedation for a patient younger than five, provided by a physician or qualified health care professional other than the clinician performing the procedure. The sedation clinician monitors the patient’s level of consciousness and vital signs and manages the sedation while another clinician performs a diagnostic or therapeutic service. Examples of procedures that may involve moderate sedation include endoscopy and image-guided interventions.
Report this code for the separate sedation clinician’s initial intraservice interval, not when the procedural clinician also provides the sedation. Documentation should identify the sedation clinician, the patient’s age, the procedure supported, the sedation and monitoring performed, and the intraservice time. For additional time, use the corresponding add-on code, 99157, when its requirements are met. The patient’s age and which clinician provided the sedation distinguish this code from other moderate-sedation codes.
Where the value comes from
- Work RVU1.90 · 78%
- Practice expense (office) RVU0.30 · 12%
- Malpractice RVU0.24 · 10%
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.
99155 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
Both describe separate-clinician sedation, but 99156 is for patients age five or older; 99155 is for patients younger than five.
No office rate
99155 reports the initial 15 minutes for a patient younger than five. Code 99157 reports each qualifying additional 15-minute interval.
The same code, a different location
How does Austin compare?
99155 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 99155
Office
Unavailable
Facility
$80.21
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 99155
Office
Unavailable
Facility
$83.24
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 99155
Office
Unavailable
Facility
$87.61
No comparable office rate is available.
Miami
Florida · 99155
Office
Unavailable
Facility
$94.17
No comparable office rate is available.
Chicago
Illinois · 99155
Office
Unavailable
Facility
$92.37
No comparable office rate is available.
Manhattan
New York · 99155
Office
Unavailable
Facility
$91.88
No comparable office rate is available.
Alaska*
Alaska · 99155
Office
Unavailable
Facility
$110.28
No comparable office rate is available.
Alabama
Alabama · 99155
Office
Unavailable
Facility
$76.77
No comparable office rate is available.
Arkansas
Arkansas · 99155
Office
Unavailable
Facility
$76.20
No comparable office rate is available.
Arizona
Arizona · 99155
Office
Unavailable
Facility
$80.03
No comparable office rate is available.
Bakersfield
California · 99155
Office
Unavailable
Facility
$80.53
No comparable office rate is available.
Chico
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
El Centro
California · 99155
Office
Unavailable
Facility
$79.86
No comparable office rate is available.
Fresno
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Hanford-Corcoran
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Madera
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Merced
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Modesto
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Napa
California · 99155
Office
Unavailable
Facility
$84.74
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 99155
Office
Unavailable
Facility
$82.08
No comparable office rate is available.
Redding
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Rest Of California
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 99155
Office
Unavailable
Facility
$82.42
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 99155
Office
Unavailable
Facility
$81.70
No comparable office rate is available.
Salinas
California · 99155
Office
Unavailable
Facility
$81.34
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 99155
Office
Unavailable
Facility
$81.69
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 99155
Office
Unavailable
Facility
$87.30
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 99155
Office
Unavailable
Facility
$87.03
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 99155
Office
Unavailable
Facility
$89.19
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 99155
Office
Unavailable
Facility
$88.07
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 99155
Office
Unavailable
Facility
$80.25
No comparable office rate is available.
Santa Cruz-Watsonville
California · 99155
Office
Unavailable
Facility
$81.27
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 99155
Office
Unavailable
Facility
$81.22
No comparable office rate is available.
Santa Rosa-Petaluma
California · 99155
Office
Unavailable
Facility
$81.97
No comparable office rate is available.
Stockton
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Vallejo
California · 99155
Office
Unavailable
Facility
$84.35
No comparable office rate is available.
Visalia
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Yuba City
California · 99155
Office
Unavailable
Facility
$79.82
No comparable office rate is available.
Colorado
Colorado · 99155
Office
Unavailable
Facility
$81.15
No comparable office rate is available.
Connecticut
Connecticut · 99155
Office
Unavailable
Facility
$85.22
No comparable office rate is available.
Delaware
Delaware · 99155
Office
Unavailable
Facility
$80.89
No comparable office rate is available.
Fort Lauderdale
Florida · 99155
Office
Unavailable
Facility
$88.11
No comparable office rate is available.
Rest Of Florida
Florida · 99155
Office
Unavailable
Facility
$85.09
No comparable office rate is available.
Atlanta
Georgia · 99155
Office
Unavailable
Facility
$83.46
No comparable office rate is available.
Rest Of Georgia
Georgia · 99155
Office
Unavailable
Facility
$81.96
No comparable office rate is available.
Hawaii, Guam
Hawaii · 99155
Office
Unavailable
Facility
$79.50
No comparable office rate is available.
Iowa
Iowa · 99155
Office
Unavailable
Facility
$75.81
No comparable office rate is available.
Idaho
Idaho · 99155
Office
Unavailable
Facility
$76.47
No comparable office rate is available.
East St. Louis
Illinois · 99155
Office
Unavailable
Facility
$88.83
No comparable office rate is available.
Rest Of Illinois
Illinois · 99155
Office
Unavailable
Facility
$85.14
No comparable office rate is available.
Suburban Chicago
Illinois · 99155
Office
Unavailable
Facility
$88.40
No comparable office rate is available.
Indiana
Indiana · 99155
Office
Unavailable
Facility
$76.65
No comparable office rate is available.
Kansas
Kansas · 99155
Office
Unavailable
Facility
$76.56
No comparable office rate is available.
Kentucky
Kentucky · 99155
Office
Unavailable
Facility
$79.70
No comparable office rate is available.
New Orleans
Louisiana · 99155
Office
Unavailable
Facility
$82.00
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 99155
Office
Unavailable
Facility
$80.01
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 99155
Office
Unavailable
Facility
$85.16
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 99155
Office
Unavailable
Facility
$81.42
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 99155
Office
Unavailable
Facility
$85.14
No comparable office rate is available.
Rest Of Maryland
Maryland · 99155
Office
Unavailable
Facility
$81.60
No comparable office rate is available.
Rest Of Maine
Maine · 99155
Office
Unavailable
Facility
$77.67
No comparable office rate is available.
Southern Maine
Maine · 99155
Office
Unavailable
Facility
$78.45
No comparable office rate is available.
Detroit
Michigan · 99155
Office
Unavailable
Facility
$86.65
No comparable office rate is available.
Rest Of Michigan
Michigan · 99155
Office
Unavailable
Facility
$81.66
No comparable office rate is available.
Minnesota
Minnesota · 99155
Office
Unavailable
Facility
$76.15
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 99155
Office
Unavailable
Facility
$80.70
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 99155
Office
Unavailable
Facility
$81.03
No comparable office rate is available.
Rest Of Missouri
Missouri · 99155
Office
Unavailable
Facility
$79.91
No comparable office rate is available.
Mississippi
Mississippi · 99155
Office
Unavailable
Facility
$78.01
No comparable office rate is available.
Montana**
Montana · 99155
Office
Unavailable
Facility
$81.48
No comparable office rate is available.
North Carolina
North Carolina · 99155
Office
Unavailable
Facility
$77.93
No comparable office rate is available.
North Dakota**
North Dakota · 99155
Office
Unavailable
Facility
$76.74
No comparable office rate is available.
Nebraska
Nebraska · 99155
Office
Unavailable
Facility
$75.74
No comparable office rate is available.
New Hampshire
New Hampshire · 99155
Office
Unavailable
Facility
$80.91
No comparable office rate is available.
Northern Nj
New Jersey · 99155
Office
Unavailable
Facility
$87.64
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 99155
Office
Unavailable
Facility
$85.74
No comparable office rate is available.
New Mexico
New Mexico · 99155
Office
Unavailable
Facility
$82.28
No comparable office rate is available.
Nevada**
Nevada · 99155
Office
Unavailable
Facility
$80.17
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 99155
Office
Unavailable
Facility
$94.32
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 99155
Office
Unavailable
Facility
$86.99
No comparable office rate is available.
Queens
New York · 99155
Office
Unavailable
Facility
$90.93
No comparable office rate is available.
Rest Of New York
New York · 99155
Office
Unavailable
Facility
$78.62
No comparable office rate is available.
Ohio
Ohio · 99155
Office
Unavailable
Facility
$80.69
No comparable office rate is available.
Oklahoma
Oklahoma · 99155
Office
Unavailable
Facility
$78.64
No comparable office rate is available.
Portland
Oregon · 99155
Office
Unavailable
Facility
$81.57
No comparable office rate is available.
Rest Of Oregon
Oregon · 99155
Office
Unavailable
Facility
$79.08
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 99155
Office
Unavailable
Facility
$84.60
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 99155
Office
Unavailable
Facility
$80.24
No comparable office rate is available.
Puerto Rico
Puerto Rico · 99155
Office
Unavailable
Facility
$81.49
No comparable office rate is available.
Rhode Island
Rhode Island · 99155
Office
Unavailable
Facility
$82.17
No comparable office rate is available.
South Carolina
South Carolina · 99155
Office
Unavailable
Facility
$79.53
No comparable office rate is available.
South Dakota**
South Dakota · 99155
Office
Unavailable
Facility
$76.18
No comparable office rate is available.
Tennessee
Tennessee · 99155
Office
Unavailable
Facility
$76.87
No comparable office rate is available.
Utah
Utah · 99155
Office
Unavailable
Facility
$80.08
No comparable office rate is available.
Virginia
Virginia · 99155
Office
Unavailable
Facility
$78.97
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 99155
Office
Unavailable
Facility
$81.49
No comparable office rate is available.
Vermont
Vermont · 99155
Office
Unavailable
Facility
$77.44
No comparable office rate is available.
Rest Of Washington
Washington · 99155
Office
Unavailable
Facility
$80.94
No comparable office rate is available.
Seattle (King Cnty)
Washington · 99155
Office
Unavailable
Facility
$85.48
No comparable office rate is available.
Wisconsin
Wisconsin · 99155
Office
Unavailable
Facility
$75.53
No comparable office rate is available.
West Virginia
West Virginia · 99155
Office
Unavailable
Facility
$83.64
No comparable office rate is available.
Wyoming**
Wyoming · 99155
Office
Unavailable
Facility
$79.41
No comparable office rate is available.
See how rates vary across the country
99155 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 99155 in Austin
Multiple payment areas
- 99155 in Barton Creek
- 99155 in Bee Cave
- 99155 in Briarcliff
- 99155 in Cedar Park
Multiple payment areas
- 99155 in Creedmoor
Multiple payment areas
- 99155 in Elgin
Multiple payment areas
- 99155 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 99155 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$89.42
$81.29 × 110% = $89.42
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99155 in Austin.
PPRRVU2026_Oct_nonQPP.csv
12,992
- Code
- 99155
- Physician work
- 1.90
- Practice expense
- 0.30
- Malpractice
- 0.24
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.90 | × 1.002 | 1.9038 |
| Practice expense | 0.30 | × 1.058 | 0.3174 |
| Malpractice | 0.24 | × 0.886 | 0.2126 |
| Total RVUs | 2.4338 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$81.29
Open 99155 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.9 | 1.002 |
| Practice expense | 0.3 | 1.058 |
| Malpractice | 0.24 | 0.886 |
(1.9 × 1.002 + 0.3 × 1.058 + 0.24 × 0.886) × $33.4009 = $81.29
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
99155 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $81.29 | RVU26D |
| 2026-07-01 | Not available in this setting | $81.29 | RVU26C |
| 2026-04-01 | Not available in this setting | $81.29 | RVU26B |
| 2026-01-01 | Not available in this setting | $81.29 | RVU26A |
| 2025-10-01 | Not available in this setting | $79.51 | RVU25D |
| 2025-07-01 | Not available in this setting | $79.51 | RVU25C |
| 2025-04-01 | Not available in this setting | $79.51 | RVU25B |
| 2025-01-01 | Not available in this setting | $79.51 | RVU25A |
99155 billing questions
When should 99155 be chosen instead of 99151?
Use 99155 when a physician or qualified health care professional other than the procedural clinician provides moderate sedation to a patient younger than five. Code 99151 describes sedation provided by the procedural clinician for a patient in that age group.
What is the age distinction between 99155 and 99156?
Both describe sedation provided by someone other than the procedural clinician. Use 99155 for a patient younger than five and 99156 for a patient age five or older.
What does the initial service include?
Code 99155 represents the initial 15 minutes of intraservice moderate sedation for a patient younger than five. Document the intraservice time and the sedation clinician’s monitoring and management.
How is additional sedation time reported?
Code 99157 is the add-on code for each additional 15 minutes when the requirements for additional intraservice time are met. It is paired with 99155 when a separate clinician provides the sedation.
Can the procedural clinician report 99155?
No. The code is for sedation provided by a physician or qualified health care professional other than the clinician performing the diagnostic or therapeutic procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,98999151,,Mod sed same phys/qhp <5 yrs,A,,0.50,1.33,,0.10,,0.03,1.86,0.63,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99099152,,Mod sed same phys/qhp 5/>yrs,A,,0.25,1.26,,0.05,,0.03,1.54,0.33,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99199153,,Mod sed same phys/qhp ea,A,,0.00,0.35,,0.35,NA,0.02,0.37,0.37,3,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99299155,,Mod sed oth phys/qhp <5 yrs,A,,1.90,0.30,NA,0.30,,0.24,2.44,2.44,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99399156,,Mod sed oth phys/qhp 5/>yrs,A,,1.65,0.29,NA,0.29,,0.19,2.13,2.13,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99499157,,Mod sed other phys/qhp ea,A,,1.25,0.23,NA,0.23,,0.14,1.62,1.62,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,99599170,,Anogenital exam child w imag,A,,1.71,3.18,,0.35,,0.09,4.98,2.15,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858