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CMS RVU26D · Effective 2026-10-01

99152 in Delaware

Office / nonfacility

$50.87

Base rate per service

Facility setting

$10.94

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 99152: Moderate sedation by proceduralist, age 5 or older

Report initial moderate sedation for a patient age 5 or older when the procedure provider directs it with an independent trained observer.

99152 covers moderate sedation directed by the physician or other qualified health care professional performing the underlying procedure for a patient age 5 or older. During a bronchoscopy, cardiac catheterization, transesophageal echocardiogram, or image-guided intervention, the proceduralist remains face-to-face with the patient while an independent trained observer, often a nurse, monitors consciousness and physiologic status. These services occur in catheterization labs, hospital procedure suites, and equipped offices.

Report 99152 once for the initial sedation period when at least 10 minutes of intraservice time are documented. Time begins when the sedating agent is administered and ends when the proceduralist’s continuous face-to-face attendance ends. Add 99153 at 23 minutes, with further units at 38 minutes and each subsequent 15-minute mark. Exclude preassessment and recovery from intraservice time; document agents, doses, the observer, monitoring, and start and stop times. For Medicare GI endoscopy with sedation directed by the endoscopist, report G0500 instead. The office practice-expense value reflects resources supplied by the practice rather than a facility.

Where the value comes from

  • Work RVU0.25 · 16%
  • Practice expense (office) RVU1.26 · 82%
  • Malpractice RVU0.03 · 2%

1.4M

Medicare services in 2024 · #113 by national volume

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.

99152 compared with similar codes

Office rates for Delaware, from the same CMS release.

99156

Moderate sedation

Other clinician, age 5+

No office rate

Use 99152 when the proceduralist directs sedation. Use 99156 when a separate physician or qualified health care professional provides it for a patient age 5 or older.

99151

Moderate sedation

Same proceduralist, under five

$61.57

Both describe initial sedation directed by the proceduralist. Use 99151 for patients younger than 5 and 99152 for patients age 5 or older.

G0500

Endoscopy sedation

Initial 15 minutes, age 5+

$65.64

For Medicare GI endoscopy with endoscopist-directed sedation, report G0500 instead of 99152. Code 99152 can describe proceduralist-directed sedation for non-GI procedures such as bronchoscopy or cardiac catheterization.

99153

Moderate sedation

Each additional 15 minutes

$12.15

Report 99152 once for the initial sedation period. Add the first unit of 99153 when total intraservice time reaches 23 minutes.

The same code, a different location

How does Delaware compare?

99152 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $50.87

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $59.14

    $8.27 higher than Delaware

  3. Dc + Md/Va Suburbs

    $59.49

    $8.62 higher than Delaware

  4. Miami

    $54.69

    $3.82 higher than Delaware

  5. Chicago

    $53.00

    $2.13 higher than Delaware

  6. Manhattan

    $59.38

    $8.51 higher than Delaware

  7. Alaska*

    $57.90

    $7.03 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 99152 ranges from $45.02 in Arkansas to $70.49 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Alabama

    Alabama · 99152

    Office

    $45.74

    Facility

    $10.38

    $5.13 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 99152

    Office

    $45.02

    Facility

    $10.30

    $5.85 lower than Delaware for the office setting.

  • Arizona

    Arizona · 99152

    Office

    $49.99

    Facility

    $10.83

    $0.88 lower than Delaware for the office setting.

  • Bakersfield

    California · 99152

    Office

    $55.24

    Facility

    $10.95

    $4.37 higher than Delaware for the office setting.

  • Chico

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • El Centro

    California · 99152

    Office

    $55.16

    Facility

    $10.86

    $4.29 higher than Delaware for the office setting.

  • Fresno

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Madera

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Merced

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Modesto

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Napa

    California · 99152

    Office

    $64.85

    Facility

    $11.59

    $13.98 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99152

    Office

    $58.95

    Facility

    $11.18

    $8.08 higher than Delaware for the office setting.

  • Redding

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Rest Of California

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99152

    Office

    $55.48

    Facility

    $11.19

    $4.61 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99152

    Office

    $58.13

    Facility

    $11.13

    $7.26 higher than Delaware for the office setting.

  • Salinas

    California · 99152

    Office

    $57.92

    Facility

    $11.08

    $7.05 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99152

    Office

    $59.48

    Facility

    $11.14

    $8.61 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99152

    Office

    $68.94

    Facility

    $11.96

    $18.07 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 99152

    Office

    $68.91

    Facility

    $11.92

    $18.04 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 99152

    Office

    $70.49

    Facility

    $12.21

    $19.62 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 99152

    Office

    $70.35

    Facility

    $12.07

    $19.48 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99152

    Office

    $56.96

    Facility

    $10.93

    $6.09 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 99152

    Office

    $60.20

    Facility

    $11.09

    $9.33 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 99152

    Office

    $58.19

    Facility

    $11.07

    $7.32 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 99152

    Office

    $60.82

    Facility

    $11.19

    $9.95 higher than Delaware for the office setting.

  • Stockton

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Vallejo

    California · 99152

    Office

    $64.80

    Facility

    $11.54

    $13.93 higher than Delaware for the office setting.

  • Visalia

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Yuba City

    California · 99152

    Office

    $55.15

    Facility

    $10.86

    $4.28 higher than Delaware for the office setting.

  • Colorado

    Colorado · 99152

    Office

    $54.01

    Facility

    $11.01

    $3.14 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 99152

    Office

    $55.06

    Facility

    $11.53

    $4.19 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 99152

    Office

    $52.79

    Facility

    $11.85

    $1.92 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 99152

    Office

    $50.09

    Facility

    $11.45

    $0.78 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 99152

    Office

    $52.34

    Facility

    $11.28

    $1.47 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 99152

    Office

    $47.08

    Facility

    $11.03

    $3.79 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 99152

    Office

    $56.78

    Facility

    $10.83

    $5.91 higher than Delaware for the office setting.

  • Iowa

    Iowa · 99152

    Office

    $47.26

    Facility

    $10.28

    $3.61 lower than Delaware for the office setting.

  • Idaho

    Idaho · 99152

    Office

    $47.54

    Facility

    $10.36

    $3.33 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 99152

    Office

    $49.09

    Facility

    $11.90

    $1.78 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 99152

    Office

    $48.34

    Facility

    $11.44

    $2.53 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 99152

    Office

    $53.41

    Facility

    $11.90

    $2.54 higher than Delaware for the office setting.

  • Indiana

    Indiana · 99152

    Office

    $47.85

    Facility

    $10.39

    $3.02 lower than Delaware for the office setting.

  • Kansas

    Kansas · 99152

    Office

    $46.90

    Facility

    $10.36

    $3.97 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 99152

    Office

    $46.68

    Facility

    $10.75

    $4.19 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 99152

    Office

    $49.09

    Facility

    $11.06

    $1.78 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 99152

    Office

    $46.56

    Facility

    $10.79

    $4.31 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 99152

    Office

    $59.83

    Facility

    $11.58

    $8.96 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99152

    Office

    $53.60

    Facility

    $11.04

    $2.73 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99152

    Office

    $54.88

    Facility

    $11.52

    $4.01 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 99152

    Office

    $51.94

    Facility

    $11.04

    $1.07 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 99152

    Office

    $47.69

    Facility

    $10.51

    $3.18 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 99152

    Office

    $50.69

    Facility

    $10.64

    $0.18 lower than Delaware for the office setting.

  • Detroit

    Michigan · 99152

    Office

    $50.65

    Facility

    $11.65

    $0.22 lower than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 99152

    Office

    $47.91

    Facility

    $11.01

    $2.96 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 99152

    Office

    $51.95

    Facility

    $10.37

    $1.08 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 99152

    Office

    $48.85

    Facility

    $10.90

    $2.02 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 99152

    Office

    $49.42

    Facility

    $10.94

    $1.45 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 99152

    Office

    $45.60

    Facility

    $10.77

    $5.27 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 99152

    Office

    $45.33

    Facility

    $10.53

    $5.54 lower than Delaware for the office setting.

  • Montana**

    Montana · 99152

    Office

    $51.44

    Facility

    $11.02

    $0.57 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 99152

    Office

    $48.26

    Facility

    $10.55

    $2.61 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 99152

    Office

    $50.84

    Facility

    $10.43

    $0.03 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 99152

    Office

    $47.57

    Facility

    $10.27

    $3.30 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 99152

    Office

    $53.04

    Facility

    $10.97

    $2.17 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 99152

    Office

    $58.77

    Facility

    $11.88

    $7.90 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 99152

    Office

    $55.74

    Facility

    $11.61

    $4.87 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 99152

    Office

    $48.15

    Facility

    $11.09

    $2.72 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 99152

    Office

    $51.31

    Facility

    $10.86

    $0.44 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99152

    Office

    $60.78

    Facility

    $12.73

    $9.91 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99152

    Office

    $56.02

    Facility

    $11.77

    $5.15 higher than Delaware for the office setting.

  • Queens

    New York · 99152

    Office

    $60.07

    Facility

    $12.30

    $9.20 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 99152

    Office

    $49.04

    Facility

    $10.64

    $1.83 lower than Delaware for the office setting.

  • Ohio

    Ohio · 99152

    Office

    $47.78

    Facility

    $10.89

    $3.09 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 99152

    Office

    $46.71

    Facility

    $10.62

    $4.16 lower than Delaware for the office setting.

  • Portland

    Oregon · 99152

    Office

    $55.99

    Facility

    $11.08

    $5.12 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 99152

    Office

    $50.97

    Facility

    $10.72

    $0.10 higher than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99152

    Office

    $53.51

    Facility

    $11.43

    $2.64 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99152

    Office

    $47.93

    Facility

    $10.83

    $2.94 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 99152

    Office

    $51.89

    Facility

    $11.03

    $1.02 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 99152

    Office

    $52.88

    Facility

    $11.13

    $2.01 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 99152

    Office

    $48.09

    Facility

    $10.75

    $2.78 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 99152

    Office

    $50.77

    Facility

    $10.36

    $0.10 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 99152

    Office

    $47.14

    Facility

    $10.41

    $3.73 lower than Delaware for the office setting.

  • Austin

    Texas · 99152

    Office

    $53.78

    Facility

    $11.02

    $2.91 higher than Delaware for the office setting.

  • Beaumont

    Texas · 99152

    Office

    $47.58

    Facility

    $10.80

    $3.29 lower than Delaware for the office setting.

  • Brazoria

    Texas · 99152

    Office

    $50.90

    Facility

    $10.85

    $0.03 higher than Delaware for the office setting.

  • Dallas

    Texas · 99152

    Office

    $51.20

    Facility

    $10.95

    $0.33 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 99152

    Office

    $50.79

    Facility

    $10.94

    $0.08 lower than Delaware for the office setting.

  • Galveston

    Texas · 99152

    Office

    $51.04

    Facility

    $10.91

    $0.17 higher than Delaware for the office setting.

  • Houston

    Texas · 99152

    Office

    $51.59

    Facility

    $11.45

    $0.72 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 99152

    Office

    $49.19

    Facility

    $10.84

    $1.68 lower than Delaware for the office setting.

  • Utah

    Utah · 99152

    Office

    $48.81

    Facility

    $10.82

    $2.06 lower than Delaware for the office setting.

  • Virginia

    Virginia · 99152

    Office

    $50.43

    Facility

    $10.70

    $0.44 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99152

    Office

    $51.89

    Facility

    $11.03

    $1.02 higher than Delaware for the office setting.

  • Vermont

    Vermont · 99152

    Office

    $50.52

    Facility

    $10.51

    $0.35 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 99152

    Office

    $53.54

    Facility

    $10.98

    $2.67 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 99152

    Office

    $61.22

    Facility

    $11.64

    $10.35 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 99152

    Office

    $48.98

    Facility

    $10.26

    $1.89 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 99152

    Office

    $46.36

    Facility

    $11.24

    $4.51 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 99152

    Office

    $51.18

    Facility

    $10.76

    $0.31 higher than Delaware for the office setting.

See how rates vary across the country

99152 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$45.02

$62.82

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$57.901
AL$45.741
AR$45.021
AZ$49.991
CA$55.15–$70.4929
CO$54.011
CT$55.061
DC$59.491
DE$50.871
FL$50.09–$54.693
GA$47.08–$52.342
GU$56.781
HI$56.781
IA$47.261
ID$47.541
IL$48.34–$53.414
IN$47.851
KS$46.901
KY$46.681
LA$46.56–$49.092
MA$53.60–$59.832
MD$51.94–$59.493
ME$47.69–$50.692
MI$47.91–$50.652
MN$51.951
MO$45.60–$49.423
MS$45.331
MT$51.441
NC$48.261
ND$50.841
NE$47.571
NH$53.041
NJ$55.74–$58.772
NM$48.151
NV$51.311
NY$49.04–$60.785
OH$47.781
OK$46.711
OR$50.97–$55.992
PA$47.93–$53.512
PR$51.891
RI$52.881
SC$48.091
SD$50.771
TN$47.141
TX$47.58–$53.788
UT$48.811
VA$50.43–$59.492
VI$51.891
VT$50.521
WA$53.54–$61.222
WI$48.981
WV$46.361
WY$51.181

Explore 99152 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 99152 in Delaware, the physician’s office rate is $50.87 and the facility-setting rate is $10.94: a difference of $39.93.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99152 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$55.96

$50.87 × 110% = $55.96

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.

Compare your contract offer →

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 99152 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

12,990

Code
99152
Physician work
0.25
Practice expense
1.26
Malpractice
0.03

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 99152 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.25× 1.0050.2512
Practice expense1.26× 0.9881.2449
Malpractice0.03× 0.8990.0270
Total RVUs1.5231
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$50.87

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 99152 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.251.005
Practice expense1.260.988
Malpractice0.030.899

(0.25 × 1.005 + 1.26 × 0.988 + 0.03 × 0.899) × $33.4009 = $50.87

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.251.005
Practice expense0.050.988
Malpractice0.030.899

(0.25 × 1.005 + 0.05 × 0.988 + 0.03 × 0.899) × $33.4009 = $10.94

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

99152 · Office / nonfacility

$50.87

Effective 2026-10-01

The base rate is $2.64 higher than on 2025-10-01, moving from $48.23 to $50.87 (5.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $48.23changed to$50.87

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.22 changed to 1.26
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $48.23

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$50.87$10.94RVU26D
2026-07-01$50.87$10.94RVU26C
2026-04-01$50.87$10.94RVU26B
2026-01-01$50.87$10.94RVU26A
2025-10-01$48.23$11.65RVU25D
2025-07-01$48.23$11.65RVU25C
2025-04-01$48.23$11.65RVU25B
2025-01-01$48.23$11.65RVU25A

99152 billing questions

What is the minimum time needed to report 99152?

At least 10 minutes of intraservice time is required. Sedation lasting under 10 minutes is not reported separately.

When is 99153 added?

Report one unit of 99153 when total intraservice time reaches 23 minutes. Additional units begin at 38 minutes, 53 minutes, and each subsequent 15-minute mark.

Can 99152 be billed if no independent observer is present?

No. This code requires a trained observer to monitor the patient while the proceduralist directs sedation and performs the procedure.

How does this differ from sedation provided by a separate clinician?

For a patient age 5 or older, a separate physician or qualified health care professional providing sedation reports 99156, adding 99157 only when the time warrants it. For a younger patient, the separate-provider initial code is 99155.

Should 99152 be used with a Medicare screening or diagnostic colonoscopy?

No. When the endoscopist provides moderate sedation for Medicare GI endoscopy to a patient age 5 or older, report G0500 instead of 99152.

Does the presedation evaluation count toward sedation time?

No. Presedation assessment, consent, and recovery monitoring after the proceduralist’s face-to-face attendance ends are excluded from intraservice time.

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.

RVUs for 99152PPRRVU2026_Oct_nonQPP.csv, line 12,990 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet