$45.02
Both describe initial moderate sedation by the proceduralist; select 99151 for a patient younger than five and 99152 for a patient age five or older.
On this page
CMS RVU26D · Effective 2026-10-01
99151 Moderate sedation Medicare reimbursement rates in Arkansas
Moderate sedation performed by the procedure’s physician or qualified health professional for a patient younger than five, during the initial time interval. Compare 99151 office and facility rates across CMS payment localities in Arkansas.
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.
What does Medicare pay for 99151 in Arkansas?
Arkansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$55.38
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
Facility setting
$20.09
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Moderate sedation
About 99151: Same-proceduralist moderate sedation, child under five
Moderate sedation performed by the procedure’s physician or qualified health professional for a patient younger than five, during the initial time interval.
This code describes moderate sedation delivered by the physician or qualified health professional who also performs the diagnostic or therapeutic procedure. An independent trained observer assists with monitoring the patient’s consciousness and physiologic status. A typical situation is an image-guided procedure, such as a biopsy, when the proceduralist provides the sedation. The patient must be younger than five years.
Report this code for the initial 15-minute intra-service interval. Documentation should identify the patient’s age, the supported procedure, the clinician providing both services, the observer, and sedation start and stop times. Use a different code when another physician or qualified health professional provides the sedation. Additional intra-service time is reported with 99153 when supported by the service and documentation. Medicare fee-schedule valuation is shown separately from this description.
Where the value comes from
- Work RVU0.50 · 27%
- Practice expense (office) RVU1.33 · 72%
- Malpractice RVU0.03 · 2%
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.
99151 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
For a patient younger than five, use 99155 when a different physician or qualified health professional provides the sedation rather than the proceduralist.
$10.39
99151 reports the initial 15-minute interval. Code 99153 reports each additional qualifying 15-minute interval.
No office rate
99156 is the initial service when another clinician provides sedation to a patient age five or older; 99151 is for the proceduralist’s sedation of a younger patient.
Compare 99151 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Arkansas →
Office / nonfacility
$55.38
Facility
$20.09
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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 99151 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
12,989
- Code
- 99151
- Physician work
- 0.50
- Practice expense
- 1.33
- Malpractice
- 0.03
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 1.33 | × 0.859 | 1.1425 |
| Malpractice | 0.03 | × 0.515 | 0.0155 |
| Total RVUs | 1.6579 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Arkansas$55.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.5 | 1 |
| Practice expense | 1.33 | 0.859 |
| Malpractice | 0.03 | 0.515 |
(0.5 × 1 + 1.33 × 0.859 + 0.03 × 0.515) × $33.4009 = $55.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.5 | 1 |
| Practice expense | 0.1 | 0.859 |
| Malpractice | 0.03 | 0.515 |
(0.5 × 1 + 0.1 × 0.859 + 0.03 × 0.515) × $33.4009 = $20.09
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.
99151 billing questions
When should 99151 be used instead of 99152?
Use 99151 for a patient younger than five when the proceduralist provides the moderate sedation. Code 99152 is for the same-proceduralist service when the patient is five or older.
Does 99151 apply when a different clinician provides the sedation?
No. For a patient younger than five, 99155 is the corresponding initial service when a different physician or qualified health professional provides the sedation.
What time does 99151 represent?
It represents the initial 15-minute intra-service interval. Additional qualifying intra-service time may be reported with 99153.
What documentation supports reporting 99151?
Document the patient’s age, the procedure supported by sedation, the proceduralist’s role in providing sedation, the trained observer, monitoring, and intra-service start and stop times.
Is medication administration alone enough to report 99151?
No. The record should support the moderate-sedation service, including the proceduralist’s role and the observer’s monitoring assistance, rather than medication administration alone.
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.
12,98699116,,Anes comp tot bdy hypthrm,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,98799135,,Anes comp ctrld hypotension,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,98899140,,Anes comp emergency cond,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,98999151,,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
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541