$50.09–$54.69
Choose 99152 when the clinician providing moderate sedation also performs the procedure. Choose 99156 when those roles are performed by different clinicians and the patient is aged 5 or older.
On this page
CMS RVU26D · Effective 2026-10-01
99156 Moderate sedation Medicare reimbursement rates in Florida
Reports the initial moderate-sedation service for a patient aged 5 or older when a physician or qualified professional other than the proceduralist provides sedation. Compare 99156 office and facility rates across CMS payment localities in Florida.
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 99156 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$73.91–$81.24
3 of 3 localities have a supported rate.
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.
Where 99156 pays more and less in Florida
Moderate sedation
About 99156: Moderate sedation by separate clinician
Reports the initial moderate-sedation service for a patient aged 5 or older when a physician or qualified professional other than the proceduralist provides sedation.
99156 represents a physician’s or qualified health care professional’s work to provide moderate sedation for a patient aged 5 or older while another clinician performs the diagnostic or therapeutic procedure. A common setting is an image-guided intervention in which a separate clinician manages sedation and monitors the patient. The sedation clinician’s service includes intraservice care, with a trained observer assisting with monitoring.
Report one unit for the initial 15 minutes of intraservice time, supported by documentation identifying the sedation clinician and recording the time, medications, patient response, and monitoring. Do not include preparation or recovery time in the intraservice time. Report 99157 with 99156 for qualifying additional time. Use 99152 when the same physician or qualified professional provides sedation and performs the procedure, or 99155 when a separate clinician provides sedation to a child younger than 5.
Where the value comes from
- Work RVU1.65 · 77%
- Practice expense (office) RVU0.29 · 14%
- Malpractice RVU0.19 · 9%
7.4K
Medicare services in 2024 · #1626 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.
99156 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
99155 is for separate-clinician moderate sedation for a child younger than 5. 99156 is for the same provider arrangement when the patient is aged 5 or older.
No office rate
99157 reports qualifying additional intraservice time with 99156; it does not represent the initial sedation service.
$12.18–$13.86
99153 reports qualifying additional time when the proceduralist provides the sedation. Use 99157 for additional time when a different clinician provides it.
Compare 99156 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$76.40
Miami →
Office / nonfacility
Unavailable
Facility
$81.24
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$73.91
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99156 billing questions
How is 99156 different from 99152?
Use 99156 when a physician or qualified professional other than the proceduralist provides the moderate sedation. Use 99152 when the same clinician performs the procedure and provides sedation.
What service is reported with 99157?
99157 reports qualifying additional intraservice time beyond the initial period represented by 99156. It is an add-on code reported with 99156, not by itself.
Which time should the record support?
Document the sedation clinician’s intraservice time, along with the medications, monitoring, and patient response. Preparation and recovery time are not part of that intraservice time.
When does age change the code?
For a patient aged 5 or older, use 99156 when a separate physician or qualified professional provides sedation. For a child younger than 5 in that same provider arrangement, use 99155.
What documentation distinguishes this from sedation by the proceduralist?
Identify the clinician who provided sedation and the clinician who performed the procedure. The record should make clear that they were different clinicians and support the sedation service and its 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.
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
12,99699172,,Ocular function screen,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00