$64.54–$71.32
99151 reports the initial same-provider sedation service for a patient younger than 5 years; 99153 reports additional time after the initial service.
On this page
CMS RVU26D · Effective 2026-10-01
99153 Moderate sedation Medicare reimbursement rates in Massachusetts
Reports each additional 15-minute increment of moderate sedation when the physician or qualified health care professional also performs the underlying procedure. Compare 99153 office and facility rates across CMS payment localities in Massachusetts.
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 99153 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$12.84–$14.55
2 of 2 localities have a supported rate.
Facility setting
No 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.
Moderate sedation
About 99153: Same-provider moderate sedation, additional time
Reports each additional 15-minute increment of moderate sedation when the physician or qualified health care professional also performs the underlying procedure.
Code 99153 represents additional intraservice time for moderate sedation provided by the physician or qualified health care professional performing the procedure that requires sedation. It may be relevant during services such as endoscopy, cardiac catheterization, or image-guided intervention when the procedural clinician provides the sedation and a trained observer assists with monitoring the patient’s level of consciousness and physiological status. Count the time spent providing the sedation service, not recovery time.
Report 99153 only with the related primary procedure and the appropriate initial same-provider sedation code, 99151 or 99152. Documentation should identify who performed the procedure and sedation, the observer, the patient’s monitored status, and the intraservice time supporting each additional unit. CMS treats this as an add-on code paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation.
CMS billing rules for 99153
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.35 · 95%
- Malpractice RVU0.02 · 5%
228.4K
Medicare services in 2024 · #358 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.
99153 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$53.60–$59.83
99152 reports the initial same-provider sedation service for a patient age 5 or older. Use 99153 for additional time, not as a substitute for the initial code.
No office rate
99153 applies when the procedural clinician provides the sedation; 99157 applies to additional time when a different physician or qualified health care professional provides it.
Compare 99153 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$14.55
Facility
Unavailable
Rest Of Massachusetts →
Office / nonfacility
$12.84
Facility
Unavailable
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99153 billing questions
Can 99153 be reported by itself?
No. It is an add-on code and must be reported with the related primary procedure and the appropriate initial same-provider sedation code.
Should 99153 be paired with 99151 or 99152?
Use 99151 for the initial same-provider sedation service for a patient younger than 5 years, or 99152 for a patient age 5 or older. Code 99153 reports additional time.
When is 99157 used instead?
99157 is for additional moderate-sedation time when a physician or qualified health care professional other than the procedural clinician provides the sedation.
What time should the record support?
Document the intraservice sedation time and the additional time represented by the units billed. Recovery time is not the additional sedation time reported with 99153.
Does 99153 include an interpretation service?
No. CMS classifies 99153 as technical-component-only, with interpretation covered by a separate code.
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.
12,98899140,,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
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