# CPT 99153: Mod Sed Same Phys/qhp Each Addl 15 Mins

Medicare CPT 99153 pays $12.36 in a non-facility setting and $12.36 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $10.39 in Arkansas to $14.51 in District of Columbia, a 40% spread.

Web page: https://www.med-reveal.com/rates/99153-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Emergency Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $12.36 |
| National facility | $12.36 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| District of Columbia | $14.51 | $14.51 |
| California | $14.19 | $14.19 |
| New York | $13.95 | $13.95 |
| New Jersey | $13.89 | $13.89 |
| Washington | $13.86 | $13.86 |
| Massachusetts | $13.70 | $13.70 |
| Hawaii | $13.68 | $13.68 |
| Connecticut | $13.40 | $13.40 |
| Florida | $13.03 | $13.03 |
| Colorado | $12.96 | $12.96 |
| Maryland | $12.91 | $12.91 |
| Alaska | $12.82 | $12.82 |
| Oregon | $12.80 | $12.80 |
| New Hampshire | $12.75 | $12.75 |
| Rhode Island | $12.67 | $12.67 |
| Illinois | $12.57 | $12.57 |
| Puerto Rico | $12.48 | $12.48 |
| Virgin Islands | $12.48 | $12.48 |
| Montana | $12.36 | $12.36 |
| Nevada | $12.26 | $12.26 |
| Minnesota | $12.23 | $12.23 |
| Wyoming | $12.18 | $12.18 |
| Pennsylvania | $12.17 | $12.17 |
| Delaware | $12.15 | $12.15 |
| Texas | $12.13 | $12.13 |
| North Dakota | $11.96 | $11.96 |
| Virginia | $11.96 | $11.96 |
| Georgia | $11.95 | $11.95 |
| Michigan | $11.92 | $11.92 |
| South Dakota | $11.91 | $11.91 |
| Vermont | $11.91 | $11.91 |
| Arizona | $11.90 | $11.90 |
| Maine | $11.59 | $11.59 |
| Utah | $11.59 | $11.59 |
| New Mexico | $11.52 | $11.52 |
| Wisconsin | $11.41 | $11.41 |
| Missouri | $11.39 | $11.39 |
| Louisiana | $11.38 | $11.38 |
| South Carolina | $11.37 | $11.37 |
| Ohio | $11.35 | $11.35 |
| North Carolina | $11.33 | $11.33 |
| Indiana | $11.16 | $11.16 |
| West Virginia | $11.11 | $11.11 |
| Idaho | $11.07 | $11.07 |
| Nebraska | $11.04 | $11.04 |
| Kentucky | $11.00 | $11.00 |
| Tennessee | $10.99 | $10.99 |
| Iowa | $10.96 | $10.96 |
| Oklahoma | $10.96 | $10.96 |
| Kansas | $10.90 | $10.90 |
| Alabama | $10.61 | $10.61 |
| Mississippi | $10.56 | $10.56 |
| Arkansas | $10.39 | $10.39 |

## Related codes

- 90632: Hepa Vaccine Adult Dose for Intramuscular Use — https://www.med-reveal.com/rates/90632-cpt-fee-schedule
- 90633: Hepa Vaccine 2 Dose Schedule Ped/adolesc Im Use — https://www.med-reveal.com/rates/90633-cpt-fee-schedule
- 90647: Hib Prp-omp Vaccine 3 Dose Schedule Im Use — https://www.med-reveal.com/rates/90647-cpt-fee-schedule
- 90648: Hib Prp-t Vaccine 4 Dose Schedule Im Use — https://www.med-reveal.com/rates/90648-cpt-fee-schedule
- 90680: Rv5 Vaccine 3 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90680-cpt-fee-schedule
- 90681: Rv1 Vaccine 2 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90681-cpt-fee-schedule
- 90698: Dtap-ipv/hib Vaccine for Intramuscular Use — https://www.med-reveal.com/rates/90698-cpt-fee-schedule
- 90710: Measles Mumps Rubella Varicella Vacc Live Subq — https://www.med-reveal.com/rates/90710-cpt-fee-schedule

Commercial negotiated rates for 99153 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules