# CPT 99157: Mod Sed Other Phys/qhp Each Addl 15 Mins

Medicare CPT 99157 pays $54.11 in a non-facility setting and $54.11 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $50.55 in Wisconsin to $73.38 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99157-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Emergency Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $54.11 |
| National facility | $54.11 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $73.38 | $73.38 |
| New York | $58.66 | $58.66 |
| Florida | $58.56 | $58.56 |
| District of Columbia | $58.26 | $58.26 |
| Illinois | $58.26 | $58.26 |
| New Jersey | $57.61 | $57.61 |
| Connecticut | $56.52 | $56.52 |
| Michigan | $55.55 | $55.55 |
| Massachusetts | $55.52 | $55.52 |
| Washington | $55.52 | $55.52 |
| Maryland | $55.35 | $55.35 |
| West Virginia | $55.12 | $55.12 |
| California | $54.87 | $54.87 |
| Georgia | $54.74 | $54.74 |
| Pennsylvania | $54.65 | $54.65 |
| Rhode Island | $54.65 | $54.65 |
| New Mexico | $54.41 | $54.41 |
| Puerto Rico | $54.12 | $54.12 |
| Virgin Islands | $54.12 | $54.12 |
| Montana | $54.10 | $54.10 |
| Colorado | $54.08 | $54.08 |
| Texas | $53.89 | $53.89 |
| New Hampshire | $53.84 | $53.84 |
| Delaware | $53.75 | $53.75 |
| Louisiana | $53.66 | $53.66 |
| Oregon | $53.56 | $53.56 |
| Ohio | $53.48 | $53.48 |
| Missouri | $53.40 | $53.40 |
| Nevada | $53.34 | $53.34 |
| Arizona | $53.20 | $53.20 |
| Hawaii | $53.19 | $53.19 |
| Utah | $53.17 | $53.17 |
| Wyoming | $52.89 | $52.89 |
| Kentucky | $52.86 | $52.86 |
| South Carolina | $52.82 | $52.82 |
| Virginia | $52.60 | $52.60 |
| Oklahoma | $52.24 | $52.24 |
| Maine | $52.02 | $52.02 |
| North Carolina | $51.91 | $51.91 |
| Mississippi | $51.82 | $51.82 |
| Vermont | $51.72 | $51.72 |
| North Dakota | $51.33 | $51.33 |
| Tennessee | $51.25 | $51.25 |
| Indiana | $51.15 | $51.15 |
| Alabama | $51.12 | $51.12 |
| Kansas | $51.05 | $51.05 |
| Minnesota | $51.04 | $51.04 |
| Idaho | $51.03 | $51.03 |
| South Dakota | $51.00 | $51.00 |
| Arkansas | $50.76 | $50.76 |
| Iowa | $50.64 | $50.64 |
| Nebraska | $50.61 | $50.61 |
| Wisconsin | $50.55 | $50.55 |

## 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 99157 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