99155 Mod sed oth phys/qhp <5 yrs
Also known as: conscious sedation separate, procedural sedation separate, anesthesia provider
Moderate sedation or anesthesia administered by a different physician/qualified healthcare provider (not the procedure provider) on a patient for less than five years or first encounter.
Clinical Context
Used when a dedicated anesthesia provider administers moderate sedation while another physician performs the procedure, for patients under five years.
RVU Breakdown
| Work RVU | 1.90 |
| Practice Expense RVU | 0.30 |
| Malpractice RVU | 0.24 |
| Total RVU | 2.44 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Specialties
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.