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.
In Plain Language
sedation given by a separate anesthesia doctor
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 |
| Total RVU | 1.90 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
Medicine section codes cover a wide range of non-surgical services. Documentation should include the clinical indication, procedure details, interpretation (if applicable), and any patient-specific findings.
How This Code Compares
With a work RVU of 1.90, this code ranks in the 76th percentile among Medicine codes — 2.4x the median (0.78). The highest wRVU in this category is 23.92.
Specialties
Frequently Asked Questions
What is CPT code 99155?
CPT 99155 (Mod sed oth phys/qhp <5 yrs) is a Medicine code. 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.
Who uses CPT code 99155?
CPT 99155 is used by Anesthesiology, Gastroenterology, Surgery. Used when a dedicated anesthesia provider administers moderate sedation while another physician performs the procedure, for patients under five years.
When is CPT 99155 used?
Used when a dedicated anesthesia provider administers moderate sedation while another physician performs the procedure, for patients under five years.
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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.