CPT 99153 Other
Mod sed same phys/qhp ea Cost
Body System: General
Medicare Facility Rate
$12
CMS PFS CY2026
Medicare Non-Facility Rate
$12
Office/clinic setting
Frequently Asked Questions
How much does Mod sed same phys/qhp ea cost?
The Medicare facility rate is $12. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Mod sed same phys/qhp ea cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $12.