CPT code 90951: ESRD monthly care, under 2 years, 4+ visits2026 Medicare rate & RVUs in Merced, CA

Monthly ESRD management for a patient younger than 2 years, reported when the physician or qualified professional provides at least four face-to-face visits.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Merced, CA, Medicare pays $1,206.94 for 90951 in the office and $1,206.94 when it’s performed in a hospital or facility.

$1,206.94Office (non-facility)
$1,206.94Hospital or facility
+2.0%vs the national office rate ($1,183.73)

Check a contract rate as a % of Medicare · 90951 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 90951 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Merced, CA
  2. What 90951 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 90951 covers

CPT 90951 represents a month of ongoing end-stage renal disease management for a child younger than 2 years who receives at least four face-to-face visits from a physician or other qualified health care professional during that month. A nephrologist commonly provides this care in connection with dialysis, assessing matters such as the dialysis plan, fluid status, vascular access, laboratory findings, and related complications. The service is distinct from documenting a single dialysis treatment encounter.

Choose the monthly code using both the patient’s age category and the number of face-to-face visits in the month. The record should support the visits and the ESRD-related assessment and management provided; report the service for the month, not as one unit for each visit. For a patient receiving home dialysis, compare the home-dialysis monthly family, 90963–90966. When management covers only part of a month, compare the age-specific daily service family, 90967–90970.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Merced, CA compares for 90951

Across 109 of 109 payment localities, the office rate for 90951 runs from $1,112.70 in Arkansas to $1,583.15 in Alaska. Merced, CA pays $1,206.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

90951 in Merced, CA vs other payment areas
  1. Merced, CA · this page$1,206.94
  2. Bakersfield, CA · California$1,212.10+$5.16
  3. Chico, CA · California$1,206.94
  4. El Centro, CA · California$1,207.18+$0.24
  5. Fresno, CA · California$1,206.94
  6. Hanford, CA · California$1,206.94
  7. Los Angeles, CA · California$1,261.59+$54.65

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

90951 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$1,206.94$1,206.94
Modesto, CACalifornia$1,206.94$1,206.94
Napa, CACalifornia$1,316.92$1,316.92
Oxnard, CACalifornia$1,248.87$1,248.87
Redding, CACalifornia$1,206.94$1,206.94
Rest of CaliforniaCalifornia$1,206.94$1,206.94
Riverside, CACalifornia$1,223.20$1,223.20
Sacramento, CACalifornia$1,244.63$1,244.63

90951 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,112.70

$1,583.15

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90951 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,583.151
AL$1,120.561
AR$1,112.701
AZ$1,166.291
CA$1,206.94–$1,397.5029
CO$1,204.141
CT$1,235.821
DC$1,292.191
DE$1,178.771
FL$1,193.47–$1,272.073
GA$1,156.80–$1,201.302
GU$1,209.231
HI$1,209.231
IA$1,125.761
ID$1,131.151
IL$1,181.95–$1,254.154
IN$1,134.131
KS$1,127.281
KY$1,142.291
LA$1,143.04–$1,170.542
MA$1,204.42–$1,276.312
MD$1,191.75–$1,292.193
ME$1,138.41–$1,162.712
MI$1,160.79–$1,205.422
MN$1,159.141
MO$1,136.09–$1,167.703
MS$1,124.291
MT$1,183.631
NC$1,143.611
ND$1,154.761
NE$1,127.521
NH$1,191.411
NJ$1,251.33–$1,291.142
NM$1,165.641
NV$1,175.921
NY$1,152.44–$1,340.165
OH$1,154.881
OK$1,136.901
OR$1,167.90–$1,221.322
PA$1,153.49–$1,221.302
PR$1,186.691
RI$1,204.731
SC$1,150.881
SD$1,151.351
TN$1,130.571
TX$1,150.02–$1,206.108
UT$1,158.591
VA$1,163.68–$1,292.192
VI$1,186.691
VT$1,156.281
WA$1,200.27–$1,291.032
WI$1,135.871
WV$1,160.731
WY$1,171.051

See 90951 in every payment locality

How the 90951 rate is calculated

Each of 90951’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 90951

RVUs × geographic indexes × conversion factor

Office or facility?

Work23.92

23.92 RVUs× 1.000 GPCI

Practice expense10.06

10.06 RVUs× 1.000 GPCI

Malpractice1.46

1.46 RVUs× 1.000 GPCI

Adjusted RVUs

35.4400

Conversion factor

$33.4009

Medicare rate

$1,183.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Merced, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,564

Code
90951
Physician work
23.92
Practice expense
10.06
Malpractice
1.46

GPCI2026.csv

15

Locality
Merced, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 90951 in Merced, CA
ComponentRVULocality factorAdjusted
Physician work23.92× 1.01724.3266
Practice expense10.06× 1.09611.0258
Malpractice1.46× 0.5360.7826
Total RVUs36.1350
Conversion factor× 33.4009

Office rate, Merced, CA$1206.94

Office: (23.92 × 1.017 + 10.06 × 1.096 + 1.46 × 0.536) × $33.4009 = $1206.94

Facility: (23.92 × 1.017 + 10.06 × 1.096 + 1.46 × 0.536) × $33.4009 = $1206.94

Open 90951 in the RVU calculator

Payment rules and modifiers for 90951

90951 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 90951

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$1,183.73

Non-facility (office)
$1,183.73
Facility
$1,183.73

Higher because the practice carries its own overhead.

How 90951 has changed in Merced, CA

90951 · Office / nonfacility

$1206.94

Effective 2026-10-01

The base rate is $73.07 higher than on 2025-10-01, moving from $1133.87 to $1206.94 (6.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $1133.87changed to$1206.94

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 9.04 changed to 10.06
    • Malpractice RVU 1.64 changed to 1.46
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1171.95changed to$1133.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.18 changed to 9.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1152.83changed to$1171.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1191.73changed to$1152.83

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.10 changed to 9.18
    • Malpractice RVU 1.60 changed to 1.64
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $1222.63changed to$1191.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.21 changed to 9.10
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1219.46changed to$1222.63

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.88 changed to 9.21
    • Malpractice RVU 1.55 changed to 1.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $975.67changed to$1219.46

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 18.46 changed to 23.92
    • Practice expense RVU 6.96 changed to 8.88
    • Malpractice RVU 1.18 changed to 1.55
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $973.04changed to$975.67

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.99 changed to 6.96
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $974.48changed to$973.04

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.06 changed to 6.99
    • Malpractice RVU 1.17 changed to 1.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $975.25changed to$974.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.01 changed to 7.06
    • Malpractice RVU 1.16 changed to 1.17
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$975.25

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,206.94$1,206.94RVU26D
2026-07-01$1,206.94$1,206.94RVU26C
2026-04-01$1,206.94$1,206.94RVU26B
2026-01-01$1,206.94$1,206.94RVU26A
2025-10-01$1,133.87$1,133.87RVU25D
2025-07-01$1,133.87$1,133.87RVU25C
2025-04-01$1,133.87$1,133.87RVU25B
2025-01-01$1,133.87$1,133.87RVU25A
2024-10-01$1,171.95$1,171.95RVU24D
2024-07-01$1,171.95$1,171.95RVU24C
2024-04-01$1,171.95$1,171.95RVU24B
2024-03-09$1,171.95$1,171.95RVU24AR
2024-01-01$1,152.83$1,152.83RVU24A
2023-10-01$1,191.73$1,191.73RVU23D
2023-07-01$1,191.73$1,191.73RVU23C
2023-04-01$1,191.73$1,191.73RVU23B
2023-01-01$1,191.73$1,191.73RVU23A
2022-10-01$1,222.63$1,222.63RVU22D
2022-07-01$1,222.63$1,222.63RVU22C
2022-04-01$1,222.63$1,222.63RVU22B
2022-01-01$1,222.63$1,222.63RVU22A
2021-10-01$1,219.46$1,219.46RVU21D
2021-07-01$1,219.46$1,219.46RVU21C
2021-04-01$1,219.46$1,219.46RVU21B
2021-01-01$1,219.46$1,219.46RVU21A
2020-10-01$975.67$975.67RVU20D
2020-07-01$975.67$975.67RVU20C
2020-04-01$975.67$975.67RVU20B
2020-01-01$975.67$975.67RVU20A
2019-10-01$973.04$973.04RVU19D
2019-07-01$973.04$973.04RVU19C
2019-04-01$973.04$973.04RVU19B
2019-01-01$973.04$973.04RVU19A
2018-10-01$974.48$974.48RVU18D
2018-07-01$974.48$974.48RVU18C
2018-04-01$974.48$974.48RVU18B
2018-01-01$974.48$974.48RVU18AR1
2017-10-01$975.25$975.25RVU17D
2017-07-01$975.25$975.25RVU17C
2017-04-01$975.25$975.25RVU17B
2017-01-01$975.25$975.25RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90951 for an earlier date of service

Where the Merced, CA rate applies

Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Merced
  • Atwater
  • Ballico
  • Bear Creek
  • Cressey
  • Delhi
  • Dos Palos
  • Dos Palos Y

Browse all communities in California

90951 billing questions

How many visits support 90951?

The patient must have at least four face-to-face visits with a physician or other qualified health care professional during the month. The record should support the visits and the ESRD-related management.

Is 90951 billed once for each visit?

No. It represents monthly ESRD-related management, selected by the monthly visit count rather than billed as a separate unit for each visit.

When should 90952 or 90953 be used instead?

For a patient younger than 2 years, 90952 is the sibling for two or three face-to-face visits in the month, and 90953 is for one visit.

Does 90951 describe home dialysis management?

For a patient receiving home dialysis, compare the age-based home-dialysis monthly codes 90963–90966 rather than choosing this code solely by visit count.

What documentation supports the monthly service?

Document the patient's age category, dates of face-to-face visits, and the ESRD-related assessment and management performed, such as review of dialysis needs, fluid status, access, or relevant laboratory findings.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 90951PPRRVU2026_Oct_nonQPP.csv, line 11,564 (RVU26D)
Geographic factors for Merced, CAGPCI2026.csv, line 15 (RVU26D)

Open CMS sourceHow we calculate rates

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