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

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 North Carolina, Medicare pays $1,143.61 for 90951 in the office and $1,143.61 when it’s performed in a hospital or facility.

$1,143.61Office (non-facility)
$1,143.61Hospital or facility
−3.4%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 North Carolina
  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 North Carolina 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. North Carolina pays $1,143.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

90951 in North Carolina vs other payment areas
  1. North Carolina · this page$1,143.61
  2. Los Angeles, CA · California$1,261.59+$117.98
  3. Washington, DC area · District of Columbia$1,292.19+$148.58
  4. Miami, FL · Florida$1,272.07+$128.46
  5. Chicago, IL · Illinois$1,254.15+$110.54
  6. Manhattan, NY · New York$1,317.87+$174.26
  7. Alaska · Alaska$1,583.15+$439.54

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

Every other payment area

90951 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,120.56$1,120.56
ArkansasArkansas$1,112.70$1,112.70
ArizonaArizona$1,166.29$1,166.29
Bakersfield, CACalifornia$1,212.10$1,212.10
Chico, CACalifornia$1,206.94$1,206.94
El Centro, CACalifornia$1,207.18$1,207.18
Fresno, CACalifornia$1,206.94$1,206.94
Hanford, CACalifornia$1,206.94$1,206.94

90951 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 90951 in North Carolina
ComponentRVULocality factorAdjusted
Physician work23.92× 1.00023.9200
Practice expense10.06× 0.9339.3860
Malpractice1.46× 0.6390.9329
Total RVUs34.2389
Conversion factor× 33.4009

Office rate, North Carolina$1143.61

Office: (23.92 × 1 + 10.06 × 0.933 + 1.46 × 0.639) × $33.4009 = $1143.61

Facility: (23.92 × 1 + 10.06 × 0.933 + 1.46 × 0.639) × $33.4009 = $1143.61

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.

Codes related to 90951

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 90951
CodeHow it relatesOffice range, North Carolina
Same family
90952ESRD monthly services, 2-3 visits, under age 2For patients younger than 2 years with two or three face-to-face visits in the month.No office rate
90953Monthly ESRD services, one visit, under age 2For patients younger than 2 years with one face-to-face visit in the month.No office rate
90954ESRD management, age 2–11, four visitsUses the four-or-more-visit level for patients ages 2 through 11.$998.94
Used instead
90963ESRD management, home dialysis, under age 2Monthly ESRD-related service code for a patient younger than 2 years receiving home dialysis.$604.00
90967ESRD services, patient younger than 2Age-specific daily ESRD service code for patients younger than 2 years when management is reported by day.$17.73

How 90951 has changed in North Carolina

90951 · Office / nonfacility

$1143.61

Effective 2026-10-01

The base rate is $63.83 higher than on 2025-10-01, moving from $1079.78 to $1143.61 (5.9%).

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

    $1079.78changed to$1143.61

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1115.51changed to$1079.78

    • 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

    $1097.30changed to$1115.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1136.67changed to$1097.30

    • 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
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $1168.90changed to$1136.67

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.21 changed to 9.10
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1166.48changed to$1168.90

    • 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

    $932.05changed to$1166.48

    • 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
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $929.37changed to$932.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.99 changed to 6.96
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $930.45changed to$929.37

    • 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

    $927.20changed to$930.45

    • 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
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $925.34changed to$927.20

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.85 changed to 7.01
    • Malpractice RVU 1.32 changed to 1.16
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $926.22changed to$925.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.95 changed to 6.85
    • Malpractice RVU 1.11 changed to 1.32

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $921.61changed to$926.22

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $915.95changed to$921.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.88 changed to 6.95
    • Malpractice RVU 0.98 changed to 1.11
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $885.26changed to$915.95

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.39 changed to 6.88
    • Malpractice RVU 1.02 changed to 0.98
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $885.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,143.61$1,143.61RVU26D
2026-07-01$1,143.61$1,143.61RVU26C
2026-04-01$1,143.61$1,143.61RVU26B
2026-01-01$1,143.61$1,143.61RVU26A
2025-10-01$1,079.78$1,079.78RVU25D
2025-07-01$1,079.78$1,079.78RVU25C
2025-04-01$1,079.78$1,079.78RVU25B
2025-01-01$1,079.78$1,079.78RVU25A
2024-10-01$1,115.51$1,115.51RVU24D
2024-07-01$1,115.51$1,115.51RVU24C
2024-04-01$1,115.51$1,115.51RVU24B
2024-03-09$1,115.51$1,115.51RVU24AR
2024-01-01$1,097.30$1,097.30RVU24A
2023-10-01$1,136.67$1,136.67RVU23D
2023-07-01$1,136.67$1,136.67RVU23C
2023-04-01$1,136.67$1,136.67RVU23B
2023-01-01$1,136.67$1,136.67RVU23A
2022-10-01$1,168.90$1,168.90RVU22D
2022-07-01$1,168.90$1,168.90RVU22C
2022-04-01$1,168.90$1,168.90RVU22B
2022-01-01$1,168.90$1,168.90RVU22A
2021-10-01$1,166.48$1,166.48RVU21D
2021-07-01$1,166.48$1,166.48RVU21C
2021-04-01$1,166.48$1,166.48RVU21B
2021-01-01$1,166.48$1,166.48RVU21A
2020-10-01$932.05$932.05RVU20D
2020-07-01$932.05$932.05RVU20C
2020-04-01$932.05$932.05RVU20B
2020-01-01$932.05$932.05RVU20A
2019-10-01$929.37$929.37RVU19D
2019-07-01$929.37$929.37RVU19C
2019-04-01$929.37$929.37RVU19B
2019-01-01$929.37$929.37RVU19A
2018-10-01$930.45$930.45RVU18D
2018-07-01$930.45$930.45RVU18C
2018-04-01$930.45$930.45RVU18B
2018-01-01$930.45$930.45RVU18AR1
2017-10-01$927.20$927.20RVU17D
2017-07-01$927.20$927.20RVU17C
2017-04-01$927.20$927.20RVU17B
2017-01-01$927.20$927.20RVU17A
2016-10-01$925.34$925.34RVU16D
2016-07-01$925.34$925.34RVU16C
2016-04-01$925.34$925.34RVU16B
2016-01-01$925.34$925.34RVU16A
2015-10-01$926.22$925.89RVU15D
2015-07-01$926.22$925.89RVU15C
2015-04-01$921.61$921.28RVU15B
2015-01-01$921.61$921.28RVU15A
2014-10-01$915.95$915.95RVU14D
2014-07-01$915.95$915.95RVU14C
2014-04-01$915.95$915.95RVU14B
2014-01-01$915.95$915.95RVU14A
2013-10-01$885.26$885.26RVU13D
2013-07-01$885.26$885.26RVU13C
2013-04-01$885.26$885.26RVU13B
2013-01-01$885.26$885.26RVU13AR

Price 90951 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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