CPT code 90952: ESRD monthly services, 2-3 visits, under age 22026 Medicare rate & RVUs

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

What 90952 covers

This code represents monthly management of end-stage renal disease for a patient younger than 2 years who receives 2 or 3 face-to-face visits during the month. A physician or other qualified health care professional, typically a pediatric nephrologist, reports it for ongoing ESRD care. The visits address the patient’s renal status and dialysis management; this is not a code for an individual dialysis treatment or vascular access study.

Medicare assigns physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The code is selected by the patient’s age and the number of face-to-face visits in the month. It represents monthly services, rather than a separate unit for each visit.

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.

Where 90952 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90952 rates by state

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

How the 90952 rate is calculated

Each of 90952’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.

Payment rules and modifiers for 90952

90952 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.

90952 compared with similar codes

How to choose

90951ESRD monthly careUnder 2 years, 4+ visits

Both apply to patients younger than 2 years, but 90951 is for 4 face-to-face visits during the month; 90952 is for 2 or 3.

90953Monthly ESRD servicesOne visit, under age 2

90953 is the monthly service code for 1 face-to-face visit for a patient under 2; 90952 covers 2 or 3 visits.

90955Monthly ESRD careAges 2–11, 2–3 visits

The visit count is the same, but 90955 is for patients ages 2 through 11. 90952 is for patients younger than 2.

90963ESRD managementHome dialysis, under age 2

90963 describes monthly ESRD services for a patient under 2 receiving home dialysis; 90952 is the monthly code for 2 or 3 visits in the other ESRD service category.

Codes related to 90952

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

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

Open CMS sourceHow we calculate rates