CPT code 90953: Monthly ESRD services, one visit, under age 22026 Medicare rate & RVUs in Michigan
Monthly ESRD services for a patient younger than 2 with one visit during the month are reported with this age- and visit-specific code.
CMS doesn’t publish an office rate for 90953 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 90953 covers
90953 identifies monthly ESRD services for a patient younger than 2 years when one visit is furnished during the month. It is part of the age- and visit-count-based monthly ESRD service series. For patients younger than 2, 90951 is the code for four or more visits and 90952 covers two to three visits; 90953 is the one-visit code. Codes 90954 through 90962 cover other age groups, while 90963 through 90966 identify monthly services for home patients.
Medicare assigns 90953 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 identifies a monthly service, distinguished from the per-day ESRD service label for patients younger than 2. Selection within the monthly series follows the patient's age group and the number of visits during the month.
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 90953 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the 90953 rate is calculated
Each of 90953’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 · 90953
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90953
90953 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 · 90953
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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90953 isn’t priced in this setting.
90953 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 90951ESRD monthly careUnder 2 years, 4+ visits
- Both are monthly ESRD service codes for patients younger than 2. Code 90951 is for four or more visits; 90953 is for one visit.
- 90952ESRD monthly services2-3 visits, under age 2
- Both are monthly codes for patients younger than 2. Code 90952 is for two to three visits; 90953 is for one.
- 90956ESRD serviceAges 2–11, one monthly visit
- Both represent monthly ESRD services with one visit. Code 90956 is for patients ages 2 through 11; 90953 is for patients younger than 2.
- 90963ESRD managementHome dialysis, under age 2
- Code 90963 identifies monthly ESRD services for a home patient younger than 2; 90953 is the one-visit code in the other monthly ESRD service series.
90953 billing questions
When is 90953 selected instead of 90951 or 90952?
90953 is the monthly code for one visit for a patient younger than 2. Code 90951 is for four or more visits, and 90952 is for two to three visits.
Which age group does 90953 cover?
It is for a patient younger than 2. The monthly ESRD service series has separate codes for older age groups.
Which monthly code series identifies home patients?
Codes 90963 through 90966 identify monthly ESRD services for home patients, with 90963 designated for patients younger than 2.
How does Medicare price 90953?
Its physician fee schedule status is carrier priced. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.
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
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