CPT code 90954: ESRD management, age 2–11, four visits2026 Medicare rate & RVUs in Kentucky

Monthly ESRD management for a child age 2 through 11 when four or more face-to-face visits are documented during the month.

CMS RVU26DEffective Oct 1, 2026One payment locality368 Medicare services in 2024

In Kentucky, Medicare pays $998.08 for 90954 in the office and $998.08 when it’s performed in a hospital or facility.

$998.08Office (non-facility)

$998.08Hospital or facility

−3.5%vs the national office rate ($1,034.43)

Check a contract rate as a % of Medicare · 90954 nationwide

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

On this page 11 sections

Rate in Kentucky
What 90954 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

What 90954 covers

This code represents a month of physician management for a patient with end-stage renal disease who is 2 through 11 years old and receives four or more face-to-face visits that month. A nephrologist or other physician managing the child’s renal disease typically provides these services in connection with ongoing dialysis care. The work may involve assessing the child’s condition, reviewing clinical information, and managing the renal treatment plan across the month.

Select this code using the patient’s age and the documented number of face-to-face visits in the month. The record should support the ESRD-related management and the visits counted, rather than treating each dialysis session as a separate monthly service. Report the monthly service that matches the documented visit count and age; codes 90955 and 90956 distinguish lower visit counts for the same age group. CMS assigns physician fee schedule work, practice expense, and malpractice RVUs to this service.

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 Kentucky compares for 90954

Across 109 of 109 payment localities, the office rate for 90954 runs from $971.76 in Arkansas to $1,382.26 in Alaska. Kentucky pays $998.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

90954 in Kentucky vs other payment areas

Kentucky · this page$998.08
Los Angeles, CA · California$1,102.08+$104.00
Washington, DC area · District of Columbia$1,129.31+$131.23
Miami, FL · Florida$1,113.38+$115.30
Chicago, IL · Illinois$1,097.44+$99.36
Manhattan, NY · New York$1,152.27+$154.19
Alaska · Alaska$1,382.26+$384.18

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

Every other payment area

90954 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	$978.70	$978.70
ArkansasArkansas	$971.76	$971.76
ArizonaArizona	$1,019.01	$1,019.01
Bakersfield, CACalifornia	$1,058.77	$1,058.77
Chico, CACalifornia	$1,054.19	$1,054.19
El Centro, CACalifornia	$1,054.40	$1,054.40
Fresno, CACalifornia	$1,054.19	$1,054.19
Hanford, CACalifornia	$1,054.19	$1,054.19
Madera, CACalifornia	$1,054.19	$1,054.19
Merced, CACalifornia	$1,054.19	$1,054.19
Modesto, CACalifornia	$1,054.19	$1,054.19
Napa, CACalifornia	$1,150.26	$1,150.26
Oxnard, CACalifornia	$1,090.93	$1,090.93
Redding, CACalifornia	$1,054.19	$1,054.19
Rest of CaliforniaCalifornia	$1,054.19	$1,054.19
Riverside, CACalifornia	$1,068.75	$1,068.75
Sacramento, CACalifornia	$1,087.12	$1,087.12
Salinas, CACalifornia	$1,082.46	$1,082.46
San Diego, CACalifornia	$1,092.90	$1,092.90
Marin County, CACalifornia	$1,197.46	$1,197.46
San Francisco, CACalifornia	$1,195.97	$1,195.97
San Benito County, CACalifornia	$1,220.68	$1,220.68
Santa Clara County, CACalifornia	$1,214.60	$1,214.60
San Luis Obispo, CACalifornia	$1,066.82	$1,066.82
Santa Cruz, CACalifornia	$1,091.95	$1,091.95
Santa Maria, CACalifornia	$1,082.42	$1,082.42
Santa Rosa, CACalifornia	$1,102.04	$1,102.04
Stockton, CACalifornia	$1,054.19	$1,054.19
Vallejo, CACalifornia	$1,148.12	$1,148.12
Visalia, CACalifornia	$1,054.19	$1,054.19
Yuba City, CACalifornia	$1,054.19	$1,054.19
ColoradoColorado	$1,052.02	$1,052.02
ConnecticutConnecticut	$1,080.18	$1,080.18
DelawareDelaware	$1,029.96	$1,029.96
Fort Lauderdale, FLFlorida	$1,073.60	$1,073.60
Rest of FloridaFlorida	$1,043.50	$1,043.50
Atlanta, GAGeorgia	$1,050.01	$1,050.01
Rest of GeorgiaGeorgia	$1,011.08	$1,011.08
Hawaii, Guam, HIHawaii	$1,056.27	$1,056.27
IowaIowa	$983.06	$983.06
IdahoIdaho	$987.85	$987.85
East St. Louis, ILIllinois	$1,055.28	$1,055.28
Rest of IllinoisIllinois	$1,033.49	$1,033.49
Suburban Chicago, ILIllinois	$1,081.02	$1,081.02
IndianaIndiana	$990.48	$990.48
KansasKansas	$984.51	$984.51
New Orleans, LALouisiana	$1,023.03	$1,023.03
Rest of LouisianaLouisiana	$998.79	$998.79
Metropolitan Boston, MAMassachusetts	$1,115.20	$1,115.20
Rest of MassachusettsMassachusetts	$1,052.27	$1,052.27
Baltimore area, MDMaryland	$1,077.40	$1,077.40
Rest of MarylandMaryland	$1,041.33	$1,041.33
Rest of MaineMaine	$994.37	$994.37
Southern Maine, MEMaine	$1,015.63	$1,015.63
Detroit, MIMichigan	$1,054.15	$1,054.15
Rest of MichiganMichigan	$1,014.50	$1,014.50
MinnesotaMinnesota	$1,012.15	$1,012.15
Metropolitan Kansas City, MOMissouri	$1,015.49	$1,015.49
Metropolitan St. Louis, MOMissouri	$1,020.40	$1,020.40
Rest of MissouriMissouri	$992.73	$992.73
MississippiMississippi	$982.15	$982.15
MontanaMontana	$1,034.34	$1,034.34
North CarolinaNorth Carolina	$998.94	$998.94
North DakotaNorth Dakota	$1,008.44	$1,008.44
NebraskaNebraska	$984.58	$984.58
New HampshireNew Hampshire	$1,041.01	$1,041.01
Northern New JerseyNew Jersey	$1,128.32	$1,128.32
Rest of New JerseyNew Jersey	$1,093.58	$1,093.58
New MexicoNew Mexico	$1,018.82	$1,018.82
NevadaNevada	$1,027.41	$1,027.41
NYC suburbs and Long Island, NYNew York	$1,172.07	$1,172.07
Poughkeepsie and northern NYC suburbs, NYNew York	$1,102.89	$1,102.89
Queens, NYNew York	$1,151.85	$1,151.85
Rest of New YorkNew York	$1,006.73	$1,006.73
OhioOhio	$1,009.20	$1,009.20
OklahomaOklahoma	$993.22	$993.22
Portland, OROregon	$1,067.00	$1,067.00
Rest of OregonOregon	$1,020.25	$1,020.25
Metropolitan Philadelphia, PAPennsylvania	$1,067.46	$1,067.46
Rest of PennsylvaniaPennsylvania	$1,007.92	$1,007.92
Puerto RicoPuerto Rico	$1,037.00	$1,037.00
Rhode IslandRhode Island	$1,052.64	$1,052.64
South CarolinaSouth Carolina	$1,005.52	$1,005.52
South DakotaSouth Dakota	$1,005.37	$1,005.37
TennesseeTennessee	$987.42	$987.42
Austin, TXTexas	$1,047.88	$1,047.88
Beaumont, TXTexas	$1,004.87	$1,004.87
Brazoria, TXTexas	$1,027.73	$1,027.73
Dallas, TXTexas	$1,033.31	$1,033.31
Fort Worth, TXTexas	$1,030.94	$1,030.94
Galveston, TXTexas	$1,030.42	$1,030.42
Houston, TXTexas	$1,054.39	$1,054.39
Rest of TexasTexas	$1,015.19	$1,015.19
UtahUtah	$1,012.33	$1,012.33
VirginiaVirginia	$1,016.57	$1,016.57
Virgin Islands, VIUnited States Virgin Islands	$1,037.00	$1,037.00
VermontVermont	$1,009.87	$1,009.87
Rest of WashingtonWashington	$1,048.60	$1,048.60
King County, WAWashington	$1,127.98	$1,127.98
WisconsinWisconsin	$991.80	$991.80
West VirginiaWest Virginia	$1,014.78	$1,014.78
WyomingWyoming	$1,023.05	$1,023.05

90954 rates by state

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

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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.

$971.76

$1,382.26

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

View every state and territory as a table

90954 office rate range by state
State / territory	Office rate range	Localities
AK	$1,382.26	1
AL	$978.70	1
AR	$971.76	1
AZ	$1,019.01	1
CA	$1,054.19–$1,220.68	29
CO	$1,052.02	1
CT	$1,080.18	1
DC	$1,129.31	1
DE	$1,029.96	1
FL	$1,043.50–$1,113.38	3
GA	$1,011.08–$1,050.01	2
GU	$1,056.27	1
HI	$1,056.27	1
IA	$983.06	1
ID	$987.85	1
IL	$1,033.49–$1,097.44	4
IN	$990.48	1
KS	$984.51	1
KY	$998.08	1
LA	$998.79–$1,023.03	2
MA	$1,052.27–$1,115.20	2
MD	$1,041.33–$1,129.31	3
ME	$994.37–$1,015.63	2
MI	$1,014.50–$1,054.15	2
MN	$1,012.15	1
MO	$992.73–$1,020.40	3
MS	$982.15	1
MT	$1,034.34	1
NC	$998.94	1
ND	$1,008.44	1
NE	$984.58	1
NH	$1,041.01	1
NJ	$1,093.58–$1,128.32	2
NM	$1,018.82	1
NV	$1,027.41	1
NY	$1,006.73–$1,172.07	5
OH	$1,009.20	1
OK	$993.22	1
OR	$1,020.25–$1,067.00	2
PA	$1,007.92–$1,067.46	2
PR	$1,037.00	1
RI	$1,052.64	1
SC	$1,005.52	1
SD	$1,005.37	1
TN	$987.42	1
TX	$1,004.87–$1,054.39	8
UT	$1,012.33	1
VA	$1,016.57–$1,129.31	2
VI	$1,037.00	1
VT	$1,009.87	1
WA	$1,048.60–$1,127.98	2
WI	$991.80	1
WV	$1,014.78	1
WY	$1,023.05	1

See 90954 in every payment locality

How the 90954 rate is calculated

Each of 90954’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 · 90954

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work20.86

20.86 RVUs× 1.000 GPCI

Practice expense8.80

8.80 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

30.9700

Conversion factor

$33.4009

Medicare rate

$1,034.43

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,567

Code: 90954
Physician work: 20.86
Practice expense: 8.80
Malpractice: 1.31

GPCI2026.csv

Locality: Kentucky
Physician work: 1.000
Practice expense: 0.889
Malpractice: 0.915

Office calculation for 90954 in Kentucky
Component	RVU	Locality factor	Adjusted
Physician work	20.86	× 1.000	20.8600
Practice expense	8.80	× 0.889	7.8232
Malpractice	1.31	× 0.915	1.1986
Total RVUs			29.8819
Conversion factor			× 33.4009

Office rate, Kentucky$998.08

Office: (20.86 × 1 + 8.8 × 0.889 + 1.31 × 0.915) × $33.4009 = $998.08

Facility: (20.86 × 1 + 8.8 × 0.889 + 1.31 × 0.915) × $33.4009 = $998.08

Open 90954 in the RVU calculator

Payment rules and modifiers for 90954

90954 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 · 90954

Which rate does Medicare pay?

Place of service

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

POS 11 · non-facility rate · national

$1,034.43

Non-facility (office): $1,034.43
Facility: $1,034.43

Higher because the practice carries its own overhead.

Codes related to 90954

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

Codes related to 90954
Code	How it relates	Office range, Kentucky
Same family
90951	ESRD monthly care, under 2 years, 4+ visitsFour-or-more-visit monthly ESRD management for patients younger than 2.	$1,142.29
90955	Monthly ESRD care, ages 2–11, 2–3 visitsMonthly ESRD management for ages 2–11 with two or three visits.	$517.47
90956	ESRD service, ages 2–11, one monthly visitMonthly ESRD management for ages 2–11 with one visit.	$351.01
90957	ESRD monthly care, age 12–19, four or more visitsFour-or-more-visit monthly ESRD management for patients ages 12–19.	$766.65
90960	Monthly ESRD services, age 20+, four or more visitsFour-or-more-visit monthly ESRD management for patients age 20 or older.	$356.85
Used instead
90968	ESRD daily care, ages 2–11, partial monthPer-day ESRD service code for ages 2–11 when monthly services are reported by day.	$17.02

How 90954 has changed in Kentucky

90954 · Office / nonfacility

$998.08

Effective 2026-10-01

Compare with release effective

The base rate is $67.87 higher than on 2025-10-01, moving from $930.21 to $998.08 (7.3%).

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

January 1, 2026
RVU26A
$930.21changed to$998.08
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 7.60 changed to 8.80
- Malpractice RVU 1.35 changed to 1.31
- Practice expense GPCI 0.877 changed to 0.889
- Malpractice GPCI 0.913 changed to 0.915
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$956.40changed to$930.21
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.57 changed to 7.60
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$940.79changed to$956.40
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$967.98changed to$940.79
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.51 changed to 7.57
- Malpractice RVU 1.32 changed to 1.35
- Practice expense GPCI 0.873 changed to 0.877
- Malpractice GPCI 0.870 changed to 0.913
January 1, 2023
RVU23A
$989.96changed to$967.98
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.62 changed to 7.51
- Malpractice RVU 1.36 changed to 1.32
- Practice expense GPCI 0.869 changed to 0.873
- Malpractice GPCI 0.827 changed to 0.870
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$758.07changed to$989.96
- Conversion factor 34.8931 changed to 34.6062
- Work RVU 15.98 changed to 20.86
- Practice expense RVU 5.66 changed to 7.62
- Malpractice RVU 1.00 changed to 1.36
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$798.52changed to$758.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.10 changed to 5.66
- Malpractice RVU 0.99 changed to 1.00
- Practice expense GPCI 0.874 changed to 0.869
- Malpractice GPCI 0.823 changed to 0.827
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$795.18changed to$798.52
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.03 changed to 6.10
- Malpractice RVU 0.95 changed to 0.99
- Practice expense GPCI 0.880 changed to 0.874
- Malpractice GPCI 0.819 changed to 0.823
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$795.53changed to$795.18
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.05 changed to 6.03
- Malpractice RVU 0.97 changed to 0.95
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$792.09changed to$795.53
- Conversion factor 35.8887 changed to 35.9996
- Malpractice RVU 0.98 changed to 0.97
- Practice expense GPCI 0.876 changed to 0.880
- Malpractice GPCI 0.807 changed to 0.819
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$789.51changed to$792.09
- Conversion factor 35.8043 changed to 35.8887
- Malpractice RVU 1.00 changed to 0.98
- Practice expense GPCI 0.872 changed to 0.876
- Malpractice GPCI 0.795 changed to 0.807
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$794.26changed to$789.51
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.12 changed to 6.05
- Malpractice RVU 0.99 changed to 1.00
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$790.31changed to$794.26
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$783.72changed to$790.31
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.00 changed to 6.12
- Malpractice RVU 0.86 changed to 0.99
- Malpractice GPCI 0.774 changed to 0.795
Held through RVU15B.
January 1, 2014
RVU14A
$759.04changed to$783.72
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.49 changed to 6.00
- Malpractice RVU 0.90 changed to 0.86
- Practice expense GPCI 0.871 changed to 0.872
- Malpractice GPCI 0.752 changed to 0.774
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $759.04
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$998.08	$998.08	RVU26D
2026-07-01	$998.08	$998.08	RVU26C
2026-04-01	$998.08	$998.08	RVU26B
2026-01-01	$998.08	$998.08	RVU26A
2025-10-01	$930.21	$930.21	RVU25D
2025-07-01	$930.21	$930.21	RVU25C
2025-04-01	$930.21	$930.21	RVU25B
2025-01-01	$930.21	$930.21	RVU25A
2024-10-01	$956.40	$956.40	RVU24D
2024-07-01	$956.40	$956.40	RVU24C
2024-04-01	$956.40	$956.40	RVU24B
2024-03-09	$956.40	$956.40	RVU24AR
2024-01-01	$940.79	$940.79	RVU24A
2023-10-01	$967.98	$967.98	RVU23D
2023-07-01	$967.98	$967.98	RVU23C
2023-04-01	$967.98	$967.98	RVU23B
2023-01-01	$967.98	$967.98	RVU23A
2022-10-01	$989.96	$989.96	RVU22D
2022-07-01	$989.96	$989.96	RVU22C
2022-04-01	$989.96	$989.96	RVU22B
2022-01-01	$989.96	$989.96	RVU22A
2021-10-01	$758.07	$758.07	RVU21D
2021-07-01	$758.07	$758.07	RVU21C
2021-04-01	$758.07	$758.07	RVU21B
2021-01-01	$758.07	$758.07	RVU21A
2020-10-01	$798.52	$798.52	RVU20D
2020-07-01	$798.52	$798.52	RVU20C
2020-04-01	$798.52	$798.52	RVU20B
2020-01-01	$798.52	$798.52	RVU20A
2019-10-01	$795.18	$795.18	RVU19D
2019-07-01	$795.18	$795.18	RVU19C
2019-04-01	$795.18	$795.18	RVU19B
2019-01-01	$795.18	$795.18	RVU19A
2018-10-01	$795.53	$795.53	RVU18D
2018-07-01	$795.53	$795.53	RVU18C
2018-04-01	$795.53	$795.53	RVU18B
2018-01-01	$795.53	$795.53	RVU18AR1
2017-10-01	$792.09	$792.09	RVU17D
2017-07-01	$792.09	$792.09	RVU17C
2017-04-01	$792.09	$792.09	RVU17B
2017-01-01	$792.09	$792.09	RVU17A
2016-10-01	$789.51	$789.51	RVU16D
2016-07-01	$789.51	$789.51	RVU16C
2016-04-01	$789.51	$789.51	RVU16B
2016-01-01	$789.51	$789.51	RVU16A
2015-10-01	$794.26	$793.95	RVU15D
2015-07-01	$794.26	$793.95	RVU15C
2015-04-01	$790.31	$790.00	RVU15B
2015-01-01	$790.31	$790.00	RVU15A
2014-10-01	$783.72	$783.72	RVU14D
2014-07-01	$783.72	$783.72	RVU14C
2014-04-01	$783.72	$783.72	RVU14B
2014-01-01	$783.72	$783.72	RVU14A
2013-10-01	$759.04	$759.04	RVU13D
2013-07-01	$759.04	$759.04	RVU13C
2013-04-01	$759.04	$759.04	RVU13B
2013-01-01	$759.04	$759.04	RVU13AR

Price 90954 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

Adairville
Ages
Albany
Alexandria
Allen
Allensville
Anchorage
Annville

Browse all communities in Kentucky

90954 billing questions

What visit count supports 90954?

Use it for a patient age 2 through 11 when four or more face-to-face visits are documented during the month. The record should support the visits and the related ESRD management.

How does 90954 differ from 90955?

Both are monthly ESRD management codes for patients age 2 through 11. Choose 90954 for four or more visits; 90955 is for two or three.

When should 90956 be selected instead?

90956 is the same-age monthly code for one face-to-face visit. Use 90954 when the documented count reaches four or more.

Is 90954 reported for each dialysis treatment?

No. It represents monthly ESRD-related physician management based on the visit count, not a separate monthly service for each dialysis session.

Which code applies when the patient turns 12?

For a patient age 12 through 19 with four or more face-to-face visits in the month, compare 90957. The applicable age group and documented monthly visit count determine the code.

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 90954PPRRVU2026_Oct_nonQPP.csv, line 11,567 (RVU26D)

11,56490951,,[CPT descriptor omitted],A,,23.92,10.06,,10.06,,1.46,35.44,35.44,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56590952,,[CPT descriptor omitted],C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56690953,,[CPT descriptor omitted],C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56790954,,[CPT descriptor omitted],A,,20.86,8.80,,8.80,,1.31,30.97,30.97,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56890955,,[CPT descriptor omitted],A,,10.32,5.16,,5.16,,0.64,16.12,16.12,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56990956,,[CPT descriptor omitted],A,,6.64,3.93,,3.93,,0.41,10.98,10.98,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,57090957,,[CPT descriptor omitted],A,,15.46,7.42,,7.42,,0.98,23.86,23.86,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

5208102,IN,00,INDIANA,1.000,0.927,0.486

5305102,IA,00,IOWA,1.000,0.915,0.397

5405202,KS,00,KANSAS,1.000,0.904,0.504

5515102,KY,00,KENTUCKY,1.000,0.889,0.915

5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136

5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958

5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631

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Which code applies when the patient turns 12?

Where these rates come from

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