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CPT code 90955: Monthly ESRD care, ages 2–11, 2–3 visits2026 Medicare rate & RVUs in Austin, TX

Monthly ESRD-related management for a patient aged 2–11 when the physician or qualified health care professional provides two or three face-to-face visits.

CMS RVU26DEffective Oct 1, 2026One payment locality81 Medicare services in 2024

In Austin, TX, Medicare pays $546.67 for 90955 in the office and $546.67 when it’s performed in a hospital or facility.

$546.67Office (non-facility)
$546.67Hospital or facility
+1.5%vs the national office rate ($538.42)

Check a contract rate as a % of Medicare · 90955 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 90955 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Austin, TX
  2. What 90955 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 90955 covers

CPT 90955 represents monthly end-stage renal disease (ESRD)-related care for a patient aged 2 through 11 when the physician or qualified health care professional conducts two or three face-to-face visits during the month. Pediatric nephrologists commonly report it while managing children receiving maintenance dialysis. Monthly care may involve reviewing the dialysis plan, volume and blood-pressure status, laboratory results, medications, vascular or peritoneal access concerns, and treatment complications. This is monthly management, not a code for an individual dialysis treatment.

Choose the code by the patient’s age and the number of qualifying face-to-face visits during the month. The record should support the visit dates and the renal management provided; count these visits, not dialysis sessions. Report the monthly service once for the applicable month, rather than assigning 90955 to each visit. CMS assigns work, practice-expense, and malpractice relative value units to the 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 Austin, TX compares for 90955

Across 109 of 109 payment localities, the office rate for 90955 runs from $503.75 in Arkansas to $712.38 in Alaska. Austin, TX pays $546.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

90955 in Austin, TX vs other payment areas
  1. Austin, TX · this page$546.67
  2. Beaumont, TX · Texas$521.39−$25.28
  3. Brazoria, TX · Texas$534.93−$11.74
  4. Dallas, TX · Texas$537.80−$8.87
  5. Fort Worth, TX · Texas$536.35−$10.32
  6. Galveston, TX · Texas$536.30−$10.37
  7. Houston, TX · Texas$548.01+$1.34

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

Every other payment area

90955 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$527.56$527.56
Los Angeles, CACalifornia$576.91$576.91
Washington, DC areaDistrict of Columbia$590.13$590.13
Miami, FLFlorida$578.17$578.17
Chicago, ILIllinois$569.38$569.38
Manhattan, NYNew York$600.93$600.93
AlaskaAlaska$712.38$712.38
AlabamaAlabama$507.60$507.60

90955 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.

$503.75

$712.38

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

View every state and territory as a table
90955 office rate range by state
State / territoryOffice rate rangeLocalities
AK$712.381
AL$507.601
AR$503.751
AZ$530.001
CA$550.91–$642.6029
CO$548.911
CT$563.081
DC$590.131
DE$535.921
FL$541.59–$578.173
GA$523.91–$546.512
GU$553.031
HI$553.031
IA$510.881
ID$513.371
IL$535.46–$569.384
IN$514.851
KS$511.271
KY$517.471
LA$517.70–$531.162
MA$548.73–$583.642
MD$542.18–$590.133
ME$516.55–$528.982
MI$526.19–$547.052
MN$528.371
MO$514.08–$530.193
MS$508.891
MT$538.381
NC$519.161
ND$525.721
NE$511.861
NH$542.821
NJ$570.14–$589.172
NM$528.411
NV$535.021
NY$523.46–$611.385
OH$523.601
OK$515.211
OR$531.38–$557.602
PA$523.11–$555.822
PR$540.001
RI$548.351
SC$522.121
SD$524.231
TN$512.841
TX$521.39–$548.018
UT$525.901
VA$529.21–$590.132
VI$540.001
VT$526.141
WA$546.93–$590.872
WI$516.391
WV$525.061
WY$532.861

See 90955 in every payment locality

How the 90955 rate is calculated

Each of 90955’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 · 90955

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.32

10.32 RVUs× 1.000 GPCI

Practice expense5.16

5.16 RVUs× 1.000 GPCI

Malpractice0.64

0.64 RVUs× 1.000 GPCI

Adjusted RVUs

16.1200

Conversion factor

$33.4009

Medicare rate

$538.42

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

The exact Austin, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,568

Code
90955
Physician work
10.32
Practice expense
5.16
Malpractice
0.64

GPCI2026.csv

96

Locality
Austin, TX
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office calculation for 90955 in Austin, TX
ComponentRVULocality factorAdjusted
Physician work10.32× 1.00210.3406
Practice expense5.16× 1.0585.4593
Malpractice0.64× 0.8860.5670
Total RVUs16.3670
Conversion factor× 33.4009

Office rate, Austin, TX$546.67

Office: (10.32 × 1.002 + 5.16 × 1.058 + 0.64 × 0.886) × $33.4009 = $546.67

Facility: (10.32 × 1.002 + 5.16 × 1.058 + 0.64 × 0.886) × $33.4009 = $546.67

Open 90955 in the RVU calculator

Payment rules and modifiers for 90955

90955 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 · 90955

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$538.42

Non-facility (office)
$538.42
Facility
$538.42

Higher because the practice carries its own overhead.

Codes related to 90955

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

Codes related to 90955
CodeHow it relatesOffice range, Austin, TX
Same family
90954ESRD management, age 2–11, four visitsSame age band; selected for four or more face-to-face visits during the month.$1,047.88
90956ESRD service, ages 2–11, one monthly visitSame age band; selected for one face-to-face visit during the month.$373.24
90952ESRD monthly services, 2-3 visits, under age 2Same two-to-three-visit level for patients younger than 2.No office rate
90958ESRD management, age 12-19, 2-3 visitsSame two-to-three-visit level for patients aged 12 through 19.$526.84
90961ESRD management, 2-3 visits, age 20+Same two-to-three-visit level for patients aged 20 or older.$316.25

How 90955 has changed in Austin, TX

90955 · Office / nonfacility

$546.67

Effective 2026-10-01

The base rate is $37.57 higher than on 2025-10-01, moving from $509.10 to $546.67 (7.4%).

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

    $509.10changed to$546.67

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 4.63 changed to 5.16
    • Malpractice RVU 0.63 changed to 0.64
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $520.55changed to$509.10

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.49 changed to 4.63
    • Malpractice RVU 0.68 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $512.06changed to$520.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $522.33changed to$512.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.43 changed to 4.49
    • Malpractice RVU 0.59 changed to 0.68
    • Practice expense GPCI 1.053 changed to 1.046
    • Malpractice GPCI 0.727 changed to 0.914

  5. January 1, 2023

    RVU23A

    $532.52changed to$522.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.46 changed to 4.43
    • Malpractice RVU 0.64 changed to 0.59
    • Practice expense GPCI 1.059 changed to 1.053
    • Malpractice GPCI 0.539 changed to 0.727

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $533.24changed to$532.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.37 changed to 4.46
    • Malpractice RVU 0.62 changed to 0.64

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $467.79changed to$533.24

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 8.79 changed to 10.32
    • Practice expense RVU 3.69 changed to 4.37
    • Malpractice RVU 0.52 changed to 0.62
    • Practice expense GPCI 1.040 changed to 1.059
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $464.08changed to$467.79

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.63 changed to 3.69
    • Malpractice RVU 0.51 changed to 0.52
    • Practice expense GPCI 1.021 changed to 1.040
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $462.84changed to$464.08

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.61 changed to 3.63

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $461.82changed to$462.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.59 changed to 3.61
    • Malpractice RVU 0.55 changed to 0.51
    • Practice expense GPCI 1.020 changed to 1.021
    • Malpractice GPCI 0.757 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $460.33changed to$461.82

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.60 changed to 3.59
    • Malpractice RVU 0.52 changed to 0.55
    • Practice expense GPCI 1.019 changed to 1.020
    • Malpractice GPCI 0.766 changed to 0.757

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $462.35changed to$460.33

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.61 changed to 3.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $460.05changed to$462.35

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $459.16changed to$460.05

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.62 changed to 3.61
    • Malpractice RVU 0.47 changed to 0.52
    • Practice expense GPCI 1.014 changed to 1.019
    • Malpractice GPCI 0.759 changed to 0.766

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $445.81changed to$459.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.91 changed to 3.62
    • Malpractice RVU 0.49 changed to 0.47
    • Practice expense GPCI 1.009 changed to 1.014
    • Malpractice GPCI 0.751 changed to 0.759

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $445.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$546.67$546.67RVU26D
2026-07-01$546.67$546.67RVU26C
2026-04-01$546.67$546.67RVU26B
2026-01-01$546.67$546.67RVU26A
2025-10-01$509.10$509.10RVU25D
2025-07-01$509.10$509.10RVU25C
2025-04-01$509.10$509.10RVU25B
2025-01-01$509.10$509.10RVU25A
2024-10-01$520.55$520.55RVU24D
2024-07-01$520.55$520.55RVU24C
2024-04-01$520.55$520.55RVU24B
2024-03-09$520.55$520.55RVU24AR
2024-01-01$512.06$512.06RVU24A
2023-10-01$522.33$522.33RVU23D
2023-07-01$522.33$522.33RVU23C
2023-04-01$522.33$522.33RVU23B
2023-01-01$522.33$522.33RVU23A
2022-10-01$532.52$532.52RVU22D
2022-07-01$532.52$532.52RVU22C
2022-04-01$532.52$532.52RVU22B
2022-01-01$532.52$532.52RVU22A
2021-10-01$533.24$533.24RVU21D
2021-07-01$533.24$533.24RVU21C
2021-04-01$533.24$533.24RVU21B
2021-01-01$533.24$533.24RVU21A
2020-10-01$467.79$467.79RVU20D
2020-07-01$467.79$467.79RVU20C
2020-04-01$467.79$467.79RVU20B
2020-01-01$467.79$467.79RVU20A
2019-10-01$464.08$464.08RVU19D
2019-07-01$464.08$464.08RVU19C
2019-04-01$464.08$464.08RVU19B
2019-01-01$464.08$464.08RVU19A
2018-10-01$462.84$462.84RVU18D
2018-07-01$462.84$462.84RVU18C
2018-04-01$462.84$462.84RVU18B
2018-01-01$462.84$462.84RVU18AR1
2017-10-01$461.82$461.82RVU17D
2017-07-01$461.82$461.82RVU17C
2017-04-01$461.82$461.82RVU17B
2017-01-01$461.82$461.82RVU17A
2016-10-01$460.33$460.33RVU16D
2016-07-01$460.33$460.33RVU16C
2016-04-01$460.33$460.33RVU16B
2016-01-01$460.33$460.33RVU16A
2015-10-01$462.35$461.99RVU15D
2015-07-01$462.35$461.99RVU15C
2015-04-01$460.05$459.69RVU15B
2015-01-01$460.05$459.69RVU15A
2014-10-01$459.16$459.16RVU14D
2014-07-01$459.16$459.16RVU14C
2014-04-01$459.16$459.16RVU14B
2014-01-01$459.16$459.16RVU14A
2013-10-01$445.81$445.81RVU13D
2013-07-01$445.81$445.81RVU13C
2013-04-01$445.81$445.81RVU13B
2013-01-01$445.81$445.81RVU13AR

Price 90955 for an earlier date of service

Where the Austin, TX rate applies

Austin, TX is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

90955 billing questions

How many visits support 90955?

The patient must be 2 through 11 years old and have two or three qualifying face-to-face visits during the month. The number of dialysis sessions does not determine the visit level.

Should 90955 be reported for each monthly visit?

No. It represents the monthly ESRD-related service, so report it once for the month rather than once per face-to-face visit.

When should 90954 be used instead?

For a patient aged 2 through 11, use 90954 when the monthly visit count meets the four-or-more-visit level. Use 90955 for two or three visits.

What documentation supports 90955?

Document the patient's age, the dates of the two or three face-to-face visits, and the ESRD-related assessment and management furnished at those visits.

Is 90955 for an individual dialysis-session evaluation?

No. It represents monthly ESRD-related care. Codes such as 90935 or 90945 describe evaluation associated with an individual dialysis service, rather than this monthly visit-count service.

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 90955PPRRVU2026_Oct_nonQPP.csv, line 11,568 (RVU26D)
Geographic factors for Austin, TXGPCI2026.csv, line 96 (RVU26D)

Open CMS sourceHow we calculate rates

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