CPT code 90956: ESRD service, ages 2–11, one monthly visit2026 Medicare rate & RVUs in Arizona
Reports monthly ESRD-related physician services for a patient ages 2–11 when one face-to-face visit is furnished during the month.
In Arizona, Medicare pays $360.70 for 90956 in the office and $360.70 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90956 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
What 90956 covers
This code represents monthly ESRD-related care for a patient who is 2 through 11 years old and receives one face-to-face visit during the month. A nephrologist commonly provides the visit in a dialysis setting, reviewing the child’s clinical course and addressing ESRD management needs such as dialysis tolerance, fluid status, laboratory findings, medications, and growth or nutrition concerns. It represents monthly care, not a separate evaluation for each dialysis treatment.
Select the code by the patient’s age and the number of face-to-face visits furnished in the month. Documentation should support the patient’s age, the date and substance of the visit, and the ESRD-related management performed. Use the corresponding sibling when the monthly visit count or age band differs; the home-dialysis monthly series and per-day services describe different circumstances. CMS assigns physician fee schedule values 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 Arizona compares for 90956
Across 109 of 109 payment localities, the office rate for 90956 runs from $341.59 in Arkansas to $480.02 in Alaska. Arizona pays $360.70. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arizona · this page$360.70
- Los Angeles, CA · California$395.26+$34.56
- Washington, DC area · District of Columbia$403.63+$42.93
- Miami, FL · Florida$393.06+$32.36
- Chicago, IL · Illinois$386.68+$25.98
- Manhattan, NY · New York$410.23+$49.53
- Alaska · Alaska$480.02+$119.32
Other areas in Arizona first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $344.39 | $344.39 |
| ArkansasArkansas | $341.59 | $341.59 |
| Bakersfield, CACalifornia | $378.20 | $378.20 |
| Chico, CACalifornia | $376.76 | $376.76 |
| El Centro, CACalifornia | $376.83 | $376.83 |
| Fresno, CACalifornia | $376.76 | $376.76 |
| Hanford, CACalifornia | $376.76 | $376.76 |
| Madera, CACalifornia | $376.76 | $376.76 |
| Merced, CACalifornia | $376.76 | $376.76 |
| Modesto, CACalifornia | $376.76 | $376.76 |
| Napa, CACalifornia | $415.72 | $415.72 |
| Oxnard, CACalifornia | $391.68 | $391.68 |
| Redding, CACalifornia | $376.76 | $376.76 |
| Rest of CaliforniaCalifornia | $376.76 | $376.76 |
| Riverside, CACalifornia | $381.32 | $381.32 |
| Sacramento, CACalifornia | $389.77 | $389.77 |
| Salinas, CACalifornia | $388.13 | $388.13 |
| San Diego, CACalifornia | $392.85 | $392.85 |
| Marin County, CACalifornia | $434.22 | $434.22 |
| San Francisco, CACalifornia | $433.76 | $433.76 |
| San Benito County, CACalifornia | $442.80 | $442.80 |
| Santa Clara County, CACalifornia | $440.90 | $440.90 |
| San Luis Obispo, CACalifornia | $382.40 | $382.40 |
| Santa Cruz, CACalifornia | $393.27 | $393.27 |
| Santa Maria, CACalifornia | $388.39 | $388.39 |
| Santa Rosa, CACalifornia | $396.97 | $396.97 |
| Stockton, CACalifornia | $376.76 | $376.76 |
| Vallejo, CACalifornia | $415.05 | $415.05 |
| Visalia, CACalifornia | $376.76 | $376.76 |
| Yuba City, CACalifornia | $376.76 | $376.76 |
| ColoradoColorado | $374.81 | $374.81 |
| ConnecticutConnecticut | $384.16 | $384.16 |
| DelawareDelaware | $364.89 | $364.89 |
| Fort Lauderdale, FLFlorida | $379.51 | $379.51 |
| Rest of FloridaFlorida | $367.85 | $367.85 |
| Atlanta, GAGeorgia | $372.26 | $372.26 |
| Rest of GeorgiaGeorgia | $355.19 | $355.19 |
| Hawaii, Guam, HIHawaii | $378.96 | $378.96 |
| IowaIowa | $347.33 | $347.33 |
| IdahoIdaho | $349.02 | $349.02 |
| East St. Louis, ILIllinois | $370.13 | $370.13 |
| Rest of IllinoisIllinois | $363.03 | $363.03 |
| Suburban Chicago, ILIllinois | $382.41 | $382.41 |
| IndianaIndiana | $350.12 | $350.12 |
| KansasKansas | $347.35 | $347.35 |
| KentuckyKentucky | $351.01 | $351.01 |
| New Orleans, LALouisiana | $360.86 | $360.86 |
| Rest of LouisianaLouisiana | $351.07 | $351.07 |
| Metropolitan Boston, MAMassachusetts | $399.79 | $399.79 |
| Rest of MassachusettsMassachusetts | $374.47 | $374.47 |
| Baltimore area, MDMaryland | $383.12 | $383.12 |
| Rest of MarylandMaryland | $369.41 | $369.41 |
| Rest of MaineMaine | $351.06 | $351.06 |
| Southern Maine, MEMaine | $360.51 | $360.51 |
| Detroit, MIMichigan | $371.54 | $371.54 |
| Rest of MichiganMichigan | $357.09 | $357.09 |
| MinnesotaMinnesota | $360.91 | $360.91 |
| Metropolitan Kansas City, MOMissouri | $358.42 | $358.42 |
| Metropolitan St. Louis, MOMissouri | $360.47 | $360.47 |
| Rest of MissouriMissouri | $348.27 | $348.27 |
| MississippiMississippi | $344.92 | $344.92 |
| MontanaMontana | $366.71 | $366.71 |
| North CarolinaNorth Carolina | $353.00 | $353.00 |
| North DakotaNorth Dakota | $358.61 | $358.61 |
| NebraskaNebraska | $348.12 | $348.12 |
| New HampshireNew Hampshire | $370.41 | $370.41 |
| Northern New JerseyNew Jersey | $402.65 | $402.65 |
| Rest of New JerseyNew Jersey | $389.02 | $389.02 |
| New MexicoNew Mexico | $358.60 | $358.60 |
| NevadaNevada | $364.59 | $364.59 |
| NYC suburbs and Long Island, NYNew York | $417.48 | $417.48 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $392.07 | $392.07 |
| Queens, NYNew York | $410.88 | $410.88 |
| Rest of New YorkNew York | $356.11 | $356.11 |
| OhioOhio | $355.43 | $355.43 |
| OklahomaOklahoma | $349.64 | $349.64 |
| Portland, OROregon | $381.36 | $381.36 |
| Rest of OregonOregon | $362.15 | $362.15 |
| Metropolitan Philadelphia, PAPennsylvania | $378.76 | $378.76 |
| Rest of PennsylvaniaPennsylvania | $355.22 | $355.22 |
| Puerto RicoPuerto Rico | $367.98 | $367.98 |
| Rhode IslandRhode Island | $373.81 | $373.81 |
| South CarolinaSouth Carolina | $354.71 | $354.71 |
| South DakotaSouth Dakota | $357.65 | $357.65 |
| TennesseeTennessee | $348.46 | $348.46 |
| Austin, TXTexas | $373.24 | $373.24 |
| Beaumont, TXTexas | $353.96 | $353.96 |
| Brazoria, TXTexas | $364.32 | $364.32 |
| Dallas, TXTexas | $366.27 | $366.27 |
| Fort Worth, TXTexas | $365.13 | $365.13 |
| Galveston, TXTexas | $365.24 | $365.24 |
| Houston, TXTexas | $372.75 | $372.75 |
| Rest of TexasTexas | $358.72 | $358.72 |
| UtahUtah | $357.47 | $357.47 |
| VirginiaVirginia | $360.48 | $360.48 |
| Virgin Islands, VIUnited States Virgin Islands | $367.98 | $367.98 |
| VermontVermont | $358.66 | $358.66 |
| Rest of WashingtonWashington | $373.31 | $373.31 |
| King County, WAWashington | $405.12 | $405.12 |
| WisconsinWisconsin | $351.75 | $351.75 |
| West VirginiaWest Virginia | $355.45 | $355.45 |
| WyomingWyoming | $363.18 | $363.18 |
90956 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$341.59
$480.02
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $480.02 | 1 |
| AL | $344.39 | 1 |
| AR | $341.59 | 1 |
| AZ | $360.70 | 1 |
| CA | $376.76–$442.80 | 29 |
| CO | $374.81 | 1 |
| CT | $384.16 | 1 |
| DC | $403.63 | 1 |
| DE | $364.89 | 1 |
| FL | $367.85–$393.06 | 3 |
| GA | $355.19–$372.26 | 2 |
| GU | $378.96 | 1 |
| HI | $378.96 | 1 |
| IA | $347.33 | 1 |
| ID | $349.02 | 1 |
| IL | $363.03–$386.68 | 4 |
| IN | $350.12 | 1 |
| KS | $347.35 | 1 |
| KY | $351.01 | 1 |
| LA | $351.07–$360.86 | 2 |
| MA | $374.47–$399.79 | 2 |
| MD | $369.41–$403.63 | 3 |
| ME | $351.06–$360.51 | 2 |
| MI | $357.09–$371.54 | 2 |
| MN | $360.91 | 1 |
| MO | $348.27–$360.47 | 3 |
| MS | $344.92 | 1 |
| MT | $366.71 | 1 |
| NC | $353.00 | 1 |
| ND | $358.61 | 1 |
| NE | $348.12 | 1 |
| NH | $370.41 | 1 |
| NJ | $389.02–$402.65 | 2 |
| NM | $358.60 | 1 |
| NV | $364.59 | 1 |
| NY | $356.11–$417.48 | 5 |
| OH | $355.43 | 1 |
| OK | $349.64 | 1 |
| OR | $362.15–$381.36 | 2 |
| PA | $355.22–$378.76 | 2 |
| PR | $367.98 | 1 |
| RI | $373.81 | 1 |
| SC | $354.71 | 1 |
| SD | $357.65 | 1 |
| TN | $348.46 | 1 |
| TX | $353.96–$373.24 | 8 |
| UT | $357.47 | 1 |
| VA | $360.48–$403.63 | 2 |
| VI | $367.98 | 1 |
| VT | $358.66 | 1 |
| WA | $373.31–$405.12 | 2 |
| WI | $351.75 | 1 |
| WV | $355.45 | 1 |
| WY | $363.18 | 1 |
How the 90956 rate is calculated
Each of 90956’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 · 90956
RVUs × geographic indexes × conversion factor
Work6.64
6.64 RVUs× 1.000 GPCI
Practice expense3.93
3.93 RVUs× 1.000 GPCI
Malpractice0.41
0.41 RVUs× 1.000 GPCI
Adjusted RVUs
10.9800
Conversion factor
$33.4009
Medicare rate
$366.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arizona inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,569
- Code
- 90956
- Physician work
- 6.64
- Practice expense
- 3.93
- Malpractice
- 0.41
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.64 | × 1.000 | 6.6400 |
| Practice expense | 3.93 | × 0.969 | 3.8082 |
| Malpractice | 0.41 | × 0.856 | 0.3510 |
| Total RVUs | 10.7991 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Arizona$360.70
Office: (6.64 × 1 + 3.93 × 0.969 + 0.41 × 0.856) × $33.4009 = $360.70
Facility: (6.64 × 1 + 3.93 × 0.969 + 0.41 × 0.856) × $33.4009 = $360.70
Payment rules and modifiers for 90956
90956 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 · 90956
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$366.74
- Non-facility (office)
- $366.74
- Facility
- $366.74
Higher because the practice carries its own overhead.
How 90956 has changed in Arizona
90956 · Office / nonfacility
$360.70
Effective 2026-10-01
The base rate is $28.23 higher than on 2025-10-01, moving from $332.47 to $360.70 (8.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
$332.47changed to$360.70
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 3.39 changed to 3.93
- Malpractice RVU 0.39 changed to 0.41
- Practice expense GPCI 0.975 changed to 0.969
- Malpractice GPCI 0.854 changed to 0.856
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$339.18changed to$332.47
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.29 changed to 3.39
- Malpractice RVU 0.40 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$333.64changed to$339.18
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$340.77changed to$333.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.21 changed to 3.29
- Malpractice RVU 0.38 changed to 0.40
- Practice expense GPCI 0.963 changed to 0.975
- Malpractice GPCI 0.855 changed to 0.854
January 1, 2023
RVU23A
$345.94changed to$340.77
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.16 changed to 3.21
- Malpractice RVU 0.41 changed to 0.38
- Practice expense GPCI 0.951 changed to 0.963
- Malpractice GPCI 0.857 changed to 0.855
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$347.42changed to$345.94
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.10 changed to 3.16
- Malpractice RVU 0.43 changed to 0.41
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$320.71changed to$347.42
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 5.95 changed to 6.64
- Practice expense RVU 2.73 changed to 3.10
- Malpractice RVU 0.37 changed to 0.43
- Practice expense GPCI 0.961 changed to 0.951
- Malpractice GPCI 0.846 changed to 0.857
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$319.44changed to$320.71
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.70 changed to 2.73
- Malpractice RVU 0.35 changed to 0.37
- Practice expense GPCI 0.971 changed to 0.961
- Malpractice GPCI 0.834 changed to 0.846
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$318.09changed to$319.44
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.68 changed to 2.70
- Malpractice RVU 0.34 changed to 0.35
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$319.03changed to$318.09
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.66 changed to 2.68
- Malpractice RVU 0.37 changed to 0.34
- Practice expense GPCI 0.986 changed to 0.971
- Malpractice GPCI 0.856 changed to 0.834
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$320.70changed to$319.03
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.70 changed to 2.66
- Malpractice RVU 0.35 changed to 0.37
- Practice expense GPCI 1.000 changed to 0.986
- Malpractice GPCI 0.877 changed to 0.856
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$323.29changed to$320.70
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.74 changed to 2.70
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$321.68changed to$323.29
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$319.63changed to$321.68
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.69 changed to 2.74
- Malpractice RVU 0.33 changed to 0.35
- Practice expense GPCI 0.989 changed to 1.000
- Malpractice GPCI 0.946 changed to 0.877
Held through RVU15B.
January 1, 2014
RVU14A
$310.34changed to$319.63
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.89 changed to 2.69
- Malpractice RVU 0.34 changed to 0.33
- Practice expense GPCI 0.978 changed to 0.989
- Malpractice GPCI 1.015 changed to 0.946
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $310.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $360.70 | $360.70 | RVU26D |
| 2026-07-01 | $360.70 | $360.70 | RVU26C |
| 2026-04-01 | $360.70 | $360.70 | RVU26B |
| 2026-01-01 | $360.70 | $360.70 | RVU26A |
| 2025-10-01 | $332.47 | $332.47 | RVU25D |
| 2025-07-01 | $332.47 | $332.47 | RVU25C |
| 2025-04-01 | $332.47 | $332.47 | RVU25B |
| 2025-01-01 | $332.47 | $332.47 | RVU25A |
| 2024-10-01 | $339.18 | $339.18 | RVU24D |
| 2024-07-01 | $339.18 | $339.18 | RVU24C |
| 2024-04-01 | $339.18 | $339.18 | RVU24B |
| 2024-03-09 | $339.18 | $339.18 | RVU24AR |
| 2024-01-01 | $333.64 | $333.64 | RVU24A |
| 2023-10-01 | $340.77 | $340.77 | RVU23D |
| 2023-07-01 | $340.77 | $340.77 | RVU23C |
| 2023-04-01 | $340.77 | $340.77 | RVU23B |
| 2023-01-01 | $340.77 | $340.77 | RVU23A |
| 2022-10-01 | $345.94 | $345.94 | RVU22D |
| 2022-07-01 | $345.94 | $345.94 | RVU22C |
| 2022-04-01 | $345.94 | $345.94 | RVU22B |
| 2022-01-01 | $345.94 | $345.94 | RVU22A |
| 2021-10-01 | $347.42 | $347.42 | RVU21D |
| 2021-07-01 | $347.42 | $347.42 | RVU21C |
| 2021-04-01 | $347.42 | $347.42 | RVU21B |
| 2021-01-01 | $347.42 | $347.42 | RVU21A |
| 2020-10-01 | $320.71 | $320.71 | RVU20D |
| 2020-07-01 | $320.71 | $320.71 | RVU20C |
| 2020-04-01 | $320.71 | $320.71 | RVU20B |
| 2020-01-01 | $320.71 | $320.71 | RVU20A |
| 2019-10-01 | $319.44 | $319.44 | RVU19D |
| 2019-07-01 | $319.44 | $319.44 | RVU19C |
| 2019-04-01 | $319.44 | $319.44 | RVU19B |
| 2019-01-01 | $319.44 | $319.44 | RVU19A |
| 2018-10-01 | $318.09 | $318.09 | RVU18D |
| 2018-07-01 | $318.09 | $318.09 | RVU18C |
| 2018-04-01 | $318.09 | $318.09 | RVU18B |
| 2018-01-01 | $318.09 | $318.09 | RVU18AR1 |
| 2017-10-01 | $319.03 | $319.03 | RVU17D |
| 2017-07-01 | $319.03 | $319.03 | RVU17C |
| 2017-04-01 | $319.03 | $319.03 | RVU17B |
| 2017-01-01 | $319.03 | $319.03 | RVU17A |
| 2016-10-01 | $320.70 | $320.70 | RVU16D |
| 2016-07-01 | $320.70 | $320.70 | RVU16C |
| 2016-04-01 | $320.70 | $320.70 | RVU16B |
| 2016-01-01 | $320.70 | $320.70 | RVU16A |
| 2015-10-01 | $323.29 | $323.29 | RVU15D |
| 2015-07-01 | $323.29 | $323.29 | RVU15C |
| 2015-04-01 | $321.68 | $321.68 | RVU15B |
| 2015-01-01 | $321.68 | $321.68 | RVU15A |
| 2014-10-01 | $319.63 | $319.63 | RVU14D |
| 2014-07-01 | $319.63 | $319.63 | RVU14C |
| 2014-04-01 | $319.63 | $319.63 | RVU14B |
| 2014-01-01 | $319.63 | $319.63 | RVU14A |
| 2013-10-01 | $310.34 | $310.34 | RVU13D |
| 2013-07-01 | $310.34 | $310.34 | RVU13C |
| 2013-04-01 | $310.34 | $310.34 | RVU13B |
| 2013-01-01 | $310.34 | $310.34 | RVU13AR |
Where the Arizona rate applies
Arizona is a Medicare payment area, not a city. Our Census mapping connects it to 467 cities and communities in Arizona. Some span more than one payment area; confirm with the service ZIP.
- Aguila
- Ajo
- Ak Chin
- Ak-Chin Village
- Alamo Lake
- Ali Chuk
- Ali Chukson
- Ali Molina
90956 billing questions
When is 90956 selected instead of 90955?
Use 90956 for a patient ages 2–11 with one face-to-face visit during the month. Code 90955 represents the same age band when two or three visits are furnished.
Does this code represent each dialysis treatment?
No. It represents monthly ESRD-related services and is selected by monthly face-to-face visit count, not by the number of dialysis sessions.
What documentation supports reporting 90956?
Record the patient’s age, the face-to-face visit date, and the ESRD-related assessment and management performed during the visit.
Can 90956 be used for a partial month?
The code describes monthly services with one visit. Per-day ESRD services are represented by a separate code series for partial-month circumstances.
Is 90956 the monthly code for home dialysis?
No. The ESRD monthly series has a separate code for home dialysis patients ages 2–11; select according to the applicable patient and service circumstances.
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
Fee sheets · Coming soon
Put 90956 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist