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CPT code 90957: ESRD monthly care, age 12–19, four or more visits2026 Medicare rate & RVUs in Queens, NY

Monthly ESRD-related management for a patient age 12 through 19 when the clinician provides at least four face-to-face visits during the month.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In Queens, NY, Medicare pays $889.57 for 90957 in the office and $889.57 when it’s performed in a hospital or facility.

$889.57Office (non-facility)
$889.57Hospital or facility
+11.6%vs the national office rate ($796.95)

Check a contract rate as a % of Medicare · 90957 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 90957 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 90957 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 90957 covers

Code 90957 represents monthly management of end-stage renal disease for a patient age 12 through 19 who receives four or more face-to-face visits during the month. A nephrologist or other qualified clinician typically provides this care in connection with the patient’s dialysis program. The work may include assessing dialysis adequacy, volume status, nutrition, vascular access, complications, and the ongoing treatment plan, as well as coordinating care with the dialysis team.

Report one monthly service when the age and visit-count criteria are met; this is not a per-dialysis-session code. Documentation should support the patient’s age, the ESRD-related management provided, and at least four face-to-face visits in that calendar month. Select a different monthly code when the patient has fewer qualifying visits, falls into another age band, or receives home dialysis services represented by the home-dialysis series.

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 Queens, NY compares for 90957

Across 109 of 109 payment localities, the office rate for 90957 runs from $746.13 in Arkansas to $1,056.55 in Alaska. Queens, NY pays $889.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

90957 in Queens, NY vs other payment areas
  1. Queens, NY · this page$889.57
  2. Manhattan, NY · New York$889.32−$0.25
  3. NYC suburbs and Long Island, NY · New York$904.89+$15.32
  4. Poughkeepsie and northern NYC suburbs, NY · New York$850.60−$38.97
  5. Rest of New York · New York$774.83−$114.74
  6. Los Angeles, CA · California$852.47−$37.10
  7. Washington, DC area · District of Columbia$872.64−$16.93

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

Every other payment area

90957 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$857.16$857.16
Chicago, ILIllinois$844.19$844.19
AlaskaAlaska$1,056.55$1,056.55
AlabamaAlabama$751.76$751.76
ArkansasArkansas$746.13$746.13
ArizonaArizona$784.55$784.55
Bakersfield, CACalifornia$817.75$817.75
Chico, CACalifornia$814.33$814.33

90957 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.

$746.13

$1,056.55

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

View every state and territory as a table
90957 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,056.551
AL$751.761
AR$746.131
AZ$784.551
CA$814.33–$948.1029
CO$811.831
CT$833.231
DC$872.641
DE$793.251
FL$802.51–$857.163
GA$776.46–$809.042
GU$817.121
HI$817.121
IA$756.141
ID$759.871
IL$793.81–$844.194
IN$762.031
KS$756.921
KY$766.651
LA$767.07–$786.772
MA$811.70–$862.602
MD$802.40–$872.643
ME$764.75–$782.642
MI$779.61–$810.732
MN$781.091
MO$761.89–$785.113
MS$753.951
MT$796.881
NC$768.521
ND$777.501
NE$757.501
NH$803.021
NJ$843.58–$871.362
NM$782.951
NV$791.731
NY$774.83–$904.895
OH$775.651
OK$763.131
OR$786.23–$824.342
PA$774.82–$822.722
PR$799.181
RI$811.401
SC$773.201
SD$775.211
TN$759.241
TX$772.32–$811.658
UT$778.741
VA$783.11–$872.642
VI$799.181
VT$778.301
WA$808.97–$873.032
WI$763.891
WV$778.591
WY$788.431

See 90957 in every payment locality

How the 90957 rate is calculated

Each of 90957’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 · 90957

RVUs × geographic indexes × conversion factor

Office or facility?

Work15.46

15.46 RVUs× 1.000 GPCI

Practice expense7.42

7.42 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

23.8600

Conversion factor

$33.4009

Medicare rate

$796.95

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

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,570

Code
90957
Physician work
15.46
Practice expense
7.42
Malpractice
0.98

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 90957 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work15.46× 1.06416.4494
Practice expense7.42× 1.1828.7704
Malpractice0.98× 1.4421.4132
Total RVUs26.6330
Conversion factor× 33.4009

Office rate, Queens, NY$889.57

Office: (15.46 × 1.064 + 7.42 × 1.182 + 0.98 × 1.442) × $33.4009 = $889.57

Facility: (15.46 × 1.064 + 7.42 × 1.182 + 0.98 × 1.442) × $33.4009 = $889.57

Open 90957 in the RVU calculator

Payment rules and modifiers for 90957

90957 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 · 90957

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$796.95

Non-facility (office)
$796.95
Facility
$796.95

Higher because the practice carries its own overhead.

Codes related to 90957

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

Codes related to 90957
CodeHow it relatesOffice range, Queens, NY
Same family
90958ESRD management, age 12-19, 2-3 visitsMonthly ESRD management for ages 12–19 with two or three face-to-face visits.$579.52
90959ESRD monthly care, age 12–19, one visitMonthly ESRD management for ages 12–19 with one face-to-face visit.$379.71
90954ESRD management, age 2–11, four visitsFour-or-more-visit monthly ESRD management for patients ages 2–11.$1,151.85
90960Monthly ESRD services, age 20+, four or more visitsFour-or-more-visit monthly ESRD management for patients age 20 or older.$417.65
Used instead
90965Home dialysis, ages 12 through 19Monthly ESRD service for a home-dialysis patient age 12–19.$576.55
90969Daily ESRD care, ages 12-19Per-day ESRD service for a patient age 12–19 when a monthly service is not represented.$19.40

How 90957 has changed in Queens, NY

90957 · Office / nonfacility

$889.57

Effective 2026-10-01

The base rate is $62.10 higher than on 2025-10-01, moving from $827.47 to $889.57 (7.5%).

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

    $827.47changed to$889.57

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 6.43 changed to 7.42
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $848.85changed to$827.47

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.35 changed to 6.43
    • Malpractice RVU 0.99 changed to 0.98

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $834.99changed to$848.85

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $880.42changed to$834.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.27 changed to 6.35
    • Malpractice RVU 0.96 changed to 0.99
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $926.91changed to$880.42

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.35 changed to 6.27
    • Malpractice RVU 1.00 changed to 0.96
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $924.03changed to$926.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.19 changed to 6.35
    • Malpractice RVU 0.96 changed to 1.00

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $762.61changed to$924.03

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 12.52 changed to 15.46
    • Practice expense RVU 5.00 changed to 6.19
    • Malpractice RVU 0.78 changed to 0.96
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $744.01changed to$762.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.92 changed to 5.00
    • Malpractice RVU 0.74 changed to 0.78
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $743.96changed to$744.01

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.75 changed to 0.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $742.05changed to$743.96

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.91 changed to 4.92
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $743.00changed to$742.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.94 changed to 4.91
    • Malpractice RVU 0.76 changed to 0.75
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $744.82changed to$743.00

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.92 changed to 4.94

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $741.11changed to$744.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $732.13changed to$741.11

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.96 changed to 4.92
    • Malpractice RVU 0.69 changed to 0.76
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $707.64changed to$732.13

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.38 changed to 4.96
    • Malpractice RVU 0.72 changed to 0.69
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $707.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$889.57$889.57RVU26D
2026-07-01$889.57$889.57RVU26C
2026-04-01$889.57$889.57RVU26B
2026-01-01$889.57$889.57RVU26A
2025-10-01$827.47$827.47RVU25D
2025-07-01$827.47$827.47RVU25C
2025-04-01$827.47$827.47RVU25B
2025-01-01$827.47$827.47RVU25A
2024-10-01$848.85$848.85RVU24D
2024-07-01$848.85$848.85RVU24C
2024-04-01$848.85$848.85RVU24B
2024-03-09$848.85$848.85RVU24AR
2024-01-01$834.99$834.99RVU24A
2023-10-01$880.42$880.42RVU23D
2023-07-01$880.42$880.42RVU23C
2023-04-01$880.42$880.42RVU23B
2023-01-01$880.42$880.42RVU23A
2022-10-01$926.91$926.91RVU22D
2022-07-01$926.91$926.91RVU22C
2022-04-01$926.91$926.91RVU22B
2022-01-01$926.91$926.91RVU22A
2021-10-01$924.03$924.03RVU21D
2021-07-01$924.03$924.03RVU21C
2021-04-01$924.03$924.03RVU21B
2021-01-01$924.03$924.03RVU21A
2020-10-01$762.61$762.61RVU20D
2020-07-01$762.61$762.61RVU20C
2020-04-01$762.61$762.61RVU20B
2020-01-01$762.61$762.61RVU20A
2019-10-01$744.01$744.01RVU19D
2019-07-01$744.01$744.01RVU19C
2019-04-01$744.01$744.01RVU19B
2019-01-01$744.01$744.01RVU19A
2018-10-01$743.96$743.96RVU18D
2018-07-01$743.96$743.96RVU18C
2018-04-01$743.96$743.96RVU18B
2018-01-01$743.96$743.96RVU18AR1
2017-10-01$742.05$742.05RVU17D
2017-07-01$742.05$742.05RVU17C
2017-04-01$742.05$742.05RVU17B
2017-01-01$742.05$742.05RVU17A
2016-10-01$743.00$743.00RVU16D
2016-07-01$743.00$743.00RVU16C
2016-04-01$743.00$743.00RVU16B
2016-01-01$743.00$743.00RVU16A
2015-10-01$744.82$744.39RVU15D
2015-07-01$744.82$744.39RVU15C
2015-04-01$741.11$740.68RVU15B
2015-01-01$741.11$740.68RVU15A
2014-10-01$732.13$732.13RVU14D
2014-07-01$732.13$732.13RVU14C
2014-04-01$732.13$732.13RVU14B
2014-01-01$732.13$732.13RVU14A
2013-10-01$707.64$707.64RVU13D
2013-07-01$707.64$707.64RVU13C
2013-04-01$707.64$707.64RVU13B
2013-01-01$707.64$707.64RVU13AR

Price 90957 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

90957 billing questions

When should I choose 90957 instead of 90958?

Use 90957 for a patient age 12 through 19 with four or more face-to-face visits during the month. Code 90958 is the same age group with two or three visits.

Is 90957 reported for each dialysis treatment?

No. It represents monthly ESRD-related management, with the number of face-to-face visits determining the applicable monthly code.

What supports reporting four or more visits?

Keep documentation of the face-to-face ESRD-related encounters during the month, along with the assessments and management provided. The record should support the patient’s age and the monthly service.

How does this differ from 90935?

Code 90957 describes monthly ESRD-related management for the specified age and visit count. Code 90935 describes a hemodialysis service with one evaluation, rather than monthly management.

What if the patient received only one visit that month?

For a patient age 12 through 19 with one face-to-face visit, use the corresponding one-visit monthly code, 90959, rather than 90957.

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 90957PPRRVU2026_Oct_nonQPP.csv, line 11,570 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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