CPT code 90957: ESRD monthly care, age 12–19, four or more visits2026 Medicare rate & RVUs in South Dakota
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.
In South Dakota, Medicare pays $775.21 for 90957 in the office and $775.21 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $775.21. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$775.21
- Los Angeles, CA · California$852.47+$77.26
- Washington, DC area · District of Columbia$872.64+$97.43
- Miami, FL · Florida$857.16+$81.95
- Chicago, IL · Illinois$844.19+$68.98
- Manhattan, NY · New York$889.32+$114.11
- Alaska · Alaska$1,056.55+$281.34
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| El Centro, CACalifornia | $814.49 | $814.49 |
| Fresno, CACalifornia | $814.33 | $814.33 |
| Hanford, CACalifornia | $814.33 | $814.33 |
| Madera, CACalifornia | $814.33 | $814.33 |
| Merced, CACalifornia | $814.33 | $814.33 |
| Modesto, CACalifornia | $814.33 | $814.33 |
| Napa, CACalifornia | $892.18 | $892.18 |
| Oxnard, CACalifornia | $844.17 | $844.17 |
| Redding, CACalifornia | $814.33 | $814.33 |
| Rest of CaliforniaCalifornia | $814.33 | $814.33 |
| Riverside, CACalifornia | $825.22 | $825.22 |
| Sacramento, CACalifornia | $840.74 | $840.74 |
| Salinas, CACalifornia | $837.17 | $837.17 |
| San Diego, CACalifornia | $846.02 | $846.02 |
| Marin County, CACalifornia | $929.91 | $929.91 |
| San Francisco, CACalifornia | $928.79 | $928.79 |
| San Benito County, CACalifornia | $948.10 | $948.10 |
| Santa Clara County, CACalifornia | $943.55 | $943.55 |
| San Luis Obispo, CACalifornia | $824.98 | $824.98 |
| Santa Cruz, CACalifornia | $845.89 | $845.89 |
| Santa Maria, CACalifornia | $837.36 | $837.36 |
| Santa Rosa, CACalifornia | $853.76 | $853.76 |
| Stockton, CACalifornia | $814.33 | $814.33 |
| Vallejo, CACalifornia | $890.58 | $890.58 |
| Visalia, CACalifornia | $814.33 | $814.33 |
| Yuba City, CACalifornia | $814.33 | $814.33 |
| ColoradoColorado | $811.83 | $811.83 |
| ConnecticutConnecticut | $833.23 | $833.23 |
| DelawareDelaware | $793.25 | $793.25 |
| Fort Lauderdale, FLFlorida | $826.62 | $826.62 |
| Rest of FloridaFlorida | $802.51 | $802.51 |
| Atlanta, GAGeorgia | $809.04 | $809.04 |
| Rest of GeorgiaGeorgia | $776.46 | $776.46 |
| Hawaii, Guam, HIHawaii | $817.12 | $817.12 |
| IowaIowa | $756.14 | $756.14 |
| IdahoIdaho | $759.87 | $759.87 |
| East St. Louis, ILIllinois | $810.31 | $810.31 |
| Rest of IllinoisIllinois | $793.81 | $793.81 |
| Suburban Chicago, ILIllinois | $832.52 | $832.52 |
| IndianaIndiana | $762.03 | $762.03 |
| KansasKansas | $756.92 | $756.92 |
| KentuckyKentucky | $766.65 | $766.65 |
| New Orleans, LALouisiana | $786.77 | $786.77 |
| Rest of LouisianaLouisiana | $767.07 | $767.07 |
| Metropolitan Boston, MAMassachusetts | $862.60 | $862.60 |
| Rest of MassachusettsMassachusetts | $811.70 | $811.70 |
| Baltimore area, MDMaryland | $831.06 | $831.06 |
| Rest of MarylandMaryland | $802.40 | $802.40 |
| Rest of MaineMaine | $764.75 | $764.75 |
| Southern Maine, MEMaine | $782.64 | $782.64 |
| Detroit, MIMichigan | $810.73 | $810.73 |
| Rest of MichiganMichigan | $779.61 | $779.61 |
| MinnesotaMinnesota | $781.09 | $781.09 |
| Metropolitan Kansas City, MOMissouri | $781.07 | $781.07 |
| Metropolitan St. Louis, MOMissouri | $785.11 | $785.11 |
| Rest of MissouriMissouri | $761.89 | $761.89 |
| MississippiMississippi | $753.95 | $753.95 |
| MontanaMontana | $796.88 | $796.88 |
| North CarolinaNorth Carolina | $768.52 | $768.52 |
| North DakotaNorth Dakota | $777.50 | $777.50 |
| NebraskaNebraska | $757.50 | $757.50 |
| New HampshireNew Hampshire | $803.02 | $803.02 |
| Northern New JerseyNew Jersey | $871.36 | $871.36 |
| Rest of New JerseyNew Jersey | $843.58 | $843.58 |
| New MexicoNew Mexico | $782.95 | $782.95 |
| NevadaNevada | $791.73 | $791.73 |
| NYC suburbs and Long Island, NYNew York | $904.89 | $904.89 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $850.60 | $850.60 |
| Queens, NYNew York | $889.57 | $889.57 |
| Rest of New YorkNew York | $774.83 | $774.83 |
| OhioOhio | $775.65 | $775.65 |
| OklahomaOklahoma | $763.13 | $763.13 |
| Portland, OROregon | $824.34 | $824.34 |
| Rest of OregonOregon | $786.23 | $786.23 |
| Metropolitan Philadelphia, PAPennsylvania | $822.72 | $822.72 |
| Rest of PennsylvaniaPennsylvania | $774.82 | $774.82 |
| Puerto RicoPuerto Rico | $799.18 | $799.18 |
| Rhode IslandRhode Island | $811.40 | $811.40 |
| South CarolinaSouth Carolina | $773.20 | $773.20 |
| TennesseeTennessee | $759.24 | $759.24 |
| Austin, TXTexas | $808.62 | $808.62 |
| Beaumont, TXTexas | $772.32 | $772.32 |
| Brazoria, TXTexas | $791.64 | $791.64 |
| Dallas, TXTexas | $795.95 | $795.95 |
| Fort Worth, TXTexas | $793.90 | $793.90 |
| Galveston, TXTexas | $793.71 | $793.71 |
| Houston, TXTexas | $811.65 | $811.65 |
| Rest of TexasTexas | $781.13 | $781.13 |
| UtahUtah | $778.74 | $778.74 |
| VirginiaVirginia | $783.11 | $783.11 |
| Virgin Islands, VIUnited States Virgin Islands | $799.18 | $799.18 |
| VermontVermont | $778.30 | $778.30 |
| Rest of WashingtonWashington | $808.97 | $808.97 |
| King County, WAWashington | $873.03 | $873.03 |
| WisconsinWisconsin | $763.89 | $763.89 |
| West VirginiaWest Virginia | $778.59 | $778.59 |
| WyomingWyoming | $788.43 | $788.43 |
90957 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.
$746.13
$1,056.55
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 | $1,056.55 | 1 |
| AL | $751.76 | 1 |
| AR | $746.13 | 1 |
| AZ | $784.55 | 1 |
| CA | $814.33–$948.10 | 29 |
| CO | $811.83 | 1 |
| CT | $833.23 | 1 |
| DC | $872.64 | 1 |
| DE | $793.25 | 1 |
| FL | $802.51–$857.16 | 3 |
| GA | $776.46–$809.04 | 2 |
| GU | $817.12 | 1 |
| HI | $817.12 | 1 |
| IA | $756.14 | 1 |
| ID | $759.87 | 1 |
| IL | $793.81–$844.19 | 4 |
| IN | $762.03 | 1 |
| KS | $756.92 | 1 |
| KY | $766.65 | 1 |
| LA | $767.07–$786.77 | 2 |
| MA | $811.70–$862.60 | 2 |
| MD | $802.40–$872.64 | 3 |
| ME | $764.75–$782.64 | 2 |
| MI | $779.61–$810.73 | 2 |
| MN | $781.09 | 1 |
| MO | $761.89–$785.11 | 3 |
| MS | $753.95 | 1 |
| MT | $796.88 | 1 |
| NC | $768.52 | 1 |
| ND | $777.50 | 1 |
| NE | $757.50 | 1 |
| NH | $803.02 | 1 |
| NJ | $843.58–$871.36 | 2 |
| NM | $782.95 | 1 |
| NV | $791.73 | 1 |
| NY | $774.83–$904.89 | 5 |
| OH | $775.65 | 1 |
| OK | $763.13 | 1 |
| OR | $786.23–$824.34 | 2 |
| PA | $774.82–$822.72 | 2 |
| PR | $799.18 | 1 |
| RI | $811.40 | 1 |
| SC | $773.20 | 1 |
| SD | $775.21 | 1 |
| TN | $759.24 | 1 |
| TX | $772.32–$811.65 | 8 |
| UT | $778.74 | 1 |
| VA | $783.11–$872.64 | 2 |
| VI | $799.18 | 1 |
| VT | $778.30 | 1 |
| WA | $808.97–$873.03 | 2 |
| WI | $763.89 | 1 |
| WV | $778.59 | 1 |
| WY | $788.43 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.46 | × 1.000 | 15.4600 |
| Practice expense | 7.42 | × 1.000 | 7.4200 |
| Malpractice | 0.98 | × 0.336 | 0.3293 |
| Total RVUs | 23.2093 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$775.21
Office: (15.46 × 1 + 7.42 × 1 + 0.98 × 0.336) × $33.4009 = $775.21
Facility: (15.46 × 1 + 7.42 × 1 + 0.98 × 0.336) × $33.4009 = $775.21
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.
How 90957 has changed in South Dakota
90957 · Office / nonfacility
$775.21
Effective 2026-10-01
The base rate is $55.04 higher than on 2025-10-01, moving from $720.17 to $775.21 (7.6%).
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
$720.17changed to$775.21
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 6.43 changed to 7.42
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$738.59changed to$720.17
- 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.
March 9, 2024
RVU24AR
$726.53changed to$738.59
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$748.21changed to$726.53
- 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
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$766.77changed to$748.21
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$767.06changed to$766.77
- 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.
January 1, 2021
RVU21A
$642.65changed to$767.06
- 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
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$638.90changed to$642.65
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$638.34changed to$638.90
- Conversion factor 35.9996 changed to 36.0391
- Malpractice RVU 0.75 changed to 0.74
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$636.17changed to$638.34
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.91 changed to 4.92
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$636.03changed to$636.17
- 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
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$637.60changed to$636.03
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.92 changed to 4.94
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$634.43changed to$637.60
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$636.47changed to$634.43
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$619.59changed to$636.47
- 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
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $619.59
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $775.21 | $775.21 | RVU26D |
| 2026-07-01 | $775.21 | $775.21 | RVU26C |
| 2026-04-01 | $775.21 | $775.21 | RVU26B |
| 2026-01-01 | $775.21 | $775.21 | RVU26A |
| 2025-10-01 | $720.17 | $720.17 | RVU25D |
| 2025-07-01 | $720.17 | $720.17 | RVU25C |
| 2025-04-01 | $720.17 | $720.17 | RVU25B |
| 2025-01-01 | $720.17 | $720.17 | RVU25A |
| 2024-10-01 | $738.59 | $738.59 | RVU24D |
| 2024-07-01 | $738.59 | $738.59 | RVU24C |
| 2024-04-01 | $738.59 | $738.59 | RVU24B |
| 2024-03-09 | $738.59 | $738.59 | RVU24AR |
| 2024-01-01 | $726.53 | $726.53 | RVU24A |
| 2023-10-01 | $748.21 | $748.21 | RVU23D |
| 2023-07-01 | $748.21 | $748.21 | RVU23C |
| 2023-04-01 | $748.21 | $748.21 | RVU23B |
| 2023-01-01 | $748.21 | $748.21 | RVU23A |
| 2022-10-01 | $766.77 | $766.77 | RVU22D |
| 2022-07-01 | $766.77 | $766.77 | RVU22C |
| 2022-04-01 | $766.77 | $766.77 | RVU22B |
| 2022-01-01 | $766.77 | $766.77 | RVU22A |
| 2021-10-01 | $767.06 | $767.06 | RVU21D |
| 2021-07-01 | $767.06 | $767.06 | RVU21C |
| 2021-04-01 | $767.06 | $767.06 | RVU21B |
| 2021-01-01 | $767.06 | $767.06 | RVU21A |
| 2020-10-01 | $642.65 | $642.65 | RVU20D |
| 2020-07-01 | $642.65 | $642.65 | RVU20C |
| 2020-04-01 | $642.65 | $642.65 | RVU20B |
| 2020-01-01 | $642.65 | $642.65 | RVU20A |
| 2019-10-01 | $638.90 | $638.90 | RVU19D |
| 2019-07-01 | $638.90 | $638.90 | RVU19C |
| 2019-04-01 | $638.90 | $638.90 | RVU19B |
| 2019-01-01 | $638.90 | $638.90 | RVU19A |
| 2018-10-01 | $638.34 | $638.34 | RVU18D |
| 2018-07-01 | $638.34 | $638.34 | RVU18C |
| 2018-04-01 | $638.34 | $638.34 | RVU18B |
| 2018-01-01 | $638.34 | $638.34 | RVU18AR1 |
| 2017-10-01 | $636.17 | $636.17 | RVU17D |
| 2017-07-01 | $636.17 | $636.17 | RVU17C |
| 2017-04-01 | $636.17 | $636.17 | RVU17B |
| 2017-01-01 | $636.17 | $636.17 | RVU17A |
| 2016-10-01 | $636.03 | $636.03 | RVU16D |
| 2016-07-01 | $636.03 | $636.03 | RVU16C |
| 2016-04-01 | $636.03 | $636.03 | RVU16B |
| 2016-01-01 | $636.03 | $636.03 | RVU16A |
| 2015-10-01 | $637.60 | $637.24 | RVU15D |
| 2015-07-01 | $637.60 | $637.24 | RVU15C |
| 2015-04-01 | $634.43 | $634.07 | RVU15B |
| 2015-01-01 | $634.43 | $634.07 | RVU15A |
| 2014-10-01 | $636.47 | $636.47 | RVU14D |
| 2014-07-01 | $636.47 | $636.47 | RVU14C |
| 2014-04-01 | $636.47 | $636.47 | RVU14B |
| 2014-01-01 | $636.47 | $636.47 | RVU14A |
| 2013-10-01 | $619.59 | $619.59 | RVU13D |
| 2013-07-01 | $619.59 | $619.59 | RVU13C |
| 2013-04-01 | $619.59 | $619.59 | RVU13B |
| 2013-01-01 | $619.59 | $619.59 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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