CPT code 90961: ESRD management, 2-3 visits, age 20+2026 Medicare rate & RVUs in Atlanta, GA

Monthly ESRD management for patients age 20 or older, reported when the physician provides two or three face-to-face visits during the month.

CMS RVU26DEffective Oct 1, 2026One payment locality393K Medicare services in 2024

In Atlanta, GA, Medicare pays $315.43 for 90961 in the office and $315.43 when it’s performed in a hospital or facility.

$315.43Office (non-facility)
$315.43Hospital or facility
+1.5%vs the national office rate ($310.63)

Check a contract rate as a % of Medicare · 90961 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 90961 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Atlanta, GA
  2. What 90961 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 90961 covers

This code represents a month of ongoing management for an adult with end-stage renal disease receiving dialysis. A nephrologist or other physician overseeing the patient’s ESRD care may assess dialysis adequacy, fluid status, anemia, mineral and bone disease, medications, vascular access, and related treatment needs. The work may occur in the context of outpatient dialysis care and includes the physician’s continuing management across the month, not just a single dialysis treatment.

Select this monthly level for a patient age 20 or older when the physician provides two or three face-to-face visits during the month. The visit count, dates, age, and documented ESRD management support the level reported. Do not count dialysis sessions as physician visits. The adjacent monthly levels distinguish patients with four or more visits from those with one visit; separate home-dialysis and per-day codes describe different circumstances.

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 Atlanta, GA compares for 90961

Across 109 of 109 payment localities, the office rate for 90961 runs from $288.69 in Arkansas to $404.84 in Alaska. Atlanta, GA pays $315.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

90961 in Atlanta, GA vs other payment areas
  1. Atlanta, GA · this page$315.43
  2. Rest of Georgia · Georgia$300.60−$14.83
  3. Los Angeles, CA · California$335.05+$19.62
  4. Washington, DC area · District of Columbia$342.28+$26.85
  5. Miami, FL · Florida$333.70+$18.27
  6. Chicago, IL · Illinois$328.06+$12.63
  7. Manhattan, NY · New York$347.98+$32.55

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

Every other payment area

90961 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$404.84$404.84
AlabamaAlabama$291.13$291.13
ArkansasArkansas$288.69$288.69
ArizonaArizona$305.36$305.36
Bakersfield, CACalifornia$320.40$320.40
Chico, CACalifornia$319.15$319.15
El Centro, CACalifornia$319.21$319.21
Fresno, CACalifornia$319.15$319.15

90961 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.

$288.69

$404.84

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

View every state and territory as a table
90961 office rate range by state
State / territoryOffice rate rangeLocalities
AK$404.841
AL$291.131
AR$288.691
AZ$305.361
CA$319.15–$375.8229
CO$317.521
CT$325.641
DC$342.281
DE$308.971
FL$311.65–$333.703
GA$300.60–$315.432
GU$321.221
HI$321.221
IA$293.671
ID$295.151
IL$307.46–$328.064
IN$296.111
KS$293.701
KY$296.931
LA$296.99–$305.522
MA$317.19–$339.032
MD$312.86–$342.283
ME$296.94–$305.162
MI$302.24–$314.882
MN$305.481
MO$294.55–$305.173
MS$291.611
MT$310.601
NC$298.631
ND$303.491
NE$294.351
NH$313.811
NJ$329.68–$341.342
NM$303.561
NV$308.731
NY$301.35–$354.325
OH$300.791
OK$295.721
OR$306.60–$323.182
PA$300.60–$320.952
PR$311.701
RI$316.601
SC$300.141
SD$302.641
TN$294.671
TX$299.49–$316.258
UT$302.551
VA$305.15–$342.282
VI$311.701
VT$303.551
WA$316.21–$343.582
WI$297.511
WV$300.851
WY$307.501

See 90961 in every payment locality

How the 90961 rate is calculated

Each of 90961’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 · 90961

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.52

5.52 RVUs× 1.000 GPCI

Practice expense3.42

3.42 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

9.3000

Conversion factor

$33.4009

Medicare rate

$310.63

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

The exact Atlanta, GA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,574

Code
90961
Physician work
5.52
Practice expense
3.42
Malpractice
0.36

GPCI2026.csv

44

Locality
Atlanta, GA
Physician work
1.003
Practice expense
1.016
Malpractice
1.201
Office calculation for 90961 in Atlanta, GA
ComponentRVULocality factorAdjusted
Physician work5.52× 1.0035.5366
Practice expense3.42× 1.0163.4747
Malpractice0.36× 1.2010.4324
Total RVUs9.4436
Conversion factor× 33.4009

Office rate, Atlanta, GA$315.43

Office: (5.52 × 1.003 + 3.42 × 1.016 + 0.36 × 1.201) × $33.4009 = $315.43

Facility: (5.52 × 1.003 + 3.42 × 1.016 + 0.36 × 1.201) × $33.4009 = $315.43

Open 90961 in the RVU calculator

Payment rules and modifiers for 90961

90961 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 · 90961

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$310.63

Non-facility (office)
$310.63
Facility
$310.63

Higher because the practice carries its own overhead.

How 90961 has changed in Atlanta, GA

90961 · Office / nonfacility

$315.43

Effective 2026-10-01

The base rate is $29.66 higher than on 2025-10-01, moving from $285.77 to $315.43 (10.4%).

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

    $285.77changed to$315.43

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.94 changed to 3.42
    • Malpractice RVU 0.34 changed to 0.36
    • Work GPCI 1.000 changed to 1.003
    • Practice expense GPCI 0.997 changed to 1.016
    • Malpractice GPCI 1.128 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $291.43changed to$285.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.86 changed to 2.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $286.67changed to$291.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $293.46changed to$286.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.80 changed to 2.86
    • Practice expense GPCI 0.998 changed to 0.997
    • Malpractice GPCI 1.016 changed to 1.128
  5. January 1, 2023

    RVU23A

    $298.37changed to$293.46

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice GPCI 0.904 changed to 1.016

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $298.78changed to$298.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.75 changed to 2.80
    • Malpractice RVU 0.33 changed to 0.34

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $244.49changed to$298.78

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 4.26 changed to 5.52
    • Practice expense RVU 2.26 changed to 2.75
    • Malpractice RVU 0.26 changed to 0.33
    • Malpractice GPCI 0.996 changed to 0.904

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $243.46changed to$244.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.23 changed to 2.26
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.997 changed to 0.998
    • Malpractice GPCI 1.088 changed to 0.996

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $243.19changed to$243.46

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$243.19

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$315.43$315.43RVU26D
2026-07-01$315.43$315.43RVU26C
2026-04-01$315.43$315.43RVU26B
2026-01-01$315.43$315.43RVU26A
2025-10-01$285.77$285.77RVU25D
2025-07-01$285.77$285.77RVU25C
2025-04-01$285.77$285.77RVU25B
2025-01-01$285.77$285.77RVU25A
2024-10-01$291.43$291.43RVU24D
2024-07-01$291.43$291.43RVU24C
2024-04-01$291.43$291.43RVU24B
2024-03-09$291.43$291.43RVU24AR
2024-01-01$286.67$286.67RVU24A
2023-10-01$293.46$293.46RVU23D
2023-07-01$293.46$293.46RVU23C
2023-04-01$293.46$293.46RVU23B
2023-01-01$293.46$293.46RVU23A
2022-10-01$298.37$298.37RVU22D
2022-07-01$298.37$298.37RVU22C
2022-04-01$298.37$298.37RVU22B
2022-01-01$298.37$298.37RVU22A
2021-10-01$298.78$298.78RVU21D
2021-07-01$298.78$298.78RVU21C
2021-04-01$298.78$298.78RVU21B
2021-01-01$298.78$298.78RVU21A
2020-10-01$244.49$244.49RVU20D
2020-07-01$244.49$244.49RVU20C
2020-04-01$244.49$244.49RVU20B
2020-01-01$244.49$244.49RVU20A
2019-10-01$243.46$243.46RVU19D
2019-07-01$243.46$243.46RVU19C
2019-04-01$243.46$243.46RVU19B
2019-01-01$243.46$243.46RVU19A
2018-10-01$243.19$243.19RVU18D
2018-07-01$243.19$243.19RVU18C
2018-04-01$243.19$243.19RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90961 for an earlier date of service

Where the Atlanta, GA rate applies

Atlanta, GA is a Medicare payment area, not a city. Our Census mapping connects it to 114 cities and communities in Georgia. Some span more than one payment area; confirm with the service ZIP.

  • Atlanta
  • Acworth
  • Alpharetta
  • 90961 in Auburn · multiple payment areas
  • Austell
  • Avondale Estates
  • Ball Ground
  • Belvedere Park

Browse all communities in Georgia

90961 billing questions

How does 90961 differ from 90960 and 90962?

For patients age 20 or older, 90961 represents two or three face-to-face visits in the month. Use 90960 for four or more visits and 90962 for one visit.

Are dialysis sessions counted as visits?

No. The level is based on the physician’s face-to-face visits with the patient during the month, not the number of dialysis treatments.

What documentation supports reporting 90961?

Record the patient’s age, the dates of the two or three face-to-face visits, and the ESRD management addressed during the month.

Is 90961 reported once per visit?

No. It represents monthly ESRD management at the two-to-three-visit level, rather than a separate unit for each visit.

How does 90961 differ from 90966?

90961 is selected by the monthly face-to-face visit count for an adult patient. 90966 describes monthly ESRD services for an adult receiving home dialysis.

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 90961PPRRVU2026_Oct_nonQPP.csv, line 11,574 (RVU26D)
Geographic factors for Atlanta, GAGPCI2026.csv, line 44 (RVU26D)

Open CMS sourceHow we calculate rates

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