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

In Wisconsin, Medicare pays $297.51 for 90961 in the office and $297.51 when it’s performed in a hospital or facility.

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.

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 Wisconsin 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. Wisconsin pays $297.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90961 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

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.

Codes related to 90961

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

How 90961 has changed in Wisconsin

Price 90961 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

• Abbotsford
• Abrams
• Adams
• Adell
• Albany
• Algoma
• Allens Grove
• Allenton

Browse all communities in Wisconsin

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

Open CMS sourceHow we calculate rates