CPT code 90968: ESRD daily care, ages 2–11, partial month2026 Medicare rate & RVUs in Merced, CA

Reports daily ESRD-related management for a dialysis patient age 2 through 11 when the clinician’s care covers less than a full month.

CMS RVU26DEffective Oct 1, 2026One payment locality2.1K Medicare services in 2024

In Merced, CA, Medicare pays $18.13 for 90968 in the office and $18.13 when it’s performed in a hospital or facility.

$18.13Office (non-facility)
$18.13Hospital or facility
+2.4%vs the national office rate ($17.70)

Check a contract rate as a % of Medicare · 90968 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 90968 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Merced, CA
  2. What 90968 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 90968 covers

A nephrologist or other qualified clinician reports 90968 for ESRD-related management of a dialysis patient age 2 through 11 when care covers less than a full month. A partial month may occur when a patient begins care after a transfer or starts dialysis, or when care ends during the month after a transplant or another change. The service reflects ongoing ESRD management, such as assessing dialysis-related status and coordinating the care plan; it is not a code for each dialysis run.

The payment unit is a day. Report the code for the days of ESRD-related care in the partial-month period, rather than selecting it by dialysis-session count. Documentation should support the patient’s age, the dates of care, why the period is less than a full month, and the ESRD management provided. For a complete month, choose the applicable monthly ESRD service code based on the care setting and monthly visit category.

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 Merced, CA compares for 90968

Across 109 of 109 payment localities, the office rate for 90968 runs from $16.58 in Arkansas to $23.45 in Alaska. Merced, CA pays $18.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

90968 in Merced, CA vs other payment areas
  1. Merced, CA · this page$18.13
  2. Bakersfield, CA · California$18.20+$0.07
  3. Chico, CA · California$18.13
  4. El Centro, CA · California$18.13
  5. Fresno, CA · California$18.13
  6. Hanford, CA · California$18.13
  7. Los Angeles, CA · California$18.98+$0.85

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

Every other payment area

90968 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$18.13$18.13
Modesto, CACalifornia$18.13$18.13
Napa, CACalifornia$19.89$19.89
Oxnard, CACalifornia$18.80$18.80
Redding, CACalifornia$18.13$18.13
Rest of CaliforniaCalifornia$18.13$18.13
Riverside, CACalifornia$18.35$18.35
Sacramento, CACalifornia$18.73$18.73

90968 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.

$16.58

$23.45

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

View every state and territory as a table
90968 office rate range by state
State / territoryOffice rate rangeLocalities
AK$23.451
AL$16.701
AR$16.581
AZ$17.431
CA$18.13–$21.1529
CO$18.061
CT$18.511
DC$19.401
DE$17.621
FL$17.79–$18.963
GA$17.22–$17.962
GU$18.201
HI$18.201
IA$16.821
ID$16.901
IL$17.58–$18.684
IN$16.941
KS$16.831
KY$17.021
LA$17.02–$17.462
MA$18.05–$19.202
MD$17.83–$19.403
ME$17.00–$17.402
MI$17.29–$17.962
MN$17.401
MO$16.90–$17.433
MS$16.741
MT$17.701
NC$17.081
ND$17.311
NE$16.851
NH$17.851
NJ$18.74–$19.372
NM$17.371
NV$17.601
NY$17.22–$20.075
OH$17.211
OK$16.951
OR$17.48–$18.342
PA$17.20–$18.272
PR$17.751
RI$18.031
SC$17.171
SD$17.261
TN$16.881
TX$17.14–$18.008
UT$17.291
VA$17.41–$19.402
VI$17.751
VT$17.321
WA$17.99–$19.442
WI$17.001
WV$17.251
WY$17.531

See 90968 in every payment locality

How the 90968 rate is calculated

Each of 90968’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 · 90968

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.34

0.34 RVUs× 1.000 GPCI

Practice expense0.17

0.17 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.5300

Conversion factor

$33.4009

Medicare rate

$17.70

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

The exact Merced, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,581

Code
90968
Physician work
0.34
Practice expense
0.17
Malpractice
0.02

GPCI2026.csv

15

Locality
Merced, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 90968 in Merced, CA
ComponentRVULocality factorAdjusted
Physician work0.34× 1.0170.3458
Practice expense0.17× 1.0960.1863
Malpractice0.02× 0.5360.0107
Total RVUs0.5428
Conversion factor× 33.4009

Office rate, Merced, CA$18.13

Office: (0.34 × 1.017 + 0.17 × 1.096 + 0.02 × 0.536) × $33.4009 = $18.13

Facility: (0.34 × 1.017 + 0.17 × 1.096 + 0.02 × 0.536) × $33.4009 = $18.13

Open 90968 in the RVU calculator

Payment rules and modifiers for 90968

90968 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 · 90968

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$17.70

Non-facility (office)
$17.70
Facility
$17.70

Higher because the practice carries its own overhead.

How 90968 has changed in Merced, CA

90968 · Office / nonfacility

$18.13

Effective 2026-10-01

The base rate is $1.31 higher than on 2025-10-01, moving from $16.82 to $18.13 (7.8%).

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

    $16.82changed to$18.13

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.15 changed to 0.17
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $17.31changed to$16.82

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $17.02changed to$17.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $17.64changed to$17.02

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $18.03changed to$17.64

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $18.17changed to$18.03

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $16.53changed to$18.17

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.30 changed to 0.34
    • Practice expense RVU 0.13 changed to 0.15
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $16.46changed to$16.53

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $16.06changed to$16.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.12 changed to 0.13

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $16.11changed to$16.06

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$16.11

    Held through RVU17B, RVU17C, RVU17D.

  12. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$18.13$18.13RVU26D
2026-07-01$18.13$18.13RVU26C
2026-04-01$18.13$18.13RVU26B
2026-01-01$18.13$18.13RVU26A
2025-10-01$16.82$16.82RVU25D
2025-07-01$16.82$16.82RVU25C
2025-04-01$16.82$16.82RVU25B
2025-01-01$16.82$16.82RVU25A
2024-10-01$17.31$17.31RVU24D
2024-07-01$17.31$17.31RVU24C
2024-04-01$17.31$17.31RVU24B
2024-03-09$17.31$17.31RVU24AR
2024-01-01$17.02$17.02RVU24A
2023-10-01$17.64$17.64RVU23D
2023-07-01$17.64$17.64RVU23C
2023-04-01$17.64$17.64RVU23B
2023-01-01$17.64$17.64RVU23A
2022-10-01$18.03$18.03RVU22D
2022-07-01$18.03$18.03RVU22C
2022-04-01$18.03$18.03RVU22B
2022-01-01$18.03$18.03RVU22A
2021-10-01$18.17$18.17RVU21D
2021-07-01$18.17$18.17RVU21C
2021-04-01$18.17$18.17RVU21B
2021-01-01$18.17$18.17RVU21A
2020-10-01$16.53$16.53RVU20D
2020-07-01$16.53$16.53RVU20C
2020-04-01$16.53$16.53RVU20B
2020-01-01$16.53$16.53RVU20A
2019-10-01$16.46$16.46RVU19D
2019-07-01$16.46$16.46RVU19C
2019-04-01$16.46$16.46RVU19B
2019-01-01$16.46$16.46RVU19A
2018-10-01$16.06$16.06RVU18D
2018-07-01$16.06$16.06RVU18C
2018-04-01$16.06$16.06RVU18B
2018-01-01$16.06$16.06RVU18AR1
2017-10-01$16.11$16.11RVU17D
2017-07-01$16.11$16.11RVU17C
2017-04-01$16.11$16.11RVU17B
2017-01-01$16.11$16.11RVU17A
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 90968 for an earlier date of service

Where the Merced, CA rate applies

Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Merced
  • Atwater
  • Ballico
  • Bear Creek
  • Cressey
  • Delhi
  • Dos Palos
  • Dos Palos Y

Browse all communities in California

90968 billing questions

How does 90968 differ from 90967 or 90969?

These per-day codes distinguish patient age: 90968 is for ages 2 through 11, 90967 for patients under 2, and 90969 for ages 12 through 19.

Can 90968 be reported for a full month of care?

No. It represents ESRD-related services for less than a full month. For a complete month, use the applicable monthly ESRD service code.

Is 90968 reported for each dialysis treatment?

No. Its unit is a day of ESRD-related care, not an individual dialysis run or session.

What documentation supports 90968?

Keep the patient’s age, dates of care establishing the partial-month period, and documentation of the ESRD-related management provided.

When might 90955 be used instead?

90955 is a monthly ESRD service code for a patient age 2 through 11 in the 2-to-3-visit category. It is for a full-month service period, unlike 90968.

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 90968PPRRVU2026_Oct_nonQPP.csv, line 11,581 (RVU26D)
Geographic factors for Merced, CAGPCI2026.csv, line 15 (RVU26D)

Open CMS sourceHow we calculate rates

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