CPT code 90969: Daily ESRD care, ages 12-192026 Medicare rate & RVUs in Nebraska

Reports ESRD-related services provided to a patient ages 12 through 19 for each covered day when care spans less than a full month.

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

In Nebraska, Medicare pays $16.52 for 90969 in the office and $16.52 when it’s performed in a hospital or facility.

$16.52Office (non-facility)
$16.52Hospital or facility
−4.9%vs the national office rate ($17.37)

Check a contract rate as a % of Medicare · 90969 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 90969 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nebraska
  2. What 90969 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 90969 covers

Code 90969 represents daily management of end-stage renal disease for a patient who is 12 through 19 years old when the clinician provides care for less than a full month. Nephrologists and other clinicians managing ESRD may report it for a partial month of care, such as when a patient starts or ends care with the practice during the month. It is a daily service code, not a monthly code selected by counting face-to-face visits.

Report the code for each day of ESRD-related services during the partial month, using the patient’s age and the period of care to select the code. The record should support the dates care was furnished, the patient’s age, and the ESRD-related management provided. For a full month of care, use the applicable monthly ESRD service code instead; the monthly code selection depends on the patient’s age, treatment context, and visit count.

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 Nebraska compares for 90969

Across 109 of 109 payment localities, the office rate for 90969 runs from $16.24 in Arkansas to $22.95 in Alaska. Nebraska pays $16.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

90969 in Nebraska vs other payment areas
  1. Nebraska · this page$16.52
  2. Los Angeles, CA · California$18.64+$2.12
  3. Washington, DC area · District of Columbia$19.05+$2.53
  4. Miami, FL · Florida$18.62+$2.10
  5. Chicago, IL · Illinois$18.34+$1.82
  6. Manhattan, NY · New York$19.39+$2.87
  7. Alaska · Alaska$22.95+$6.43

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

Every other payment area

90969 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$16.37$16.37
ArkansasArkansas$16.24$16.24
ArizonaArizona$17.10$17.10
Bakersfield, CACalifornia$17.86$17.86
Chico, CACalifornia$17.79$17.79
El Centro, CACalifornia$17.79$17.79
Fresno, CACalifornia$17.79$17.79
Hanford, CACalifornia$17.79$17.79

90969 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.

$16.24

$22.95

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

View every state and territory as a table
90969 office rate range by state
State / territoryOffice rate rangeLocalities
AK$22.951
AL$16.371
AR$16.241
AZ$17.101
CA$17.79–$20.7829
CO$17.721
CT$18.171
DC$19.051
DE$17.291
FL$17.45–$18.623
GA$16.88–$17.632
GU$17.871
HI$17.871
IA$16.481
ID$16.561
IL$17.25–$18.344
IN$16.611
KS$16.491
KY$16.681
LA$16.69–$17.122
MA$17.71–$18.852
MD$17.49–$19.053
ME$16.66–$17.072
MI$16.96–$17.632
MN$17.061
MO$16.57–$17.103
MS$16.401
MT$17.371
NC$16.751
ND$16.971
NE$16.521
NH$17.521
NJ$18.40–$19.022
NM$17.031
NV$17.261
NY$16.89–$19.725
OH$16.881
OK$16.611
OR$17.15–$18.002
PA$16.87–$17.932
PR$17.421
RI$17.691
SC$16.841
SD$16.921
TN$16.541
TX$16.81–$17.678
UT$16.961
VA$17.08–$19.052
VI$17.421
VT$16.981
WA$17.65–$19.092
WI$16.671
WV$16.911
WY$17.191

See 90969 in every payment locality

How the 90969 rate is calculated

Each of 90969’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 · 90969

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.33

0.33 RVUs× 1.000 GPCI

Practice expense0.17

0.17 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.5200

Conversion factor

$33.4009

Medicare rate

$17.37

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

The exact Nebraska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,582

Code
90969
Physician work
0.33
Practice expense
0.17
Malpractice
0.02

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for 90969 in Nebraska
ComponentRVULocality factorAdjusted
Physician work0.33× 1.0000.3300
Practice expense0.17× 0.9230.1569
Malpractice0.02× 0.3780.0076
Total RVUs0.4945
Conversion factor× 33.4009

Office rate, Nebraska$16.52

Office: (0.33 × 1 + 0.17 × 0.923 + 0.02 × 0.378) × $33.4009 = $16.52

Facility: (0.33 × 1 + 0.17 × 0.923 + 0.02 × 0.378) × $33.4009 = $16.52

Open 90969 in the RVU calculator

Payment rules and modifiers for 90969

90969 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 · 90969

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$17.37

Non-facility (office)
$17.37
Facility
$17.37

Higher because the practice carries its own overhead.

How 90969 has changed in Nebraska

90969 · Office / nonfacility

$16.52

Effective 2026-10-01

The base rate is $1.20 higher than on 2025-10-01, moving from $15.32 to $16.52 (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

    $15.32changed to$16.52

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.15 changed to 0.17
    • Practice expense GPCI 0.917 changed to 0.923
    • Malpractice GPCI 0.304 changed to 0.378

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $15.77changed to$15.32

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $15.51changed to$15.77

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $16.01changed to$15.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.913 changed to 0.917
    • Malpractice GPCI 0.269 changed to 0.304
  5. January 1, 2023

    RVU23A

    $16.30changed to$16.01

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.235 changed to 0.269

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $16.11changed to$16.30

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.14 changed to 0.15

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $14.60changed to$16.11

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.29 changed to 0.33
    • Practice expense RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.909 changed to 0.908
    • Malpractice GPCI 0.277 changed to 0.235

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $14.62changed to$14.60

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.910 changed to 0.909
    • Malpractice GPCI 0.318 changed to 0.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $14.60changed to$14.62

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $14.57changed to$14.60

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.909 changed to 0.910
    • Malpractice GPCI 0.340 changed to 0.318

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $14.54changed to$14.57

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.908 changed to 0.909
    • Malpractice GPCI 0.362 changed to 0.340

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $14.60changed to$14.54

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $14.52changed to$14.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $14.41changed to$14.52

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.01 changed to 0.02
    • Practice expense GPCI 0.906 changed to 0.908
    • Malpractice GPCI 0.342 changed to 0.362

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $13.97changed to$14.41

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.904 changed to 0.906
    • Malpractice GPCI 0.322 changed to 0.342

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $13.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$16.52$16.52RVU26D
2026-07-01$16.52$16.52RVU26C
2026-04-01$16.52$16.52RVU26B
2026-01-01$16.52$16.52RVU26A
2025-10-01$15.32$15.32RVU25D
2025-07-01$15.32$15.32RVU25C
2025-04-01$15.32$15.32RVU25B
2025-01-01$15.32$15.32RVU25A
2024-10-01$15.77$15.77RVU24D
2024-07-01$15.77$15.77RVU24C
2024-04-01$15.77$15.77RVU24B
2024-03-09$15.77$15.77RVU24AR
2024-01-01$15.51$15.51RVU24A
2023-10-01$16.01$16.01RVU23D
2023-07-01$16.01$16.01RVU23C
2023-04-01$16.01$16.01RVU23B
2023-01-01$16.01$16.01RVU23A
2022-10-01$16.30$16.30RVU22D
2022-07-01$16.30$16.30RVU22C
2022-04-01$16.30$16.30RVU22B
2022-01-01$16.30$16.30RVU22A
2021-10-01$16.11$16.11RVU21D
2021-07-01$16.11$16.11RVU21C
2021-04-01$16.11$16.11RVU21B
2021-01-01$16.11$16.11RVU21A
2020-10-01$14.60$14.60RVU20D
2020-07-01$14.60$14.60RVU20C
2020-04-01$14.60$14.60RVU20B
2020-01-01$14.60$14.60RVU20A
2019-10-01$14.62$14.62RVU19D
2019-07-01$14.62$14.62RVU19C
2019-04-01$14.62$14.62RVU19B
2019-01-01$14.62$14.62RVU19A
2018-10-01$14.60$14.60RVU18D
2018-07-01$14.60$14.60RVU18C
2018-04-01$14.60$14.60RVU18B
2018-01-01$14.60$14.60RVU18AR1
2017-10-01$14.57$14.57RVU17D
2017-07-01$14.57$14.57RVU17C
2017-04-01$14.57$14.57RVU17B
2017-01-01$14.57$14.57RVU17A
2016-10-01$14.54$14.54RVU16D
2016-07-01$14.54$14.54RVU16C
2016-04-01$14.54$14.54RVU16B
2016-01-01$14.54$14.54RVU16A
2015-10-01$14.60$14.60RVU15D
2015-07-01$14.60$14.60RVU15C
2015-04-01$14.52$14.52RVU15B
2015-01-01$14.52$14.52RVU15A
2014-10-01$14.41$14.41RVU14D
2014-07-01$14.41$14.41RVU14C
2014-04-01$14.41$14.41RVU14B
2014-01-01$14.41$14.41RVU14A
2013-10-01$13.97$13.97RVU13D
2013-07-01$13.97$13.97RVU13C
2013-04-01$13.97$13.97RVU13B
2013-01-01$13.97$13.97RVU13AR

Price 90969 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

90969 billing questions

When is 90969 appropriate instead of a monthly ESRD code?

Use 90969 when ESRD-related care for a patient ages 12 through 19 covers less than a full month. A full month of care is reported with the applicable monthly code, selected by the patient’s age, treatment context, and visit count.

How many units should be reported?

Report one unit for each day of ESRD-related services furnished during the partial month. Keep documentation supporting the service dates.

Does the number of visits determine whether 90969 applies?

No. This code is for daily services during less than a full month of care; monthly ESRD codes use face-to-face visit counts to distinguish levels.

Which code applies to a patient age 20 or older?

For a patient age 20 or older receiving ESRD-related services for less than a full month, use 90970 rather than 90969.

How does 90969 differ from 90965?

90969 reports daily ESRD-related services during a partial month for a patient ages 12 through 19. Code 90965 is for home dialysis services over a full month in that age group.

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 90969PPRRVU2026_Oct_nonQPP.csv, line 11,582 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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