CPT code 90969: Daily ESRD care, ages 12-192026 Medicare rate & RVUs in Manhattan, NY
Reports ESRD-related services provided to a patient ages 12 through 19 for each covered day when care spans less than a full month.
In Manhattan, NY, Medicare pays $19.39 for 90969 in the office and $19.39 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Manhattan, NY 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. Manhattan, NY pays $19.39. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Manhattan, NY · this page$19.39
- NYC suburbs and Long Island, NY · New York$19.72+$0.33
- Poughkeepsie and northern NYC suburbs, NY · New York$18.54−$0.85
- Queens, NY · New York$19.40+$0.01
- Rest of New York · New York$16.89−$2.50
- Los Angeles, CA · California$18.64−$0.75
- Washington, DC area · District of Columbia$19.05−$0.34
Other areas in New York first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Miami, FLFlorida | $18.62 | $18.62 |
| Chicago, ILIllinois | $18.34 | $18.34 |
| AlaskaAlaska | $22.95 | $22.95 |
| 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 |
| Madera, CACalifornia | $17.79 | $17.79 |
| Merced, CACalifornia | $17.79 | $17.79 |
| Modesto, CACalifornia | $17.79 | $17.79 |
| Napa, CACalifornia | $19.54 | $19.54 |
| Oxnard, CACalifornia | $18.46 | $18.46 |
| Redding, CACalifornia | $17.79 | $17.79 |
| Rest of CaliforniaCalifornia | $17.79 | $17.79 |
| Riverside, CACalifornia | $18.01 | $18.01 |
| Sacramento, CACalifornia | $18.38 | $18.38 |
| Salinas, CACalifornia | $18.30 | $18.30 |
| San Diego, CACalifornia | $18.51 | $18.51 |
| Marin County, CACalifornia | $20.38 | $20.38 |
| San Francisco, CACalifornia | $20.36 | $20.36 |
| San Benito County, CACalifornia | $20.78 | $20.78 |
| Santa Clara County, CACalifornia | $20.69 | $20.69 |
| San Luis Obispo, CACalifornia | $18.04 | $18.04 |
| Santa Cruz, CACalifornia | $18.51 | $18.51 |
| Santa Maria, CACalifornia | $18.31 | $18.31 |
| Santa Rosa, CACalifornia | $18.68 | $18.68 |
| Stockton, CACalifornia | $17.79 | $17.79 |
| Vallejo, CACalifornia | $19.51 | $19.51 |
| Visalia, CACalifornia | $17.79 | $17.79 |
| Yuba City, CACalifornia | $17.79 | $17.79 |
| ColoradoColorado | $17.72 | $17.72 |
| ConnecticutConnecticut | $18.17 | $18.17 |
| DelawareDelaware | $17.29 | $17.29 |
| Fort Lauderdale, FLFlorida | $17.98 | $17.98 |
| Rest of FloridaFlorida | $17.45 | $17.45 |
| Atlanta, GAGeorgia | $17.63 | $17.63 |
| Rest of GeorgiaGeorgia | $16.88 | $16.88 |
| Hawaii, Guam, HIHawaii | $17.87 | $17.87 |
| IowaIowa | $16.48 | $16.48 |
| IdahoIdaho | $16.56 | $16.56 |
| East St. Louis, ILIllinois | $17.59 | $17.59 |
| Rest of IllinoisIllinois | $17.25 | $17.25 |
| Suburban Chicago, ILIllinois | $18.11 | $18.11 |
| IndianaIndiana | $16.61 | $16.61 |
| KansasKansas | $16.49 | $16.49 |
| KentuckyKentucky | $16.68 | $16.68 |
| New Orleans, LALouisiana | $17.12 | $17.12 |
| Rest of LouisianaLouisiana | $16.69 | $16.69 |
| Metropolitan Boston, MAMassachusetts | $18.85 | $18.85 |
| Rest of MassachusettsMassachusetts | $17.71 | $17.71 |
| Baltimore area, MDMaryland | $18.12 | $18.12 |
| Rest of MarylandMaryland | $17.49 | $17.49 |
| Rest of MaineMaine | $16.66 | $16.66 |
| Southern Maine, MEMaine | $17.07 | $17.07 |
| Detroit, MIMichigan | $17.63 | $17.63 |
| Rest of MichiganMichigan | $16.96 | $16.96 |
| MinnesotaMinnesota | $17.06 | $17.06 |
| Metropolitan Kansas City, MOMissouri | $17.01 | $17.01 |
| Metropolitan St. Louis, MOMissouri | $17.10 | $17.10 |
| Rest of MissouriMissouri | $16.57 | $16.57 |
| MississippiMississippi | $16.40 | $16.40 |
| MontanaMontana | $17.37 | $17.37 |
| North CarolinaNorth Carolina | $16.75 | $16.75 |
| North DakotaNorth Dakota | $16.97 | $16.97 |
| NebraskaNebraska | $16.52 | $16.52 |
| New HampshireNew Hampshire | $17.52 | $17.52 |
| Northern New JerseyNew Jersey | $19.02 | $19.02 |
| Rest of New JerseyNew Jersey | $18.40 | $18.40 |
| New MexicoNew Mexico | $17.03 | $17.03 |
| NevadaNevada | $17.26 | $17.26 |
| OhioOhio | $16.88 | $16.88 |
| OklahomaOklahoma | $16.61 | $16.61 |
| Portland, OROregon | $18.00 | $18.00 |
| Rest of OregonOregon | $17.15 | $17.15 |
| Metropolitan Philadelphia, PAPennsylvania | $17.93 | $17.93 |
| Rest of PennsylvaniaPennsylvania | $16.87 | $16.87 |
| Puerto RicoPuerto Rico | $17.42 | $17.42 |
| Rhode IslandRhode Island | $17.69 | $17.69 |
| South CarolinaSouth Carolina | $16.84 | $16.84 |
| South DakotaSouth Dakota | $16.92 | $16.92 |
| TennesseeTennessee | $16.54 | $16.54 |
| Austin, TXTexas | $17.64 | $17.64 |
| Beaumont, TXTexas | $16.81 | $16.81 |
| Brazoria, TXTexas | $17.26 | $17.26 |
| Dallas, TXTexas | $17.35 | $17.35 |
| Fort Worth, TXTexas | $17.30 | $17.30 |
| Galveston, TXTexas | $17.30 | $17.30 |
| Houston, TXTexas | $17.67 | $17.67 |
| Rest of TexasTexas | $17.01 | $17.01 |
| UtahUtah | $16.96 | $16.96 |
| VirginiaVirginia | $17.08 | $17.08 |
| Virgin Islands, VIUnited States Virgin Islands | $17.42 | $17.42 |
| VermontVermont | $16.98 | $16.98 |
| Rest of WashingtonWashington | $17.65 | $17.65 |
| King County, WAWashington | $19.09 | $19.09 |
| WisconsinWisconsin | $16.67 | $16.67 |
| West VirginiaWest Virginia | $16.91 | $16.91 |
| WyomingWyoming | $17.19 | $17.19 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $22.95 | 1 |
| AL | $16.37 | 1 |
| AR | $16.24 | 1 |
| AZ | $17.10 | 1 |
| CA | $17.79–$20.78 | 29 |
| CO | $17.72 | 1 |
| CT | $18.17 | 1 |
| DC | $19.05 | 1 |
| DE | $17.29 | 1 |
| FL | $17.45–$18.62 | 3 |
| GA | $16.88–$17.63 | 2 |
| GU | $17.87 | 1 |
| HI | $17.87 | 1 |
| IA | $16.48 | 1 |
| ID | $16.56 | 1 |
| IL | $17.25–$18.34 | 4 |
| IN | $16.61 | 1 |
| KS | $16.49 | 1 |
| KY | $16.68 | 1 |
| LA | $16.69–$17.12 | 2 |
| MA | $17.71–$18.85 | 2 |
| MD | $17.49–$19.05 | 3 |
| ME | $16.66–$17.07 | 2 |
| MI | $16.96–$17.63 | 2 |
| MN | $17.06 | 1 |
| MO | $16.57–$17.10 | 3 |
| MS | $16.40 | 1 |
| MT | $17.37 | 1 |
| NC | $16.75 | 1 |
| ND | $16.97 | 1 |
| NE | $16.52 | 1 |
| NH | $17.52 | 1 |
| NJ | $18.40–$19.02 | 2 |
| NM | $17.03 | 1 |
| NV | $17.26 | 1 |
| NY | $16.89–$19.72 | 5 |
| OH | $16.88 | 1 |
| OK | $16.61 | 1 |
| OR | $17.15–$18.00 | 2 |
| PA | $16.87–$17.93 | 2 |
| PR | $17.42 | 1 |
| RI | $17.69 | 1 |
| SC | $16.84 | 1 |
| SD | $16.92 | 1 |
| TN | $16.54 | 1 |
| TX | $16.81–$17.67 | 8 |
| UT | $16.96 | 1 |
| VA | $17.08–$19.05 | 2 |
| VI | $17.42 | 1 |
| VT | $16.98 | 1 |
| WA | $17.65–$19.09 | 2 |
| WI | $16.67 | 1 |
| WV | $16.91 | 1 |
| WY | $17.19 | 1 |
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
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 Manhattan, NY 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
78
- Locality
- Manhattan, NY
- Physician work
- 1.064
- Practice expense
- 1.162
- Malpractice
- 1.586
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.33 | × 1.064 | 0.3511 |
| Practice expense | 0.17 | × 1.162 | 0.1975 |
| Malpractice | 0.02 | × 1.586 | 0.0317 |
| Total RVUs | 0.5804 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Manhattan, NY$19.39
Office: (0.33 × 1.064 + 0.17 × 1.162 + 0.02 × 1.586) × $33.4009 = $19.39
Facility: (0.33 × 1.064 + 0.17 × 1.162 + 0.02 × 1.586) × $33.4009 = $19.39
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 Manhattan, NY
90969 · Office / nonfacility
$19.39
Effective 2026-10-01
The base rate is $1.29 higher than on 2025-10-01, moving from $18.10 to $19.39 (7.1%).
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
$18.10changed to$19.39
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.15 changed to 0.17
- Work GPCI 1.065 changed to 1.064
- Practice expense GPCI 1.166 changed to 1.162
- Malpractice GPCI 1.656 changed to 1.586
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$18.62changed to$18.10
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$18.32changed to$18.62
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$19.13changed to$18.32
- Conversion factor 33.8872 changed to 32.7442
- Work GPCI 1.061 changed to 1.065
- Practice expense GPCI 1.184 changed to 1.166
- Malpractice GPCI 1.843 changed to 1.656
January 1, 2023
RVU23A
$19.71changed to$19.13
- Conversion factor 34.6062 changed to 33.8872
- Work GPCI 1.056 changed to 1.061
- Practice expense GPCI 1.203 changed to 1.184
- Malpractice GPCI 2.031 changed to 1.843
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$19.45changed to$19.71
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.14 changed to 0.15
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$17.51changed to$19.45
- 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
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.192 changed to 1.203
- Malpractice GPCI 1.823 changed to 2.031
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$17.26changed to$17.51
- Conversion factor 36.0391 changed to 36.0896
- Work GPCI 1.052 changed to 1.054
- Practice expense GPCI 1.180 changed to 1.192
- Malpractice GPCI 1.615 changed to 1.823
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$17.24changed to$17.26
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$17.22changed to$17.24
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 1.174 changed to 1.180
- Malpractice GPCI 1.690 changed to 1.615
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$17.20changed to$17.22
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 1.168 changed to 1.174
- Malpractice GPCI 1.764 changed to 1.690
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$17.27changed to$17.20
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$17.18changed to$17.27
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$16.53changed to$17.18
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.01 changed to 0.02
- Work GPCI 1.057 changed to 1.052
- Practice expense GPCI 1.165 changed to 1.168
- Malpractice GPCI 1.518 changed to 1.764
Held through RVU15B.
January 1, 2014
RVU14A
$16.05changed to$16.53
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.13 changed to 0.12
- Work GPCI 1.062 changed to 1.057
- Practice expense GPCI 1.162 changed to 1.165
- Malpractice GPCI 1.271 changed to 1.518
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $16.05
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $19.39 | $19.39 | RVU26D |
| 2026-07-01 | $19.39 | $19.39 | RVU26C |
| 2026-04-01 | $19.39 | $19.39 | RVU26B |
| 2026-01-01 | $19.39 | $19.39 | RVU26A |
| 2025-10-01 | $18.10 | $18.10 | RVU25D |
| 2025-07-01 | $18.10 | $18.10 | RVU25C |
| 2025-04-01 | $18.10 | $18.10 | RVU25B |
| 2025-01-01 | $18.10 | $18.10 | RVU25A |
| 2024-10-01 | $18.62 | $18.62 | RVU24D |
| 2024-07-01 | $18.62 | $18.62 | RVU24C |
| 2024-04-01 | $18.62 | $18.62 | RVU24B |
| 2024-03-09 | $18.62 | $18.62 | RVU24AR |
| 2024-01-01 | $18.32 | $18.32 | RVU24A |
| 2023-10-01 | $19.13 | $19.13 | RVU23D |
| 2023-07-01 | $19.13 | $19.13 | RVU23C |
| 2023-04-01 | $19.13 | $19.13 | RVU23B |
| 2023-01-01 | $19.13 | $19.13 | RVU23A |
| 2022-10-01 | $19.71 | $19.71 | RVU22D |
| 2022-07-01 | $19.71 | $19.71 | RVU22C |
| 2022-04-01 | $19.71 | $19.71 | RVU22B |
| 2022-01-01 | $19.71 | $19.71 | RVU22A |
| 2021-10-01 | $19.45 | $19.45 | RVU21D |
| 2021-07-01 | $19.45 | $19.45 | RVU21C |
| 2021-04-01 | $19.45 | $19.45 | RVU21B |
| 2021-01-01 | $19.45 | $19.45 | RVU21A |
| 2020-10-01 | $17.51 | $17.51 | RVU20D |
| 2020-07-01 | $17.51 | $17.51 | RVU20C |
| 2020-04-01 | $17.51 | $17.51 | RVU20B |
| 2020-01-01 | $17.51 | $17.51 | RVU20A |
| 2019-10-01 | $17.26 | $17.26 | RVU19D |
| 2019-07-01 | $17.26 | $17.26 | RVU19C |
| 2019-04-01 | $17.26 | $17.26 | RVU19B |
| 2019-01-01 | $17.26 | $17.26 | RVU19A |
| 2018-10-01 | $17.24 | $17.24 | RVU18D |
| 2018-07-01 | $17.24 | $17.24 | RVU18C |
| 2018-04-01 | $17.24 | $17.24 | RVU18B |
| 2018-01-01 | $17.24 | $17.24 | RVU18AR1 |
| 2017-10-01 | $17.22 | $17.22 | RVU17D |
| 2017-07-01 | $17.22 | $17.22 | RVU17C |
| 2017-04-01 | $17.22 | $17.22 | RVU17B |
| 2017-01-01 | $17.22 | $17.22 | RVU17A |
| 2016-10-01 | $17.20 | $17.20 | RVU16D |
| 2016-07-01 | $17.20 | $17.20 | RVU16C |
| 2016-04-01 | $17.20 | $17.20 | RVU16B |
| 2016-01-01 | $17.20 | $17.20 | RVU16A |
| 2015-10-01 | $17.27 | $17.27 | RVU15D |
| 2015-07-01 | $17.27 | $17.27 | RVU15C |
| 2015-04-01 | $17.18 | $17.18 | RVU15B |
| 2015-01-01 | $17.18 | $17.18 | RVU15A |
| 2014-10-01 | $16.53 | $16.53 | RVU14D |
| 2014-07-01 | $16.53 | $16.53 | RVU14C |
| 2014-04-01 | $16.53 | $16.53 | RVU14B |
| 2014-01-01 | $16.53 | $16.53 | RVU14A |
| 2013-10-01 | $16.05 | $16.05 | RVU13D |
| 2013-07-01 | $16.05 | $16.05 | RVU13C |
| 2013-04-01 | $16.05 | $16.05 | RVU13B |
| 2013-01-01 | $16.05 | $16.05 | RVU13AR |
Where the Manhattan, NY rate applies
Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.
- 90969 in New York · multiple payment areas
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
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