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

In Wisconsin, Medicare pays $16.67 for 90969 in the office and $16.67 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.

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 Wisconsin 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. Wisconsin pays $16.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90969 rates by state

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

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.

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.

Codes related to 90969

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

How 90969 has changed in Wisconsin

Price 90969 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