$685.37
Both codes cover monthly ESRD management for ages 12–19. Choose 90957 for four or more face-to-face visits and 90958 for two or three.
On this page
CMS RVU26D · Effective 2026-10-01
90957 ESRD monthly care Medicare reimbursement rates in Alaska
Monthly ESRD-related management for a patient age 12 through 19 when the clinician provides at least four face-to-face visits during the month. Compare 90957 office and facility rates across CMS payment localities in Alaska.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90957 in Alaska?
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$1056.55
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
Facility setting
$1056.55
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nephrology
About 90957: Monthly ESRD management, four or more visits
Monthly ESRD-related management for a patient age 12 through 19 when the clinician provides at least four face-to-face visits during the month.
Code 90957 represents monthly management of end-stage renal disease for a patient age 12 through 19 who receives four or more face-to-face visits during the month. A nephrologist or other qualified clinician typically provides this care in connection with the patient’s dialysis program. The work may include assessing dialysis adequacy, volume status, nutrition, vascular access, complications, and the ongoing treatment plan, as well as coordinating care with the dialysis team.
Report one monthly service when the age and visit-count criteria are met; this is not a per-dialysis-session code. Documentation should support the patient’s age, the ESRD-related management provided, and at least four face-to-face visits in that calendar month. Select a different monthly code when the patient has fewer qualifying visits, falls into another age band, or receives home dialysis services represented by the home-dialysis series. CMS lists no payment rules for this code in the supplied facts.
Where the value comes from
- Work RVU15.46 · 65%
- Practice expense (office) RVU7.42 · 31%
- Malpractice RVU0.98 · 4%
1.3K
Medicare services in 2024 · #2773 by national volume
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.
90957 compared with similar codes
Office rates for Alaska, from the same CMS release.
$444.30
Both apply to ages 12–19, but 90959 represents one face-to-face visit during the month; 90957 requires four or more.
$487.96
Both represent monthly ESRD management with four or more face-to-face visits. Code 90960 is for patients age 20 or older, while 90957 is for ages 12–19.
No office rate
Code 90935 describes hemodialysis with one evaluation. Code 90957 represents monthly ESRD-related management for a patient ages 12–19 with four or more face-to-face visits.
Compare 90957 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alaska* →
Office / nonfacility
$1056.55
Facility
$1056.55
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 90957 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
11,570
- Code
- 90957
- Physician work
- 15.46
- Practice expense
- 7.42
- Malpractice
- 0.98
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.46 | × 1.500 | 23.1900 |
| Practice expense | 7.42 | × 1.065 | 7.9023 |
| Malpractice | 0.98 | × 0.551 | 0.5400 |
| Total RVUs | 31.6323 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alaska*$1056.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.46 | 1.5 |
| Practice expense | 7.42 | 1.065 |
| Malpractice | 0.98 | 0.551 |
(15.46 × 1.5 + 7.42 × 1.065 + 0.98 × 0.551) × $33.4009 = $1056.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.46 | 1.5 |
| Practice expense | 7.42 | 1.065 |
| Malpractice | 0.98 | 0.551 |
(15.46 × 1.5 + 7.42 × 1.065 + 0.98 × 0.551) × $33.4009 = $1056.55
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
90957 billing questions
When should I choose 90957 instead of 90958?
Use 90957 for a patient age 12 through 19 with four or more face-to-face visits during the month. Code 90958 is the same age group with two or three visits.
Is 90957 reported for each dialysis treatment?
No. It represents monthly ESRD-related management, with the number of face-to-face visits determining the applicable monthly code.
What supports reporting four or more visits?
Keep documentation of the face-to-face ESRD-related encounters during the month, along with the assessments and management provided. The record should support the patient’s age and the monthly service.
How does this differ from 90935?
Code 90957 describes monthly ESRD-related management for the specified age and visit count. Code 90935 describes a hemodialysis service with one evaluation, rather than monthly management.
What if the patient received only one visit that month?
For a patient age 12 through 19 with one face-to-face visit, use the corresponding one-visit monthly code, 90959, rather than 90957.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,56790954,,Esrd serv 4 vsts p mo 2-11,A,,20.86,8.80,,8.80,,1.31,30.97,30.97,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56890955,,Esrd srv 2-3 vsts p mo 2-11,A,,10.32,5.16,,5.16,,0.64,16.12,16.12,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56990956,,Esrd srv 1 visit p mo 2-11,A,,6.64,3.93,,3.93,,0.41,10.98,10.98,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57090957,,Esrd srv 4 vsts p mo 12-19,A,,15.46,7.42,,7.42,,0.98,23.86,23.86,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57190958,,Esrd srv 2-3 vsts p mo 12-19,A,,9.87,5.05,,5.05,,0.61,15.53,15.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57290959,,Esrd serv 1 vst p mo 12-19,A,,6.19,3.57,,3.57,,0.39,10.15,10.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57390960,,Esrd srv 4 visits p mo 20+,A,,6.77,3.96,,3.96,,0.43,11.16,11.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609