90955 Esrd srv 2-3 vsts p mo 2-11
What 90955 is
CMS fee schedule short descriptor: Esrd srv 2-3 vsts p mo 2-11.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 90955 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 10.32 | 5.16 | 0.64 | 16.12 | $538.42 |
| Facility (hospital, ASC) | 10.32 | 5.16 | 0.64 | 16.12 | $538.42 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 90955 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 90955? These codes are bundled into it
90955 is a Column 1 code in 172 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0407U | 1 - modifier may bypass | Check pair | |
0591T | Hlth&wb coaching indiv 1st | 1 - modifier may bypass | Check pair |
0592T | Hlth&wb coaching indiv f-up | 1 - modifier may bypass | Check pair |
0593T | Hlth&wb coaching group | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
90952 | Esrd serv 2-3 vsts p mo <2yr | 0 - no modifier bypass | Check pair |
90953 | Esrd serv 1 visit p mo <2yrs | 0 - no modifier bypass | Check pair |
90956 | Esrd srv 1 visit p mo 2-11 | 0 - no modifier bypass | Check pair |
90958 | Esrd srv 2-3 vsts p mo 12-19 | 0 - no modifier bypass | Check pair |
90959 | Esrd serv 1 vst p mo 12-19 | 0 - no modifier bypass | Check pair |
90960 | Esrd srv 4 visits p mo 20+ | 0 - no modifier bypass | Check pair |
90961 | Esrd srv 2-3 vsts p mo 20+ | 0 - no modifier bypass | Check pair |
90962 | Esrd serv 1 visit p mo 20+ | 0 - no modifier bypass | Check pair |
90965 | Esrd home pt serv p mo 12-19 | 0 - no modifier bypass | Check pair |
90966 | Esrd home pt serv p mo 20+ | 0 - no modifier bypass | Check pair |
90967 | Esrd svc pr day pt <2 | 0 - no modifier bypass | Check pair |
90968 | Esrd svc pr day pt 2-11 | 0 - no modifier bypass | Check pair |
90969 | Esrd svc pr day pt 12-19 | 0 - no modifier bypass | Check pair |
90970 | Esrd svc pr day pt 20+ | 0 - no modifier bypass | Check pair |
96160 | Pt-focused hlth risk assmt | 1 - modifier may bypass | Check pair |
96161 | Caregiver health risk assmt | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97802 | Medical nutrition indiv in | 0 - no modifier bypass | Check pair |
97803 | Med nutrition indiv subseq | 0 - no modifier bypass | Check pair |
97804 | Medical nutrition group | 0 - no modifier bypass | Check pair |
98000 | Synch audio-video new sf 15 | 1 - modifier may bypass | Check pair |
98001 | Synch audio-video new low 30 | 1 - modifier may bypass | Check pair |
98002 | Synch audio-video new mod 45 | 1 - modifier may bypass | Check pair |
98003 | Synch audio-video new hi 60 | 1 - modifier may bypass | Check pair |
Showing 30 of 172 column 2 codes. Use the pair checker for any specific combination.
90955 is bundled into these codes
90955 appears as a Column 2 code in 10 active edits. Reported with one of these Column 1 codes on the same date of service, 90955 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
90951 | Esrd serv 4 visits p mo <2yr | 0 | Check pair |
90954 | Esrd serv 4 vsts p mo 2-11 | 0 | Check pair |
90957 | Esrd srv 4 vsts p mo 12-19 | 0 | Check pair |
90963 | Esrd home pt serv p mo <2yrs | 0 | Check pair |
90964 | Esrd home pt serv p mo 2-11 | 0 | Check pair |
99439 | Chrnc care mgmt staf ea addl | 0 | Check pair |
99487 | Cplx chrnc care 1st 60 min | 0 | Check pair |
99489 | Cplx chrnc care ea addl 30 | 0 | Check pair |
99490 | Chrnc care mgmt staff 1st 20 | 0 | Check pair |
99491 | Chrnc care mgmt phys 1st 30 | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.