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Medicare Physician Fee Schedule Effective Locality 05102-00 CMS RVU26D Updated

CPT 90834 Medicare rate in Des Moines, IA

Standard therapy session in ZIPs including 50309, 52401, and 52240

The Medicare allowed amount is $111.14 in the Office (non-facility) setting and $90.97 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

90834 Q4 2026
Locality-adjusted allowed amount
$111.14
in a doctor’s own office or clinic

Des Moines, IA flag Des Moines, IA (Locality 05102-00)

2.4% below the national baseline ($113.90)

CMS RVU26DOctober 1 – December 31, 2026revision 2

( Work2.56 × 1.000 + Practice exp.0.83 × 0.915 + Malpractice0.02 × 0.397 ) × Conv. factor$33.4009 = $111.14

row 11,531

F Work RVU

2.56

G Non‑facility PE RVU

0.83

K MP RVU

0.02

Z Conversion factor

33.4009

row 53

E Work GPCI

1.000

F PE GPCI

0.915

G MP GPCI

0.397

The Medicare allowed amount is $111.14 in the Office (non-facility) setting and $90.97 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

Assumes a participating provider, no modifiers, the whole service, before sequestration.

Customize service date, participation, and modifiers Check service-location ZIP CMS sources and method

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What Medicare locality is Des Moines, IA in? Copy link

CMS prices all of Iowa as one Medicare payment locality, so this amount applies statewide, including Cedar Rapids, Davenport and Iowa City—not only in Des Moines, IA.

Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.

ZIP codes in this payment locality (1,080)

The CMS ZIP-to-locality crosswalk maps 1,080 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 3 span more than one locality and need ZIP+4 for an exact match.

50001 50002 50003 50005 50006 50007 50008 50009 50010 50011 50012 50013 50014 50015 50020 50021 50022 50023 50025 50026 50027 50028 50029 50031 50032 50033 50034 50035 50036 50037 50038 50039 50040 50041 50042 50043 50044 50046 50047 50048 50049 50050 50051 50052 50054 50055 50056 50057 50058 50059 50060 50061 50062 50063 50064 50065 50066 50067 50068 50069 50070 50071 50072 50073 50074 50075 50076 50078 50099 50101 50102 50103 50104 50105 50106 50107 50108 50109 50110 50111 50112 50115 50116 50117 50118 50119 50120 50122 50123 50124 50125 50126 50127 50128 50129 50130 50131 50132 50133 50134

980 more ZIP codes map to this locality. The Des Moines, IA locality page lists the full set.

Which ZIP codes does the Des Moines, IA rate for 90834 cover?

The CMS ZIP-to-locality crosswalk maps 1,080 ZIP codes to this payment locality, and 90834 has the same amount in every one of them. Examples include 50001, 50002, 50003, 50005, 50006, 50007. Of these, 3 span more than one payment locality and need ZIP+4 for an exact match.

Does this 90834 rate apply everywhere in Iowa?

Yes. CMS prices Iowa as a single Medicare payment locality, so the same GPCIs—and the same allowed amount—apply statewide, not only in Des Moines, IA. That includes Cedar Rapids, Davenport and Iowa City. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.

How locality affects the amount Copy link

Office (non-facility) · Q4 2026 · Participating · Whole service

Des Moines, IA (this locality)
$111.14
National PFS baseline (GPCI 1.000)
$113.90

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Des Moines, IA 2.4% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.915
Malpractice GPCI
0.397
2026 conversion factor
$33.4009

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Why is the 90834 rate in Des Moines, IA different from the national amount?

The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices—work 1.000, practice expense 0.915, malpractice 0.397—scale each RVU component before the conversion factor is applied, which is why the Des Moines, IA amount is lower than the $113.90 baseline.

Formula and inputs Copy link

For the office (non-facility) amount, each of 90834's RVU components is multiplied by its Des Moines, IA GPCI; the products are summed and multiplied by the conversion factor.

Code
90834
DOS
Not selected; uses this release’s rates
Locality
IOWA (IA)
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
Sequestration
Shown separately from the allowed amount

Formula

(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor

Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.

RVU × GPCI components of Des Moines, IA allowed amount for 90834
Component RVU × GPCI = Adjusted
Work 2.56 × 1.000 2.5600
Practice expense · Office (non-facility) 0.83 × 0.915 0.7595
Malpractice 0.02 × 0.397 0.0079
Sum of adjusted RVUs 3.3274
× 33.4009 conversion factor = formula amount $111.14

Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.

  1. Locality-adjusted allowed amount $111.14

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • 90834’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

    PPRRVU2026_Oct_nonQPP.csv row 11,531 in rvu26d-updated-08-26-2026.zip

    A HCPCS
    90834
    B Modifier
    blank
    D Status code
    A
    F Work RVU
    2.56
    G Non-facility PE RVU
    0.83
    K MP RVU
    0.02
    Z Conversion factor
    33.4009
    In the CMS file

    Loading rows 11,529–11,533 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

  • Locality 05102-00’s GPCIs

    Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2

    GPCI2026.csv row 53 in rvu26d-updated-08-26-2026.zip

    A MAC
    05102
    C Locality number
    00
    E Work GPCI
    1.000
    F PE GPCI
    0.915
    G MP GPCI
    0.397
    In the CMS file

    Loading rows 51–55 of GPCI2026.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

CMS RVU26DOctober 1 – December 31, 2026revision 2

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 90834 in Des Moines, IA is $90.97, versus $111.14 in the Office (non-facility) setting. Only the practice-expense RVU changes with the setting: the facility bills its own fee for overhead, so the professional amount is lower. See which setting applies to your place of service.

What is the Facility amount for 90834 in Des Moines, IA?

$90.97 in a facility, versus $111.14 in the Office (non-facility) setting—a $20.17 difference. Only the practice-expense RVU changes with the setting: in the Office (non-facility) setting the practice carries the overhead, so the professional amount is higher; in a hospital or ASC the facility bills its own fee.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Des Moines, IA. Medicare pays part of the allowed amount and the patient pays the rest; the rows below show each figure. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 90834 in Des Moines, IA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $111.14
Non-participating allowed amount 95% of the participating amount. $105.58
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $121.42
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $88.91
Patient coinsurance The remaining 20%. $22.23
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $1.78
Net Medicare payment Medicare's share after the sequestration reduction. $87.13
What is the non-participating amount and limiting charge for 90834 in Des Moines, IA?

A non-participating provider is paid $105.58—95% of the $111.14 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $121.42, which is 115% of the non-participating amount.

How much of the Des Moines, IA 90834 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($88.91) once the annual Part B deductible is met, and the beneficiary owes 20% ($22.23). Sequestration reduces Medicare's share by about 2% ($1.78), leaving $87.13. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Des Moines, IA Copy link

Commercial contracts are often written as a percentage of the Medicare fee schedule. The part that gets misread is which Medicare amount: a contract benchmarked to the fee schedule prices off this locality's allowed amount—$111.14 in the office (non-facility) setting—not the $113.90 national baseline.

Opens the calculator set to Des Moines, IA and your selected setting, where you can also compare what a payer paid against the expected amount. See how to find your contract's actual percentage.

90834 in nearby payment localities Copy link

Payment localities in the same region as Des Moines, IA, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 90834. Neighboring localities often differ.

Percentages are against Des Moines, IA. Every payment locality nationwide is on the CPT 90834 rate map.

Other codes priced in Des Moines, IA Copy link

Office (non-facility) allowed amounts in this same payment locality, Q4 2026.

Other curated codes and their allowed amounts in Des Moines, IA
Code and service Allowed vs. national
90837 Extended Therapy Session $163.19 -2.3%
90791 Psychiatric Diagnostic Evaluation $169.17 -2.4%
90792 Psychiatric Diagnostic Evaluation With Medical Services $193.77 -4.1%
90853 Behavioral health $29.54 -2.8%
99213 Routine Follow-Up Office Visit $89.23 -6.3%
99214 Long Follow-Up Office Visit $127.11 -6.3%
66984 Cataract Surgery $434.29 -6.1%
92014 Full Eye Exam, Returning Patient $119.78 -5.9%
99204 Long New Patient Office Visit $165.51 -6.7%
99212 Brief Follow-Up Office Visit $55.35 -6.9%
99215 Longest Follow-Up Office Visit $180.35 -6.3%
97110 Physical Therapy Exercises $27.69 -4.7%

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q4 2026 release: this code's RVUs from the relative value file, multiplied by payment locality 05102-00's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q4 2026 release. Past releases are never edited, so an amount for an earlier quarter always matches what CMS published for it. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 11,531)
Geographic practice cost indices (Q4 2026) · rvu26d-updated-08-26-2026.zip (GPCI2026.csv row 53)
ZIP code to carrier locality crosswalk (Q4 2026) · zip-code-carrier-locality-file-updated-08-13-2026.zip (ZIP5_OCT2026.txt)

Working a claim with an earlier date of service? The calculator prices 90834 in Des Moines, IA against the release in effect on that date. Dates of service this quarter don't need an account; earlier dates need a free account.

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