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CPT code 90870: Electroconvulsive therapy2026 Medicare rate & RVUs in Los Angeles, CA

Report this service for a psychiatrist-administered electroconvulsive treatment session using electrical stimulation to induce a therapeutic seizure under anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality82.2K Medicare services in 2024

In Los Angeles, CA, Medicare pays $201.93 for 90870 in the office and $103.15 when it’s performed in a hospital or facility.

$201.93Office (non-facility)
$103.15Hospital or facility
+10.9%vs the national office rate ($182.03)

Check a contract rate as a % of Medicare · 90870 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 90870 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 90870 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 90870 covers

Electroconvulsive therapy (ECT) is a treatment session in which a clinician applies a brief electrical stimulus through scalp electrodes to produce a controlled seizure. A psychiatrist typically directs or performs the treatment for severe mood disorders, catatonia, or other psychiatric conditions when ECT is clinically selected. It is commonly delivered in a hospital or ambulatory procedure setting with anesthesia, muscle relaxation, and physiologic monitoring; anesthesia services are generally furnished by a separate anesthesia professional.

Report 90870 for the ECT treatment itself, not for psychotherapy or an entire course of treatment. The record should identify the treatment session and support that ECT was performed, including the clinical indication and procedural details. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. An assistant-at-surgery service is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.

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 Los Angeles, CA compares for 90870

Across 109 of 109 payment localities, the office rate for 90870 runs from $167.11 in Arkansas to $232.05 in San Benito County, CA. Los Angeles, CA pays $201.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

90870 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$201.93
  2. Bakersfield, CA · California$191.62−$10.31
  3. Chico, CA · California$191.23−$10.70
  4. El Centro, CA · California$191.25−$10.68
  5. Fresno, CA · California$191.23−$10.70
  6. Hanford, CA · California$191.23−$10.70
  7. Madera, CA · California$191.23−$10.70

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

90870 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$191.23$99.71
Modesto, CACalifornia$191.23$99.71
Napa, CACalifornia$216.19$106.14
Oxnard, CACalifornia$200.63$101.93
Redding, CACalifornia$191.23$99.71
Rest of CaliforniaCalifornia$191.23$99.71
Riverside, CACalifornia$192.27$100.75
Sacramento, CACalifornia$199.22$102.10

90870 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$167.11

$228.65

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90870 office rate range by state
State / territoryOffice rate rangeLocalities
AK$228.651
AL$168.791
AR$167.111
AZ$178.641
CA$191.23–$232.0529
CO$188.491
CT$191.691
DC$203.891
DE$181.001
FL$179.34–$190.553
GA$172.30–$184.422
GU$193.861
HI$193.861
IA$172.101
ID$172.811
IL$175.42–$187.524
IN$173.521
KS$171.371
KY$171.181
LA$170.92–$176.812
MA$187.82–$203.662
MD$183.77–$203.893
ME$173.26–$180.072
MI$174.11–$180.752
MN$182.691
MO$168.77–$177.463
MS$167.971
MT$182.031
NC$174.551
ND$180.251
NE$172.811
NH$185.581
NJ$194.46–$202.782
NM$174.711
NV$181.631
NY$176.37–$208.015
OH$173.751
OK$171.141
OR$180.76–$193.202
PA$174.04–$188.032
PR$183.041
RI$186.451
SC$174.321
SD$180.041
TN$171.951
TX$173.22–$187.408
UT$176.001
VA$179.53–$203.892
VI$183.041
VT$179.591
WA$187.46–$207.342
WI$175.941
WV$170.821
WY$181.251

See 90870 in every payment locality

How the 90870 rate is calculated

Each of 90870’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 · 90870

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.50

2.50 RVUs× 1.000 GPCI

Practice expense2.86

2.86 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

5.4500

Conversion factor

$33.4009

Medicare rate

$182.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,547

Code
90870
Physician work
2.50
Practice expense
2.86
Malpractice
0.09

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 90870 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work2.50× 1.0412.6025
Practice expense2.86× 1.1833.3834
Malpractice0.09× 0.6640.0598
Total RVUs6.0456
Conversion factor× 33.4009

Office rate, Los Angeles, CA$201.93

Office: (2.5 × 1.041 + 2.86 × 1.183 + 0.09 × 0.664) × $33.4009 = $201.93

Facility: (2.5 × 1.041 + 0.36 × 1.183 + 0.09 × 0.664) × $33.4009 = $103.15

Open 90870 in the RVU calculator

Payment rules and modifiers for 90870

The CMS indicators that decide how 90870 is paid alongside other services.

CMS payment indicators · 90870

Electroconvulsive therapy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 90870

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

Codes related to 90870
CodeHow it relatesOffice range, Los Angeles, CA
Often billed with
00104ECT anesthesiaAnesthesia for ECT is commonly furnished and reported separately by the anesthesia professional.No office rate
Used instead
90867TMS treatment, initial mapping and treatmentTranscranial magnetic stimulation planning is a different treatment approach from ECT.No office rate
90868TMS treatment, per sessionTranscranial magnetic stimulation treatment is a non-ECT treatment approach.No office rate
90869TMS Redetermination, motor ThresholdThis reports TMS parameter redetermination, not an ECT session.No office rate

How 90870 has changed in Los Angeles, CA

90870 · Office / nonfacility

$201.93

Effective 2026-10-01

The base rate is $16.95 higher than on 2025-10-01, moving from $184.98 to $201.93 (9.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $184.98changed to$201.93

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.55 changed to 2.86
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $191.55changed to$184.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.58 changed to 2.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $188.43changed to$191.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $191.78changed to$188.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.51 changed to 2.58
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $195.49changed to$191.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.52 changed to 2.51
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $195.89changed to$195.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.49 changed to 2.52

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $198.68changed to$195.89

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.40 changed to 2.49
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $196.85changed to$198.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.36 changed to 2.40
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $196.63changed to$196.85

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $196.66changed to$196.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.38 changed to 2.36
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $196.73changed to$196.66

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.40 changed to 2.38
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $197.12changed to$196.73

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $196.14changed to$197.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $194.69changed to$196.14

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.37 changed to 2.40
    • Malpractice RVU 0.11 changed to 0.09
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $194.57changed to$194.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.65 changed to 2.37
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$194.57

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$201.93$103.15RVU26D
2026-07-01$201.93$103.15RVU26C
2026-04-01$201.93$103.15RVU26B
2026-01-01$201.93$103.15RVU26A
2025-10-01$184.98$106.58RVU25D
2025-07-01$184.98$106.58RVU25C
2025-04-01$184.98$106.58RVU25B
2025-01-01$184.98$106.58RVU25A
2024-10-01$191.55$109.68RVU24D
2024-07-01$191.55$109.68RVU24C
2024-04-01$191.55$109.68RVU24B
2024-03-09$191.55$109.68RVU24AR
2024-01-01$188.43$107.89RVU24A
2023-10-01$191.78$111.46RVU23D
2023-07-01$191.78$111.46RVU23C
2023-04-01$191.78$111.46RVU23B
2023-01-01$191.78$111.46RVU23A
2022-10-01$195.49$113.76RVU22D
2022-07-01$195.49$113.76RVU22C
2022-04-01$195.49$113.76RVU22B
2022-01-01$195.49$113.76RVU22A
2021-10-01$195.89$114.71RVU21D
2021-07-01$195.89$114.71RVU21C
2021-04-01$195.89$114.71RVU21B
2021-01-01$195.89$114.71RVU21A
2020-10-01$198.68$118.89RVU20D
2020-07-01$198.68$118.89RVU20C
2020-04-01$198.68$118.89RVU20B
2020-01-01$198.68$118.89RVU20A
2019-10-01$196.85$118.80RVU19D
2019-07-01$196.85$118.80RVU19C
2019-04-01$196.85$118.80RVU19B
2019-01-01$196.85$118.80RVU19A
2018-10-01$196.63$119.09RVU18D
2018-07-01$196.63$119.09RVU18C
2018-04-01$196.63$119.09RVU18B
2018-01-01$196.63$119.09RVU18AR1
2017-10-01$196.66$118.63RVU17D
2017-07-01$196.66$118.63RVU17C
2017-04-01$196.66$118.63RVU17B
2017-01-01$196.66$118.63RVU17A
2016-10-01$196.73$118.58RVU16D
2016-07-01$196.73$118.58RVU16C
2016-04-01$196.73$118.58RVU16B
2016-01-01$196.73$118.58RVU16A
2015-10-01$197.12$118.69RVU15D
2015-07-01$197.12$118.69RVU15C
2015-04-01$196.14$118.10RVU15B
2015-01-01$196.14$118.10RVU15A
2014-10-01$194.69$118.36RVU14D
2014-07-01$194.69$118.36RVU14C
2014-04-01$194.69$118.36RVU14B
2014-01-01$194.69$118.36RVU14A
2013-10-01$194.57$112.90RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90870 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

90870 billing questions

How does 90870 differ from transcranial magnetic stimulation?

90870 reports ECT, which uses electrical stimulation to induce a therapeutic seizure under anesthesia. Code 90868 reports a transcranial magnetic stimulation treatment session.

Can anesthesia be reported separately?

An anesthesia professional may report 00104 for anesthesia furnished for ECT when the service is performed and documented. Code 90870 reports the ECT treatment itself.

Does 90870 cover an entire course of ECT?

No. Report the code for each ECT treatment session performed, rather than for the overall course or treatment plan.

Should modifier 50 be appended for bilateral electrode placement?

No. CMS identifies bilateral adjustment as inappropriate for 90870, regardless of electrode placement.

When can an assistant-at-surgery service be paid?

CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

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
RVUs for 90870PPRRVU2026_Oct_nonQPP.csv, line 11,547 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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