CPT code 90937: Hemodialysis, repeated physician evaluations2026 Medicare rate & RVUs in New York
Report 90937 for a hemodialysis treatment in which the physician performs repeated clinical evaluations during the session, with or without dialysis-prescription revision.
CMS doesn’t publish an office rate for 90937 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 90937 covers
This service captures physician management during a hemodialysis treatment when the patient requires repeated clinical evaluations during that session. A nephrologist or other physician assesses the patient’s response to dialysis more than once and may make a substantial change to the dialysis prescription; a prescription change is not required when repeated evaluations are documented. It is used for in-center or hospital hemodialysis encounters, not simply because the patient receives recurring dialysis.
Choose 90937 rather than 90935 when repeated evaluations, rather than a single evaluation, support the service. Report the treatment once, not one unit for each assessment. The record should identify the serial assessments, clinical findings, response to treatment, and any resulting prescription decisions. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; 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.
Where 90937 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | $97.95 |
| NYC suburbs and Long Island, NY | Unavailable | $99.54 |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | $93.98 |
| Queens, NY | Unavailable | $97.63 |
| Rest of New York | Unavailable | $86.45 |
How the 90937 rate is calculated
Each of 90937’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 · 90937
RVUs × geographic indexes × conversion factor
Work2.06
2.06 RVUs× 1.000 GPCI
Practice expense0.46
0.46 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
2.6500
Conversion factor
$33.4009
Medicare rate
$88.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90937
The CMS indicators that decide how 90937 is paid alongside other services.
CMS payment indicators · 90937
Hemodialysis, repeated physician evaluations
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
90937 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90935HemodialysisOne clinician evaluation
- Both concern hemodialysis, but 90935 represents a single physician evaluation during the treatment. Choose 90937 when repeated evaluations are documented.
- 90945Dialysis evaluationOther than hemodialysis, single evaluation
- 90945 is for a dialysis procedure other than hemodialysis with a single physician evaluation. 90937 is specifically for hemodialysis with repeated evaluations.
- 90947Dialysis evaluationRepeated evaluations
- 90947 covers repeated evaluations during dialysis other than hemodialysis; 90937 applies when the treatment is hemodialysis.
90937 billing questions
When should 90937 be chosen over 90935?
Use 90937 when the physician performs repeated clinical evaluations during the hemodialysis session. Use 90935 when the documented service involves a single evaluation.
Does the physician have to change the dialysis prescription?
No. Repeated evaluations support 90937 even when the prescription remains unchanged, provided the record documents the assessments and clinical findings.
Should each evaluation be billed as a separate unit?
No. Report the hemodialysis treatment once; the repeated evaluations distinguish 90937 from a single-evaluation service.
How does 90947 differ from 90937?
90937 describes repeated physician evaluations during hemodialysis. 90947 is for repeated evaluations during a dialysis procedure other than hemodialysis.
Can modifier 50 be appended to 90937?
No. The CMS bilateral indicator makes modifier 50 inappropriate for this service.
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
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