CPT code 90945: Dialysis evaluation, other than hemodialysis, single evaluation2026 Medicare rate & RVUs in Illinois
Reports a dialysis treatment other than hemodialysis with one physician or qualified health care professional evaluation during the treatment.
CMS doesn’t publish an office rate for 90945 in Illinois.
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 90945 covers
Code 90945 captures a dialysis treatment other than hemodialysis together with one physician or other qualified health care professional evaluation during that treatment. Common contexts include nephrologist oversight of peritoneal dialysis or hemofiltration, including continuous renal replacement therapy in an acute-care setting. The service may be provided in hospital or outpatient dialysis settings and is distinct from monthly ESRD management.
Report it when the record supports a non-hemodialysis modality and one evaluation during the dialysis procedure; document the modality, treatment context, and clinician’s assessment. Use 90947 when repeated evaluations are performed for a non-hemodialysis procedure, and select the hemodialysis codes for hemodialysis. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. Do not use modifier 50 for bilateral billing. 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 90945 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $81.52 |
| East St. Louis, IL | Unavailable | $78.33 |
| Rest of Illinois | Unavailable | $76.81 |
| Suburban Chicago, IL | Unavailable | $80.46 |
How the 90945 rate is calculated
Each of 90945’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 · 90945
RVUs × geographic indexes × conversion factor
Work1.52
1.52 RVUs× 1.000 GPCI
Practice expense0.70
0.70 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
2.3100
Conversion factor
$33.4009
Medicare rate
$77.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90945
The CMS indicators that decide how 90945 is paid alongside other services.
CMS payment indicators · 90945
Dialysis evaluation, other than hemodialysis, single evaluation
| 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. |
90945 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90935HemodialysisOne clinician evaluation
- Choose 90935 for hemodialysis with one evaluation. Choose 90945 for one evaluation during a dialysis procedure other than hemodialysis.
- 90937HemodialysisRepeated physician evaluations
- 90937 describes repeated evaluations during hemodialysis; 90945 is for one evaluation during dialysis other than hemodialysis.
- 90947Dialysis evaluationRepeated evaluations
- Both concern dialysis other than hemodialysis, but 90945 is for one evaluation and 90947 is for repeated evaluations.
90945 billing questions
How do I choose between 90945 and 90947?
Use 90945 for one evaluation during a dialysis procedure other than hemodialysis. Use 90947 when repeated evaluations are performed during that non-hemodialysis procedure.
How does 90945 differ from 90935?
90945 is for dialysis other than hemodialysis, such as peritoneal dialysis or hemofiltration. 90935 is the single-evaluation code when the treatment is hemodialysis.
What documentation supports reporting 90945?
Document the dialysis modality, the treatment context, and the physician’s or qualified health care professional’s evaluation during the procedure.
Should modifier 50 be appended?
No. This dialysis service is not a bilateral procedure, so modifier 50 is inappropriate.
How does the global period affect same-day care?
The 0-day global period includes same-day preoperative and postoperative care. CMS assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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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