CPT code 90960: Monthly ESRD services, age 20+, four or more visits2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $363.22 for 90960 in the office and $363.22 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 90960 nationwide

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

What 90960 covers

This service covers a full calendar month of professional ESRD management for a patient age 20 or older receiving facility-based dialysis, commonly in-center hemodialysis. A nephrologist or qualified nonphysician practitioner typically reviews dialysis adequacy, laboratory results, anemia treatment, bone-mineral management, fluid status, blood pressure, and vascular access concerns. Face-to-face visits commonly occur at the dialysis facility, with care coordinated with its staff.

Report one unit for the month when at least four qualifying face-to-face visits are documented; the visits do not generate four monthly units. Record each visit's date, practitioner, and ESRD-related assessment or management. Use 90961 or 90962 for a full month with fewer visits, and 90966 for monthly home dialysis management in this age group. For a partial month, such as dialysis initiation or a transplant during the month, consider the age-appropriate per-day ESRD code. Hospitalization alone does not make a month partial. The monthly professional service includes management of ESRD-related problems; dialysis facility services are distinct.

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 South Dakota compares for 90960

Across 109 of 109 payment localities, the office rate for 90960 runs from $347.14 in Arkansas to $487.96 in Alaska. South Dakota pays $363.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90960 rates by state

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

See 90960 in every payment locality

How the 90960 rate is calculated

Each of 90960’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.

Payment rules and modifiers for 90960

90960 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Codes related to 90960

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

How 90960 has changed in South Dakota

Price 90960 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates