CPT code 90964: ESRD services, home dialysis, ages 2–112026 Medicare rate & RVUs in Hawaii, Guam, HI

Report this monthly physician service for ongoing ESRD-related care of a patient ages 2 through 11 who receives dialysis at home.

CMS RVU26DEffective Oct 1, 2026One payment locality605 Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $548.79 for 90964 in the office and $548.79 when it’s performed in a hospital or facility.

$548.79Office (non-facility)
$548.79Hospital or facility
+2.8%vs the national office rate ($534.08)

Check a contract rate as a % of Medicare · 90964 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 90964 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 90964 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 90964 covers

This code represents a month of physician management for a child ages 2 through 11 receiving home dialysis. A nephrologist typically assesses the child’s dialysis-related status, reviews treatment and laboratory information, and manages issues such as fluid balance, blood pressure, medications, vascular access, and dialysis complications. Care may involve coordination with the family and the home dialysis team in an outpatient setting.

Select the code based on the patient’s age and home-dialysis status for the month. Documentation should support the patient’s age, home dialysis, and the physician’s ESRD-related management during that month. This is a monthly service code, not a code for each home dialysis session. For a partial month, compare the circumstances with the applicable per-day ESRD service code rather than treating this as a per-session service.

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 Hawaii, Guam, HI compares for 90964

Across 109 of 109 payment localities, the office rate for 90964 runs from $499.92 in Arkansas to $707.08 in Alaska. Hawaii, Guam, HI pays $548.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

90964 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$548.79
  2. Los Angeles, CA · California$572.45+$23.66
  3. Washington, DC area · District of Columbia$585.35+$36.56
  4. Miami, FL · Florida$572.76+$23.97
  5. Chicago, IL · Illinois$564.15+$15.36
  6. Manhattan, NY · New York$595.83+$47.04
  7. Alaska · Alaska$707.08+$158.29

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

Every other payment area

90964 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$503.72$503.72
ArkansasArkansas$499.92$499.92
ArizonaArizona$525.80$525.80
Bakersfield, CACalifornia$548.91$548.91
Chico, CACalifornia$546.71$546.71
El Centro, CACalifornia$546.81$546.81
Fresno, CACalifornia$546.71$546.71
Hanford, CACalifornia$546.71$546.71

90964 rates by state

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

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.

$499.92

$707.08

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

View every state and territory as a table
90964 office rate range by state
State / territoryOffice rate rangeLocalities
AK$707.081
AL$503.721
AR$499.921
AZ$525.801
CA$546.71–$637.7229
CO$544.601
CT$558.441
DC$585.351
DE$531.651
FL$536.97–$572.763
GA$519.59–$542.012
GU$548.791
HI$548.791
IA$507.061
ID$509.491
IL$530.86–$564.154
IN$510.951
KS$507.391
KY$513.341
LA$513.54–$526.812
MA$544.42–$579.022
MD$537.86–$585.353
ME$512.57–$524.902
MI$521.87–$542.302
MN$524.461
MO$509.94–$525.913
MS$504.901
MT$534.041
NC$515.151
ND$521.781
NE$508.031
NH$538.501
NJ$565.52–$584.422
NM$524.051
NV$530.791
NY$519.38–$606.065
OH$519.371
OK$511.161
OR$527.25–$553.242
PA$518.92–$551.252
PR$535.651
RI$543.991
SC$517.981
SD$520.331
TN$508.931
TX$517.22–$543.418
UT$521.711
VA$525.08–$585.352
VI$535.651
VT$522.141
WA$542.65–$586.232
WI$512.571
WV$520.601
WY$528.701

See 90964 in every payment locality

How the 90964 rate is calculated

Each of 90964’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 · 90964

RVUs × geographic indexes × conversion factor

Office or facility?

Work10.25

10.25 RVUs× 1.000 GPCI

Practice expense5.12

5.12 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

15.9900

Conversion factor

$33.4009

Medicare rate

$534.08

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,577

Code
90964
Physician work
10.25
Practice expense
5.12
Malpractice
0.62

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 90964 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work10.25× 1.00010.2500
Practice expense5.12× 1.1375.8214
Malpractice0.62× 0.5790.3590
Total RVUs16.4304
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$548.79

Office: (10.25 × 1 + 5.12 × 1.137 + 0.62 × 0.579) × $33.4009 = $548.79

Facility: (10.25 × 1 + 5.12 × 1.137 + 0.62 × 0.579) × $33.4009 = $548.79

Open 90964 in the RVU calculator

Payment rules and modifiers for 90964

90964 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.

Place of service · 90964

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$534.08

Non-facility (office)
$534.08
Facility
$534.08

Higher because the practice carries its own overhead.

How 90964 has changed in Hawaii, Guam, HI

90964 · Office / nonfacility

$548.79

Effective 2026-10-01

The base rate is $36.71 higher than on 2025-10-01, moving from $512.08 to $548.79 (7.2%).

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

    $512.08changed to$548.79

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 4.54 changed to 5.12
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $526.40changed to$512.08

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.52 changed to 4.54
    • Malpractice RVU 0.66 changed to 0.65

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $517.81changed to$526.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $535.20changed to$517.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.46 changed to 4.52
    • Malpractice RVU 0.65 changed to 0.66
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561
  5. January 1, 2023

    RVU23A

    $550.25changed to$535.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.47 changed to 4.46
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $550.59changed to$550.25

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.37 changed to 4.47
    • Malpractice RVU 0.64 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $502.57changed to$550.59

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 9.14 changed to 10.25
    • Practice expense RVU 3.82 changed to 4.37
    • Malpractice RVU 0.56 changed to 0.64
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $498.21changed to$502.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.79 changed to 3.82
    • Malpractice RVU 0.54 changed to 0.56
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $497.47changed to$498.21

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.78 changed to 3.79
    • Malpractice RVU 0.55 changed to 0.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $496.37changed to$497.47

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.75 changed to 3.78
    • Malpractice RVU 0.56 changed to 0.55
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $496.23changed to$496.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.74 changed to 3.75
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $497.15changed to$496.23

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.73 changed to 3.74
    • Malpractice RVU 0.54 changed to 0.56

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $494.68changed to$497.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $496.68changed to$494.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.78 changed to 3.73
    • Malpractice RVU 0.50 changed to 0.54
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $484.72changed to$496.68

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.11 changed to 3.78
    • Malpractice RVU 0.52 changed to 0.50
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$484.72

  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$548.79$548.79RVU26D
2026-07-01$548.79$548.79RVU26C
2026-04-01$548.79$548.79RVU26B
2026-01-01$548.79$548.79RVU26A
2025-10-01$512.08$512.08RVU25D
2025-07-01$512.08$512.08RVU25C
2025-04-01$512.08$512.08RVU25B
2025-01-01$512.08$512.08RVU25A
2024-10-01$526.40$526.40RVU24D
2024-07-01$526.40$526.40RVU24C
2024-04-01$526.40$526.40RVU24B
2024-03-09$526.40$526.40RVU24AR
2024-01-01$517.81$517.81RVU24A
2023-10-01$535.20$535.20RVU23D
2023-07-01$535.20$535.20RVU23C
2023-04-01$535.20$535.20RVU23B
2023-01-01$535.20$535.20RVU23A
2022-10-01$550.25$550.25RVU22D
2022-07-01$550.25$550.25RVU22C
2022-04-01$550.25$550.25RVU22B
2022-01-01$550.25$550.25RVU22A
2021-10-01$550.59$550.59RVU21D
2021-07-01$550.59$550.59RVU21C
2021-04-01$550.59$550.59RVU21B
2021-01-01$550.59$550.59RVU21A
2020-10-01$502.57$502.57RVU20D
2020-07-01$502.57$502.57RVU20C
2020-04-01$502.57$502.57RVU20B
2020-01-01$502.57$502.57RVU20A
2019-10-01$498.21$498.21RVU19D
2019-07-01$498.21$498.21RVU19C
2019-04-01$498.21$498.21RVU19B
2019-01-01$498.21$498.21RVU19A
2018-10-01$497.47$497.47RVU18D
2018-07-01$497.47$497.47RVU18C
2018-04-01$497.47$497.47RVU18B
2018-01-01$497.47$497.47RVU18AR1
2017-10-01$496.37$496.37RVU17D
2017-07-01$496.37$496.37RVU17C
2017-04-01$496.37$496.37RVU17B
2017-01-01$496.37$496.37RVU17A
2016-10-01$496.23$496.23RVU16D
2016-07-01$496.23$496.23RVU16C
2016-04-01$496.23$496.23RVU16B
2016-01-01$496.23$496.23RVU16A
2015-10-01$497.15$496.74RVU15D
2015-07-01$497.15$496.74RVU15C
2015-04-01$494.68$494.27RVU15B
2015-01-01$494.68$494.27RVU15A
2014-10-01$496.68$496.68RVU14D
2014-07-01$496.68$496.68RVU14C
2014-04-01$496.68$496.68RVU14B
2014-01-01$496.68$496.68RVU14A
2013-10-01$484.72$484.72RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90964 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

90964 billing questions

How is 90964 distinguished from 90963 and 90965?

These are monthly home-dialysis ESRD service codes distinguished by patient age. Code 90964 is for ages 2 through 11; 90963 is for patients younger than 2, and 90965 is for ages 12 through 19.

Is 90964 reported for every home dialysis treatment?

No. It represents monthly ESRD-related physician management, not an individual dialysis session.

What documentation supports reporting 90964?

Document the patient’s age, home-dialysis status, and the ESRD-related assessment and management provided during the month.

When should a per-day code be considered instead?

Consider the age-appropriate per-day ESRD service code when the applicable circumstances involve a partial month. Code 90968 is the per-day code for ages 2 through 11.

How does 90964 differ from 90954?

Both relate to patients ages 2 through 11, but 90964 is for home dialysis. Code 90954 is a monthly ESRD service code for a different dialysis setting and visit-count category.

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 90964PPRRVU2026_Oct_nonQPP.csv, line 11,577 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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