CPT code 90964: ESRD services, home dialysis, ages 2–112026 Medicare rate & RVUs in North Carolina
Report this monthly physician service for ongoing ESRD-related care of a patient ages 2 through 11 who receives dialysis at home.
In North Carolina, Medicare pays $515.15 for 90964 in the office and $515.15 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $515.15. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$515.15
- Los Angeles, CA · California$572.45+$57.30
- Washington, DC area · District of Columbia$585.35+$70.20
- Miami, FL · Florida$572.76+$57.61
- Chicago, IL · Illinois$564.15+$49.00
- Manhattan, NY · New York$595.83+$80.68
- Alaska · Alaska$707.08+$191.93
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $546.71 | $546.71 |
| Merced, CACalifornia | $546.71 | $546.71 |
| Modesto, CACalifornia | $546.71 | $546.71 |
| Napa, CACalifornia | $599.84 | $599.84 |
| Oxnard, CACalifornia | $566.98 | $566.98 |
| Redding, CACalifornia | $546.71 | $546.71 |
| Rest of CaliforniaCalifornia | $546.71 | $546.71 |
| Riverside, CACalifornia | $553.62 | $553.62 |
| Sacramento, CACalifornia | $564.67 | $564.67 |
| Salinas, CACalifornia | $562.28 | $562.28 |
| San Diego, CACalifornia | $568.39 | $568.39 |
| Marin County, CACalifornia | $625.52 | $625.52 |
| San Francisco, CACalifornia | $624.81 | $624.81 |
| San Benito County, CACalifornia | $637.72 | $637.72 |
| Santa Clara County, CACalifornia | $634.84 | $634.84 |
| San Luis Obispo, CACalifornia | $554.06 | $554.06 |
| Santa Cruz, CACalifornia | $568.43 | $568.43 |
| Santa Maria, CACalifornia | $562.45 | $562.45 |
| Santa Rosa, CACalifornia | $573.73 | $573.73 |
| Stockton, CACalifornia | $546.71 | $546.71 |
| Vallejo, CACalifornia | $598.83 | $598.83 |
| Visalia, CACalifornia | $546.71 | $546.71 |
| Yuba City, CACalifornia | $546.71 | $546.71 |
| ColoradoColorado | $544.60 | $544.60 |
| ConnecticutConnecticut | $558.44 | $558.44 |
| DelawareDelaware | $531.65 | $531.65 |
| Fort Lauderdale, FLFlorida | $553.04 | $553.04 |
| Rest of FloridaFlorida | $536.97 | $536.97 |
| Atlanta, GAGeorgia | $542.01 | $542.01 |
| Rest of GeorgiaGeorgia | $519.59 | $519.59 |
| Hawaii, Guam, HIHawaii | $548.79 | $548.79 |
| IowaIowa | $507.06 | $507.06 |
| IdahoIdaho | $509.49 | $509.49 |
| East St. Louis, ILIllinois | $541.40 | $541.40 |
| Rest of IllinoisIllinois | $530.86 | $530.86 |
| Suburban Chicago, ILIllinois | $557.08 | $557.08 |
| IndianaIndiana | $510.95 | $510.95 |
| KansasKansas | $507.39 | $507.39 |
| KentuckyKentucky | $513.34 | $513.34 |
| New Orleans, LALouisiana | $526.81 | $526.81 |
| Rest of LouisianaLouisiana | $513.54 | $513.54 |
| Metropolitan Boston, MAMassachusetts | $579.02 | $579.02 |
| Rest of MassachusettsMassachusetts | $544.42 | $544.42 |
| Baltimore area, MDMaryland | $556.95 | $556.95 |
| Rest of MarylandMaryland | $537.86 | $537.86 |
| Rest of MaineMaine | $512.57 | $512.57 |
| Southern Maine, MEMaine | $524.90 | $524.90 |
| Detroit, MIMichigan | $542.30 | $542.30 |
| Rest of MichiganMichigan | $521.87 | $521.87 |
| MinnesotaMinnesota | $524.46 | $524.46 |
| Metropolitan Kansas City, MOMissouri | $523.17 | $523.17 |
| Metropolitan St. Louis, MOMissouri | $525.91 | $525.91 |
| Rest of MissouriMissouri | $509.94 | $509.94 |
| MississippiMississippi | $504.90 | $504.90 |
| MontanaMontana | $534.04 | $534.04 |
| North DakotaNorth Dakota | $521.78 | $521.78 |
| NebraskaNebraska | $508.03 | $508.03 |
| New HampshireNew Hampshire | $538.50 | $538.50 |
| Northern New JerseyNew Jersey | $584.42 | $584.42 |
| Rest of New JerseyNew Jersey | $565.52 | $565.52 |
| New MexicoNew Mexico | $524.05 | $524.05 |
| NevadaNevada | $530.79 | $530.79 |
| NYC suburbs and Long Island, NYNew York | $606.06 | $606.06 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $570.08 | $570.08 |
| Queens, NYNew York | $596.27 | $596.27 |
| Rest of New YorkNew York | $519.38 | $519.38 |
| OhioOhio | $519.37 | $519.37 |
| OklahomaOklahoma | $511.16 | $511.16 |
| Portland, OROregon | $553.24 | $553.24 |
| Rest of OregonOregon | $527.25 | $527.25 |
| Metropolitan Philadelphia, PAPennsylvania | $551.25 | $551.25 |
| Rest of PennsylvaniaPennsylvania | $518.92 | $518.92 |
| Puerto RicoPuerto Rico | $535.65 | $535.65 |
| Rhode IslandRhode Island | $543.99 | $543.99 |
| South CarolinaSouth Carolina | $517.98 | $517.98 |
| South DakotaSouth Dakota | $520.33 | $520.33 |
| TennesseeTennessee | $508.93 | $508.93 |
| Austin, TXTexas | $542.32 | $542.32 |
| Beaumont, TXTexas | $517.22 | $517.22 |
| Brazoria, TXTexas | $530.72 | $530.72 |
| Dallas, TXTexas | $533.54 | $533.54 |
| Fort Worth, TXTexas | $532.10 | $532.10 |
| Galveston, TXTexas | $532.06 | $532.06 |
| Houston, TXTexas | $543.41 | $543.41 |
| Rest of TexasTexas | $523.35 | $523.35 |
| UtahUtah | $521.71 | $521.71 |
| VirginiaVirginia | $525.08 | $525.08 |
| Virgin Islands, VIUnited States Virgin Islands | $535.65 | $535.65 |
| VermontVermont | $522.14 | $522.14 |
| Rest of WashingtonWashington | $542.65 | $542.65 |
| King County, WAWashington | $586.23 | $586.23 |
| WisconsinWisconsin | $512.57 | $512.57 |
| West VirginiaWest Virginia | $520.60 | $520.60 |
| WyomingWyoming | $528.70 | $528.70 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $707.08 | 1 |
| AL | $503.72 | 1 |
| AR | $499.92 | 1 |
| AZ | $525.80 | 1 |
| CA | $546.71–$637.72 | 29 |
| CO | $544.60 | 1 |
| CT | $558.44 | 1 |
| DC | $585.35 | 1 |
| DE | $531.65 | 1 |
| FL | $536.97–$572.76 | 3 |
| GA | $519.59–$542.01 | 2 |
| GU | $548.79 | 1 |
| HI | $548.79 | 1 |
| IA | $507.06 | 1 |
| ID | $509.49 | 1 |
| IL | $530.86–$564.15 | 4 |
| IN | $510.95 | 1 |
| KS | $507.39 | 1 |
| KY | $513.34 | 1 |
| LA | $513.54–$526.81 | 2 |
| MA | $544.42–$579.02 | 2 |
| MD | $537.86–$585.35 | 3 |
| ME | $512.57–$524.90 | 2 |
| MI | $521.87–$542.30 | 2 |
| MN | $524.46 | 1 |
| MO | $509.94–$525.91 | 3 |
| MS | $504.90 | 1 |
| MT | $534.04 | 1 |
| NC | $515.15 | 1 |
| ND | $521.78 | 1 |
| NE | $508.03 | 1 |
| NH | $538.50 | 1 |
| NJ | $565.52–$584.42 | 2 |
| NM | $524.05 | 1 |
| NV | $530.79 | 1 |
| NY | $519.38–$606.06 | 5 |
| OH | $519.37 | 1 |
| OK | $511.16 | 1 |
| OR | $527.25–$553.24 | 2 |
| PA | $518.92–$551.25 | 2 |
| PR | $535.65 | 1 |
| RI | $543.99 | 1 |
| SC | $517.98 | 1 |
| SD | $520.33 | 1 |
| TN | $508.93 | 1 |
| TX | $517.22–$543.41 | 8 |
| UT | $521.71 | 1 |
| VA | $525.08–$585.35 | 2 |
| VI | $535.65 | 1 |
| VT | $522.14 | 1 |
| WA | $542.65–$586.23 | 2 |
| WI | $512.57 | 1 |
| WV | $520.60 | 1 |
| WY | $528.70 | 1 |
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
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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.25 | × 1.000 | 10.2500 |
| Practice expense | 5.12 | × 0.933 | 4.7770 |
| Malpractice | 0.62 | × 0.639 | 0.3962 |
| Total RVUs | 15.4231 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$515.15
Office: (10.25 × 1 + 5.12 × 0.933 + 0.62 × 0.639) × $33.4009 = $515.15
Facility: (10.25 × 1 + 5.12 × 0.933 + 0.62 × 0.639) × $33.4009 = $515.15
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 North Carolina
90964 · Office / nonfacility
$515.15
Effective 2026-10-01
The base rate is $33.63 higher than on 2025-10-01, moving from $481.52 to $515.15 (7.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$481.52changed to$515.15
- 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 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$495.13changed to$481.52
- 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.
March 9, 2024
RVU24AR
$487.05changed to$495.13
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$503.79changed to$487.05
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$516.69changed to$503.79
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.47 changed to 4.46
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$517.45changed to$516.69
- 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.
January 1, 2021
RVU21A
$473.37changed to$517.45
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$470.09changed to$473.37
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$469.49changed to$470.09
- 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.
January 1, 2018
RVU18AR1
$468.03changed to$469.49
- 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
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$467.18changed to$468.03
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.74 changed to 3.75
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$467.98changed to$467.18
- 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.
July 1, 2015
RVU15C
$465.66changed to$467.98
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$466.33changed to$465.66
- 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
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$452.89changed to$466.33
- 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
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $452.89
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $515.15 | $515.15 | RVU26D |
| 2026-07-01 | $515.15 | $515.15 | RVU26C |
| 2026-04-01 | $515.15 | $515.15 | RVU26B |
| 2026-01-01 | $515.15 | $515.15 | RVU26A |
| 2025-10-01 | $481.52 | $481.52 | RVU25D |
| 2025-07-01 | $481.52 | $481.52 | RVU25C |
| 2025-04-01 | $481.52 | $481.52 | RVU25B |
| 2025-01-01 | $481.52 | $481.52 | RVU25A |
| 2024-10-01 | $495.13 | $495.13 | RVU24D |
| 2024-07-01 | $495.13 | $495.13 | RVU24C |
| 2024-04-01 | $495.13 | $495.13 | RVU24B |
| 2024-03-09 | $495.13 | $495.13 | RVU24AR |
| 2024-01-01 | $487.05 | $487.05 | RVU24A |
| 2023-10-01 | $503.79 | $503.79 | RVU23D |
| 2023-07-01 | $503.79 | $503.79 | RVU23C |
| 2023-04-01 | $503.79 | $503.79 | RVU23B |
| 2023-01-01 | $503.79 | $503.79 | RVU23A |
| 2022-10-01 | $516.69 | $516.69 | RVU22D |
| 2022-07-01 | $516.69 | $516.69 | RVU22C |
| 2022-04-01 | $516.69 | $516.69 | RVU22B |
| 2022-01-01 | $516.69 | $516.69 | RVU22A |
| 2021-10-01 | $517.45 | $517.45 | RVU21D |
| 2021-07-01 | $517.45 | $517.45 | RVU21C |
| 2021-04-01 | $517.45 | $517.45 | RVU21B |
| 2021-01-01 | $517.45 | $517.45 | RVU21A |
| 2020-10-01 | $473.37 | $473.37 | RVU20D |
| 2020-07-01 | $473.37 | $473.37 | RVU20C |
| 2020-04-01 | $473.37 | $473.37 | RVU20B |
| 2020-01-01 | $473.37 | $473.37 | RVU20A |
| 2019-10-01 | $470.09 | $470.09 | RVU19D |
| 2019-07-01 | $470.09 | $470.09 | RVU19C |
| 2019-04-01 | $470.09 | $470.09 | RVU19B |
| 2019-01-01 | $470.09 | $470.09 | RVU19A |
| 2018-10-01 | $469.49 | $469.49 | RVU18D |
| 2018-07-01 | $469.49 | $469.49 | RVU18C |
| 2018-04-01 | $469.49 | $469.49 | RVU18B |
| 2018-01-01 | $469.49 | $469.49 | RVU18AR1 |
| 2017-10-01 | $468.03 | $468.03 | RVU17D |
| 2017-07-01 | $468.03 | $468.03 | RVU17C |
| 2017-04-01 | $468.03 | $468.03 | RVU17B |
| 2017-01-01 | $468.03 | $468.03 | RVU17A |
| 2016-10-01 | $467.18 | $467.18 | RVU16D |
| 2016-07-01 | $467.18 | $467.18 | RVU16C |
| 2016-04-01 | $467.18 | $467.18 | RVU16B |
| 2016-01-01 | $467.18 | $467.18 | RVU16A |
| 2015-10-01 | $467.98 | $467.65 | RVU15D |
| 2015-07-01 | $467.98 | $467.65 | RVU15C |
| 2015-04-01 | $465.66 | $465.32 | RVU15B |
| 2015-01-01 | $465.66 | $465.32 | RVU15A |
| 2014-10-01 | $466.33 | $466.33 | RVU14D |
| 2014-07-01 | $466.33 | $466.33 | RVU14C |
| 2014-04-01 | $466.33 | $466.33 | RVU14B |
| 2014-01-01 | $466.33 | $466.33 | RVU14A |
| 2013-10-01 | $452.89 | $452.89 | RVU13D |
| 2013-07-01 | $452.89 | $452.89 | RVU13C |
| 2013-04-01 | $452.89 | $452.89 | RVU13B |
| 2013-01-01 | $452.89 | $452.89 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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