CPT code 90967: ESRD services, patient younger than 22026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $19.21 for 90967 in the office and $19.21 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 90967 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 90967 covers

This code represents a day of end-stage renal disease management for a patient younger than 2 years when the clinician’s care covers less than a full month. A nephrologist or other clinician managing the child’s ESRD may report it for daily management related to dialysis, such as assessing the child’s status and directing the renal care plan. The patient’s age and the per-day service basis distinguish this code from monthly ESRD management codes.

Report one unit for each day of qualifying ESRD-related services in the partial month. Documentation should establish the patient’s age, the dates care was furnished, and the ESRD management provided on those dates. This is a per-day code, not a monthly code selected by counting face-to-face visits; use the applicable monthly code when services meet that code’s criteria for a full month of care.

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 Connecticut compares for 90967

Across 109 of 109 payment localities, the office rate for 90967 runs from $17.20 in Arkansas to $24.31 in Alaska. Connecticut pays $19.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90967 rates by state

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

See 90967 in every payment locality

How the 90967 rate is calculated

Each of 90967’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 90967

90967 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 90967

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

How 90967 has changed in Connecticut

Price 90967 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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