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

Report 90967 for each day of ESRD-related management furnished to a patient younger than 2 when care covers less than a full month.

CMS RVU26DEffective Oct 1, 2026One payment locality

In South Dakota, Medicare pays $17.93 for 90967 in the office and $17.93 when it’s performed in a hospital or facility.

$17.93Office (non-facility)
$17.93Hospital or facility
−2.4%vs the national office rate ($18.37)

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.

We’ll open 90967 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 90967 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 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 South Dakota 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. South Dakota pays $17.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

90967 in South Dakota vs other payment areas
  1. South Dakota · this page$17.93
  2. Los Angeles, CA · California$19.73+$1.80
  3. Washington, DC area · District of Columbia$20.15+$2.22
  4. Miami, FL · Florida$19.64+$1.71
  5. Chicago, IL · Illinois$19.35+$1.42
  6. Manhattan, NY · New York$20.48+$2.55
  7. Alaska · Alaska$24.31+$6.38

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

Every other payment area

90967 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$17.33$17.33
ArkansasArkansas$17.20$17.20
ArizonaArizona$18.09$18.09
Bakersfield, CACalifornia$18.91$18.91
Chico, CACalifornia$18.84$18.84
El Centro, CACalifornia$18.84$18.84
Fresno, CACalifornia$18.84$18.84
Hanford, CACalifornia$18.84$18.84

90967 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.

$17.20

$24.31

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

View every state and territory as a table
90967 office rate range by state
State / territoryOffice rate rangeLocalities
AK$24.311
AL$17.331
AR$17.201
AZ$18.091
CA$18.84–$22.0029
CO$18.751
CT$19.211
DC$20.151
DE$18.291
FL$18.44–$19.643
GA$17.85–$18.642
GU$18.911
HI$18.911
IA$17.461
ID$17.541
IL$18.22–$19.354
IN$17.591
KS$17.461
KY$17.651
LA$17.65–$18.112
MA$18.74–$19.942
MD$18.50–$20.153
ME$17.64–$18.072
MI$17.93–$18.622
MN$18.071
MO$17.52–$18.083
MS$17.361
MT$18.371
NC$17.731
ND$17.971
NE$17.491
NH$18.531
NJ$19.46–$20.112
NM$18.011
NV$18.261
NY$17.87–$20.835
OH$17.851
OK$17.581
OR$18.15–$19.052
PA$17.84–$18.962
PR$18.431
RI$18.721
SC$17.811
SD$17.931
TN$17.511
TX$17.78–$18.678
UT$17.941
VA$18.07–$20.152
VI$18.431
VT$17.981
WA$18.68–$20.202
WI$17.661
WV$17.871
WY$18.201

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.

How the rate is built · 90967

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.35

0.35 RVUs× 1.000 GPCI

Practice expense0.18

0.18 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.5500

Conversion factor

$33.4009

Medicare rate

$18.37

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,580

Code
90967
Physician work
0.35
Practice expense
0.18
Malpractice
0.02

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 90967 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.35× 1.0000.3500
Practice expense0.18× 1.0000.1800
Malpractice0.02× 0.3360.0067
Total RVUs0.5367
Conversion factor× 33.4009

Office rate, South Dakota$17.93

Office: (0.35 × 1 + 0.18 × 1 + 0.02 × 0.336) × $33.4009 = $17.93

Facility: (0.35 × 1 + 0.18 × 1 + 0.02 × 0.336) × $33.4009 = $17.93

Open 90967 in the RVU calculator

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.

Place of service · 90967

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$18.37

Non-facility (office)
$18.37
Facility
$18.37

Higher because the practice carries its own overhead.

How 90967 has changed in South Dakota

90967 · Office / nonfacility

$17.93

Effective 2026-10-01

The base rate is $1.51 higher than on 2025-10-01, moving from $16.42 to $17.93 (9.2%).

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

    $16.42changed to$17.93

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.15 changed to 0.18
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $16.90changed to$16.42

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $16.62changed to$16.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $17.19changed to$16.62

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $17.54changed to$17.19

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $17.69changed to$17.54

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $17.95changed to$17.69

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.14 changed to 0.15
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $17.94changed to$17.95

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $17.92changed to$17.94

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $17.87changed to$17.92

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $17.83changed to$17.87

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $17.89changed to$17.83

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $17.81changed to$17.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $17.70changed to$17.81

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.01 changed to 0.02
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $17.16changed to$17.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.15 changed to 0.14
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $17.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$17.93$17.93RVU26D
2026-07-01$17.93$17.93RVU26C
2026-04-01$17.93$17.93RVU26B
2026-01-01$17.93$17.93RVU26A
2025-10-01$16.42$16.42RVU25D
2025-07-01$16.42$16.42RVU25C
2025-04-01$16.42$16.42RVU25B
2025-01-01$16.42$16.42RVU25A
2024-10-01$16.90$16.90RVU24D
2024-07-01$16.90$16.90RVU24C
2024-04-01$16.90$16.90RVU24B
2024-03-09$16.90$16.90RVU24AR
2024-01-01$16.62$16.62RVU24A
2023-10-01$17.19$17.19RVU23D
2023-07-01$17.19$17.19RVU23C
2023-04-01$17.19$17.19RVU23B
2023-01-01$17.19$17.19RVU23A
2022-10-01$17.54$17.54RVU22D
2022-07-01$17.54$17.54RVU22C
2022-04-01$17.54$17.54RVU22B
2022-01-01$17.54$17.54RVU22A
2021-10-01$17.69$17.69RVU21D
2021-07-01$17.69$17.69RVU21C
2021-04-01$17.69$17.69RVU21B
2021-01-01$17.69$17.69RVU21A
2020-10-01$17.95$17.95RVU20D
2020-07-01$17.95$17.95RVU20C
2020-04-01$17.95$17.95RVU20B
2020-01-01$17.95$17.95RVU20A
2019-10-01$17.94$17.94RVU19D
2019-07-01$17.94$17.94RVU19C
2019-04-01$17.94$17.94RVU19B
2019-01-01$17.94$17.94RVU19A
2018-10-01$17.92$17.92RVU18D
2018-07-01$17.92$17.92RVU18C
2018-04-01$17.92$17.92RVU18B
2018-01-01$17.92$17.92RVU18AR1
2017-10-01$17.87$17.87RVU17D
2017-07-01$17.87$17.87RVU17C
2017-04-01$17.87$17.87RVU17B
2017-01-01$17.87$17.87RVU17A
2016-10-01$17.83$17.83RVU16D
2016-07-01$17.83$17.83RVU16C
2016-04-01$17.83$17.83RVU16B
2016-01-01$17.83$17.83RVU16A
2015-10-01$17.89$17.89RVU15D
2015-07-01$17.89$17.89RVU15C
2015-04-01$17.81$17.81RVU15B
2015-01-01$17.81$17.81RVU15A
2014-10-01$17.70$17.70RVU14D
2014-07-01$17.70$17.70RVU14C
2014-04-01$17.70$17.70RVU14B
2014-01-01$17.70$17.70RVU14A
2013-10-01$17.16$17.16RVU13D
2013-07-01$17.16$17.16RVU13C
2013-04-01$17.16$17.16RVU13B
2013-01-01$17.16$17.16RVU13AR

Price 90967 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

90967 billing questions

When should 90967 be used instead of a monthly ESRD code?

Use 90967 when ESRD-related care for a patient younger than 2 covers less than a full month and is reported by day. Monthly codes apply when the care qualifies for a full-month service.

Does the number of visits determine the units?

No. Report one unit for each day of qualifying ESRD-related services, rather than selecting units by counting visits.

What documentation supports reporting 90967?

Record the patient’s age, the dates of service, and the ESRD-related management furnished on each reported day.

Can 90967 be reported for a patient who is exactly 2 years old?

No. This code is for patients younger than 2; the daily code for patients ages 2 through 11 is 90968.

Is 90967 specific to home dialysis?

No. The code identifies daily ESRD-related services for the under-2 age group, not a home-dialysis monthly service 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 90967PPRRVU2026_Oct_nonQPP.csv, line 11,580 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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