CPT code 90970: ESRD services, per day, age 20 or older2026 Medicare rate & RVUs

Medicare pays $10.02 for 90970 nationally in the office and $10.02 in a hospital or facility. Local office rates run $9.34–$13.12.

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

What 90970 covers

This code represents physician services related to end-stage renal disease for a patient age 20 or older during a period shorter than a full month. A nephrologist commonly reports it when the patient’s ESRD care begins or ends partway through the month, or when care shifts between providers. Services may occur in a dialysis facility, hospital, or other setting where the physician manages the patient’s ESRD care.

Report the code by day for the partial-month period, rather than selecting a monthly ESRD service code based on visit count. Documentation should support the patient’s age, dates of ESRD-related physician care, the partial-month service period, and the management performed. The service concerns physician ESRD care, not a dialysis treatment procedure such as a single dialysis evaluation. Medicare Physician Fee Schedule payment is based on the per-day service represented by this code.

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.

Where 90970 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90970 rates by state

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

How the 90970 rate is calculated

Each of 90970’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 90970

90970 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.

90970 compared with similar codes

How to choose

90960Monthly ESRD servicesAge 20+, four or more visits

90960 represents a full month of ESRD-related services for a patient age 20 or older with four or more face-to-face visits; 90970 is for a partial month and is reported by day.

90961ESRD management2-3 visits, age 20+

90961 represents a full month for a patient age 20 or older with two or three face-to-face visits. Use 90970 for a less-than-full-month service period.

90962ESRD monthly careOne visit, age 20+

90962 represents a full month for a patient age 20 or older with one face-to-face visit; 90970 describes per-day care in a partial month.

90945Dialysis evaluationOther than hemodialysis, single evaluation

90945 is a dialysis service with one evaluation, rather than per-day physician management of ESRD during a partial month.

Codes related to 90970

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

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