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

Reports a physician’s ESRD-related services by day for a patient age 20 or older whose care spans less than a full month.

CMS RVU26DEffective Oct 1, 2026One payment locality463.8K Medicare services in 2024

In Connecticut, Medicare pays $10.49 for 90970 in the office and $10.49 when it’s performed in a hospital or facility.

$10.49Office (non-facility)
$10.49Hospital or facility
+4.7%vs the national office rate ($10.02)

Check a contract rate as a % of Medicare · 90970 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 90970 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 90970 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 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.

How Connecticut compares for 90970

Across 109 of 109 payment localities, the office rate for 90970 runs from $9.34 in Arkansas to $13.12 in Alaska. Connecticut pays $10.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

90970 in Connecticut vs other payment areas
  1. Connecticut · this page$10.49
  2. Los Angeles, CA · California$10.83+$0.34
  3. Washington, DC area · District of Columbia$11.04+$0.55
  4. Miami, FL · Florida$10.68+$0.19
  5. Chicago, IL · Illinois$10.51+$0.02
  6. Manhattan, NY · New York$11.20+$0.71
  7. Alaska · Alaska$13.12+$2.63

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

Every other payment area

90970 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$9.42$9.42
ArkansasArkansas$9.34$9.34
ArizonaArizona$9.86$9.86
Bakersfield, CACalifornia$10.36$10.36
Chico, CACalifornia$10.32$10.32
El Centro, CACalifornia$10.32$10.32
Fresno, CACalifornia$10.32$10.32
Hanford, CACalifornia$10.32$10.32

90970 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.

$9.34

$13.12

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

View every state and territory as a table
90970 office rate range by state
State / territoryOffice rate rangeLocalities
AK$13.121
AL$9.421
AR$9.341
AZ$9.861
CA$10.32–$12.1529
CO$10.251
CT$10.491
DC$11.041
DE$9.971
FL$10.03–$10.683
GA$9.69–$10.162
GU$10.381
HI$10.381
IA$9.511
ID$9.551
IL$9.89–$10.514
IN$9.581
KS$9.501
KY$9.581
LA$9.58–$9.852
MA$10.24–$10.942
MD$10.10–$11.043
ME$9.60–$9.862
MI$9.74–$10.122
MN$9.891
MO$9.50–$9.843
MS$9.421
MT$10.021
NC$9.651
ND$9.821
NE$9.531
NH$10.131
NJ$10.63–$11.012
NM$9.781
NV$9.971
NY$9.74–$11.395
OH$9.701
OK$9.551
OR$9.91–$10.442
PA$9.70–$10.342
PR$10.061
RI$10.221
SC$9.691
SD$9.801
TN$9.531
TX$9.67–$10.218
UT$9.771
VA$9.86–$11.042
VI$10.061
VT$9.821
WA$10.21–$11.092
WI$9.631
WV$9.681
WY$9.931

See 90970 in every payment locality

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.

How the rate is built · 90970

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.11

0.11 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.3000

Conversion factor

$33.4009

Medicare rate

$10.02

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,583

Code
90970
Physician work
0.18
Practice expense
0.11
Malpractice
0.01

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 90970 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0200.1836
Practice expense0.11× 1.0770.1185
Malpractice0.01× 1.2100.0121
Total RVUs0.3142
Conversion factor× 33.4009

Office rate, Connecticut$10.49

Office: (0.18 × 1.02 + 0.11 × 1.077 + 0.01 × 1.21) × $33.4009 = $10.49

Facility: (0.18 × 1.02 + 0.11 × 1.077 + 0.01 × 1.21) × $33.4009 = $10.49

Open 90970 in the RVU calculator

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.

Place of service · 90970

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$10.02

Non-facility (office)
$10.02
Facility
$10.02

Higher because the practice carries its own overhead.

How 90970 has changed in Connecticut

90970 · Office / nonfacility

$10.49

Effective 2026-10-01

The base rate is $0.62 higher than on 2025-10-01, moving from $9.87 to $10.49 (6.3%).

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

    $9.87changed to$10.49

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.10 changed to 0.11
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $9.79changed to$9.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.09 changed to 0.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $9.63changed to$9.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $10.01changed to$9.63

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207
  5. January 1, 2023

    RVU23A

    $10.25changed to$10.01

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $10.34changed to$10.25

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $8.81changed to$10.34

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.14 changed to 0.18
    • Practice expense RVU 0.08 changed to 0.09
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $8.41changed to$8.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.07 changed to 0.08
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $8.40changed to$8.41

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $8.39changed to$8.40

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $8.38changed to$8.39

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $8.41changed to$8.38

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $8.37changed to$8.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $8.38changed to$8.37

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $8.32changed to$8.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.08 changed to 0.07
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $8.32

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$10.49$10.49RVU26D
2026-07-01$10.49$10.49RVU26C
2026-04-01$10.49$10.49RVU26B
2026-01-01$10.49$10.49RVU26A
2025-10-01$9.87$9.87RVU25D
2025-07-01$9.87$9.87RVU25C
2025-04-01$9.87$9.87RVU25B
2025-01-01$9.87$9.87RVU25A
2024-10-01$9.79$9.79RVU24D
2024-07-01$9.79$9.79RVU24C
2024-04-01$9.79$9.79RVU24B
2024-03-09$9.79$9.79RVU24AR
2024-01-01$9.63$9.63RVU24A
2023-10-01$10.01$10.01RVU23D
2023-07-01$10.01$10.01RVU23C
2023-04-01$10.01$10.01RVU23B
2023-01-01$10.01$10.01RVU23A
2022-10-01$10.25$10.25RVU22D
2022-07-01$10.25$10.25RVU22C
2022-04-01$10.25$10.25RVU22B
2022-01-01$10.25$10.25RVU22A
2021-10-01$10.34$10.34RVU21D
2021-07-01$10.34$10.34RVU21C
2021-04-01$10.34$10.34RVU21B
2021-01-01$10.34$10.34RVU21A
2020-10-01$8.81$8.81RVU20D
2020-07-01$8.81$8.81RVU20C
2020-04-01$8.81$8.81RVU20B
2020-01-01$8.81$8.81RVU20A
2019-10-01$8.41$8.41RVU19D
2019-07-01$8.41$8.41RVU19C
2019-04-01$8.41$8.41RVU19B
2019-01-01$8.41$8.41RVU19A
2018-10-01$8.40$8.40RVU18D
2018-07-01$8.40$8.40RVU18C
2018-04-01$8.40$8.40RVU18B
2018-01-01$8.40$8.40RVU18AR1
2017-10-01$8.39$8.39RVU17D
2017-07-01$8.39$8.39RVU17C
2017-04-01$8.39$8.39RVU17B
2017-01-01$8.39$8.39RVU17A
2016-10-01$8.38$8.38RVU16D
2016-07-01$8.38$8.38RVU16C
2016-04-01$8.38$8.38RVU16B
2016-01-01$8.38$8.38RVU16A
2015-10-01$8.41$8.41RVU15D
2015-07-01$8.41$8.41RVU15C
2015-04-01$8.37$8.37RVU15B
2015-01-01$8.37$8.37RVU15A
2014-10-01$8.38$8.38RVU14D
2014-07-01$8.38$8.38RVU14C
2014-04-01$8.38$8.38RVU14B
2014-01-01$8.38$8.38RVU14A
2013-10-01$8.32$8.32RVU13D
2013-07-01$8.32$8.32RVU13C
2013-04-01$8.32$8.32RVU13B
2013-01-01$8.32$8.32RVU13AR

Price 90970 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

90970 billing questions

When should this code be used instead of 90960, 90961, or 90962?

Use 90970 when ESRD-related services cover less than a full month for a patient age 20 or older. The monthly codes represent a full month of service and are selected according to the number of face-to-face visits.

Is the code reported per day or per dialysis treatment?

It is a per-day code for ESRD-related physician services during a partial month. A dialysis treatment session is not, by itself, the unit described by this code.

What documentation supports reporting 90970?

Record the patient’s age, dates of service, why the ESRD service period was shorter than a full month, and the physician’s ESRD-related management.

Does this code represent the dialysis treatment itself?

No. It represents the physician’s ESRD-related care. Codes such as 90945 and 90947 describe dialysis services with evaluation and are distinct services.

Which age group does 90970 cover?

It is for patients age 20 or older. The related per-day codes 90967, 90968, and 90969 cover younger age groups.

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 90970PPRRVU2026_Oct_nonQPP.csv, line 11,583 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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