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

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 North Carolina, Medicare pays $9.65 for 90970 in the office and $9.65 when it’s performed in a hospital or facility.

$9.65Office (non-facility)
$9.65Hospital or facility
−3.7%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 North Carolina
  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 North Carolina 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. North Carolina pays $9.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

90970 in North Carolina vs other payment areas
  1. North Carolina · this page$9.65
  2. Los Angeles, CA · California$10.83+$1.18
  3. Washington, DC area · District of Columbia$11.04+$1.39
  4. Miami, FL · Florida$10.68+$1.03
  5. Chicago, IL · Illinois$10.51+$0.86
  6. Manhattan, NY · New York$11.20+$1.55
  7. Alaska · Alaska$13.12+$3.47

Other areas in North Carolina 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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 90970 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0000.1800
Practice expense0.11× 0.9330.1026
Malpractice0.01× 0.6390.0064
Total RVUs0.2890
Conversion factor× 33.4009

Office rate, North Carolina$9.65

Office: (0.18 × 1 + 0.11 × 0.933 + 0.01 × 0.639) × $33.4009 = $9.65

Facility: (0.18 × 1 + 0.11 × 0.933 + 0.01 × 0.639) × $33.4009 = $9.65

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 North Carolina

90970 · Office / nonfacility

$9.65

Effective 2026-10-01

The base rate is $0.62 higher than on 2025-10-01, moving from $9.03 to $9.65 (6.9%).

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

    $9.03changed to$9.65

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $8.99changed to$9.03

    • 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

    $8.84changed to$8.99

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $9.18changed to$8.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $9.40changed to$9.18

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $9.48changed to$9.40

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $8.01changed to$9.48

    • 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
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $7.64changed to$8.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $7.64changed to$7.64

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $7.63changed to$7.64

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $7.62changed to$7.63

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $7.65changed to$7.62

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $7.61changed to$7.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $7.61changed to$7.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $7.52changed to$7.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $7.52

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$9.65$9.65RVU26D
2026-07-01$9.65$9.65RVU26C
2026-04-01$9.65$9.65RVU26B
2026-01-01$9.65$9.65RVU26A
2025-10-01$9.03$9.03RVU25D
2025-07-01$9.03$9.03RVU25C
2025-04-01$9.03$9.03RVU25B
2025-01-01$9.03$9.03RVU25A
2024-10-01$8.99$8.99RVU24D
2024-07-01$8.99$8.99RVU24C
2024-04-01$8.99$8.99RVU24B
2024-03-09$8.99$8.99RVU24AR
2024-01-01$8.84$8.84RVU24A
2023-10-01$9.18$9.18RVU23D
2023-07-01$9.18$9.18RVU23C
2023-04-01$9.18$9.18RVU23B
2023-01-01$9.18$9.18RVU23A
2022-10-01$9.40$9.40RVU22D
2022-07-01$9.40$9.40RVU22C
2022-04-01$9.40$9.40RVU22B
2022-01-01$9.40$9.40RVU22A
2021-10-01$9.48$9.48RVU21D
2021-07-01$9.48$9.48RVU21C
2021-04-01$9.48$9.48RVU21B
2021-01-01$9.48$9.48RVU21A
2020-10-01$8.01$8.01RVU20D
2020-07-01$8.01$8.01RVU20C
2020-04-01$8.01$8.01RVU20B
2020-01-01$8.01$8.01RVU20A
2019-10-01$7.64$7.64RVU19D
2019-07-01$7.64$7.64RVU19C
2019-04-01$7.64$7.64RVU19B
2019-01-01$7.64$7.64RVU19A
2018-10-01$7.64$7.64RVU18D
2018-07-01$7.64$7.64RVU18C
2018-04-01$7.64$7.64RVU18B
2018-01-01$7.64$7.64RVU18AR1
2017-10-01$7.63$7.63RVU17D
2017-07-01$7.63$7.63RVU17C
2017-04-01$7.63$7.63RVU17B
2017-01-01$7.63$7.63RVU17A
2016-10-01$7.62$7.62RVU16D
2016-07-01$7.62$7.62RVU16C
2016-04-01$7.62$7.62RVU16B
2016-01-01$7.62$7.62RVU16A
2015-10-01$7.65$7.65RVU15D
2015-07-01$7.65$7.65RVU15C
2015-04-01$7.61$7.61RVU15B
2015-01-01$7.61$7.61RVU15A
2014-10-01$7.61$7.61RVU14D
2014-07-01$7.61$7.61RVU14C
2014-04-01$7.61$7.61RVU14B
2014-01-01$7.61$7.61RVU14A
2013-10-01$7.52$7.52RVU13D
2013-07-01$7.52$7.52RVU13C
2013-04-01$7.52$7.52RVU13B
2013-01-01$7.52$7.52RVU13AR

Price 90970 for an earlier date of service

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

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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