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

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 Wyoming, Medicare pays $9.93 for 90970 in the office and $9.93 when it’s performed in a hospital or facility.

$9.93Office (non-facility)
$9.93Hospital or facility
−0.9%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 Wyoming
  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 Wyoming 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. Wyoming pays $9.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

90970 in Wyoming vs other payment areas
  1. Wyoming · this page$9.93
  2. Los Angeles, CA · California$10.83+$0.90
  3. Washington, DC area · District of Columbia$11.04+$1.11
  4. Miami, FL · Florida$10.68+$0.75
  5. Chicago, IL · Illinois$10.51+$0.58
  6. Manhattan, NY · New York$11.20+$1.27
  7. Alaska · Alaska$13.12+$3.19

Other areas in Wyoming 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 Wyoming 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

112

Locality
Wyoming
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office calculation for 90970 in Wyoming
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0000.1800
Practice expense0.11× 1.0000.1100
Malpractice0.01× 0.7400.0074
Total RVUs0.2974
Conversion factor× 33.4009

Office rate, Wyoming$9.93

Office: (0.18 × 1 + 0.11 × 1 + 0.01 × 0.74) × $33.4009 = $9.93

Facility: (0.18 × 1 + 0.11 × 1 + 0.01 × 0.74) × $33.4009 = $9.93

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 Wyoming

90970 · Office / nonfacility

$9.93

Effective 2026-10-01

The base rate is $0.63 higher than on 2025-10-01, moving from $9.30 to $9.93 (6.8%).

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

    $9.30changed to$9.93

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.10 changed to 0.11
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $9.23changed to$9.30

    • 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

    $9.08changed to$9.23

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $9.42changed to$9.08

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice GPCI 0.790 changed to 0.739
  5. January 1, 2023

    RVU23A

    $9.63changed to$9.42

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice GPCI 0.841 changed to 0.790

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $9.71changed to$9.63

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $8.25changed to$9.71

    • 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
    • Malpractice GPCI 0.860 changed to 0.841

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $7.89changed to$8.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.07 changed to 0.08
    • Malpractice GPCI 0.880 changed to 0.860

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $7.88changed to$7.89

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $7.91changed to$7.88

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 1.050 changed to 0.880

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $7.96changed to$7.91

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 1.219 changed to 1.050

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $7.98changed to$7.96

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $7.94changed to$7.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $7.96changed to$7.94

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice GPCI 1.226 changed to 1.219

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $7.90changed to$7.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.08 changed to 0.07
    • Malpractice GPCI 1.233 changed to 1.226

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $7.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$9.93$9.93RVU26D
2026-07-01$9.93$9.93RVU26C
2026-04-01$9.93$9.93RVU26B
2026-01-01$9.93$9.93RVU26A
2025-10-01$9.30$9.30RVU25D
2025-07-01$9.30$9.30RVU25C
2025-04-01$9.30$9.30RVU25B
2025-01-01$9.30$9.30RVU25A
2024-10-01$9.23$9.23RVU24D
2024-07-01$9.23$9.23RVU24C
2024-04-01$9.23$9.23RVU24B
2024-03-09$9.23$9.23RVU24AR
2024-01-01$9.08$9.08RVU24A
2023-10-01$9.42$9.42RVU23D
2023-07-01$9.42$9.42RVU23C
2023-04-01$9.42$9.42RVU23B
2023-01-01$9.42$9.42RVU23A
2022-10-01$9.63$9.63RVU22D
2022-07-01$9.63$9.63RVU22C
2022-04-01$9.63$9.63RVU22B
2022-01-01$9.63$9.63RVU22A
2021-10-01$9.71$9.71RVU21D
2021-07-01$9.71$9.71RVU21C
2021-04-01$9.71$9.71RVU21B
2021-01-01$9.71$9.71RVU21A
2020-10-01$8.25$8.25RVU20D
2020-07-01$8.25$8.25RVU20C
2020-04-01$8.25$8.25RVU20B
2020-01-01$8.25$8.25RVU20A
2019-10-01$7.89$7.89RVU19D
2019-07-01$7.89$7.89RVU19C
2019-04-01$7.89$7.89RVU19B
2019-01-01$7.89$7.89RVU19A
2018-10-01$7.88$7.88RVU18D
2018-07-01$7.88$7.88RVU18C
2018-04-01$7.88$7.88RVU18B
2018-01-01$7.88$7.88RVU18AR1
2017-10-01$7.91$7.91RVU17D
2017-07-01$7.91$7.91RVU17C
2017-04-01$7.91$7.91RVU17B
2017-01-01$7.91$7.91RVU17A
2016-10-01$7.96$7.96RVU16D
2016-07-01$7.96$7.96RVU16C
2016-04-01$7.96$7.96RVU16B
2016-01-01$7.96$7.96RVU16A
2015-10-01$7.98$7.98RVU15D
2015-07-01$7.98$7.98RVU15C
2015-04-01$7.94$7.94RVU15B
2015-01-01$7.94$7.94RVU15A
2014-10-01$7.96$7.96RVU14D
2014-07-01$7.96$7.96RVU14C
2014-04-01$7.96$7.96RVU14B
2014-01-01$7.96$7.96RVU14A
2013-10-01$7.90$7.90RVU13D
2013-07-01$7.90$7.90RVU13C
2013-04-01$7.90$7.90RVU13B
2013-01-01$7.90$7.90RVU13AR

Price 90970 for an earlier date of service

Where the Wyoming rate applies

Wyoming is a Medicare payment area, not a city. Our Census mapping connects it to 205 cities and communities in Wyoming. Some span more than one payment area; confirm with the service ZIP.

  • Afton
  • Albany
  • Albin
  • Alcova
  • Alpine
  • Alpine Northeast
  • Alpine Northwest
  • Alta

Browse all communities in Wyoming

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 WyomingGPCI2026.csv, line 112 (RVU26D)

Open CMS sourceHow we calculate rates

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