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Billing code 90997: HemoperfusionMedicare rate & RVUs

Report hemoperfusion for a treatment that circulates blood through an adsorbent cartridge to remove selected drugs or toxins.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $76.15 for 90997 nationally in a facility.

Medicare rate · 90997

Hemoperfusion

Swap in your local Medicare rate.

Work RVUs
1.79
Total RVUs
2.28
Global days
000

National rate · 2026

$76.15

Facility setting, before claim adjustments.

See every locality for 90997 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 90997 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 90997 covers

Hemoperfusion is an extracorporeal blood-purification treatment in which blood passes through a cartridge containing adsorbent material that binds selected substances. It may be used in hospital care for severe poisoning or other toxic exposures when this removal method is chosen. Nephrologists and other physicians involved in acute toxicology or critical care may report the service when they provide the hemoperfusion treatment.

Report one service for each treatment, supported by documentation identifying the indication, treatment performed, and physician involvement. Do not substitute a dialysis-evaluation code merely because blood is processed extracorporeally; choose according to the actual method. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity, while co-surgeons and team surgery are not permitted.

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 90997 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

90997 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$72.97
Alaska*Unavailable$105.22
ArizonaUnavailable$75.23
ArkansasUnavailable$72.58
AtlantaUnavailable$77.27
AustinUnavailable$76.59
BakersfieldUnavailable$77.07
Baltimore/Surr. CntysUnavailable$78.91
BeaumontUnavailable$74.75
BrazoriaUnavailable$75.71

90997 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
90997 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 90997 rate is calculated

Each of 90997’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 · 90997

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.79Practice expense 0.38Malpractice 0.11

2.2800 adjusted RVUs×$33.4009 conversion factor=$76.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 90997

The CMS indicators that decide how 90997 is paid alongside other services.

CMS payment indicators · 90997

Hemoperfusion

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

90997 compared with similar codes

Compare codes

90997 vs 90945 vs 90947 vs 90935 vs 90999: national Medicare rates

Swap in your local Medicare rate.

  • 90997
    Hemoperfusion · 1.79 wRVU
    —
  • 90945
    Dialysis evaluation · 1.52 wRVU
    —
  • 90947
    Dialysis evaluation · 2.46 wRVU
    —
  • 90935
    Hemodialysis · 1.44 wRVU
    —
  • 90999
    · 0 wRVU
    —

How to choose

90945Dialysis evaluation
90945 describes dialysis other than hemodialysis with a single physician evaluation. Choose 90997 when the performed treatment is hemoperfusion using an adsorbent cartridge.
90947Dialysis evaluation
90947 is for other dialysis with repeated physician evaluation during the procedure. It is not the code for a hemoperfusion treatment.
90935Hemodialysis
90935 is for hemodialysis with a single physician evaluation. Hemoperfusion uses an adsorbent cartridge rather than the hemodialysis method.
90999Unlisted dialysis procedure
90999 is the unlisted dialysis procedure code. Use the specific hemoperfusion code when the service performed is hemoperfusion.

Codes related to 90997

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

Codes related to 90997
CodeHow it relatesNational office range
Used instead
90945Dialysis evaluationUse for dialysis other than hemodialysis when that is the treatment method.No office rate
90947Dialysis evaluationFor other dialysis requiring repeated physician evaluation during the procedure.No office rate
90935HemodialysisFor hemodialysis with a single physician evaluation, not hemoperfusion.No office rate
90937HemodialysisFor hemodialysis requiring repeated physician evaluation during the procedure.No office rate
90999Unlisted dialysis procedureUnlisted dialysis procedure code when no specific procedure code describes the service.No office rate

90997 billing questions

How is hemoperfusion different from hemodialysis?

Hemoperfusion uses an adsorbent cartridge to remove selected substances from blood. Hemodialysis uses a different treatment method, so select the code that matches the service actually performed.

Is this reported once per treatment or once per day?

The code represents each hemoperfusion treatment. Document each treatment provided rather than counting separate physician evaluations as additional hemoperfusion services.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care for the hemoperfusion procedure is included.

Can modifier 50 be used?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Can an assistant, co-surgeon, or surgical team be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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 90997PPRRVU2026_Oct_nonQPP.csv, line 11,586 (RVU26D)

Open CMS sourceHow we calculate rates

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